Supinated Back Pain? Part 2

As we have mentioned in a previous post, motion primes muscle.  In Part 1 of Supinated Back Pain? we identified a Supinated/rigid/arched foot’s effect in limiting the motion that subsequently triggers the hip musculature to work.

If the hip cannot capture this required motion to work from the foot, interesting things start to happen.  The motion of rotation for the hip to work is required and will take place.  The question is what will happen to create it.

I discussed with someone suffering from back pain on the right lowest region of the back.  They explained how their back pain would sometime radiate into the buttocks of the right side and keep them awake at night.

Image result for arm swing gaitWhen watching this person walk it was apparent that their upper torso rotated to the right when their right foot was flat on the ground.

They were loading their hip musculature with motion from the top down.  They would over-rotate their torso ‘out’ to make the femur rotate ‘in’ relative to the pelvis.

As a result they were abusing the area where they complained of their back pain.

Hopefully this allows us to appreciate how the body will compensate and allow us to perform the task we ask of it.  The body may not perform it in the most efficient way.  Whether it is the way we are made, or the way our bodies have adapted to our lifestyle, it is extremely beneficial to have a general understanding of how it moves to address some of our common concerns.

On a side note, the medial model of treatment had been imaging of the low back and prescriptions to address the pain.  Surgery was another option on the list to address what they had assumed was a bulging disc.  When asked, ‘Did anyone watch you walk’?  The answer was simply, ‘no’.

 

 

 

 

Supinated Back Pain? Part 1

Often times I hear reference to a healthy foot by whether or not it ‘has an arch in it’.  This is often in reference to one of the three arches known as the Medial Longitudinal Arch.  A quick and easy way to simplify the foot is if the foot is, or becomes ‘arched’ then it is rigid.  If the foot is or becomes flat then it is flexible.

Image result for medial longitudinal arch

 

 

 

 

 

A high arched, rigid foot, does not allow for torque conversion to take place in the heel bone/sub-talar joint.

Image result for subtalar joint tibial internal rotation

Therefore the knee does not spin in… Therefore the femur does not spin in… Therefore the hip musculature is not primed with motion to assist in propulsion.

 

 

Tennis elbow? But I don’t play tennis… radial nerve entrapment

Since this site is dedicated to preserving, enhancing, and restoring movement we should also think about more than muscle and bone.  I guess it’s best to present this in story form.

After many elbow specific treatments and interventions, person “X” continued to struggle with elbow pain diagnosed as ‘Tennis Elbow’.  They later relayed a ‘breakthrough’ stretch.  ‘Person X’ demonstrated this stretch that appeared quite different to the conventional stretches they were provided by their medical professional.

This stretch looked something like this…Image result for radial nerve stretch

Thinking about the structures involved I wondered why did they feel the need to move the neck and involve the shoulder?  Tennis elbow from a muscular standpoint involves wrist and elbow muscles.  So why the neck and shoulder?  What travels like this?

 

In a previous posting examining how many systems and structures are involved in our movement, it begged the question what system/structure is being biased with ‘Person X’s’ stretch.

 

Introducing the radial nerve.  Person X’s stretch most resembled a radial nerve tension moment.  After performing several of these stretches, symptoms would reduce implying that a restriction in nerve motion was present.

After sleuthing out an entrapment site and integrating the thoracic spine to reduce elbow stress the elbow was able to heal.  Person X revealed how movement involves more than muscle and bone.

 

Why do I need this motion? Story of a total knee replacement.

Recently I was posed the question, why should i push so hard to get my knee to move to 120 degrees when I am at 110 degrees of knee bend.  I am older and seem to be able to do everything that I want to do at home with my current knee mobility.

Well…  my current thought was relayed as follows.

Two reasons.  Establishing a buffer and motion primes muscle.

It may take 110 degrees to perform most tasks, but what about the story you told me when you were navigating steps into the attic and you dropped an item that you needed to pick up.  Did you have the ability to perform that task?  Having a buffer is important.

Being a male weighing close to 200#, I generally would rather sit in a chair rated for 250# versus a chair rated for 200#.  You never know when you may need that extra bit of buffer to address the unusual or unexpected demand.

