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Proprioception-Mind Body Connection
February 21, 2012
Proprioception
Mind Body Connection
The Mind body connection can be discussed from many different angles. When discussing movement such as in exercise or rehabilitation proprioceptors are a very important aspect to consider. Proprioceptors are the main source of communication between our brain and our musculoskeletal system. These receptors are found throughout our joints, muscles, ligaments, tendons, and fascia. It is how we know where parts of our body are in relationship to other parts of our body. In a sense it is the old school term “muscle memory” but much more complicated than that. They allow the perception of one’s own body position and movement . Proprioceptors give our brain information that is crucial in adjustment of movement force, position, speed, timing, and angles. They are the key to learning new skills and preventing injuries.
So you might be asking yourself why are proprioceptors important for me to consider? Proprioceptors are important for anybody who is interested in improving the mind body connection as it relates to staying healthy through movement. They must first be understood and then they must be trained. Mainly they are important to consider when stretching and exercising.
When muscles are stretched the proprioceptors (muscle spindles) are activated and they send information to the brain regarding the change in length of the muscle. This triggers what is called the stretch reflex which is an attempt to resist the change in muscle length by causing the stretched muscle to contract. The more sudden the change in contraction of muscle the stronger the stretch reflex will be. An example of this would be plyometric training. One of the reasons for performing a static hold while stretching for long periods of time is that the proprioceptors habituates and becomes accustomed to the new length and reduces the signal and eventually you then train the proprioceptors to allow more muscle length. Now if you perform static stretches to simply gain muscle length as in people with muscle imbalances this is a good technique but if you are a person who moves such as a runner or dancer dynamic stretching makes much more sense because you should train the proprioceptors to respond accordingly with just the right amount of reflexive contraction to resist end ranges of motion.
If you stretch statically you create mobility but this can be dangerous as the body has no information on how to resist the end of the movement. Dynamic stretching allows the muscle to gain length but then learn exactly how much length to gain for the specific movement and then what to do at the end of the movement. This is mainly important for preventing injuries.
When exercising proprioceptors are important and should be considered when making your goals. If your goals are weight loss then proprioceptors are less important but if you goals are improved balance, activity or sport specific, strength, or power improvements then proprioceptors should be considered. Exercise should be designed to meet your specific goals. For example if I am exercising in order to become a better cross country skier than my exercise routine should have movements that are functional and replicate specific movements that are involved during cross country skiing. Proprioceptors are trained during these activity specific exercises and allow our muscles to learn how to act during these movements. Our brain remembers these movements and then allows us to perform better during the activity we are training for. Let me give you an example. Let’s say I am exercising today to increase my abdominal strength so that my abdominals can help me be a better cross country skier and I choose a sit up to strengthen my abs. While doing the sit ups I can definitely feel my abs working hard as they are burning like crazy. Now when examining somebody cross country skiing it would appear as though each time the person strides forward there is an element of trunk flexion that occurs similar to a sit up motion but there is one element to consider. When standing upright while skiing and flexing forward gravity actually flexes your trunk, not your abdominals. Therefore, when performing a sit up you are not training your proprioceptors the right way. In fact a sit up or flexion based abdominal exercise is training your abdominals to be strong during flexion while laying down. When we are skiing we need our abdominals to stretch out into extension and rotation and control our stride length and spine extension. The sit up will train your proprioceptors the wrong way and can actually create a higher risk for injury while skiing. Specifically injuries in this situation would include abdominal muscle tears, sports hernias or lower back pain because our abdominals have not been proprioceptively trained to control the spine and legs as we stride forward.
Overall Proprioceptors are what dictates how we move. They connect the brain and the body for movement. Once we understand how they work it makes it easier to design exercise and flexibility programs that allow each one of us to reach our goals. It is truly one of the most important mind body connections that will allow us to be healthy.
