The world’s premier network for those seeking to share and discuss high-impact,high results, super practical information for the developmentof superiorphysical performance.
Results 1 to 9 of 9
Like Tree5Likes
  • 1 Post By schnieder
  • 2 Post By Andrew Lock
  • 2 Post By Andrew Lock

Thread: What is Stability? This might help.

  1. #1
    Andrew Lock is offline Junior Member
    Join Date
    Jan 2014
    Location
    Australia
    Posts
    16

    Default What is Stability? This might help.

    The flaw that pervades and confuses people in the health and fitness industry is the application of the word stability. This problem relates back to the research paper published by Richardson CA, Jull GA 1995 Muscle control-pain control. What exercises would you prescribe? Manual Therapy 1, 2-10
    Within this paper the authors discuss that a method of increasing joint stability is through enhanced muscle stiffness by the co-contraction of agonist and antagonist muscles that lie on each side of a joint. A fine theory, but it cannot be applied to spines. This theory applies to unidirectional peripheral joints such as knees, elbows, fingers. The problem is that the spinal segment is multidirectional, and does not have agonist and antagonist muscles directly attaching on each side of its joints! Read this -There are NO muscles attaching in front of the spinal joints. Spines are not similar to the unidirectional peripheral joints. Spectacularly, the research parroted by these transverse abdominis advocates is a study by Hoffer and Andreasson in 1981that contends contractions as low as 25% maximum voluntary contraction are able to provide maximal joint stiffness. They call this STABILITY!

    So noting that a peripheral joint’s stability is enhanced by co-contraction, the problem arose that it was erroneously stated that multifidus and transverse abdominis were a co-contraction force couple in the same way that biceps and triceps stabilize the elbow joint. This was due to an observation that when T/A contracted there was a noted multifidus contraction. What was never examined was why this occurred. The authors simply stated that it was a co-contraction in the manner of a peripheral joint. Anatomically it was wrong, as T/A does not cross the spinal joint so it cannot be a joint stabilizer in the manner of a peripheral joint.
    I proposed that the reason for the multifidus contraction is that T/A is the first muscle to contract in movement due its role in the production of intra-abdominal pressure. The next muscle will then be the inner oblique abdominal. The Inner oblique has a flexion action upon the lumbar spine, and anatomically the multifidus role is to oppose the flexion action of the abdominals at a segmental level. So in the anticipation of the abdominal flexion moment upon the spine the multifidus will contract. This is not the stability mechanism of a peripheral joint. This is the beginning of the abdominal bracing cascade that will involve all of the torso muscles in an integrated action to handle load and motion. Thus creating the STABILITY that is evident in FUNCTION!

    Isolating a T/A contraction is non functional and destabilizes the lumbar spine by attempting to interfere with the abdominal bracing cascade of integrated muscular contractions.
    Hope this helps clear up the misconceptions you hear in Physical Therapy departments about Pilates teaching ‘stability’ when people lie on their backs, on all fours, or reformer beds trying to isolate T/A contractions.
    Knowledge is a weapon!

  2. #2
    schnieder is offline Senior Member
    Join Date
    Nov 2008
    Location
    St. Paul
    Posts
    1,382
    Blog Entries
    121

    Default

    One general observation is the biceps/triceps is a moving system whereas t/a/multifidus stabilizes the low back. Apples and oranges. Mobility and stability - one moves the other prevents movement.

    What is interesting is the t/a activation (like in l-sits) makes the low back feel "relaxed," at least for me and some folks I train with. I wonder if the (possible) relief is from the multifudus contraction, i.e. previously it had atrophied.

    Interesting stuff here, thank you.
    Ace83 likes this.

