It’s been a while since I first wrote my Open vs Closed Chain post regarding the lower extremity. Seems like years ago. But I’ve definitely noticed that it continues to be one of my most read posts; but the problem is that I only addressed the leg. Well strap on your helmets folks because we’re about to head down the rocky road of the upper extremity. I say this because I lost my mind when I was in school trying to remember open vs closed chain principles for the arm, when in reality they are quite easy.
As you recall from my prior post regarding the lower extremity, closed chain exercises are performed with your foot (or knee) on the floor or a platform that is essentially not moving (yes unstable surfaces count at not moving). Squats are a perfect example. Open chain exercises are done with your foot not connected to a stable surface such as straight leg raises. Pretty simple to understand. Developmentally we go from open to closed chain with pur legs. They are up in the air as babies when we are on our backs and we are learning proximal stability at the trunk and hips, with good mobility in the hips, knees, ankles, and feet. We then progress through crawling, cruising, walking, and then running.
The upper extremity is no different in the principles of open chain vs closed chain.
- Open chain – Movements are performed without your hand (in reality it can be your elbow/forearm too) on the ground/floor/platform/surface. Example: rows or bicep curls
- Open chain upper extremity exercises are often thought to be more FUNCTIONAL than closed chain (in my opinion this is not true).
- Closed Chain – Movements are performed with your hand etc on the ground/floor/platform/surface. Example: Push ups or planks
- The closed chain is often overlooked in rehabilitation of the upper extremity.
Let’s revisit what I said about closed chain exercises. They are often thought to be non-functional and are overlooked in the rehabilitation of shoulders, elbows, wrists, and hands. Developmentally our upper extremities gain stability and mobility first in the open chain (like the legs) and therefore when I see poor stability patterns in the arm I will start in the supine (on back) position. But as we grow a little older as infants we start to get stronger in our trunks. If we are put on our bellies we can lift our heads, and even prop ourselves up on our elbows. This propping alone begins to develop more scapular control, and trunk stability in the CLOSED CHAIN. Sure we still wave our arms around in the open chain when on our backs, but the major stability and mobility patterns that are associated with reciprocal gait patterning are developed during creeping and crawling which are done in the closed chain for both the upper and lower extremities.
Once my patients have good movement patterns in supine and prone (this includes rolling patterns), quadruped becomes the next milestone I want to see proper stability and mobility in. Crawling, although seen as embarrassing to some of my patients, is often performed as a test and a therapeutic activity. Once quadruped has been mastered, with good scapular control, then the OPEN CHAIN can be the main focus of the treatment because as adults most of our activities are done in the open chain, for example, reaching and lifting.
So although as we get older we tend to focus most of our activities in the open chain, once we need to relearn to move, the closed chain cannot lose its importance or relevance as functional. We must establish a solid base of mobility and stability before we can layer other movement patterns on top.