Posts Tagged ‘human movement’


 

Yes, I said dormant butt syndrome, DBS for short! I see it all the time in the clinic. In athletes and people of all ages. The cause of DBS is usually tight hip flexors, again, which most people have. This is due to repetitive hip flexion from walking, running, sitting, driving and sleeping in the fetal position.  Other causes include injury and inactivity.   If you remember back to previous posts the gluteus maximus generally attaches proximally to the sacruum, and illiac crest and wraps around the hip to distally attach to the greater trochanter (the big bony bump on side of hip).  Although we think of the gluteus maximus as a powerful hip extender it is actually built for rotation.  Just look at the fiber orientation (yes, you may have to crack open the old anatomy book).  So, functionally its main function is to eccentrically control internal rotation of the femur in the transverse plane during the loading phase of gait or running, eccentrically control hip flexion in the sagittal plane and assist the gluteus medius in stabilizing hip adduction in the frontal plane.  The ability to appropriately load enhances their ability to concentrically contract during the unloadong or propulsive phase.  If the gluteus maximus is inhibited (which V. Yanda taught us) from a tight hip flexor, then the hamstrings and erector spinae group  become overactive to compensate.  This leads to the possibility of hamstring strains, low back pain, knee pain and possibly even plantar fascia.  A simple way to check for DBS is to have patient lie prone and ask them to do a leg lift.  Palpate the gluteus and the hamstring and see which contracts first.  Many times I feel the hamstring contract then the gluteus.  It should be gluteus then hamstring.  Sometimes ive seen people have a 5/5 manual muscle test and not even fire the gluteus.  They used all their hamstring and erectors to lift/hold the leg up.  Some general strategies include a basic muscle re-education of laying prone over table or bed and actively squeezing butt then lifting leg.  Sequence can also be done with bridge exercise.  Stretching the tight hip flexor, of course, and functional hip dominant exercise like single leg balance w/ arm reaches, multi planar lunges, sled walks, various step up and downs.  So now get moving and wake that sleepy butt up!

Get Strong! Stay Strong!

Chris

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By David Westerman LMT, FAFS  

Are  we  utilizing  “authentic”  principles  of  Function  when  designing  our  strength  and  

power programs?  

Is  there  a  special  population  that  might  be  missing  two  of  the  most  important  bio‐ 

motor abilities in their training and rehabilitation programs?  

As  a  former  collegiate  and  professional  strength  and  conditioning  coach,  strength  

and power were (and are) the two most emphasized bio‐motor abilities.   

Take,  for  example,  the  “power  clean”  in  an  athletic  weight  room.  This  is  one  of  the  

most  utilized  exercises  in  “power”  training.  The  typical  strategy  is  to  put  as  much  

weight  on  the  bar  and  successfully  lift  it  one  to  four  times.  Let’s  see  if  we  can  use  

part  of  our  litmus  test  of  “authentic”  strength  and  power  principles  to  better  

understand its carryover to three‐dimensional Function.  

  Is  it  three­dimensional? 

  The  power  clean  is  a  sagittal  plane‐dominate  

movement.  Most  activities  require  three‐dimensional  movement  in  all  

muscles and joints. 

  Is  it  specific  to  activity?  

Considering  most  sports  and  activities  have  a  

horizontal component to load, the power clean is mostly a vertical load.  

  What  is  the  neural  input  and  range  involved?  

If  the  weight  is  too  heavy  

and  we  go  through  long  ranges,  we  may  actually  slow  down  the  neural  input  

which will inhibit our power and strength transfer to activity.  

  Are  we  taking  advantage  of  the  Transformation  Zone?  

The  fact  that  

most  of  our  power  is  utilized  at  the  zone  in  which  a  direction  is  reversed  in  a  

motion needs to be considered (i.e. – plyometrics).  

Above  are  a  few  key  questions  that  we  can  use  for  any  population  or  exercise  we  

choose to work with.     

Typically  we  associate  strength  and  power  with  athletes.    However,  the  population  

that  may  need  it  the  most  is  our  senior  population.  With  the  baby‐boom  explosion,  

more  and  more  of  this  growing  population  are  getting  injured  and  becoming  more  

sedentary.  Consider  the  following  scenario  and  proposed  training  /  treatment  

approach:  

Scenario:  

A  75‐year‐old  woman  has  balance  problems  when  walking.  

Through  functional  assessments,  the  practitioner  finds  abdominal  muscles  

are  weak  and  significantly  lack  the  ability  to  move  in  all  three  planes  of  

motion.  