Andrew Gorecki, DPT
Posted in Uncategorized | 6 CommentsFunctional Muscle Function
December 19, 2011Functional Muscle Function
by Andrew Gorecki, DPT
One of the most important concepts that makes Superior Physical Therapy unique is the understanding of how muscles actually function. Now this may sound like an arrogant statement but let me explain. Most health and fitness professionals have learned some degree of anatomy and have knowledge of muscle origins and insertions, textbook muscle function, and exercises to increase muscle mass and strength. Functional muscle function is the understanding of biomechanics, human function, and proprioception (neuromuscular control and feedback of muscles and joints-movement memory some may say). There are a few basic rules that dictate the understanding of how muscles function during function. First of all the functional movement must be identified. Forexample running is different than throwing a baseball and muscles function differently during these movements. Second, muscles function in three planes of motion always. There may be a dominant plane of motion but there are always three sagittal ( front to back), frontal (side to side), and transverse(rotational) planes of motion. Thirdly never forget about gravity and ground reaction forces as these play an integral role in the function of muscles.
Now lets talk specifically about functional muscle function. One of the easiest topics to discuss is walking as most people understand walking is a very important function. Even more specifically lets discuss the function of the hamstrings during walking. Our textbooks have taught us over the years (decades) that the hamstrings flex the knee joint. This is to some extent true because I can stand here right now at my standing work station writing this blog and lift my foot off the ground and begin to flex my knee and feel my hamstring activating. Now thinking about what happens when walking using the basic principles of function I realize that gravity actually flexes my knee. In fact my quadriceps are activated a majority of the time in order to not flex my knee so that I don’t fall onto the ground. I also know that flexion is a sagittal plane of motion movement and even if true there are three more planes of motion to think about. Now I will tell you that the hamstrings do not flex the knee during walking. The functional muscle function of the hamstrings in the sagittal plane is to decelerate or slow down the pelvis and trunk when the foot hits the ground as we take a step. The hamstrings in the frontal plane decelerate the pelvis while it moves laterally as the foot hits the ground. Finally the hamstrings decelerate lower extremity internal rotation when the foot hits the ground and eccentrically create lower extremity external rotation as the body moves over the foot on the ground and heel off begins and we take another step.
Nowhere in that sequence did the hamstrings flex the knee. In fact the hamstrings as they decelerate the pelvis and trunk flexion actually extend the knee in the sagittal plane during walking by building up tension eccentrically. So the question of the day is why do we train our hamstrings to flex the knee?? Think about it. We have seated knee flexion machines, or we have people lay on their backs with their feet on a ball and tell them to flex the knees. This doesn’t make sense. We are training the brain proprioceptively the wrong function of the hamstrings. Proprioceptors are responsible for letting the brain know where the body is in space and what movements are safe and which ones to avoid. Therefore if we train the proprioceptors incorrectly we are setting the person up for injury and poor movement patterns. Lets think about the purpose of our exercises and develop exercises that look like the activity we are trying to get the person to improve.
Just some food for thought today…..
Cheers,
Andrew Gorecki, DPT
Posted in Uncategorized | Comments OffCalcaneal Eversion: The Switch
October 16, 2011One of the best articles I have found describing the importance our feet have on the entire bodies function. I attempted to write this in my own words but sometimes it just makes sense to hear it from the horses mouth. Enjoy this article and feel free to discuss.
Calcaneal Eversion: The Switch That Turns On The Engine
David Tiberio PhD, PT, OCS
GRAVITY, GROUND, and the SWITCH
The internal power sources that drive the body are the hips and trunk: the core of the body. There are many ways to activate that power source, but probably the most important for upright function in our gravitational environment is eversion of the calcaneus.
Calcaneal eversion occurs in the frontal plane. It is one component of the tri-plane motion of pronation of the subtalar joint (STJ). Simultaneous with the eversion, a substantial amount of abduction occurs in the transverse plane at the STJ. The motion in the frontal and transverse planes at the STJ complements the ankle joint motion, which occurs primarily in the sagittal plane, to allow the rearfoot to move in all three planes.
The calcaneal eversion results from the striking the lateral aspect of the heel when we walk. The ground reaction force (GRF) forces the calcaneus to evert. Since the motion is produced by gravity and the GRF (motion given for free), the role of the muscles is to decelerate the motion. In this process, the muscles are lengthened and activated proprioceptively. The strain created in the muscles during the deceleration is transformed into a concentric motion-producing force.
