Week 23 Cervical & Thoracic Spine with Glutes and fascia

This week have have truely been introduced to the Cervical spine along with type 1 and type 2 coupling of the Thoracic spine. The cervical spine can cause issues through the rest of the body, or be the region of pain from the rest of the body. It has unique characteristics in the upper Cervical spine compared to the lower Cervical spine. When we assess Cervical motion we want to be aware of type 1 and type 2 motion as well as troubling or triplane motion.

We want to know if the driver to the Cervical spine is a bottom up or a top down driver and incorporate the combinations of troupling with the driver direction. Sometimes it can be both a bottom up and top down driver. The eyes often have to keep the head in a horizontal direction. This means movement is often a bottom up driver.

The Thoracic spine has Type 1 and Type 2 motion. We can drive movement into the Thoracic spine via the position of the feet and movement of the hands. Again we want to use troupling when creating matrix patterns.

The Cervical spine and Thoracic spine do not move in isolation. They move with the rest of the body. The feet, hips, pelvis and shoulder girdles are all important areas to consider in treatment.

A note is the fascial system contains several proprioceptors and by creating postures and movement which is as authentic as possible, the body is mobilised and strengthened authentically.

The muscle group we discussed this week were the Glutes. These powerhouse muscles are loaded and exploded with specific movements of the pelvis and hips. They are recruited immediately on foot strike through the ITB and will be econcentrically powered via internal rotation of the hip in the front and back leg of gait. These muscles will influence up and down the chain.

Training the glutes in positions where gravity is eliminated will not train them functionally. Remember to train them in all three planes. They can decrease and increase the load to the quadriceps when the body is moved in specific directions.

The programme is shifting up to the shoulder girdle and neck prior to GG2. The information is coming together and completing these areas of the body will create a more authentic treatment approach.

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WEEK 21 & 22 Quadriceps, lumbar spine and thoracic spine

These last two weeks have been building up to Chain Reaction Biomechanics of the Lumbar and Thoracic spine. The Lumbar spine is the cross roads of the body. It reacts to what is happening in other joints of the body. The two key joints to assess with Lumbar spine pain are the hips and Thoracic spine. If the hips and Thoracic spine have good motion then the feet and the Cervical spine might be influencing their motion respectively.

When considering Chain Reaction Biomechanics of the Lumbar and Thoracic spine, look at the top down and bottom up drivers. When I am tring to influence these spinal areas, I can choose a multitutde of ways to create top down and bottom up triplane driver motion.

In the Thoracic spine we can look at in sync and out of sync motion. In sync motion means the pelvis and the shoulder move in the same direction e.g. a tennis forehand, a golf swing, a baseball batter. Out of sync means the pelvis and shoulders moving in opposite directions. When I am testing and treating the Tx, I want to choose the appropriate insyn or out of sync motion, based on the TZ I am assessing. If the TZ is insync then I can use foot and hand drivers to replicate this motion.

The Quadriceps is a a group of muscles designed to lengthen with triplane decelerating motion at the knee. This requires the physioological motion of flexion, internal rotation and abduction at the knee. It does little to help with extension of the knee in gait. This is done mainly by the soleus, Tib. Post. and P.  Longus slowing down the Tibia and the mass and momentum of the body coming over the tibia to extend the knee. Remember the factors creating the forward momentum will be the Glutes and hamstrings and the swing of the opposite leg. In fact remember all the muscles work together and we cannot fully seperate their function.

We also looked at tweaking using Triagulation variables. This means changing the Angle, Verticality or Horizontal components of triangulation together or seperately. I noticed I could get different responses in the body when I changed these components in different orders e.g. A,V,H or V,H,A or H,V,A This is a useful tool to find what is most successful for a client and where to start my rehabilitation.\

We are now building to GG2. I am looking forward putting all this information into use and learning more from the Gray Institute

 

 

WEEK 19 Iliopsoas, on the ground training and tweaking for success

This week was full of new information and concepts. We had been trained as therapists to “train the way you play” i.e. if you perform in an upright position, you should train in an upright position. The Gray Institute has looked closer at on the ground training, and thinks we are missing a key to using  the bodies natural developmental stages, in the first year of life, to assist in upright function.