More importantly motion primes muscle.  A person does not jump without first bending knees, hips, and ankles.  You cannot kick a ball forward with any force without first kicking backward away from that ball.  Motion precedes muscle function as it primes the contractile tissue to fire.  If you are missing motion you will be less efficient in stimulating the receptors to perform in their respective roles involving functional activities.

Why is she kicking backward to kick the ball forward?  Because motion primes muscle.  She is providing a quick stretch to the tissues on the front of the torso and right leg and they are gonna fire and blast the heck out of that ball.

 

Exercises for better golf swing. Insights from a newborn.

I arrived at a gym one day seeing a friend sitting on a machine that appeared to be making him do the splits.  I inquired, ‘Hey pal, what are you working on?’  Hey replied ‘oh doing some exercises I read about to improve my golf game’…

What if I started the story over and he was instead doing push ups, or sit ups, or pull ups, would it make any more sense?  Maybe, but think about this.  If we want a surefire blueprint on how exercises can translate into skill acquisition there is no better resource than looking at the process of how a baby works to gain the ability to walk.

Babies want to walk.  They prove that they want to walk by working like heck to stand on their feet.  After they are able to stand on their feet, they are pulling themselves up all of the time until the finally master the ability to walk around.

After achieving the basics of walking do they then begin to lie down again in order to get better at walking?

Why do we think that we need to do that?  Golf exercises should look like playing golf to some degree.  Fixed feet, neck rotation, torso rotation, hip rotation, arm swing, etc.  The further we move away from looking like the task that we are after, the less our body understands what we are asking from it.  I try to think of that now when I watch people purposefully exercise.  I feel like I should be able to say, ‘Yeah that looks like Golf’.

If interested the progression of a baby to walking a.k.a. gross motor milestones follow.

Image result for gross motor milestones birth to 1 year

 

 

Neuropathy, Heel raises, and return of sensation?

In the past I remember seeing an elderly woman walking with her daughter for assistance.  The daughter did not want anyone to ‘overwork’ her mother.  On the other hand, the elderly woman wanted to ‘feel like I’m getting a good workout’.  So when the daughter would run errands, the Mother would work out with increased intensity.  Part of the elderly woman’s exercises included heel raises and standing on the balls of her feet for 10 seconds throughout the day.  Within a couple of weeks she returned with an unusual report.

‘I can feel my feet working’.  Literally tears in her eyes she expounded that she was informed by her Primary Care Physician that the loss of sensation in her feet from ‘neuropathy’ had no available intervention that would help to regain sensation.

Long story short, I was surprised that exercise could do this.  Then I thought, well why wouldn’t exercise and movement help.  I am continually amazed and impacted at how something as simple as movement can be such a powerful and nourishing stimulus for healing in the days when we feel as though we need pills to facilitate this response.  I am not saying that exercise will cure neuropathy, but merely relaying this subjective report that provides further weight for the argument of movement and exercise.

Brain Health, Aging, and effects of exercise.

In a previous post I encouraged you to explore how the entire body is connected and responsive to movement.  There are many studies that highlight the positive effects of exercise on each organ, and organ systems.  Often these studies will look at and make a statement such as ‘research has proven that a forest contains trees’, or expound further to state, ‘research has proven that a forest that can sustain one type of tree may be able to sustain a different type of tree as well’.

John Medina includes in his best selling book ‘Brain Rules‘ clear cut statements concerning brain health and exercise such as:

  • “Researchers studied two elderly populations that had led different lifestyles, one sedentary and one active. Cognitive scores were profoundly influenced. Exercise positively affected executive function, spatial tasks, reaction times and quantitative skills.”
  • “Exercise increases oxygen flow into the brain, which reduces brain-bound free radicals. One of the most interesting findings of the past few decades is that an increase in oxygen is always accompanied by an uptick in mental sharpness.”
  • “Exercise acts directly on the molecular machinery of the brain itself. It increases neurons’ creation, survival, and resistance to damage and stress.”

Image result for elderly health and unhealthyImage result for jack lalanne

 

 

 

 

 

 

 

Let’s look at the big picture.

We are made to move.  Exercise nourishes us as a whole.  The lack of movement or exercise leads to decline in all areas of our lives.  Thus, regardless of the thin slicing conclusions of research, we can easily draw the conclusion that  maintaining mobility is paramount for maximizing the benefit of exercise on our lives.

p.s. God Bless Jack LaLanne (he was 70 in this picture)

 

Core versus Appendages. Function and Response

The ‘core’ can be likened to the stick in the picture below.