  3. #3
    Andrew Lock is offline Junior Member
    Join Date
    Jan 2014
    Location
    Australia
    Posts
    16

    Default

    Thanx for your input Sean,
    Your observations are exactly what I was demonstrating. It is apples and oranges.
    That was the problem with the research by Richardson and Jull. They extrapolated, without explanation, the concept of peripheral joint stability and applied it to spinal mechanics.
    I'll be honest, in my opinion, I cannot believe that such eminent researchers did not know their anatomy and I cannot comprehend that their poorly produced research paper then influenced, and still influences today the wrong direction that back care is going in professional health care. I was too new out then, still had not finished my Masters degree, to critically analyze the research that was then being promoted. I sure do now, nearly 20 years later.
    If you don't mind, I'll expand your concept a bit more. T/A and multifidus keep getting lumped together as if they work together exclusively. That's the concept that has retarded health care for lower backs ever since that research was published. Remember multifidus opposes lumbar flexion, and T/A does not produce lumbar flexion. The relationship is between ALL the abdominal and lumbar muscles working as a functional team.
    Interestingly if you perform the L-sit you will engage every muscle in the torso, so to isolate that multifidus is contracting as the reason for relief misses the thought that every other muscle that is involved, perhaps it is the overall contraction of all muscles that produces the relief.
    Consider T/A has a horizontal force, then in the L-sit there are massive vertical forces, not horizontal, applied by the external and internal obliques as well as rectus to produce a lumbar flexion moment. So if multifidus is active its role is to oppose all the flexion abdominals, except T/A due to it lacking a flexion action, on the spine. This the multifidus and iliocostalis and Longissimus especially will be opposing the lumbar flexion action.
    Perhaps consider the L-Sit as definite proof that multifidus activation is related to the obliques not T/A. A perfect example of vertical force production and opposition and not as a single force couple but as a functional unit of all muscle integration.

    Lets not muddy the waters. I'll preempt the PSOAS crew. In the L-sit psoas is a dynamic hip flexor. The only action psoas has upon the spine here is to compress the vertebrae when it contracts. There is NO lumbar lordosis action by Psoas, that's a myth. Happy to expand upon that.

    Hope this helps.
    Andrew

    P.S. The lumbar spine is a moving system as well, but lets leave that to later unless you wish me to expand upon it.
    Chris F. and schnieder like this.

  4. #4
    Chris F. is offline Senior Member
    Join Date
    Dec 2009
    Posts
    308

    Default

    Quote Originally Posted by Andrew Lock View Post

    Lets not muddy the waters. I'll preempt the PSOAS crew. In the L-sit psoas is a dynamic hip flexor. The only action psoas has upon the spine here is to compress the vertebrae when it contracts. There is NO lumbar lordosis action by Psoas, that's a myth. Happy to expand upon that.

    Hope this helps.
    Andrew

    P.S. The lumbar spine is a moving system as well, but lets leave that to later unless you wish me to expand upon it.
    I would love it Andrew if you would expand on both of these points. Your posts have been extremely helpful!

  5. #5
    schnieder is offline Senior Member
    Join Date
    Nov 2008
    Location
    St. Paul
    Posts
    1,382
    Blog Entries
    121

    Default

    Quote Originally Posted by Andrew Lock View Post
    Interestingly if you perform the L-sit you will engage every muscle in the torso, so to isolate that multifidus is contracting as the reason for relief misses the thought that every other muscle that is involved, perhaps it is the overall contraction of all muscles that produces the relief.
    Well put and hard to argue with this, especially if for those who do them.

    Quote Originally Posted by Andrew Lock View Post
    That's the concept that has retarded health care for lower backs ever since that research was published.
    Do you think it is getting caught up in the concepts that has resulted in so many messed up back or the fact that straightforward solutions such as l-sits and their regressions are not readily prescribed?

    Also - I second the request to hear you speak on the spine as a moving system - and if it the same kind of moving system as say the biceps/triceps.

    Thanks for sharing your knowledge.

  6. #6
    Andrew Lock is offline Junior Member
    Join Date
    Jan 2014
    Location
    Australia
    Posts
    16

    Default

    Hi Chris,
    Happy to help on these.
    I'll apologize up front for some of the explanations to follow. I may be unable to avoid going into anatomical jargon and I know that not everyone will be familiar with them. I do teach this face to face and it is often clearer when using a live model. I'll try to be clear, but expect it may get dense.

