Body Posture & Muscles Functions: (Part 5)

For some of you personal trainers and coaches out there, you may heard of anterior and posterior pelvic tilt during your fitness or CPT courses. And for some of you people, you may be aware of 'donald duck and pink panther syndrome'. What does these terms have in common? Well, if you notice people especially women with lower back arch, we call that posture 'Donald Duck' or also known as anterior pelvic tilt. As for people with 'pink panther syndrome' or 'butt dissapearing syndrome', it is also known as posterior pelvic tilt. 

Now, let's talk about the pelvic. An area which not many people show great interest, it plays an important role in biomechanics and postural alignment. The neutral position of the pelvis is one in which the anterosuperior-iliac spines are in the same transverse plane, and in which the spines and the symphysis pubis are in the same vertical plane. An anterior pelvic tilt is a position of the pelvis in which the vertical plane through the antero-superior-iliac spines is anterior to a vertical plane through the symphysis pubis. A posterior pelvic tilt is a position of the pelvis in which the vertical plane through the antero-superior iliac spines is posterior to a vertical plane through the symphysis pubis. In a standing position, an anterior pelvic tilt is associated with hyperextension of the lumbar spine and flexion of the hip joints, whereas a posterior pelvic tilt is associated with flexion of the lumbar spine and extension of the hip joints.

Now, let's take a look at the illustration below. 

In lateral pelvic tilt, the pelvis is not level from side to side, rather, one anterosuperior spine is higher than the other. In standing postition, a lateral tilt is associated with lateral flexion of the lumbar spine and with adduction and abduction of the hip joints. For example, in a lateral tilt of the pelvis in which the right side is higher than the left, the lumbar spine is laterally flexed resulting in a curve that is convex toward the left. The right hip joint is in adduction and the left in abduction. Please see illustration below.

I will show you a measurement test which requires minimal tool (only a ruler) to determine the length of the posterior muscles. Below are details of the measurement test and illustration of different common postural status.

Equipment: Same as for hamstring length test, plus a ruler. The ruler is used to measure the distance of the fingertips either from or beyond the base of the big toe. This measurement is used only as a record to show the overall forward bending; it in no way indicates where limitation or excessive motion has taken place.

Starting Position: Sitting with legs extended (long-sitting) and feet at, or slightly below, right angles.

Reason: To standardize the position of the feet and knees.

Test Movement: Reach forward, with knees straight, and try to touch the fingertips to the base of the big toe or beyond, reaching as far as the range of muscle length permits.

Reason: Both the back and hamstrings will elongate to their maximum.

Normal length of back, hamstring, and gastroc-soleus muscles

Excessive length of back muscles, short hamstrings and 

normal length of the gastroc-soleus.

Excessive length of the upper back muscles, slight shortness of the muscles in the mid back and in gastrocsoleus. Hamstrings and low back are normal in length

Normal length of the upper back muscles and short lower

back, hamstring and gastroc-soleus muscles.

Bear in mind, trunk muscles consist of back extensors that bend the trunk backward, lateral flexors that bend it sideways, anterior abdominals that bend it forward or tilt posteriorly, and combinations of these muscles that rotate the trunk in a clockwise or a counter-clockwise manner. All these muscles play a role in stabilizing the trunk, but the back extensors are the most important in this regard. The loss of stability that accompanies paralysis or marked weakness of the back muscles offers dramatic evidence of their importance. Fortunately, marked weakness of these muscles seldom occurs.

The term weak back, as frequently used in connection with low back pain, mistakenly suggests a weakness

of the low back muscles. The feeling of weakness that occurs with a painful back is associated with the faulty alignment the body assumes, and it is often caused by weakness of the abdominal muscles. Persons who have faulty posture with roundness of the upper back may exhibit weakness in the upper back extensors but have normal strength in those of the low back.

Despite the fact that the low back muscles are the most important trunk stabilizers, relatively little space will be devoted to them in this chapter compared to the detailed discussion of the abdominal muscles. Testing back muscles is less complicated than testing abdominal muscles, and in the field of exercise, few errors occur regarding back exercises. Many misconceptions and errors, however, occur regarding proper abdominal exercises. Furthermore, in contrast to the back muscles, weakness of the abdominal muscles is more prevalent. It is important to know how to test for strength and how to prescribe proper exercises for the abdominal muscles because of the effect that weakness of these muscles has on overall posture and the relationship of such weakness to painful postural problems.

Illustrations, definitions, and descriptions of basic concepts are used to help achieve this purpose. Both the illustrations of the trunk muscles that follow and the accompanying text provide information in detail about the origins, insertions and actions of these muscles. This information is essential to understanding the functions of these important trunk muscles.

Now, let's discuss about back extensors and neck. For back extensors, to raise the trunk from a prone position, the hip extensors must fix the pelvis in extension on the thigh. Normally, extension of the hip joints and extension of the lumbar spine are initiated simultaneously, not as two separate movements. If slight tightness exists in the hip flexors, there is no range of extension in the hip joint, and all the movement in the direction of raising the leg backward is accomplished by lumbar spine hyperextension and pelvic tilt. Please see illustrations below.