We can look at the Transformation Zone of  upright function and decide what would assist with on the ground function. We can use  a variety of start positions such as prone, supine, side ly, and kneeling, with manipulations of these positions. Then use drivers of the head, trunk, hands, pelvis, and feet to move the body for greater mostablity.

The muscle discussed this week was the Iliopsoas. It is the muscle called on in emergencies and is responsible for swinging the leg and body through from toe off to heel strike in gait. It has connection to the transverse processes of L1-L5 and vetebral bodies of T12-L4. This muscle is loaded significanlty with transverse plane motion (internal hip rotation), but also extension, Abduction (Psoas muscle) and Adduction (Iliacus muscle) of the hip. Even if the hip is flexed it’s transverse and fontal plane loading has an important part to play in function.

At the spinal level, rotation of the spine can load the Iliopsoas, depending where the spine is relative to neutral. In the front leg of gait it is unclear of the Iliopsoas decelerates lumbar rotation or rotates it in the same direction as the pelvis. The iliopsoas will decelerate contralateral Lumbar lateral flexion.

Remember AFS is.. encourage transformation in others through the creation of personalised environments, using drivers, to create normal chain reaction through the body. If we can choose the correct drivers to load the Iliopsoas, we can create the explosive power we need it to produce for function.

Finally we looked more at tweaking the body for success. If we can choose the degree of tweaks (subtle to dramatic) which encourage the desired change reaction in the body, we can become more effective at attaining success. We looked at using bilateral symmetrical and assymetrical hand drivers, and then whether to use them in an alternating fashion. We looked at the power of the pelvis as a driver and how this is often the key driver in function.

We are starting to learn more about the spine and the muscles influencing the spine. I look forward to enhancing my knowledge of chain reaction biomechanics through spine and then the shoulder girdle.

Week 18 Thoracic spine

This week we started assessment of the spine, in particular, the Thoracic spine. The Thoracic spine is an area of the body which can create problems in many other areas, such as the Low back, Cervical spine, Shoulders, Knees, Hips and Feet. The abdominal muscles require full 3D motion of the Thoracic spine if they are to be loaded to explode. The power transfer from the movements of the pelvis and hips are will maximised through full Thoracic spine motion.

The Thoracic spine can create pain in other areas of the body, but not have pain itself or have less pain. The Lumbar Spine acts as a force transmitter, passing forces between the upper and lower halves of the body. If there is low back pain, the Thoracic Spine must be assessed. 

The Thoracic spine is a region of mobility in all three planes. Some planes will have more movement depending on the level of the Thoracic spine. The rib cage makes it a stable region and the rib articulations must be assessed.

I can see the Thoracic spine assessment and treatment will use top- down and bottom- up drivers and is best done in gravity influenced positions.

Week 18 also looked at the value of tweaking the environment on the Chain Reaction. It was interesting to see how increasing the pronation of a foot (not to end range) can create greater load to the lower limb muscles and therefore be a valuable tweak in exercise progression. We also looked at diagonal lunges and how the foot position can be altered to change the load through the chain reaction.

This week was an introduction to work on the Spine. It will be great to see how we connect the shoulders to the spine and use 3D motion to rehabilitate the shoulders.

Week 17 Popliteus, forefoot running and tweakables, hip retroversion and anteversion and Achilles Tendonopathy

This week had a large number of webcasts covering a multitude of topics. The key muscle introduced was the Popliteus muscle. This is an upside down muscle. It’s tendon runs up towards the head, whilst most run towards the toes. This orientation makes it an ideal controller of external rotation of the knee. It will also control adduction and extension. 