CHAIN REACTION LINKAGE
The calcaneal eversion that creates STJ pronation produces two important reactions in the body: one distal and one proximal. When the subtalar joint is pronated, the bones of the mid-tarsal joint (MTJ) are more mobile. During weightbearing this allows the foot to adapt to uneven surfaces and, more importantly, as the arch lowers certain muscles are lengthened (loaded) in order to become more powerful (e.g. peroneus longus). When the calcaneus begins to invert these processes are reversed in order to create a more stable foot at the time the muscles are “exploding.”
The proximal effects of calcaneal eversion are more significant. Because of the angle of the STJ axis, the frontal plane motion of the calcaneus creates transverse plane motion of the lower leg. The STJ is called a “torque converter” because it converts the frontal plane motion of the foot into transverse plane motion of the leg (and vice versa). This transverse plane motion of the lower leg often transfers to the femur, pelvis, and lumbar vertebrae. Because the STJ is tri-planar and all joints move in three planes, the calcaneal eversion during weightbearing produces tri-planar reactions in the knee, hip, and spinal joints.
During walking, the knee will flex, abduct (valgus), and internally rotate. The hip responding to the calcaneal eversion and ankle motion will flex, adduct, and internally rotate. Since the pelvis is also driven by gravity and GRF, motion will be created in the lumbar spine. Remember that all these motions are “given for free” and muscles must first decelerate these motions prior to creating the opposite motions. It is these motions that turn on the hip and core muscles (both anterior and posterior), all initiated by the calcaneal eversion “switch.”
FUNCTIONAL IMPLICATIONS
Frequently clinicians and trainers evaluate calcaneal eversion to see if the STJ pronation is excessive. A better approach is to apply the “Goldilock’s Assessment” – too much, too little, or about right. Although it is important to be cognizant of the role excessive pronation of the STJ plays in raising tissue stress to a symptomatic level, it is equally important to recognize how the lack of calcaneal eversion can inhibit the normal motion and muscle activation of the entire body. If excessive eversion of the calcaneus is too much of a good thing, then limited eversion is not enough of a good thing. Insufficent calcaneal eversion will inhibit the proximal bone movements. This will minimize the loading of the hip and core muscles. The knee will often exhibit a “varus thrust” and will not be an efficient shock absorber. The ankle will be susceptible to inversion ankle sprains.
All functional assessments should include one or more tests to determine if the client has sufficient eversion available and whether they are using this motion during function. Causes of insufficient calcaneal eversion can be structural or functional. Structural limitations are determined by the amount of eversion when non-weightbearing. Many structural limitations are acquired. Any period of immobilization or protected weightbearing are likely to cause a limitation of calcaneal eversion. This motion must be restored to have a healthy and efficient body.
Functional limitations are present when the joint motion is available, but other structures inhibit the use of that motion. A structural valgus position of the forefoot or a stiff MTJ will block the calcaneal eversion. Limited internal rotation of the hip often dictates to the STJ that calcaneal eversion should not occur. These functional limitations can produce structural changes if they persist over time.
THE PRONATED-NO-AVAILABLE-EVERSION PARADOX
When our clients are standing in a weightbearing position (rather than walking or running) they may demonstrate a lot of calcaneal eversion, but they may not have any additional eversion to load the muscles. For example, a client who wants to be a quicker jumper may stand with the calcaneus everted. This excessive eversion may be caused by a structural varus of the rearfoot or forefoot. If the STJ is at end-range there is no more calcaneal eversion in order to turn on the power sources in the body. The excessively everted calcaneus has insufficient eversion to “load and explode.”
Walking Backwards
September 19, 2011
One of the most beneficial exercises one can perform in the gym is walking backwards on a treadmill. Most of the orthopeadic injuries that we see in physical therapy are caused by repetitive motions that are always done the same way thousands of times a day, like walking forward. In order to address major musculoskeletal dysfunctions or muscle imbalances it is necessary to change the way we move. Walking backwards changes the reactions and demands on the body and creates an environment that stimulates tissue lengthening and muscle imbalance correction. Some common dysfucntions that can be corrected by walking backwards include:
Lower back pain: If a persons lower back pain is caused by an imbalance known as “flat back” syndrome (often caused by tight hamstrings) walking backwards can restore the normal lumbar lordosis(curvature) and reduce stress on discs and other structures in the spine.
