Reviewing Our Basic Anatomy
Therefore as we get older it is very important to continue to exercise simply because you will gain longevity. For more information on “how to start an exercise program” contact +Heather Gansel
The latest trend in the health and fitness industry is core stabilization. Even though core stabilization exercises have been used in martial arts, tai chi, yoga and Pilates for many years, core stabilization is now being seen in a new light because of its connection with low back pain.
So what is core stabilization? Core stabilization is creating an awareness of our body’s movement through space by controlling the muscle action through strengthening an individual’s center of gravity. Our core extends from under the breast bone down to the pubic bone and focuses around the lumber spine (low back), pelvis and hip joints. So what is the purpose of core stabilization? The primary purpose of practicing core stabilization exercises is to elicit more muscular control over the outside forces acting on the body. If you think about different sporting events like boxing and karate or exercises like squats and lat pull downs or forms of mediation like yoga and tai chi, all require a person to have core strength because without inner strength they become fatigued faster, imbalanced and their overall performance would decrease.
In a recent research study at the University of North Carolina, a study was performed on six female college gymnasts to see which muscle groups would elicit a stronger core when performing certain core exercises. The study concluded that it is not one single exercise that can strengthen your core but a combination of exercises. In another study done in Denver Colorado, physiotherapists looked at EMG evidence of abdominal muscle activity during pelvic floor contraction. The study concluded with all pelvic floor activities there is abdominal muscle activity but the greatest contractions were found among the deep muscles of the abdominal cavity (transverses abdominis and internal oblique abdominis) not the superficial abdominal muscles (rectus abdominis and external oblique abdominis). Also Barbara Headley, MS PT studied people with chronic low back pain and the theory on core stabilization. Headley found that people with chronic low back pain can benefit from a core stabilization program and significantly reduce their back pain symptoms. Proving what we already know about the correlation between core stabilization and low back pain, that it is a combination of the deep abdominal muscles, the hip flexors and the deep back muscles that make our core strong not the superficial muscles of our abdomen.
So if we already know that approximately 70 to 90 percent of our population suffers from low back pain or has suffered from multiple episodes of low back pain. And we also know that most health and fitness professionals will focus on isolating structures in the low back during the treatment of low back pain then inner strength is the next step to a healthier back.
Since recent research has shown us that it does not matter if you are a conditioned athlete or someone who routinely exercises or even if you do not exercise at all, if you do not have core strength and stability then the chances of you becoming injured will increase.
So ask your local chiropractor, personal trainer, yoga instructor, Pilate’s instructor, or fitness specialist about how you can strengthen your core.
The season is approaching where we begin to experience all types of pain from the holiday season. Whether it’s from the stress of shopping for loves, being over worked just for that holiday bonus or from shoveling the snow, we all experience some form of joint pain. During the winter months the most common type of pain is back pain and especially after last year’s snow fall I am sure most of you out there understand exactly what I am saying. We have to remember that during these winter months we must take care of our backs in order to prevent further injury to our body.
Listed below are several ways to maintain a healthy back during the crazy holiday season.
Take time to stretch. Stress is more or less carried in our backs. For some it lingers in our low backs and for others it rests in between the shoulder blades. A simply stretch can help reduce the amount of tension in these areas. A nice stretch that is easy to perform is to lie on the floor on your back and let your arms reach over your head as your legs stretch out in the opposite direction. As you do this take a few deep breaths to enhance the feel.
Lift Properly. No matter if we are shoveling snow or bringing up the Christmas/Chanukah decorations from the basement we need to remember to lift properly. Remember to bend with the knees not the back. Even when we are shoveling away all the heavy snow that has fallen bending with your knees will make all the difference come later that day.
Exercise. Exercise is an important tool that we can use to maintain a healthy back. The most important types of back exercises are ones that are going to encourage core strength and spinal stability. Simply exercises like pelvic tilts are a perfect example of back exercise. There are many more back exercises that can be mentioned here but ask your trainer about some of these other back exercises so you can maintain a healthy back.
