Balance exercises can be the tail wagging the dog.

Often I see exercises directed at balance whereby the individual is asked to walk with narrow base, or balance on one leg.  Usually balance deficits are provided with exercises that mainly challenge the legs or lower extremities.  Let’s remember a few key principles concerning balance and how this may influence exercise selection to more efficiently address balance deficits.

Balance is the confluence of 3 systems

  1. Visual Input
  2. Inner Ear Input
  3. Receptor Input

Information is processed to produce a righting response whereby center of gravity is oriented over base of support.

Therefore if I most efficiently want to challenge balance, what region of the body must I incorporate dynamically?  Let’s ask this question.  What region of the body allows me to challenge visual input, inner ear input, as well as contains the greatest density of receptors in the body?  The head!!!

When challenging balance don’t forget to incorporate visual depth challenges, looking left and right, producing real and reactive head/neck movements.  This is a paradigm allowing for more efficient pursuit in affecting balance.

The root of ‘S’coliosis

When observing an individual diagnosed with ‘scoliosis’, which is defined as a lateral curving of the spine, there are generally 2 types of curves observed.  1.  An ‘S’ curve, and 2.  A ‘C’ curve.  This post is focusing on the former being the ‘S’ curve.  A ‘S’ curve scoliosis is COMPENSATORY.  A movement professional should be exploring what could be fueling this compensation, i.e. leg length, subluxation, etc.  The reason that the ‘S’ curve happens is because of one very sensitive region of the body.  Let’s see if you can find it.

Look at the picture and ask yourself what region of the spine seems to be least affected.  If you answered the neck, then you are right.  The neck is rich in receptors particularly in the upper cervical spine so much in fact that it will do anything possible to orient itself to the horizon.  If a region of the spine has a problem that requires a lateral lean then the motion segments above that problem area will compensate to orient the neck parallel with the horizon.  Otherwise, the neck would assume a position of lateral lean almost never seen in a ‘S’ type scoliosis.  Therefore, the ‘S’ type scoliosis is a compensation to allow for the upper neck to ‘right’ itself while catering to the spinal dysfunction.  So is the neck the problem?  No…But it is responsible for creating the compensatory curve to allow itself to right.  This paradigm is helpful in understanding why the body assumes a ‘S’ curve in response to the dysfunction.

 

Kyphotic? Restoring posture with the right plane’S’ of movement.

What people refer to as ‘bad posture’ often is known in the movement profession as Kyphosis, or a Kyphotic thoracic spine.  This basically is in reference to an apparent forward ‘lean’ in the mid-back giving the appearance of slouching.  Often you will see exercises to address this by merely addressing the apparent ‘forward lean’ with some sort of back bending, or using a roll to extend the mid-back over, etc.

When considering motion segments we must consider how the bones move on one another and also how the joints behave while the bones are moving on one another.  In the middle to upper thoracic spine the bones move on one another predominately side to side and with rotation.  The joints, on the other hand, glide ‘up and forward, down and backward’.

To address/restore the apparent forward bend, moving the bones of the thoracic spine in rotation and side-to-side will be in agreement with how the bones are predominately made to move.  Interestingly enough, deep spinal postural muscles that act as ‘bowstrings’ to pull the body in an erect position act individually with rotation and side-to-side movements.

So when thinking of addressing posture, consider the 3 planes and combinations in which we move.  Forward/backward, Side-to-side, and rotation.

And we’re not even touching on the nervous system…

Pool Exercises: Pressure inhibits pain

Whats the difference between exercising in water vs. out of water?  Most people will point to buoyancy.  For example when water is at waist height 50% body weight is removed from limbs submerged.  When water is at chest height approximately 75% of body weight is removed from submerged limbs/torso.

So why do people say, Ahhhh!  When initially immersing in water?  Possibly pressure.

  1.  COMPRESSION INHIBITS PAIN!! Hydrostatic pressure

A study entitled “Nonpainful wide-area compression inhibits experimental pain”, found that compression inhibited pain in a clinical setting.

