Reactive Core-Theory 101

I spent quite a bit of time at GAIN 09 examining the currently accepted model of core stability. ALL of the big core guys use it. It appears in Andry Vleeming's books from the late 90s.

It is the "pirate ship" concept. That is, a ship mast (spine) with a skull on top (head), with 2 sets of guy wires attached. An "inner unit" (multifidus, TA, Ext. Oblique et al), and an "outer unit" (erector spinae, rectus ab. et al). The inner unit providing inter segmental stability, with the outer unit in control of column movement in general.

My question was, what would happen if you took this model and tossed it in the air (gymnastics, platform diving etc)?...or tossed it in a swimming pool upside down or on it's side (swimming)? Is not core stability required in these environments?

I believe the problem is spine stability is interchangeably used with core stability. That's where we get the concept of the core as a "rigid pillar". Core strength expressed as "stiffness", connotating something isometric in nature. It's very rare someone injures their spine lying down, so this makes sense.

But when we think of core, we're not only thinking the external's influence on the internal, we are also thinking vise versa. That is, the role of the core in ACL prevention, or hustling up off the ground after a fall. I've seen McGill's bracing exercises used in ACL prevention programs. Is this the proper application of a bracing exercise?

Juan & other physios & A.T.'s that treat backs, I would really enjoy your input on this. Did Vleeming intend this to be a core stability model?

Getting back to work

Spent the weekend chill-axing in my backyard barbequing & swimming. I ended it with a half hour trip down to the Jersey shore to hang out with our buddy Lou Argondizza- EHS JV soccer coach & part time bartender at Sunsets, a restaurant in Point Pleasant.

http://www.sunsetsnj.com/

The following link from THE ONION is a great satire of what goes on at the Jersey shore in the summer, and is not too far from the truth. BadaBing indeed.

http://www.theonion.com/content/news/massive_tag_body_spray_slick

Well, I'm refreshed from the long school year & ready to get the blog rolling again.

This is more like it

It's fresh in my mind because Kelvin Giles spoke at GAIN 09. OK, I know Gray Cook's FMS is the most popular one. It just isn't my favorite:

www.movementdynamics.com

Great Experience

Just returned from GAIN '09 with my head swimming full of new ideas. My contribution was "reactive core". My goal was to scientifically challenge traditionally accepted models of core stability & simplify core training. I will clarify this in a series of upcoming posts.

I also led a heavily Mabel Todd ("the thinking body") influenced Smorgy workout; & finally applied reactive core to thrower/swimmer rehab.

I don't think Vern planned it that way (or maybe he did...), but all the presentations seemed to mesh into one another & build upon one another. Biomechanics professor Dan Cipriani started us off with his functional anatomy lecture, leading into John Perry's "propriability" lecture & workout. By the time it got to me I was worried there wasn't going to be anything to talk about!

I picked up some great shoulder rehab tips from Steve Myrland, LE tidbits from Bill Knowles. Jack Blatherwick got our BS detectors fine tuned regarding research interpretation. Ed Ryan updated us on some cool new products for edema reduction. Jim Radcliffe, strength coach at Oregon, is in a class all by himself.

It was great to see Kevin Moody again; I haven't seen him since my days at the Lake Placid OTC 12 years ago! I finally got to meet Tracy Fober, the Iron Maven herself. Oh yeah- she has this incredible secret she cannot share with anyone!

There is a LOT more, I will get to it in coming posts.

Phew!

Exhausted, & exhilarated at the same time. It's 5am, I'm brushing up on my last lecture for GAIN '09, which begins at 7:30am.

p.s.- the Aussies are incredible. They are dedicated, passionate, & are driven by sound research & methodology. They could make a big difference in American football, I'm certain.

GAIN '09

I'm really getting psyched- this time next week I'll be down in Fla knee deep in function with G-Unit. No, not the 50-cent one; but Vern & his crew.

I'll be leading the group in a smorgy workout, then giving a long talk on core training. Preparing for this has been an interesting experience. In attendance will be Dr. Dan Cipriani, biomechanics professor at San Diego State. He is the acid test as to whether I'm track or not. But I've really done my homework and certain I'm solid ground. I'll be looking forward to sharing my ideas with my blog readers in the coming weeks to get your input.

I finish at the end of the week with injury prevention concepts for the throwing athlete. Wish me luck.

Kevin Moody's Flexibility Question

Kev asked for a good substitute test for the standard sit & reach test.

I like Steve Myrland's smart-test.

It is described on the web site, but there is also a hand out you can get if you call or email them.

http://beaconathletics.com/store/products/Smart_Hurdle_Smart_Tests-502-28.html

However, remember it's all about mostibility- the ability to take advantage of just the right motion, at just the right time, at just the right speed, in just the right plane in just the right direction, not flexibility.

For rehab documentation of functional ROM, I use Gary Gray's 3D testing pole.

?

"The Use of Occlusion Training to Produce Muscle Hypertrophy"-Strength & Conditioning Journal June '09

you tie a giant rubber band around your leg & do leg extensions.

page 81- "patients who are injured, specifically ACL injuries, have been shown to benefit from an occlusive stimulus".

page 82- "even recommended for astronauts!"