Seek Chiropractic Care. If your back is troubling you during the holiday season from all the stress and preparation that goes on then do not want for the symptoms to simply go away seek chiropractic attention before the symptoms get worse. If you do happen get back symptoms during the holiday remember this simple fact: always use ice and if you are going to use heat always end in ice for the last five minutes.
If you have further questions about how you can maintain a healthy back as these winter months approach please feel free to ask Dr. Heather K. Gansel. ∞
We know from our studies in general anatomy that every muscle and visceral organ is innervated by our nervous system. Our nervous system is divided into two systems the somatic and autonomic. We are more familiar with the autonomic system because it is subdivided into the parasympathetic and sympathetic. The autonomic system is what creates the flight or fight response in our bodies. The parasympathetic and sympathetic systems are more complex systems to understand because the nerve signal is not sent directly to the organ, gland or artery/vein first. The signal goes through a ray of pathways until the signal is finally delivered to its desired destination. The somatic system is less complex because the nerve signal is sent straight from the axon to the muscle. (Figure 1.11) In the health and fitness profession we are more concerned with the somatic system because our lively hood is based on shaping and retraining muscles.
Now if we understand the basics of the nervous system then understanding neural firing can be very easy. We need to look at neural firing as the neuron that sends signals through our nerves out to the muscles or viscera. The neuron is like a messenger. The neuron carries the message being sent from the muscle/viscera to the brain via the spinal cord back down to the muscle/viscera. So if there is a muscle spasm or an organ is diseased than the neuron can not fire as quickly or may not fire at all. For an example, multiple sclerosis patients have lost their ability to fire neurons effectively because of a decrease in the number of ACH (acetylcholine) being produced at the neuromuscular junction. This is a more complex example but demonstrates the concept of neural firing very well. We will now look at how this applies to functional movement which is our main concern.
To begin we need to understand a few concepts about how our nervous system helps control functional movement patterns. The central nervous system is the command center that controls and regulates all movement patterns. Say we wanted to pick up a pencil on our desk, before the action can be preformed a signal is sent to our brain which tells the brain to conduct an action and then the signal is sent back down via the spinal cord to the muscles before the pencil is even picked up. The central nervous system directs preprogrammed patterns of movement that can be modified to react appropriately to gravity, ground reaction forces, and momentum. This concept is extremely important when we look at designing a training, reconditioning or rehabilitation program. With core stabilization we will be able to retrain muscle groups to fire correctly when doing functional exercises or activities. When a muscle becomes injured other muscle groups will protect that particular injured muscle while it heals but at the same time the other muscle groups adapt in order to perform regular movements. For example, research has demonstrated that the transverse abdominus (a major intrinsic stabilizer of the lumbar spine) has shown decreased neural firing in individuals complaining of low back pain. Therefore these individuals will have relied on the psoas, erector spinae and the superficial abdominal muscles to provide stability to the lumbo-pelvic-hip complex. And what we see in individuals with low back pain is poor posture, inadequate stabilization and decreased neuromuscular efficiency as a result of decreased core strength.
Before I had mentioned that we would look at ways to test certain muscle groups in order to see if they were weak or strong. This correlates with neural firing and the lumbo-pelvic-hip complex which is the main focus surrounding core stabilization. These are very basic ways to test our clients or patients muscles and how we can send a proprioceptive signal into the muscle belly to make the muscle fire again.
A proprioceptive signal is where we can send a stimulus into the muscle in order to wake it up again. The proprioceptive signal is sent into the golgi tendon organ of the muscle which tells the muscle to either contract or relax.
