- FR Lower Limb - Texas A&M University Medical staff private seminar Aug 4-7/14
- FR Lower Limb Cert - Toronto, Sept 19-21, 2014
- FRC Certification - New York @ Drive495 - Sept 27-28, 2014 ***SOLD OUT
- FR Upper Limb - Vancouver, BC, Oct 24-25, 2014
- FRC Certification - TORONTO @ Vaughan Strength & Conditioning - Nov 1-2, 2014
- FRC Certification - SEATTLE MARINERS & SAN DIEGO PADRES (MLB) Medical staff Private seminar Nov 12-13/14
- FRC Certification - ARIZONA DIAMONDBACKS (MLB) Medical staff Private seminar Nov 22-23/14
- FR Upper Limb Cert - New York @ PerfectStride Physical Therapy - PRIVATE COURSE - Jan 9-11/15
- FRC Certification - Portland, OR @ IMPACT - Jan 24-25, 2015
- FRC Certification - San Francisco, CA @ MoveSF - Feb 7-8, 2015
- FRC Certification - Vancouver, BC - Feb 21-22, 2015
- FR Upper Limb - Portland, OR, Mar 20-22, 2015
- FRC Certification - Connecticut @ Ranfone Training Systems - Mar 28-29, 2015
- FR Upper Limb - Chicago , Apr 17-19, 2015
- FR Lower Limb - London, England, May 2-4, 2015
- FR Upper Limb - Boston, MA, May 22-14, 2015
- FRC Certification - Dallas, TX @ Synergy Athletics - June 6-7, 2015
Seminar registration @ FunctionalAnatomySeminars.com
The problem with prescribing general ‘mobility‘ drills is that they will accentuate articular dysfunction if independent articular motions are not present.
This concept is best conceptualized when considering spinal motion. For proper spinal motion to occur, we want movements to be distributed amongst the vertebral segments. For example, with forward flexion, we want to avoid having a single motion segment creating the entire movement as this will predispose the person to segmental buckling. Rather, we want the movement to be distributed across each articulation (however minimal the intersegmental motion is). In situations where sections of the spine are ‘blocked’ (ie. moving as a single stiff unit), general mobility drills will promote compensatory hyper mobility at the individual motion segment.
The Glenohumeral joint is another example where independent motion between the humerus and scapula must be present prior to assigning general mobility drills. When independent motion is lacking, mobility drills will promote compensatory Scapulothoracic hyper mobility (which can often lead to conditions such as subacromial impingement).
During cadaveric examination of the spine, as we move from the examination of more superficial tissues to deeper spinal structures there is an obvious increase in the amount and density of the surrounding connective tissues. This tissue makes it more difficult to distinguish between named muscles as the boarders between them become more and more difficult to identify (they become progressively less pedunculated). At the level of the spinal column itself, named muscles are visualized as muscular fibers that seem to grow within an encapsulating connective tissue continuum.
This anatomical appearance is best understood when considering movement of the spine. From an evolutionary perspective, muscle cells likely developed in conjunction with movement requirements. When particular movements were naturally selected for, so to were the necessary contractile elements needed to create such movement. At the level of the spine, there is very little relative tissue motion that occurs between each spinal segment (motion segment). The creation of gross spinal movement occurs via the summation of small segmental movements across larger spinal sections. Production of such movement is the job of the more superficial muscle groups that cross several articular segments. For example, when forward flexing the lower spine, movement production is achieved by activation of the larger, stronger, superficial muscles, and the gross movement should be distributed across several lower lumbar motion segments (as well as a significant contribution from the hip articulations). In contrast, when a significant amount of movement is achieved at a single segment, tissue damage often results. We commonly refer to this phenomenon as ‘spinal segmental buckling.’
Because of this, it is more accurate to think of the spine as a single, stiff unit that ‘bends’ rather than as a collection of individual articulations that move independently. To further reinforce this concept, consider that in the CNS homunculus, the entire spine takes up very little real estate when compared to say the
hand (see figure 1). Because the hand can produce various finely tuned movements it is afforded more space and is centrally assessed, by way of afferent feedback, with significantly more specificity. In contrast, the spine is ‘thought of’ more like a single unit and is activated (moved) accordingly.
Because the movement capability between segments is small (and becomes smaller with lack of ongoing training), the function of deepest muscles is not movement production. I offer their small size, low force production capability, and poor mechanical advantage as substantial proof. Rather, their functional importance is with regards to movement assessment and afferent feedback production. This also makes logical sense, as the deepest tissues across any articulations of the body are the first to be engaged during movement and thus provides the most specific, and up to date feedback information to the CNS regarding the ongoing assessment of movement outcome. These small muscles/muscle fibers thus act to monitor tension in the connective tissue elements encasing the spine.
From a clinical perspective, this information offers some important insights with regards to the assessment and treatment of spinal motion:
- If we consider that the spine ‘bends’ vs. moves segmentally, then we shouldn’t concern ourselves with the palpation of specific inter-segmental motions. Rather we should be assessing spinal movement across larger spinal sections.