Gary Gray introduced the Chain Reaction Biomechanics of the foot in forefoot running. In calcaneal inversion the forefoot will be able to invert. Inversion of the forefoot will allow pronation to occur and normal tibial internal rotation and back butt muscle activation. The foot is magnificent in its creation and ability to shock absorb when required, and be a rigid lever for propulsion at other times.  

The course is slowly expanding into diagnosis and using small tweaks to lengthen or load muscles or make them work harder by reducing their loading. Tweaks are done in small increments. This is the real skill of a clinician. Use the right tweaks to find a clients threshold of function, find what is successful and build on that success.

If we were to test the entire body to come up with a cause and diagnosis for pain, it could be very time consuming. The Gray Institute highlighted the probable suspects for Achillies Tendinopathy to speed up this process. These were reduced ankle Dorsiflexion, Thoracic spine restriction, Cervical spine restriction, and reduced Load to Explode of the opposite leg. The primary aim is to make sure all leg muscles, especially the Glutes, are working to take load off the Achilles Tendon. This requires normal Chain Reaction Biomechanics of the Cervical spine down to the big toe.

Finally we looked at hip retroversion and antiversion. When we assess hip Range of Motion from anatomical neutral position we will see a reduction in ROM in one direction and an increase in ROM in the opposite direction of Rotation. In reality, if the hip joint is started from the mid position of the retroverted or anteverted hip, there is a normal amount of hip ROM. The start position of testing is key to seeing this in clinic. This is a structural issue and rehabilitation will need to work around this issue.

 

Week 16: Pelvis and Beginning to tweak

The content this week reinforced the movements of the pelvis on the same axis. The pelvis moves on the same axis and same plane. They create contribute to the load and explode in the Gluteal muscles in gait.  These movements can be palpated  and influenced using FMR. The use of translation and rotation in motion of the pelvis is important to assess in function.

A new series on Tweaking was introduced in the webcasts. This week teaching focussed on subtle, moderate and dramatic tweaks. This information accompanies the Process Flowchart. The degree of tweak can be altered in the TZ, Goal, movement variables, influence variables and complement drivers. This series runs for 10 weeks and leads in Gift Gathering 2 in July.\

Each week there are two webcasts by past GIFT graduates. The topic is the graduates own choice. Usually the  topic is one which inspires the graduate. This week there was an incredible presentation on using GIFT to transform the health of children. In Canada 1 in 3 children has diabetes. The skills we are learning at GIFT can be used educate and teach young children to move again. To have fun and to experience the GIFT of movement. There is resistence to change in Society, but the need for movement based therapy, cannot be highlighted enough by the state of health in our children today. There is a calling to all GIFT graduates to contribute to community, and use the knowledge gained from the course, to reverse this downward spiral of health our children.

It has been a powerful message this week in the webcasts. I am excited about using the Process Flowchart and mastering Tweakology in the next 10 weeks.

Week 15 Don’t forget the adductors

This week was the week of the adductors. What do the adductors actually do? they are massively important in function. They will function commonly with the opposite abductors and will work bilaterally. If they become short and limit movement, they will inhibit adjacent muscle function.

The adductors are will work ecconcentrically in TZ1 and TZ2. They will be influenced in all three planes of motion of the hip. They will require adequte length to create normal Chain Reaction Biomechanics (CRB) for gait.

The adductors can be the forgotten area of the legs, but they have a significant role in all planes of motion and hence function.

Week 15 introduced the translation and rotation of the pelvis with gait. We looked at what happens in all three planes. There was a difference with translation and rotation when in the same plane or along the same axis. These motions are contributing to the ability of the body to load and then explode in gait. Next week these concepts will be explained further.

GIFT is about creating empowering environments for transformation, through the use of drivers, to create desired CRB. Lets change pain into comfort, fear into confidence and guilt into compassion.

Week 16 next week and looking forward to it.