Take the gluteus maximus and medius muscles. Both muscles cause extension of the hip. To test the gluteal muscles have your client or patient stand so that they are facing forward. Then stand behind the client or patient. Have your client or patient stand next to a wall or chair encase they need something for balance. Ask them to raise one leg to 90 degrees with the knee bent and then repeat to the other side. When the leg is brought up to 90 degrees we are looking to see if the opposite gluteal muscles dip down. This simple test indicates a problem or a weakness with the gluteus medius muscle. Since we might not choose to do this test on everyone we could look at it from another stand point. Say you have a client or patient who complains of a muscle spasm when doing hip extension exercises on a therapeutic ball or on a machine, our first instinct is to stop and stretch the muscle. But what if we sent a proprioceptive signal to the muscle instead of stretching the muscle? What we are able to do is retrain the muscle and get the muscle firing again hence decreasing the spasm. Now this is not going to be a pain-free movement for your client or patient so please address that first. Next go ahead and have your client or patient lie on the uninvolved side with their backside facing you. Have your client or patient lie on a mat on the floor and not a bench to ensure safety. Next place your thumb right on the ischial tubersoity (also known as your butt bone) and ask your client if that causes the same discomfort. Next ask your client or patient to perform hip extension while you maintain your contact and resist them from performing extension. Hold for about five seconds then have them relax and repeat five times. Since the area will be inflamed and sore for about 24 to 48 hours have your client or patient ice at home for about twenty minutes and have them do this three times before going to bed for the evening. The next time your client or patient performs any action that requires hip extension the gluteus maximus and medius will fire before any other muscle fires which is what we want to happen.
Another test we can look at stems from the psoas and quadratus lumborum muscles. We already know that the two muscles aid in core stabilization and their primary muscle action is hip flexion. For this test you would want to ulitize a bench since you will be adding a stretch into the test. Have your client or patient lie on their back while you stand to the side of the bench. If your client or patient feels unsteady on the bench have them grasp the bench for additional support. But this may be difficult because the test requires them to use their hands. Ask the client or patient to bring one knee into their chest and hold have them hold it there with their hands for about five seconds and then have them relax. What you are looking for is to see if the knee bends or comes up toward the ceiling of the straight leg. If this happens it indicates that they have a tight psoas or quadratus lumborum on the straight leg side. Repeat this to the opposite side. You can add to this test by taking the straight leg off to the side of the bench keeping the rest of the body on the bench and put one hand over our client’s or patient’s hands while your other hand is placed on their thigh just above the knee. Next push gently on your client’s or patient’s hands while you also push the other leg towards the floor. Once they feel a stretch hold for five seconds. Then continue to maintain the exact position as you continue to push the leg to the floor. Hold again for five seconds once they feel the stretch and then go into one more stretch from there. You do this three times and every time you never release the stretch until the third stretch is completed. What you are doing is sending a signal into the muscle by stretching instead of applying a physical contact to the area. Again, since you might not choose to do this test with everyone of your client’s or patient’s you might notice that they have a tight psoas or quadratus when they have difficulty bringing their knee to their chest or when they try to bring both knees to their chest during stretching. This test also works as a great stretch for these two muscles since they lie deep in the abdomen and you can not physically contact the muscle belly.
One other test we can look at is when we have a client or patient complain of knee pain on the lateral side (outside part of the knee). Now the muscle most likely to be effected here is the iliotibial band. This muscle has no main connection with our core but if we look at the effect it has when it becomes too tight the connection becomes clear. If we put our hands at our sides and run them up to where we feel our hips then we have just illustrated where the iliotibial band is located. The iliotibial band is a thin muscle that starts up by the hip and runs down to the fibula. We usually see tight iliotibial bands in runners. Now if our iliotibial band is tight or in spasm then it directly effects the movement surrounding the hip, the pelvis and right up into our low backs. You can test the iliotibial band by having the client or patient side lying on a bench with you standing behind them for support. Have them lie on the uninvolved side. Next ask your client or patient to abduct their leg and extend the leg behind them. What you are looking for is the leg to stop or cause discomfort to the client or patient when performing this movement. Once they can not go any further, place one hand on their pelvis and the other on their thigh just above the knee. Then bring them into a stretch and hold once the stretch is felt for five seconds. Again you are going to maintain that position as you bring them further and further into a stretch. Repeat this three times before you have the client or patient completely relax. If you choose not to do it this way, you can also have your client or patient lie on their side on the floor. Again have them lie so the involved side is up and so their pelvis is perpendicular to the floor. Place both of your thumbs over their hip joint and apply some pressure. Remember you never want to cause any harm to our client or patient when doing any of these techniques. While you maintain your contact ask your client or patient to bring their knee to their nose and then have them fully extend from that position. This is going to be uncomfortable. Perform this exercise slowly and repeat five times. With this technique you are able to send a signal into the muscle telling the muscle to relax and stretch.