- When assessing spinal movement, we must do so in the context of the small segmental movement. We can’t confuse gross movements, where a significant portion of movement is via the contribution from the hips, scapulae, etc, with actual spinal movement.
- When treating spinal dysfunction by way of manipulation/mobilization, rather than rely on gross body movements, we should be more concerned with inputting forces that promote bending of larger spinal sections.
- This anatomical concept is in agreement with the recent literature concerning the lack of segmental specificity of spinal manipulation.
- When attempting to palpate deep spinal tissues, we should not have the incorrect preconceived notion (as offered by textbook anatomical drawings) that we will locate well pedunculated specific structures, rather we should expect to feel non-pedunculated ‘bumps.’
- For the training and promotion of spinal movement, we should employ strategies that allow gross movement to be distributed across a large number of segments. That means that the small amount of inter-segmental motion that is available should be maintained.
My interview with Justin Goodhart from WellRoundedAthlete.net for the Move Smart Podcast.
—– CLICK HERE —–
Good interviews start with good questions…and they asked a lot of good questions. We covered many topics related to health, training, and much more. We go deep on a few topics (cellular & sub cellular level)….but I think it necessary to at least have a working knowledge of this ‘realm’ in order to properly manage ones health.
I am writing this short message because I feel that you are owed an apology. For years you have come to us with your problems of lower back pain, sports injuries, weight loss issues, performance goals, etc., and for years you have likely been offered several different (and often conflicting) ‘solutions’ for your ‘problems.’ Each ‘solution’ offered was likely coupled with a claim that that person will ‘fix’ you the fastest….or that THEY have the fastest way or achieving YOUR goal for you. You may have heard or read claims of treatments that provide immediate cures, diets that ‘melt’ the pounds off effortlessly, assessments that ‘find’ out what your exact ‘problems’ are, or training strategies that immediately improve your performance. The problem is…they don’t exist.
The fact of the matter is that a general overview of all of the scientific evidence that has ever been published on human health strategies leads to one common conclusion:
Being a healthy human requires ongoing effort and dedication.
If you have an injury, that means that you have sustained a certain degree of tissue damage. Tissue, no matter the type, requires time to heal. Never, in the history of research has anyone been able to demonstrate a biological tissue responding in a permanent way to a single treatment input. There is no machine, technique, ointment, or pill that can change this fact. It is therefore unreasonable to expect a one-visit ‘cure,’ and it is equally unreasonable for someone to claim that they can provide it. What we can do is insure optimal healing over time which will work to regenerate healthy, resilient, good quality tissue…via ongoing effort and dedication.
If you are hoping to loose weight, diets don’t work (in any lasting way that is). It requires an increase in energy output, a reduction of energy input, and an ongoing diet of healthy, nutrient rich food. Of course there are exceptions and circumstances to take into account….but the solution for each of these requires an equal amount of the secret ingredient – ongoing effort and dedication.
How about the athlete looking to gain the edge on their competition? Well I have good news for you….there are indeed methods that can achieve that goal. The only stipulation is that YOU must approach said methods with ongoing effort and dedication.
Vitamins don’t work if taken only for a week here and there. Muscles don’t get stronger after a single training session. Torn ligaments/tendon/muscles can’t regenerate instantaneously. You can’t reap the rewards of meditation if you do it every now and again. New skills are unusable in absence of ongoing practice and repetition. These are the realities. These are the rules that govern human health and performance.
Don’t waste your time, money, and energy searching for ‘the solution’…I will give it to you right now…
Ongoing effort and dedication.
If you consider ‘a’ muscle to be a single unit that produces one specific function you are grossly underestimating the complexity of its structure.
A muscle is more than ‘a’ muscle as all of the units that make up the structure (myocytes) can themselves be considered ‘muscles’ in their own right, each producing the exact function independently as does the whole. Namely, they draw tension into the connective tissue elements which surround them. From this perspective, each individual sarcomere can also rightfully be thought of as an independent ‘muscle’ whose protein components interact on the molecular level to tension their endomysial encasements. Thus ‘a muscle’ is more accurately thought of as a general name given to a group several thousand functioning structures. Each of these structures produce slightly differing angles of pull and thus create differing angles of tension affecting movement production.
When we test for the strength of ‘a muscle’ this concept must be remembered…especially in lieu of the well established “specificity principle.” Based on this principle, a muscle can generate a good amount of force at a particular angle, but then fail to produce the same force when the testing angle is slightly altered (approx 15 degrees). Thus the angle of pull selected by the test cannot be used to make conclusions as to how the general ‘muscle’ is functioning. One can only conclude that the specific testing angle demonstrates weakness.
This concept must also be considered when considering the overall function of a muscle…if there actually is ‘one’ to speak of. Most of these assumed functions are based on the directionality of the muscle fibres when observed from a gross tissue perspective (I won’t add the complexity of penniform muscle here). However, when one contemplates function based on the 3-dimentional nature of the structure (taking into account differing lines of pull/tension), the complexity of the actuator (neural input), and the seemingly infinite angles of motion that can be created, one must stop and ask themselves if we have enough information, and/or mental capacity, to claim any advanced understanding.