Potential  strategy 

:  Position  client  in  a  small  stride  position  with  the  left  leg  

forward  in  front  of  a  wall  for  support  and  as  a  target.  To  create  a  load  in  the 

abdominals  we  want  to  reach  with  the  left  shoulder  posterior  (backward)  at  

shoulder  (height)  towards  the  wall  in  a  short  range  of  motion  at  a  moderate  

to fast speed.  

Rationale: 

  This  facilitates  tri‐plane  loading  of  the  abdominals  in  the  

Transformational  Zone  of  walking  with  an  exercise  that  replicates  the  

activity,  while  creating  more  power  that  will  transform  into  better  strength       

of the entire kinetic chain by using a short (safe) range and increased speed.     

Whether  you  seek  strength  or  power,  our  strategies  and  exercises  need  to  be  based  

on “authentic” principles of Function. 

Get Strong! Stay Strong! (and be functional)

Chris

 

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By my friend, mentor and all around good guy David Tiberio PhD, PT, OCS

GRAVITY, GROUND, and the SWITCH 
The internal power sources that drive the body are the hips and trunk: the core of the body. There are many ways to activate that power source, but probably the most important for upright function in our gravitational environment is eversion of the calcaneus.

Calcaneal eversion occurs in the frontal plane. It is one component of the tri-plane motion of pronation of the subtalar joint (STJ). Simultaneous with the eversion, a substantial amount of abduction occurs in the transverse plane at the STJ. The motion in the frontal and transverse planes at the STJ complements the ankle joint motion, which occurs primarily in the sagittal plane, to allow the rearfoot to move in all three planes. 
The calcaneal eversion results from the striking the lateral aspect of the heel when we walk. The ground reaction force (GRF) forces the calcaneus to evert. Since the motion is produced by gravity and the GRF (motion given for free), the role of the muscles is to decelerate the motion. In this process, the muscles are lengthened and activated proprioceptively. The strain created in the muscles during the deceleration is transformed into a concentric motion-producing force.

CHAIN REACTION LINKAGE 
The calcaneal eversion that creates STJ pronation produces two important reactions in the body: one distal and one proximal. When the subtalar joint is pronated, the bones of the mid-tarsal joint (MTJ) are more mobile. During weightbearing this allows the foot to adapt to uneven surfaces and, more importantly, as the arch lowers certain muscles are lengthened (loaded) in order to become more powerful (e.g. peroneus longus). When the calcaneus begins to invert these processes are reversed in order to create a more stable foot at the time the muscles are “exploding.” 
The proximal effects of calcaneal eversion are more significant. Because of the angle of the STJ axis, the frontal plane motion of the calcaneus creates transverse plane motion of the lower leg. The STJ is called a “torque converter” because it converts the frontal plane motion of the foot into transverse plane motion of the leg (and vice versa). This transverse plane motion of the lower leg often transfers to the femur, pelvis, and lumbar vertebrae. Because the STJ is tri-planar and all joints move in three planes, the calcaneal eversion during weightbearing produces tri-planar reactions in the knee, hip, and spinal joints.
During walking, the knee will flex, abduct (valgus), and internally rotate. The hip responding to the calcaneal eversion and ankle motion will flex, adduct, and internally rotate. Since the pelvis is also driven by gravity and GRF, motion will be created in the lumbar spine. Remember that all these motions are “given for free” and muscles must first decelerate these motions prior to creating the opposite motions. It is these motions that turn on the hip and core muscles (both anterior and posterior), all initiated by the calcaneal eversion “switch.”

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FUNCTIONAL IMPLICATIONS 
Frequently clinicians and trainers evaluate calcaneal eversion to see if the STJ pronation is excessive. A better approach is to apply the “Goldilock’s Assessment” – too much, too little, or about right. Although it is important to be cognizant of the role excessive pronation of the STJ plays in raising tissue stress to a symptomatic level, it is equally important to recognize how the lack of calcaneal eversion can inhibit the normal motion and muscle activation of the entire body. If excessive eversion of the calcaneus is too much of a good thing, then limited eversion is not enough of a good thing. Insufficent calcaneal eversion will inhibit the proximal bone movements. This will minimize the loading of the hip and core muscles. The knee will often exhibit a “varus thrust” and will not be an efficient shock absorber. The ankle will be susceptible to inversion ankle sprains. 
All functional assessments should include one or more tests to determine if the client has sufficient eversion available and whether they are using this motion during function. Causes of insufficient calcaneal eversion can be structural or functional. Structural limitations are determined by the amount of eversion when non-weightbearing. Many structural limitations are acquired. Any period of immobilization or protected weightbearing are likely to cause a limitation of calcaneal eversion. This motion must be restored to have a healthy and efficient body. 
Functional limitations are present when the joint motion is available, but other structures inhibit the use of that motion. A structural valgus position of the forefoot or a stiff MTJ will block the calcaneal eversion. Limited internal rotation of the hip often dictates to the STJ that calcaneal eversion should not occur. These functional limitations can produce structural changes if they persist over time. 

