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Entries in functional movement (6)

Friday
Sep222017

foot to core sequencing

What do feet have to do with one's core?? Turns out, everything; it all starts at the feet. The most functional movement humans do is walk. If our parts are aligned and neuro-muscularly coordinated we walk and work with ease and without pain. There is a sequence to neuro-muscular firing that is essential to this coordination.  Think of a string of fire crackers each causing the next to ignite. That's efficient. If you had to keep lighting every couple fire crackers you'd get frustrated and you wouldn't get the same effects.

So here's how it works:

We must have enough inversion of the foot in order to effect external rotation of the tibia which, in turn, causes internal rotation of the femur, activates the glutes, then initiates firing of psoas, pelvic floor and respiratory diaphragm. It's a neuro-muscular firing cascade that happens from the ground to the core by virtue of our feet impacting the ground.

We also must have enough eversion of the foot, have enough ankle dorsiflexion and be able to get over our big toe in order to effect adequate propulsion. A number of compensations reveal any inadequacies--walking with feet pointed outward, rolling the feet, twisting the leg, throwing the leg to the side or picking up the foot early. Have bunions? or flat feet? They're the result of compensations.

Neuro-muscular firing initiates while we are anticipating where to place our foot, even before the step is taken. There's an unconcious planning that takes place in walking (and running), one that either serves us well or has become a pathological habit. People who have been raised shod have more foot, ankle and leg injuries than people raised barefoot because the sensory ability of the small, intrinsic nerves of the feet have been dampened. A shod foot trying to walk is like a ear trying to hear underwater--distorted and unsure.

Getting some barefoot time in each day can re-awaken those small, instrinsic nerves, improving balance and proprioception while protecting you from injury over the long term. Many runners who change from shod to barefoot, or minimalist, get injured because they try too much too soon. It takes some time for the nerves to waken and for your body to adjust to using your muscles in new ways. Take it very slow and gradually decrease your shoe's support over time.

Check out Harvard's website on "Biomechanical Differences Between Different Foot Strikes" for more, really cool information.

Sunday
Jan102016

kinesiology taping

Since October I've been certified in kinesiology taping, also known as sports taping, by the only company teaching evidenced-based taping protocols for pain, edema, scar tissue, complaints during pregnancy and to improve functional movement. My patients call it "magic on tape".

How does it work? Two ways: It provides a microscopic lift to the skin which allows improved circulation of lymph and it's an irritant that demands the attention of the nervous system to that area. Some of the most powerful modalities are proving to be those that work with the skin--not only the largest organ but also the largest outcropping of the nervous system.

You may have seen this YouTube video of the cat who is taped and how it changes her movements (Yes, it went viral; it's a cat after all.):

Here's a video of Rupert the Papillon after being taped, proving that taping can't correct for aging (16.5 years) or  for viciousness.

**No animals were harmed in the making of these videos.**

 

Tuesday
Mar192013

Two-tone

Skeletal muscles have tone and strength. The two are often confused because in normal parlance we say that someone who has built their muscle strength, by say, weight lifting or physical activity, is 'toned'. This is not what we are referring to when pointing to muscle function.

'Muscle tone' refers to the work the muscle is doing when it is at rest, while the work that muscles do while working, or exerting force, is called 'strength'.

All muscles maintain some working fibers, even while at rest. This reflects a certain amount of electrical and chemical communication that constantly happens in order to maintain basic functions such as proprioception, balance or just structure. Those muscles that have some responsibility for posture have more slow-twitch fibers and will have greater resting tone. Slow-twitch fibers are the "white meat" of muscle. Like birds who must fly hundreds of miles to migrate, they are working much of the time to keep up some tone for endurance. The need for postural and structural support never sleeps. When some fibers need to rest, others jump in to take over. The pelvic floor is postural and is prone to hypertonicity. Hypertonic fibers are those that do too much work while at rest. A muscle that doesn't rest can't work as well and can produce pain. Most patients who show up at American pelvic pain clinics or complain of urinary symptoms present with hypertonic pelvic floors.

Muscles at work are characterised as strong or weak. Both can be hypertonic (or hypotonic, for that matter--meaning too flaccid at rest). When women are given a vaginal digital exam by a urologist in order to assess for strength, it can be difficult to accurately assess the strength of a hypertonic pelvic floor. If the muscle contracts but doesn't adequately relax afterwards, the physician will feel little difference in tension and proclaim the muscle group to be weak. What the practitioner actually felt was the result of hypertonicity and the jury is still out on the strength or weakness.

A female urologist (one who is trained on female anatomy & physiology) is more likely to be aware of this issue than the more traditional male urologist. Nearly all urologists are male urologists.

I have had patients who become concerned that exercise will worsen hypertonicity. This could not be further from the truth. When we work a muscle, we contract and relax it, over and over. In working the muscle we train the relaxation part of the cycle as much as the contraction. In fact, working the muscle is one way of treating hypertonicity.

For the pelvic floor, there are two more ways that we can aid relaxation of the muscles. One is to give a slight push out, like giving a little push to get a tampon out. It should never be a forceful or strained push; use very little effort and don't expect to feel anything different from doing it. The other way to relax the pelvic floor is to lie in rest pose--on one's back, with knees bent and soles of the feet touching each other. This minimizes the electrical activity from the large muscles of the thighs and buttocks that tends to spill into the pelvic floor. This electrical activity is normal, but too much of it promotes hypertonicity.

Wednesday
Dec262012

Sensory awareness

Since sensory awareness drives motor control, promotes sensory integration and helps to develop relationship with one's body, I've been adding sensory awareness exercises to my Core & Pelvic Floor Workout classes these past couple weeks. It is a trend I will continue.

This past week my participants and I were noticing how very minute shifts in our position--pointing a foot or leaning--can elicit profound changes in sensory perception. When one has increased awareness one enhances one's ability to control those muscles and the surrounding structures. As Janet Hulme, PT, avers, "Even muscles you are not aware of being able to control, like the bladder, are affected when you change muscles you can control." Perhaps this can be one definition of the subconscious life, connecting the unconscious and supposedly uncontrollable with the conscious and controllable. In politics the Chinese call this approach 'using the back door'. In biology it's sometimes called neuroplasticity.

Try this:

Move ever so slowly to a sitting position, paying particular attention to how your sitz bones (ischia) are moving. You should notice that as you sit, your sitz bones are spreading, moving away from each other, until the moment before sitting. As you release the tension to let yourself give your weight to the chair, the sitz bones move toward each other slightly. Do it several times in attemp to feel it.

Squat down and perform a slow, side to side swing of your buttocks. Notice the pull you feel on your opposign sitz bone. In other words, when you are swinging to your right, you should feel a slight pull on your left sitz bone. When you swing to your left, you feel that pull on your right sitz bone.

These simple exercises, and others like them, can aid in restoring normal sensation and function, when practiced over time.

Thursday
Oct042012

Contraction 

There are two types of muscle movement--concentric and eccentric. Concentric contraction is when the muscle contracts and shortens. Eccentric contraction is when the muscle contracts and lengthens. Both movements work the muscles, but in different ways. Both types of movement are important to muscle development.

In fact, both concentric and eccentric movement are necessary not only for developing the strength of a muscle, but also in developing the neuromuscular control of a muscle. Eccentric movement tends to be more challenging for us and in doing very slow movement, defecits will show up as shakiness or jerkiness.