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The interview by Todd Bumgardner from BeyondStrengthPerformance.com with Dr. Spina.

July 24, 2013

This interview covers a HUGE range of topics including mobility, stability, motor control, and movement in general…A MUST READ

Question 1: 
There’s a lot of buzz here in the states about mobility, stability and corrective exercise. In your opinion, where does the typical view of mobility and stability training fall short?

“I believe it is a matter of nomenclature, which may seem trivial at first, but it is the basis on which systems are formed.

By my definition, mobility and stability are intimately related. Mobility, which is often confused with “flexibility,” can be defined simply as the ability to move or to be moved freely and easily. Another way to think of it is the ability to actively achieve range of motion. Flexibility by contrast is the ability to passively achieve range of motion. It is therefore possible to be very flexible, however have limited mobility. The former implies that you can passively achieve a particular range, while the latter implies neurological control of a particular range as it is being actively attained.

Let’s take this a step further by examining the role of the above concepts in movement creation and control.

Active ranges of motion occur as a direct result of nervous system activity and thus, at least by the current most plausible theory (the Motor Program/Engram theory) the movement was in some way pre-planned by a central processor (the mind) and executed by the peripheral connections (the brain and nervous system). This plan has within it specific instructions needed to successfully complete the task as, once again theoretically, it is assumed that it was previously encoded. Logically, one would not make a plan with tasks that they are not able to accomplish. Similarly the mind would work within its functional limits/abilities when composing details such as speed, amplitude, angle, etc, of a certain movement. In addition to specific instructions, the nervous system also has the ability, to a certain extent, to alter/correct the plan, using efficient short “circuit loops,” to deal with unforeseen circumstances, and/or sudden plan alterations stemming from some incoming afferent information.

The actual creation of the plan is a complicated and controversial topic. We can say however that it is likely that the limits/abilities utilized in its creation are determined by movement histories that have previously been attempted, and have offered valuable afferent feedback. The execution of the active movement is more clearly understood and is known to be under the guidance, control, and protection of the nervous system (note that the control, and protective elements can be thought of as the “stability”). This is why, when considering the several thousand/millions of movement plans executed per day, we very rarely hear of cases where joints are dislocated, or even subluxated, strictly due to active motion. When it does occur, it is either as a result of execution/plan errors (e.g. Pivoting/change of direction injuries), or stemming the application of an external passive influence, or force, which exceeds the joints ability to correct (ie. “stability”) for the resultant load.

Using the above analogy, mobility can be thought of as the “functional limits of active movement,” while “the movement” itself can be thought of as the original plan. On the contrary, the flexibility of the joint refers only to the ability to passively achieve a particular range. This is under less control of the nervous system, however its limit still governed by it (as it sets the stretch reflex threshold).

Also using the above analogy, we can see how mobility, and stability are thoroughly linked. Mobility represents the physical limits of motion, while stability ensures that those limits are maintained.

Getting back to your original question (finally), where some current systems fall short in my opinion is twofold. First, is in the definition of their actual goal, “mobility” (as opposed to flexibility). Second, in that they did not account for all of the available scientific evidence in the creation of the system. These two factors lead to actual training methodology that is inefficient, and often ultimately ineffective when compared to the goal.

A quick example is the prevalent promotion of stretching with resistance bands, or the use of foam rollers. Neither can logically be concluded to improve mobility as neither trains the nervous system to control ranges of motion or movement.”

Question 2:
Motor control plus improved tissue extensibility equals improved movement–at least that’s what I gathered from your answer. Sounds a lot like your movement system Functional Range Conditioning (FRC)™. Can you tell everyone a little bit about your Functional Range Conditioning (FRC)™ system and how it differs?

“FRC™ is a system of mobility conditioning based in scientific principles and research. In its creation, every aspect of the training procedures utilized were formed on this foundation. Thus it teaches practitioners how to efficiently, and effectively improve articular mobility, which, as we have discussed, means that it builds articular stability in the process. Furthermore, in creating the system, we have also considered how best to build strength and load bearing capacity in the soft tissues simultaneously.

The system follows a general procedural “Flow Chart” that allows the certified practitioner to determine mobility goals, assess for aberrant joint mechanics, expand available ranges of motion, condition and prepare available ranges of motion for use (including improving stabilization), and finally how to begin to integrate the mobility into progressively complex movement patterns. All the while, they are keeping mindful of improving tissue quality and resilience.