THE PRONATED-NO-AVAILABLE-EVERSION PARADOX 
When our clients are standing in a weightbearing position (rather than walking or running) they may demonstrate a lot of calcaneal eversion, but they may not have any additional eversion to load the muscles. For example, a client who wants to be a quicker jumper may stand with the calcaneus everted. This excessive eversion may be caused by a structural varus of the rearfoot or forefoot. If the STJ is at end-range there is no more calcaneal eversion in order to turn on the power sources in the body. The excessively everted calcaneus has insufficient eversion to “load and explode.”

Get Strong! Stay Strong!

Chris

 

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A few weeks ago, my six-year-old nephew was sleeping over at our house. I was awaken in the middle of the night by him exclaiming, “Uncle Joe, there’s a monster underneath my bed!” I went into his room and said, “Be nice to him and he’ll be your best friend. Give him a pop tart or something.” Okay, maybe I’m not the best uncle, but please read on.

The hip is the like a monster underneath the bed, minus a few dust balls and dirty magazines. If it’s working correctly, it can be your best friend. It can assist far away joints like the shoulder or ankle. Strength Coach Vern Gambetta called it, “The engine that drives the body.” No wonder, it has 17 of the thickest, longest muscles of the body directly attached to it. But do not look for them. They are superficially hidden by that big mattress we call the gluteus maximus. A few years back, researchers Porterfield & DeRosa discovered the monster even has tentacles! Well, sort of – we call it fascia. It functionally links the hips with pretty much the entire body.

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This monster is tough all right. It has a deep suction cup of an acetabulum, with a head of the femur as round as Mini-Me’s head, and a thick synovial joint capsule to seal the deal. How does the hip stack up to other monsters, say Godzilla (he just spit fire)? The hip’s secret power is its contribution to three-dimensional loading (force reduction) and unloading (force production). Let’s use the ACL ligament of the knee as an example. Traditional rehab protocols have emphasized the quadriceps and hamstrings. However, physical therapist and biomechanist Daniel Cipriani makes the point that these muscles only become protective as the knee flexion angle approaches 90 degrees. But now look upstairs at the hips gluteus complex. By way of its multidirectional, multiplane orientation on the femur, it is well designed to control the 3D motion of the knee with the most critical being internal rotation, adduction, and flexion.

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Let’s follow those tentacles up the kinetic chain to the shoulder. Can they protect the shoulder anterior instability that creates rotator cuff issues? You bet! Now we’ll call on the infamous “front butt,” including the iliopsoas, abdominals, adductors, rectus, etc. Try it yourself: Stand in a left stride stance with your right arm horizontally abducted at shoulder height with the elbow flexed. Feel the tug at the front of hips? This means they’re locked and loaded to explode, and so are the abs by way of chain reaction between the hip and shoulder. Now turn the front butt off by sitting on it. Do the same arm reach. Feel the difference?

We make the monster happy when we feed it. No, not with pop tarts. Hips love ground, gravity, and momentum. They prefer lunges, squats, and step-ups. Adding some arm reaches in with the mix is like whip cream on top. They love variety in the form of direction, plane, speed, and load changes. However, be cautious of feeding the hips with empty calories. Many exercises performed in the prone, side lying, or supine positions are what Gary Gray refers to as “isolated isolation.” They turn off the hip’s phone lines (proprioceptors) to the rest of the body and unhook those fascia links. They should be used sparingly. Dormant daily living does not nourish the hip. Sitting and activities that require prolonged static standing promotes injurious capsular patterns.  Interrupting these patterns with frequent “snacks” helps reconnect those lines.

By Joe Przytula ATC

Get Strong! Stay Strong! (Functionally)

Chris

When you think of human movement it can be broken down into 4 basic categories.  Locomotion, Level Changes, Push/Pull and Rotation. These represent the 4 pillars of human movement as described by JC Santana in his book Functional Training; Breaking the Bonds of Traditionalism.  When designing rehab or fitness programs that are functionally based it is important to make sure all 4 pillars are incorporated.

