Eye-hand coordination is more than the idea of see and catch. What matters to most people is to move and to perform at a comfortable level. If you look at the brain, almost a third of your mind is dedicated to using your eyes! That should give you an idea of how vital your vision systems are. As a duel Sports Medicine and Orthopedic Specialist, we have been amazed at how much lasting changes happen when we address the software (brain + mind) with the machine (human body).
Your spinal muscles are taken for granted when you feel great. When you have tension or discomfort, we push through it, and then the discomfort goes away. When you take the body signals seriously or have a convenient time to help, the typical path is to target the neck or spinal muscles as the first-line treatment. We are here to help you understand that it may be wise to manage the body holistically, so you are not in the quick-fix trap.
Types of movement
There are two types of movement: power and strength versus balanced and finesse. We chose different words because we are implying movement necessary for daily and reflexive tasks. Tasks that need less cognitive thinking to execute. Then some jobs require training and different sets of skills to acquire. You might be wondering how strength is an acquired skill? You have been working on building strength your whole life. However, if you are sedentary as a child, you can still move, but lack strength. There is a lack of cognitive training to allow you to access more of the nerve to muscle connection called the motor unit.
Yes, this is a very simplistic explanation. We can break it down into reflexive and non-reflexive. Vision helps us bring a more transparent connection and intuitive control to your spinal muscles: neck, torso, rib cage, lower back, and pelvis. You can add your hips and shoulders to this.
Research has shown that when you need to react or quickly decide to reach or lift for something, your body reacts before moving your arms and legs!
You have seen the athlete that moves with finesse. Think Kobe Bryant. He makes everything look easy, but when we try, we find it harder to dribble, sneak through two defenders, and know where everyone is. Your spinal muscles need to have this Goldilock phenomenon. Your lower back and hips need to contract just enough: not too strong and not too relaxed. Your next quick step forward or decision to pounce backward is executed efficiently like you have been doing this for the 1000’s of time, or clunky. His peripheral vision is clear and his ability to manipulate his body based on his sight of the vision and vice-versa is what he has mastered.
Your vision-body circuit runs through and towards your brain’s primitive centers—your brain’s area where breathing, heart rate, emotions, and relaxation centers are. This is why you have to evaluate yourself and not assume. You can do standard eye-hand coordination drills of throw and catch or hitting a puck, but you have to isolate the actual system to appreciate what you have or need to work on. You cannot assume what you are not aware of. Your visual-movement systems are happening before you think, so how can you know how healthy a system is without testing it?
The gain of testing your visual function is an understanding of how accurate or inaccurate your “windows and mirrors” are. If you drive a car, you need to know your blind spots or how clear your windows are.
Test (and turned into treatment)
Have someone else test you and record any findings. If you have any positive tests, we advise you to seek an Ophthalmologist or contact us for further assessment. A trained medical professional will need to do an additional examination to determine if you have a central (brain-related) or peripheral (non-brain-related) condition.
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Eye static gaze:
There are 9 visual quadrants to test. The quadrants are in a 3 by 3 grid: Left/upper, central/upper, right/upper, middle/left, middle, middle/right, lower/right, lower/central, and lower/left.
Look at a specific object. An example is the tip of a pen. Look at this object for 10 seconds. If you notice shakiness in the eye, this is a positive dysfunction.
Bonus treatment suggestion: If you notice you are changing your breathing strategy while fixating within the dysfunctional visual field, practice quiet nasal only breathing while gazing at the dysfunctional area. You are ensuring your threat perception is reduced so you can re-program how you view this visual quadrant.
Eye smooth pursuits:
Distance is 3 feet from the person to be tested. Draw an “*” a tip of a pen and keep your gaze on the tip. This test has more details, but this article will have you use it as a visual screen and know when to escalate your eye-hand coordination or pain reduction care to a professional.
Dysfunction is noted when you observe jerking or lack of smoothness when the eye moves. It is common to follow this eye pattern called nystagmus towards the edges of the asterisk symbol. The actual test only goes as far as testing 30 degrees circumference from the eye’s pupil, which is 1.5 feet left and right from the midline. The speed is about 2 seconds going from left to right and vice-versa.
BONUS treatment suggestion: Perform the test sequence on a yoga cushion or sofa cushion and isolate the vision’s dysfunctional field. The added unstable surface will make the sensory systems have to learn under challenging circumstances. Do you challenge too much? It is like a Goldilock situation.
Peripheral field (PF) vision test.
Have the person look forward. The head should not move. You are using one finger to move into the central visual field steadily. Test each of the 3 by 3 visual quadrants, except the middle region, to understand any peripheral field vision dysfunction. The way you test and confirm PF accuracy is to have the person gently tap their finger on your finger.
BONUS treatment suggestion: You can grab an object of their sport, like a racquet or baseball, and test with the item in their hand. You can escalate a tennis player by having them go into a wide semi-squat position. A pitcher will be tested in a pitching-like lunge pattern.
Eye convergence test.
Take the tip of a pen and start at a level in between their eyes. Bring the pen steadily towards the middle of their eyes. Stop when they tell you when it gets blurry, or they see double vision.
Saccades (horizontal and vertical).
Grab two objects or two pens. Place them 3 feet from the person, and 1.5 feet left and right from the midline. Have the person look at one pen and quickly switch to the other without moving their head. Repeat ten times. The speed is at 200 ms and is controlled by the frontal and parietal lobe of the brain.
Vestibular Ocular reflex (VOR) test. – horizontal and vertical.
With a stretch out and straight arm, place a thumbs-up sign in front of your nose. Keep your eye gaze on target with your thumb and turn your head about 30-40 degrees without losing sight of the thumb. The pace should be 50 beats per minute.
Visual motion sensitivity test.
With a stretch out and straight arm, place a thumbs-up sign in front of your nose. Keep your eye gaze on target with your thumb. Twist to the left and right without losing sight of your gaze. The pace should be 50 beats per minute.
There are 9 visual quadrants to test. The quadrants are in a 3 by 3 grid: Left/upper, central/upper, right/upper, middle/left, middle, middle/right, lower/right, lower/central, and lower/left.
Look at a specific object. An example is the tip of a pen. Look at this object for 10 seconds. If you notice shakiness in the eye, this is a positive dysfunction.
Bonus treatment suggestion: If you notice you are changing your breathing strategy while fixating within the dysfunctional visual field, practice quiet nasal only breathing while doing your visual motion sensitivity test. You are ensuring your threat perception is reduced so you can re-program how you view this visual quadrant.
We specialize in recurrent muscle tightness and the pain the comes with it. Get your expertise second opinion with a click of the orange button below.
One LOVE,
Danh Ngo PT, DPT, OCS, SCS
Doctor of Physical Therapy
Board Certified Specialist in Orthopedic and Sports Medicine
Onbase University Certified Pitching Specialist
Certified Advanced Movement Specialist – RockTape
Certified Mobility Specialist – Rocktape
Mind Body Health Results Coach
