Monday, December 15, 2008

Rotation, part 1

It's amazing how people could read the same books & come to different conclusions. A lot of this anti-rotation stuff is extrapolated from Shirley Sahrmann's & Porterfield/DeRosa's work. I have much respect for these researchers/practitioners. In fact, P&D were pioneers in the role of fascia in the kinetic link principal.


OK, the reasoning goes something like this: The average range of motion of any one lumbar functional spinal unit is around 10 degrees flexion and 5 degrees extension, 5 degrees lateral bending and around 3 degrees rotation. Total rotation is approx. 13 degrees more or less. True Dat, as the kids say.


The T-spine, having 12 segments as opposed to 5, theoretically has a lot more rotation, approx. 35 degrees total. Word up on that too.


So, based on these anatomical configurations, exercises that are designed to ask more than 13 degrees from the lumbar spine bad. Isolating rotation in the T-spine good. Get it?


Well, that's an over simplification. Pure motion in any one cardinal plane doesn't really exist in the spine. Motions are coupled, or even troupled depending on how you look at it. If motion is not available in one plane, the spine will borrow it from another. Osteopaths, chiropractors, and P.T.'s use this concept all the time when they do their manipulations. No damage is done. In fact, these rotary manipulations that gap the facets have been proven clinically efficacious in reducing pain & muscle spasm after an injury.


A good illustration is a test John Perry, PT did at GAIN '08. He did a ROM test on Vern's feet by using upper extremity drivers! When Vern did a right trunk rotation for instance, his left foot pronated & his right foot supinated. He didn't ask Vern to do that-chain reaction biomechanics did it subconsciously. Once ROM was used up in the shoulders, the body transferred it to the ribs, T-spine, lumbar spine, hips, knees, then finally foot & ankle.


If this phenomenon does not take place, go be a detective Columbo & find out why. A particular segment could be mechanically stuck or out of sequence. Or, remember muscles are highly adaptable. They can be trained to do just about anything. Like the "proper form" enthusiasts who micro manage movement and inhibit this chain reaction.

Now, lets get to the exercises they say are absolutely contraindicated-certified back wreckers. Scorpians, seated trunk rotations et al. The proponents claim, "significant decrease in the complaints of low back pain since eliminating these exercises".

Jeez, how often were they doing these exercises? Why were they a staple of their repertoire to the point that they were causing back ache? The only application I can see to the scorpion or lying trunk rotations is maybe a wrestler. I'm not a big fan of the contraindicated exercises either, but not for the reasons they give. I'm not done yet. Stay tuned for part 2. Your input please, pro or con.

5 comments:

JH said...

Joe,
As prevelent as tis idea is in the general rehab / fitness sector, it is even more prevelent in the industrial setting!! Battling this notion that ratoation is bad period without context gets spread by those who hear about it but don't bother to see where the rumor started to begin with. However do not fret, we ATCs here in the industrial setting are doing our part to defeat the evil rumor.

Keep preachin' it brother!!

Kev said...

Can't imagine not using some rotational exercises when rehabbing a back or neck.

Brian said...

Though controversial, Freyette's Law's probably give us some idea how the spine uses combined movements proximal and distal in order to perform a gross motion. The NM control system of the spine is vastly sensitive to rotational movements. Not news here but these structures must be constantly stimulated in a FUNCTIONAL manner in order to provide stability in the transverse plane. Transverse plane motion occurs with walking, rolling out of bed, reaching to put the car seat belt on...! The motion has to be trained....

Joe Przytula said...

Correct Brian- Freyette's concept of type 1 & 2 motions may be disputed, but the concept of coupled motions in the spine HAVE been quantified in the literature.

Dan Hubbard, M.Ed., CSCS. said...

Thanks for the good post. I am looking forward to more.