LOCOMOTION:  This is the foundation for ground based force production.  It is the linear displacement of our bodies center of mass.  It is a triplane event in which all the muscles and joints are moving simultaneously in all three planes.  While at first glance it appears the body (while walking) is moving primarily in the sagittal plane(SP) (forward) close look would reveal that it is the transverse(TP) and frontal plane(FP) movement that drives us in the sagittal plane.  The TP and FP movement become more apparent when running.  This also requires the ability to efficiently load into the ground (deceleration) followed by the unloading or propulsive phase (acceleration).

LEVEL CHANGES:  This represents non locomotor tasks such as getting up off floor, picking up the baby or taking someone to the ground.

PUSHIN/PULLING: We use various push and pull movements for many everyday activities.  Opening and closing doors, pushing the stroller, taking a hanger off the rack and punching.  Pushing and pulling usually done unilaterally in a reciprocal manner is cross wired neurologically.  As one punch is thrown the opp. arm is retracted to eccentrically load in order to prepare for the next punch.  The same is true for arm swing in walking.

ROTATION:  Responsible for changes in direction and rotational torque production.  Dancing, throwing, and  running are examples of activity with a significant amount of rotation.  The transverse plane is probably the most important and the only plane not loaded by gravity.  The example I like to use to demonstrate the point is that a bicycle only moves forward because the wheels are rotating.  Approx. 90% of all the muscles are oriented in the diagonal to enhance rotational deceleration and acceleration.

Obviuosly many tasks consist of combinations if not all the above categories, but each has a unique and important contribution to human movement.  So, whether you are rehabbing or training it is important to include movements from each of the 4 pillars.

Get Strong! Stay Strong!

Chris

Medial elbow pain known as “golfers” elbow and lateral elbow pain known as “tennis” elbow can be quite painful and debilitating.  Most people complain of difficulty with gripping and twisting activities and can make lifting difficult.  Numerous modalities can help this condition such as rest, ice, electrical stimulation, stretches and iontophoresis.  While treating these conditions can be challenging finding their cause is often difficult too.  Understanding functional relationships can provide insite into why that elbow is taking a beating.  While most professionals should know that shoulder dysfunction can contribute to elbow pain, many dont even consider the hips role.  As discussed in previous posts shoulder elevation is coupled with extension of the hip.  Another functional realtionship of the hip and shoulder is that shoulder rotation is coupled with hip rotation.  So whats this have to do with the elbow you ask?  Well, think of a forehand shot in tennis.  Where does the power come from to hit this shot?  Thats right, form the hip in the transverse plane. (yes i know the trunk is involved too, but I want to stay focused).  To hit the forehand forcefully you must first eccentrically load the same side hip in the transverse plane. 

  

This requires an adequate amount oh hip internal rotation (motion).  Most people due to inactivity, sitting, driving and sleeping in the fetal position lack “normal” hip internal rotation.  Therefore their ability to eccentrically load their hip in the transverse plane will be limited which means their ability to generate concentric force is diminished.  The end result being decreased power in the forehand shot.  To make up for this most people will swing harder with the arm subjecting the medial elbow to increased strain on the medial elbow joint.  They may also flex the wrist harder to try to increase power.  All these things done repetitively can build to the point of pain.  

For lateral elbow pain, consider the backhand shot in tennis.

 In order to hit the shot with power you have to first eccentrically load the opposite side hip in the transverse plane.  Again, if hip internal rotation is limited, eccentric force production will be diminished thereby decreasing the concentric contraction and negatively effecting the power of the backhand shot.  In this scenario the stress of swinging harder with the arm (to make up for the lack of hip power) increases stress to the lateral elbow and many will  “flick” the wrist harder to try to gain power.  These relationships can also be applied to everyday tasks such as pulling a sliding glass door shut.  See, the old song we sang as kids is true…”The leg bone is connected to the hip bone, the hip bone is connected to the”…you get the picture.  Little did I know that I would make a living applying the principle of that song.  Who said kindergarten skills are’nt useful!

Get Strong! Stay Strong!

Chris

 

When the foot hits the ground:

     The calcaneus everts

     The talus drops down and in

     The tibia advances forward, internally rotates and abducts

     The knee (unlocks) flexes due to the tibia moving a little faster than the femur

     The femur internally rotates

     The hip internally rotates, flexes and adducts 

     The lumbar spine extends and sidebends/rotates to the same side

     The shoulders rotate in the opposite direction of the pelvis (loads trunk)

     The cervical spine rotates in the same direction of the pelvis. (rotates from the bottom up)

Once you understand the biomechanics of function you can better design exercises for rehab and function.

After mastering what each bone is doing in each plane of motion then start to put the muscles on the bones and see what each muscle does in each plane to see what its true function is.

It is a never ending study to understand the complexities of human movement but one that never ceases to amaze and challenge me

Get Strong! Stay Strong!

Chris