For hip extensors to raise the extremity backward

from a prone position through the few degrees of true

hip joint extension, the back extensors must stabilize

the pelvis to the trunk.

A subject with strong back extensor muscles and strong

hip extensor muscles can raise the trunk in extension.

A subject with weak or paralyzed back extensor muscles

and strong hip extensor muscles cannot raise the trunk

in extension. The hip extensors, in their action to fix the

pelvis, are unopposed. The pelvis tilts posteriorly, and

the lumbar spine flexes.

In the next post, I will discuss about the back extensors test as well as glutes and quadratus lumborum. Stay tuned. 

Body Posture & Muscles Functions: (Part 4)

Does any of you encountered low back pain? How about inability to perform full push up exercise? How about doing excessive knee bent sit up exercise regularly? In today's post, I will discuss about the trunk, primarily about vertebral column.

Innervation to the trunk muscles does not include an intervening plexus between the spinal cord and the peripheral nerves like the cervical, brachial, lumbar and sacral plexus. Abdominal muscles receive their innervation from the thoracic branches of the ventral divisions of the spinal nerves.

Based on the skeletal structures, the trunk is composed of two parts. The thoracic spine and the ribcage constitute the upper part; the lumbar spine and the pelvis constitute the lower part. The spinal column, together with the extensor muscles govern, to a great extent, the posture and movements of the trunk. This chapter examines the role of trunk muscles in movement and support of the trunk, and the role of hip muscles that act simultaneously with trunk muscles in movements and support of the pelvis.

It is interesting to note that muscles that act in unison for certain movements act in opposition to each other in support of good alignment. For example, in the prone position during the movement of spine extension, hip extensors assist by stabilizing the pelvis to the femur. In the supine position during the movement of spine flexion, the hip flexors act to stabilize the pelvis. On the other hand, in support of good postural alignment in standing, the hip extensors act with the abdominal muscles, and the hip flexors act with the back extensors. In the movement of raising the trunk up sideways, lateral trunk muscles laterally flex the trunk as the hip abductors stabilize the pelvis. In support of good alignment in standing, lateral trunk muscles are assisted by hip abductors on the opposite side.

In relation to the trunk, one of the major concerns is the painful low back. It is common knowledge that a high percentage of the adult population has suffered from low back pain at one time or another. For many, the treatment of choice consists of restoring good postural alignment and muscle balance.

The lungs and diaphragm are located in the trunk. Faulty alignment of the skeletal structures and problems of muscle imbalance can adversely affect the respiratory system. The Respiratory muscles lists the twenty three muscles (each of which has a right and left component) plus the diaphragm as the muscles of respiration. Most of these muscles also have a function related to posture and muscle balance.

The trunk, or torso, is the body excluding the head, neck, and limbs. The thorax, the abdomen, the pelvis, and the low back are all parts of the trunk. The term trunk raising may be used to describe raising the trunk against gravity from various positions, from face-lying (prone position), trunk raising backward, from side lying, trunk raising sideways, and from back lying (supine position), trunk raising forward. The term may also apply, in standing, to raising the trunk from positions of forward bending, side bending, or backward bending to the erect position.

The thorax is elevated (chest lifted upward and forward) by straightening the upper back, bringing the rib cage out of a slumped position. The thorax is depressed when sitting or standing in a slumped position, or it may be pulled downward by the action of certain abdominal muscles.

The trunk is joined to the thighs at the hip joints. The movement of hip flexion means bending forward at the hip joint. It may be done by bringing the front of the thigh toward the pelvis, as in forward leg raising, or by tilting the pelvis forward toward the thigh, as in the sit up movement.

The forward-bending, long-sitting position involves hip joint flexion along with back flexion. One must try to disregard the hip joint movement when observing the contour of the back. Range of motion and contour of the back may also be observed by having a subject bend forward from the standing position. As a test position, however, this has certain disadvantages. If the pelvis is not level or is rotated, the plane of forward bending will be altered, and the test will not be as satisfactory as that in the longsitting position in which the pelvis is level and rotation is better controlled.

Because the low back muscles are seldom weak, the range of back extension may be determined by the active strength test in the prone position. Please see photo below. 

Whether the range of motion is normal, limited, or excessive, the subject is capable of moving through the existing range. The anterosuperior-iliac spines should not be lifted from the table during back extension, because doing so adds hip extension to the back extension range of motion. Please see photo illustration below.

Back extension often is checked in the standing position. The test is useful as a gross evaluation, but it is not very specific. Swaying forward at the hips is almost a necessity for balance when bending backward, but doing so adds the element of hip extension to the test, or the knees must bend somewhat if the hip does not extend.

Similar to the test to determine range of motion in spine flexion, a test can be done to determine the range in spine extension. The subject lies prone on a table, resting on the forearms with elbows bent at right angles and arms close to the body. If the subject can extend the spine enough to prop up on the forearms with the pelvis flat on the table, the range of motion in extension is considered to be good.