How much compression does water provide?  At around 3 feet of freshwater depth, pressure will equate to approximately 75mmHg.  What does this compare to?  A medical class 3 compression garment is measured between 40-50 mmHg.

Do you hurt on rainy days?  The Barometric pressure difference from record high to record low was 75mmHg.  This low pressure pain can be offset by hydrostatic pressure in a freshwater depth ~3 feet.

So take some weight off of those painful regions by getting in your local pool and experience the freedom of buoyancy and pain inhibition to improve, restore, and preserve your  mobility!

Stretch to Shorten: The Kinetic Coil

Stretch precedes shorten.  This is how our body works in locomotion.  In 3 planes the body creates length just as a rubber band is lengthened before it is able to ‘fire’.  During locomotion and any functional task we should be able to see the torso

‘winding up’ the stretch, often times with the limbs driving the movement.  Think of walking, throwing, running, jumping…  As you become more aware of movement you are able to appreciate the cunning design that allows for the stretch before shorten principle.  Overuse injuries are often breakdowns in the synergism that is the ‘kinetic coil’.  I see movement as fluid envisioning the torso as a coil that stores and produces energy when ‘stretched’ before ‘shortened’.  Think about grandpa dancing…he’s all limbs!  No wonder his shoulders and knees hurt.

                     VS                       

First picture:  Torso winding up like a spring or coil = synergy

Second picture:  All limbs and no torso = overuse injuries

Appreciating the ‘stretch to shorten’ kinetic coil.

 

Becoming the Victim: Pain and Hyperalgesia

Hyper-sensitivity of the nervous system, hyperalgesia, complex regional pain syndrome, when the duration of Pain exceeds expected healing times is an Epidemic.  Extrapolating paradigms for treatment from current data is ongoing and cutting edge in current pain approaches.  Here are some interesting statistics and snippets of studies that relate to the title.

… results support a specific association between major sexual abuse and chronic pelvic pain and a more general association between physical abuse and chronic pain.

…Genetic factors, as well as chronic pain in a partner or spouse, contribute substantially to the risk of chronic pain for an individual. Chronic pain is genetically correlated with MDD (major depressive disorder), has a polygenic architecture, and is associated with polygenic risk of MDD.

…42% stressful life event near onset of complex regional pain syndrome.

…54% had a workers compensation claim related to complex regional pain syndrome.  

…47% had physician imposed immobilization.

…66% had myofascial component present at evaluation

1 in 3 women and 1 in 4 men experience intimate partner physical violence, intimate partner sexual violence, and/or intimate partner stalking in their lifetime.

It seems after reflecting the findings from several studies we could infer a genetic component meaning some individuals have greater risk, although not predisposed.  Environmental factors seem to play a significant role as well along with fear and apprehension of one’s own body, i.e. fearful movement.  Environmental factors are significant and highly prevalent seeming to have a positive correlation with an event that creates a victim, i.e. workplace injury, abuse, motor vehicle accident…

This is most certainly food for thought.  Being a blog emphasizing movement, I feel as though addressing pain and apprehension to movement is essential.  Implementing strategies for empowerment and focus on an internal locus becomes critical to the movement professional.  The movement professional should view professional dependencies as unhealthy i.e., external locus, while addressing the high prevalence of myofascial dysfunctions commonly present from someone fearful of movement.  Incorporating an emphasis on reconnecting with the body without shame, fear, and avoidance becomes critical in pursuing function over pain.

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Genetic and Environmental Risk for Chronic Pain and the Contribution of Risk Variants for Major Depressive Disorder: A Family-Based Mixed-Model Analysis
Published: August 16, 2016
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 1994 Aug;84(2):193-9.
Abuse history and chronic pain in women: I. Prevalences of sexual abuse and physical abuse.
Walling MK1Reiter RCO’Hara MWMilburn AKLilly GVincent SD.
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 1999 Apr;80(3):539-44.
Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients.
Allen G1Galer BSSchwartz L.