Stiff Big Toe: As we age it is common for a stiff big toe to occur which can be very painful . Walking backwards can stimulate the toe to bend more into extension and eventually create more joint mobility.
Prevent Ankle Sprains: There have been many studies that have shown that walking backwards uphill on a 7-10% incline reduces the risk for ankle sprains. This is because the ankle of the treadmill forces our ankles to plantarflex which is the position 90% of ankle sprains occur. In this position our ankles are unstable and by walking backwards it creates an opportunity of instability and our bodies eventually become stronger in that position.
The list could go on forever. For more information on walking backwards and injury prevention or treatment of nagging injuries please contact Andrew Gorecki, DPT at Superior Physical Therapy in Traverse City, MI. 231.944.6541
Posted in Uncategorized | 4 Comments
Walking Backwards
September 13, 2011One of the most beneficial exercises one can perform in the gym is walking backwards on a treadmill. Most of the orthopeadic injuries that we see in physical therapy are caused by repetitive motions that are always done the same way thousands of times a day, like walking forward. In order to address major musculoskeletal dysfunctions or muscle imbalances it is necessary to change the way we move. Walking backwards changes the reactions and demands on the body and creates an environment that stimulates tissue lengthening and muscle imbalance correction. Some common dysfucntions that can be corrected by walking backwards include:
Lower back pain: If a persons lower back pain is caused by an imbalance known as “flat back” syndrome (often caused by tight hamstrings) walking backwards can restore the normal lumbar lordosis(curvature) and reduce stress on discs and other structures in the spine.
Stiff Big Toe: As we age it is common for a stiff big toe to occur which can be very painful . Walking backwards can stimulate the toe to bend more into extension and eventually create more joint mobility.
Prevent Ankle Sprains: There have been many studies that have shown that walking backwards uphill on a 7-10% incline reduces the risk for ankle sprains. This is because the ankle of the treadmill forces our ankles to plantarflex which is the position 90% of ankle sprains occur. In this position our ankles are unstable and by walking backwards it creates an opportunity of instability and our bodies eventually become stronger in that position.
The list could go on forever. For more information on walking backwards and injury prevention or treatment of nagging injuries please contact Andrew Gorecki, DPT at Superior Physical Therapy in Traverse City, MI. 231.944.6541
Posted in Uncategorized | 10 CommentsIt’s all about the Foot
July 28, 2011Often overlooked in rehabilitating from injuries or preventing injuries is the foot and its mechanics and the effects on the entire body as a kinetic chain. When the foot hits the ground it is designed to collapse, lets call this pronation. Pronation is the bodies natural shock absorber. Often pronation gets a bad reputation because everybody has a unique arch type and some people who are overpronaters can suffer from many injuries. However pronation is an important and necessary motion and just the right amount is the key. Lets talk a bit about how pronation effects the entire body.
When the foot hits the ground it should pronate and in turn pronation causes the arch to collapse which then drives the entire leg into internal rotation. This internal rotation is the key to unlock muscle activation all the way up to the hip. This muscle activation is designed to control the internal rotation and thus absorb the forces of the body slamming into the ground (3-5 times body weight). Without pronation force transmission is increased throughout the entire body including the spine. On one hand with to much pronation the internal rotation is increased in the lower leg and muscles can become overused or overstress and inflammed and with to little pronation muscles in the lower leg can become tight and short thus creating problems in other areas of the body mainly the lower back and shoulder.
The point here is when a patient walks into the door with lower back pain, hip pain, knee pain, even shoulder pain it is always beneficial to look at what is going on in their feet. I always say its the chicken or the egg debate when it comes to the foot dysfunctions and other regions of the body being dysfunctional. It’s more times that not a foot problem.
Andrew Gorecki, DPT
For more information regarding foot dysfunctions please contact us @ 231.944.6541
Posted in Uncategorized | 2 Comments
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