    Beginning with Psoas. Here is what I think occurred. It was that many decades ago, probably even pre 1950, perhaps even further into 1930's I'm speculating, there was no good science on low back problems. But there were a lot of theorists. Erroneously, people who were treating and teaching in that area made some assumptions that were flat out wrong.
    Once of the biggest mistakes still being taught (by non specialists), is that people naturally sit in anterior pelvic tilt. There is an article called "Neanderthal no more" that still sits on some internet sites. The whole premise it is based upon, besides the fact the authors don't know their anthropology and that Neanderthals are not direct ancestors of Homo Sapiens as they propose, is that people have sway backs in sitting.
    People do not sit in Anterior Pelvic tilt. Just look around you, everybody slumps and sits in Posterior Pelvic tilt. People lose the lordosis in sitting and produce a static kyphosis (usually). This is the biggest reason for the most common form of low back injury. That I can't go into here because that is another topic!
    Now the wrong assumption that people sit in Anterior Pelvic tilt was blamed on the idea that there were tight Psoas doing this. Wrong in theory and wrong in observation.
    There is not single reputable published, scientifically reviewed , paper that states people normally sit in increased lordosis. Every piece of evidence shows the opposite. That people slump into kyphosis and posterior pelvic tilt. No more "Neanderthal no more" please! I did offer to correct this for the authors and emailed them a list of corrective references. I never heard back from them.

    Anatomically the Psoas attach to the whole lumbar spine and even a bit of the thoracic. But its 'reason' for doing so is to PRIMARILY be the base from which hip flexion occurs. Psoas is a major Hip Flexor! Psoas also performs the function of stabilizing the spine by stiffening it to oppose the action of iliacus. If iliacus was performing hip flexion without psoas action then the iliacus would cause anterior pelvic tilt and lumbar spine extension. So here is even more evidence that rather than produce lumbar spine extension the psoas opposes it when iliacus contracts as a hip flexor.
    Hope I'm doing this clearly.
    Here is a bit of a summary.

    Psoas acts to flex the hip.
    Psoas stabilizes the spine by compression of the vertebrae.
    Psoas does not produce lumbar extension when it contracts. It produces compression.
    People sit slumped in lumbar kyphosis, not in a sway back posture, and psoas is not primarily a postural muscle but a dynamic hip flexor.

    Now this is not just my thoughts but a summary of published science.

    I plan to put up a full reference list sometime, but if you want one:
    Andersson et al 1995. The role of psoas and iliacus for stability and movement of the lumbar spine, pelvis and hip. Scandinavian Journal of medicine and science in sports


    P.S. Ever had back pain yourself? or know someone else who did? How often did you find that they found relief when lying on their backs with their hips flexed and knees bent, yet to lie flat was painful? That is psoas. When lying flat the psoas will pull directly on the spine and cause an increase in intradiscal pressure, so to bend the knees and flex the hip at rest decreases the psoas pull and drops the disc pressure. That is another way of clinically testing for a disc injury, one of many, but it adds to a picture.

    I'll be onto the dynamic lumbar spine tomorrow. But even reading the above you can get a start that there is both lumbar flexion and extension in posture and movement. Yes, we teach static lumbar control with a moving body to our clients, but we must also teach them to load in both lumbar flexion and extension before they are completely rehabilitated. It's just you need to know the clearence tests, and as Sean suggested in the L-Sit, there are important progressions that professionals understand before you move a client to greater loading.

    Hope this helped. There are massive references behind this.
    Perhaps over time it might be an idea, if you wish, for me to choose say one important research paper per week to discuss. Happy to do it.
    Chris F. and GeoffreyLevens like this.