A. The S&C Journal is running out of things to write about.

B. These guys pulled off a great practical joke.

C. Like many orthopedic surgeons I have worked with, their's are also hell bent on quad hypertrophy and, well, it's the end of the school year, and these poor guys just lost it.

Juan Ruiz- Tagle asked a couple good questions I thought deserved a post:

1. In a team of a very competitive athlete, what percentage of those athlete would you expect that would get permanent injuries (labral tears, meniscus tears, rotator cuff tears, spinal dysfunctions, etc.) and in your opinion what is acceptable part of the sports and what is just poor coaching?

*In 27 years of baseball I've never had a labral tear (shoulder) or a rotator cuff tear. Maybe 5 ACL constructions from soccer/football in that time frame. About the same for meniscus tears. However, probably hundreds of aching backs. None serious, all got better with some rest, massage, rehab etc.

I'm sure that is way below the norm for a high school program as huge as ours. I can only take a small part of the credit for that. I have been privileged to work with some great coaches.

I'm not sure Juan what is avoidable & what isn't. I do know that many take certain injuries for granted, that are definitely preventable. "Shin splints" are preventable. (most) Hypermobile shoulders in swimmers & throwers are preventable. (most) non contact ACL tares. (most) hamstring strains. Athletic hernias.

Hip labrum tares? That is a matter of opinion, I say probably.

2. Do you stop the athlete from playing for a while and rehabilitate or do you rehabilitate without taking time off ?

*it depends. But, if there is any possible way I can keep an athlete in competition, I'll do it. In the inner city, there is the risk of an athlete with an injury "disappearing" from you & the team. It is not physically, nor psychologically good for the athlete to be separated from his team. If I can reasonably tape, brace, or softcast something, I'll do it. Ultimately, it depends on what they look like functionally by way of objective testing. I think that is one of the things that separates athletic training from physical therapy.

Bueno topic Juan- I'll comment on your last few blog posts in the coming weeks.

D-Day, June 6 1944

I always think of my dad on this day. He passed away over 11 years ago, yet not one day has gone by that I don't think of him.

These gangsta rappers that you hear on the radio singing about how tough life was growing up had a cake walk compared to my mom & dad. Mom grew up through the great depression as an orphan; my dad without a father.

On his 17th birthday my dad and my Uncle Dick dropped out of school & joined the army to send money home to support their mom. They joined the old horse calvary together. It was the only way two poor kids from Brooklyn would ever get to ride horses. Within a year, their unit was mechanized, & at 19 years of age my dad & my Uncle Dick were storming the beaches of Normandy. Omaha beach, dog green sector. As my dad said it, the source of his wildest dreams soon became the source of his worst nightmares.

The calvary unit, which was now 102nd recon, was supposed to set up communication systems once the 1st & 29th cleared the way. Things didn't go that way. The beach got jammed up & they became sitting ducks on the water. They wound up jumping over the side to avoid fire, with 80 pounds of equipment on their backs. Fortunately, dad & uncle Dick were strong swimmers from their summers at the city pools. Others were not so lucky, & drowned.

Only 8 of the 60 soldiers from that calvary unit made it back home alive from world war 2. Fortunately for me, both my dad Joseph sr. & my Uncle Dick were two of them.

It's Tricky

...an old Run DMC song, and also a reference to back pain.

JOSPT June '09- "Fitness, Motor competence, and Body Composition Are Weakly Associated With Adolescent Back Pain"

Here's what I get out of this article.

1. This is not the first study to find a correlation between low back pain & increased trunk flexor strength (Newcomer et al in Acta Paediactrica, '96)
2. Watch that waist line
3. I don't think you can have a healthy back without strong, powerful 3D leg strength.
4. The Sit & Reach Test is a waste of time.
5. I said this before in previous posts, but I believe that athletes in sports of a repetitive nature should spend some time in the recovery-restoration process running backwards, throwing with the opposite arm etc.

There is no such thing as "muscle confusion"

Muscles, & the human body are extremely adaptable. I have worked with students with a myriad of so called disabilities that not only expand their envelope of function, but rip it right open. This athlete is not one of mine, but a great example:

http://www.nytimes.com/2009/05/26/sports/ncaabasketball/26hoops.html?ref=sports

Don't miss this

SAGE publications, the publishers of the American Journal of Sports Medicine, Clinical Rehabilitation, Foot & Ankle Specialist, the European Journal of Hand Surgery, & Sports Health is offering free online access until July 31, '09. Dig in.

Marty's Response

"My take on anterior innominate dysfunctions is that they are usually hypermobilities that arise secondary to restricted hip and/or trunk extension, or due to weakness/inability to load the abs and glut max. Your exercise seems to load the abs by extending the hip and trunk, so it sounds good to me. I would also consider using bilateral UE drivers to drive the trunk even further and progressing to a lunge pivot, moving between hip and trunk extension for abs and hip and trunk flexion for back and butt. Similar thinking for upslips (FP dysfunctions) and torsions (TP dysfunctions)."

...hey Jonathon- didn't consider the BUE drivers. Good call. I'm jealous.

Our next question. Notice Marty recommends an anterior pivot lunge combo, perhaps using our BUE drivers anterior this time. Anyone take a guess why?