Thursday, August 4, 2011

It's whats between the notes that counts!

"Anatomical Structure determines Function, this determines Exercise Selection & Prescription- Richard Lieber

I'll agree with that...but I'll follow that with a quote by anatomist Jaap Van Der Wall...

"typically researchers "dissect what they have in their mind and lose
the continuity of the tissue."  He goes on to say, "Muscle spindles
and GTOs are mostly concentrated in areas of muscular tissue directly
intermediating distal and proximal regular dense collagenous
connective tissue structures. These mechanoreceptors occur often in
muscle/connective tissue transition."

Let's use the hamstring musculature as an example.  We've known for a long time that strains occur NEAR, but not actually AT the musculotendinous junction.  Recent MR imaging has also demonstrated tears at the epimysial boundries between muscles.

The anatomy of the hamstring muscles are complex, and even vary between individuals.  They not only have osseous attachments, but also numerous fascial expansions that attach muscle to bone, AND to other muscles. They are innervated by 2 different nerve branches; the long head of the bicep femoris, semimenbranosus & the semitendinosus by the tibial, the short head by the peroneal.  Some anatomists consider the adductor magnus muscle a 5th hamstring muscle, as it shares a common nerve and thick fascial expansions.

When we attempt to understand the function of the hamstrings, like music, we need to understand what's going on  proximal to distal, but also in between.  Not only in the sagittal plane, but in the frontal, and especially in the transverse.  The plane that a muscle is the most powerful in is not always the most important.  What the opposite side of the body is doing during a particular task; and whether it's setting the hamstrings up for success.  Now we have MR images documenting morphological improvements in an individual muscle from specific exercises.  Yes that's useful in indicating the degree of healing, but not the whole picture:

"Movement is not an isolated event that occurs in one plane of motion.  Rather it is a complex event that involves synergists, stabilizers, neutralizers and antagonists all working together to produce efficient triplanar movement"- Vern Gambetta.

The current trend of prescribing exercise by muscle architecture is subjective, and can be misleading.  Rehab the athlete, not the injury...and let them leave you a little more athletic then when they came in.  And never feel like you have to squeeze any muscle injury or prevention program into a traditional weight room exercise just because its there.

1 comment:

Mark said...

Beautiful words! I love Bruce! Thanks for the advice!