  7. #7
    Chris F. is offline Senior Member
    Join Date
    Dec 2009
    Posts
    308

    Default

    Quote Originally Posted by Andrew Lock View Post
    Hope this helped. There are massive references behind this.
    Perhaps over time it might be an idea, if you wish, for me to choose say one important research paper per week to discuss. Happy to do it.
    Fantastic! Yes please keep this discussion/education up!

  8. #8
    GeoffreyLevens is offline Senior Member
    Join Date
    Sep 2010
    Posts
    606

    Default

    Andrew, very well written and interesting. I had no trouble following it.
    People do not sit in Anterior Pelvic tilt. Just look around you, everybody slumps and sits in Posterior Pelvic tilt.
    Funny though I have notices this, me personally, esp if stressed, will go hyperlordosis route at least until I start to notice the increasing pain from really cranking on it unconsciously. When I had really severe sciatica years ago, there were actually a couple modalities that helped me tremendously and one was the almost idiot simple McKenzie lumbar stuff I learned from a $5 used book. My understanding is that this will help most out of immediate crises UNLESS they have (can't remember the term) calcium/bone deposits that are impinging. It certainly did me.

  9. #9
    Andrew Lock is offline Junior Member
    Join Date
    Jan 2014
    Location
    Australia
    Posts
    16

    Default

    Perfect example of Sherrington principles there Geoffrey! Stress is related to muscular contraction, so as the stress increases your musculature contracts and the erector muscles will pull you upright and you will fatigue and hurt. As long as we remember to see that as a result of integrated muscle action and not Psoas tightness we will be able to correctly address it.

    I actually presented with Robin McKenzie at a conference in the late 90's. He is a deep thinking person and I found him a pleasure to talk to. His principles are very logical and evidence guided. We often associate McKenzie with extension because he was the first person to really produce a system which opposed the dominant exercise treatment regimes of the time based on Flexion (Williams flexion exercises, a terrible paper that many old school medicos still use). McKenzie method is not just extension, in fact it encompasses all directions of movement, but extension is dominant only because that is the direction that resolves most low back injury.

    This now leads us to the concept of the dynamic lumbar spine as an area that moves in many directions.
    I'll try again to minimize jargon. I'll tend to paragraph the points so it may look chunky.

    We have had it drummed into us that we must learn to hold the natural lumbar lordosis in movement, and this is absolutely correct in rehabilitation.

    Low back injury is associated with segmental loss of motor skill. Consider the lumbar spine as composed a series of individual segments called L1/2, L2/3, L3/4, L4/5, L5/S1. These 5 segments have individual movement in all directions that contribute to an overall lumbar spine motion.
    There is a relatively wide estimation of the measurement of lumbar spine movement. But there is no disagreement that it moves significantly. Remember that the range changes with age, due to the discs between each segment getting stiffer with age. So if I say that a good understanding that the whole lumbar spine flexion and extension range is about 80 degrees, it is a general call for the 18-35 year old range. So from L1 to S1 the spine can move about 80 degrees. This is normal! So when you imagine rehabilitation of a lumbar spine that is what we have to restore!
    We have been very focused upon teaching the control of the neutral spine posture which is imperative but to restore pain free normal function, but our job is not finished until we restore total available function. Hence look at great deadifters, they do not lift in lordosis. The begin much closer to neutral and move closer to lordosis due to the action of the erector spinae. Seen the erectors on Bob Peoples photos? He did not build those in 'neutral'. Even the great Bill Kazmaier used to practice a round back deadlift from pins in training.
    The biggest challenge for rehab is to know how and when you move your client from the ability to hold lordosis to the ability to load into flexion.
    Don't be scared of flexion. But do be scared if you don't know what the clearance signal are to progress. I expect most health professionals might find that a challenge, but what I aim to do is to discuss this at a later date.
    This is why the swing may be the best lumbar rehab exercise that exists if you had to choose 1. It loads in both sagittal flexion and extension with isometric holding upon the individual segments. More on that later.
    I have to go now.
    Thanks for your input.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Free Course
Close