The appendages in turn can be likened to the propeller.  The more efficient the ‘core’ or stick is at transferring energy into the ‘appendages’ or propeller, the greater the influence on the environment (function) is produced.

In this picture, a general relationship can be established with the kinetic chain of the human body.

WALKING:

  1. The ‘hands’ in the picture = the foot in an activity such as walking.  This is because the foot initiates everything in the kinetic chain during an activity such as walking.
  2. The ‘post’ in the picture = the ‘core’, or axial skeleton, and surrounding tissues as they work to efficiently and in their respective roles transfer energy up the kinetic chain.
  3. The ‘propeller’ in the picture = the arms, or ‘appendages’ which become reactive to the demands that the feet, then core, place upon them.

THROWING:

  1. The ‘hands’ in the picture = the hand that is throwing the object.  This is because the hand initiates everything in the kinetic chain during the activity of throwing.
  2. The ‘post’ in the picture = the ‘core’, or axial skeleton and surrounding tissues as they work to efficiently and in their respective roles transfer energy down the kinetic chain.
  3. The ‘propeller’ in the picture = the feet which respond to assist in loading and decelerating the forces delivered from the core.

 

Less isolation more integration… cam impingement and the kinetic chain.

At one time I was able to work with an athlete who participated in sport requiring twisting of the torso while the feet are fixed to the ground.  Upon introduction, they relayed skepticism about the ‘diagnosis’ being the problem of ‘cam impingement’ seen on a radiograph.

types of femoroacetabular impingement

As we can see in the picture above the cam presented on the radiograph as bony deposit on the hip where the neck meets the ball.  Immediately I considered ‘Wolff’s Law’ which states ‘that bone in a healthy person or animal will adapt to the loads under which it is placed’.  So the question becomes, what is placing load on this region of the femur?

Watching this individual rotate his torso in a fixed feet position quickly revealed the answer.  They could not rotate through their thoracic spine.  As a result the pelvis had to move more to accommodate a reduction in mobility in the thoracic spine.

So let’s expound a bit.  Baseball is the sport.  A right handed hitter.  During the wind-up, the pelvis was placing the right femur into a flexed and internally rotated position.  The thoracic spine did not assist with rotation driven by the arms so the pelvis had to move more and faster.  This in turn provided the load stimulus on the anterior femur.  Wolff’s law then stated that bone will deposit in response to the load and as a result the formation of the ‘cam’ was the consequence.

Image result for baseball hitting technique

Facilitating motion in the thoracic spine with functional integration lead almost immediately to increase in power production and reduction in hip pain.

 

 

What am I stretching?

After years in the movement profession I am humbled by the complexity and interdependence of the body.  When I first began I would view the following as, ‘a hamstring stretch’.

Image result for hamstring stretch

I now think back to the basics from anatomy and physiology class.  There are 11 systems in the human body.  The Cardiovascular system is working hard to provide gas exchange and tissue nourishment through the circulatory system while regions are lengthening.  The Digestive system peristalsis may be facilitated through pressure gradients.  The Endocrine system may be responding in various ways such as increasing blood endorphine levels in response to the intensity of the stretch.  The Integumentary system is involved allowing excursion through motion segments because of it’s visco-elastic components.  The Lymphatic system is being stimulated through extrinsic pumps to facilitate intrinsic lymph flow.  The Muscular system at it’s respective region is being lengthened and shortened simultaneously in all 3 planes of movement.  The Nervous system is likewise being tensioned, facilitated, and inhibited allowing for perception of the stimulus.  The Renal system is working to preserve sodium for the re-absorption of water and maintaining tissue hydration thus reducing the perceived need for urination during activity.  The Reproductive system may be reactive in producing hormonal response such as testosterone in males.  The Respiratory system is working to provide gas exchange and nourish oxygen dependent tissues.  And of course the Skeletal system may be reacting to the stimulus by creating greater bone density to respond to gravity and ground reaction force.

The question becomes what is not affected during this stretch.  Thus another reason why this website is entitled Movement for Life since many of these systems perform optimally when we move and affect our surrounding environment.  We are made to move.