Many systems of mobility development are presented as either ‘warm up,’ or ‘cool down’ procedures. Thus they are more of an “after thought.” Whereas FRC is a directed system of training that either stands alone, or is integrated into ones existing programming that realizes and emphasizes the importance of real mobility development.”

Question 3:
That definitely makes sense–all training and rehab exists on a continuum, why completely separate the parts?

As a guy that works mostly with team sport athletes, most of the injuries my guys suffer are during change of direction or when muscles are placed under tension at end range. Does your Functional Range Conditioning system address either of these common injury causers?

“It does address both of these causes of injury. Regarding injury during sudden changes of motion, this implies that there is a breakdown, or inability of the compensatory system (aka dynamic stabilization) to avoid tissue damage. This type of injury is more common with unfamiliar, or untrained movement demands. It is also common with demands occurring while tissues are in ‘dangerous,’ or vulnerable positions. As we discussed, the FRC system was designed to simultaneously build tissue strength through progressive adaptation as mobility is attained. It further focus’ on training the bodies articulations in positions where they are known to be weak. For example, a shoulder that is in a position of abduction and external rotation is inherently less stable and thus can result in anterior subluxation/dislocation under minimal strain. FRC training recognizes common angular weakness and specifically trains within these ranges improving load-bearing capacity. Such tissue adaptation reduces injury rate, and/or severity by providing a “passive” reserve safety net for when dynamic stabilization fails. Put simply, when stabilization (controlled by the nervous system) fails, the difference between an injury, and prevention of an injury, comes down to how well the tissues have been prepared to handle/absorb force. FRC improves force absorption capacity over multiple joint positions. As I always say, you will always regret not training the position that you got injured in.

Regarding tissues/muscles placed under end range tension, much of the FRC systems training methods are performed at the end range of articular motion. Thus, the soft tissues, and nervous systems of FRC trained athletes are well prepared to deal with end range stress.

Along the same lines, loading under eccentric conditions is actually the most common scenario leading to injuries. The FRC system also takes this into account implementing preventative training strategies for this mechanism as well.”

Question 4:
“You will always regret not training the position that you got injured in.” That’s a profound and resonating statement, Dr. Spina, that hold’s true for every athlete that’s been sidelined by a soft-tissue or joint injury. My next question has more to do with the structures that we are affecting with training and manual therapy. I think there is a lot of confusion on the topic, and I’m sure you can clear it up.

There are quite a few mobility and manual therapy systems that do well to address the neuromuscular component of movement and rehab, but what about fascia? The fascial component is huge and it seems as though it’s often disregarded.

It is my opinion that the concentration on fascia as of late is actually equally as restrictive as a sole focus on the neuromuscular aspect. Fascia is but one tissue of the much broader ‘collection’ of tissues known as Connective Tissue. Other examples include bones, ligaments, tendons, capsules, cartilage, and blood vessels. As we thoroughly review at the FRC seminars, each of these sub-categories simply represents a tissue continuum whose boarders are difficult to delineate even with the help of a microscope. In other words, it is difficult, and unrealistic, to distinctly separate these tissue forms, as they are in fact continuous and simply represent changes in composition of identical elements. I will spare you the details here, it suffices to say that a complete system, be it mobility conditioning or manual therapy, must take this anatomical reality into account. All training activities, and manual treatment applications are affecting each and every tissue type simultaneously. We must thus account for all of them when creating a sound, complete system.”

Question 5:
Ok–so let’s stick with that line of questioning. It seems that most trainers and therapist think about movement and rehab through a neuromuscular lens–for example by trying to correct for movement patterns. How do tissues traditionally thought of as ‘passive’ affect movement and function?

“The very idea that there are ‘active’ vs. ‘passive’ tissues is one that has historically been propagated through scientific dogma. As with many topics, assumptions become inherent to the topics, which are then passed on unquestioned through the education system and literature…..

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FOR THE REST OF THE INTERVIEW  VISIT BEYONDSTRENGTHPERFORMANCE.com
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Readers, Dr. Spina is holding is first ever FRC™ certification seminar in the U.S. on October 5th and 6th at Ranfone Training Systems in Hamden, CT. To sign up, or learn more, visit FunctionalRangeConditioning.com

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