What I have illustrated here is three techniques that you can use to send a proprioceptive signal into the injured muscle. Even though they are simple techniques they are very useful with most of our clients and patients when it comes to retraining the injured muscle.
For more information or questions concerning this topic contact +Heather Gansel.
Companies lose billions of dollars every year, because their employees stay home with such ailments as headaches, backaches, eyestrain, sore feet and arm and wrist pain from repetitive motion. That is why ergonomics, or the science of designing the job, equipment, and workplace to fit the worker, is so important. In an ergonomically correct environment, employees are much more productive and positive about their work.
An ergonomics specialist designs and enhances the workstation, tools, equipment, and procedures to minimize fatigue discomfort and injuries, at the same time as effectively obtaining company goals. Ergonomics is also used to reduce errors, wasted motions, repairs, and materials damage. The National Institute of Occupational Safety and Health defines ergonomics as “the discipline that strives to develop and assemble information on people’s capacities and capabilities for use in designing jobs, products, workplaces and equipment.”
Ergonomics is founded on the science of the relationship of human physiology and pathology to work. Healthcare providers already have the understanding of and training in human physiology and the mechanisms of injury necessary to diminish the incidence and severity of workplace dangers. This knowledge and expertise can also be used to maximize work output of all workers, healthy and injured.
The Occupational Safety and Health Administration reports that annual workplace injuries, illnesses and deaths cost organizations $170 billion per year. Payment for accidents include direct costs to the employees and healthcare professionals and indirect costs for reduced productivity and manufacturing quality, additional training, and greater legal and insurance fees and premiums. In 2001, injuries from excessive carrying, holding, lifting, pushing, and pulling led to nearly $10 billion in direct costs and repetitive motion injuries added up to over $2 billion in direct costs. The indirect costs from these ergonomic injuries accounted for $39 billion.
There is documented a connection between workplace safety and an organization’s output and profits. Insurance claims increase and profits decline when workplace injuries mount. Enhanced safety and ergonomics can decrease injuries and improve bottom line profits. Research indicates that a good health and safety program can save $4 to $6 for every $1 invested due to greatly lowered workers’ compensation and medical costs, reduced absenteeism, turnover, and training costs, and higher productivity and employee morale.
The ergonomic changes must address risk factors, such as repetition and awkward posture, associated with individual work tasks. Some of the guidelines for office work modifications are: Designing tools and equipment to encourage workers to maintain a proper body position; choosing tools and equipment to lower muscle exertion and direct tissue pressure; reducing repetitive arm motions, long reaches and twisting motions; building working surfaces at the correct height; allowing working surfaces to be tilt adjustable; adjusting furniture to lower body strain from awkward posture; incorporating task lighting without glare and shadows; and using wrist and/or arm supports.
Following proper ergonomics greatly helps improve employee safety and, as a result, lowers the number of days of sick leave. Quality is greatly enhanced by cutting down or eliminating the workers’ handling of components or materials during assembly or manufacture. Profitability is increased by boosting productivity.
For more information on proper ergonomics or to have an ergonomic evaluation contact +Heather K. Gansel, DC ofHead-To-Toe Chiropractic.