Now, let's talk a little bit about flexion. In the cervical region, flexion of the spine is movement in the direction of decreasing the normal forward curve. Movement continues to the point of straightening or flattening this region of the spine, but it normally does not progress to the point of the spine curving convexly backward.

In the thoracic region, flexion of the spine is movement in the direction of increasing the normal backward curve. In normal flexion, the spine curves convexly backward, producing a continuous, gently rounded contour throughout the thoracic area. Next, in the lumbar region, flexion of the spine is movement in the direction of decreasing the normal forward curve. It progresses to the point of straightening or flattening the lower back. Normally, the lumbar spine should not curve convexly backward, but excessive flexion in the low back is not uncommon. Certain types of activities or exercises  such as knee bent sit ups, can cause flexion beyond the normal range and make the back vulnerable to strain from heavy lifting movements. I've wrote about this before in previous post. 

Moving on, let's discuss about extension. Extension of the spine is movement of the head and trunk in a backward direction, while the spine moves in the direction of curving convexly forward. In the cervical region, extension is movement in the direction of increasing the normal forward curve. It occurs by tilting the head back, bringing the occiput toward the seventh cervical vertebra. It may occur, in sitting or standing, by slumping into a round upper back, and forward-head position that results in approximating the seventh cervical vertebra toward the occiput.

In the thoracic region, extension is movement of the spine in the direction of decreasing the normal backward

curve by straightening the upper back. Movement may progress to, but normally not beyond, the straight or flat position. In the lumbar region, extension is movement in the direction of increasing the normal forward curve. It occurs by bending the trunk backward or by tilting the pelvis forward. 

In the next post, I will discuss about the posterior muscles including hamstring and spine, as well as pelvis. Stay tuned.

Body Posture & Muscles Functions: (Part 3)

In today's modern work environment, desk jockeys arguably have the most complaints and problems with posture and pains or mobility restriction in the joints. Poor biomechanics such as khyphosis, tight hip flexors, gluteal inhibition, and lower back problems. Long hours of sitting, especially from poor posture, will contribute to poor biomechanics, leading to muscles dsyfunctions and joints problems. 

Apart from desk jockeys, most of us spend many hours daily using computers, watching TV and even driving on the road. Increased dependence on computers in many work situations is frequently the cause of neck and upper back discomfort and headaches if basic ergonomic rules are ignored. The office set up below was chosen as an example of how to correct alignment and relieve strain. The key to improving posture is a well-fitting chair that adjusts for proper height, arm support and back support. Use of a phone headset to relieves neck strain.

Incorrect

Incorrect

    

Phone on shoulder, desktop computer and monitor in corner on a platform. Neck tilted left, rotated right and extended; shoulders elevated with pressure on elbows and wrists, feet propped on chair legs.

Correct

Correct

Computer placed under desk, monitor moved from comer, and platform removed. Monitor at or below eye level. Use of phone headset to relieve neck strain. Chair has proper back support and armrests to remove weight of arms from neck and shoulders. Legs supported by footrest under desk.

Now, let's discuss about massage, particularly the type of massages which aid or help on neck muscles. I know there are various forms of neck massages you may know or heard of, or even some of the common massage therapy you had enjoyed. 

Massage is an important modality in the treatment of painful neck conditions. The soothing effects of gentle massage can help relax tense muscles. Neck extensor muscles often become short from a faulty forward head posture. Massage, along with appropriate exercises, can be used to help relax and stretch the tight muscles and restore normal range of motion.

The photos below show the various positions for effectively applying massage to help relieve neck tension and stiffness. The subject is seated on a stool beside the treatment table. Pillows on the table are adjusted to a level that is comfortable for the subject when leaning forward to rest the head on the hands. Massage is applied to posterior and lateral neck muscles, primarily the upper trapezius.

Neck Massages & Stretching 

Start the massage at the occipital attachments of the upper trapezius. Begin with a smooth, firm stroking massage.

Continue the massage along the trapezius to the attachments of the clavicle and scapulae.

Repeat the massage using a kneading technique to the left and right upper trapezius

With face turned left to put a mild stretch on the left trapezius, repeat the stroking and kneading massage

With the face turned right to stretch right trapezius, repeat the stroking and kneading massage

Stretch Neck Rotators - Sit on a chair with hands grasping seat to keep shoulders down and level. Sit without tilting head, turn towards each side.

Stretch Lateral Neck Flexors - Sit on a chair with shoulders back and hands grasping seat to hold shoulders down and level. Tilt head directly sideways to stretch opposite lateral neck flexors.

Fitness Trends 2013

Decided to share some information regarding current trend in fitness industry. From most popular fitness equipments to most demanded types of trainings, data below obtained from IDEA World Fitness Equipments and Programs Trends Report 2013. Since few years back till present day, personal training one on one, still top the chart, and fitness tools such as TRX (suspension trainer), Combat/Heavy Ropes and even bodyweight exercises ranked most popular equipments.

Foam rollers and massage balls used primarily in myofascial release is also very popular, ranked 2nd. I must stress how important incorporating myofascial release routines in your daily/weekly program. It will help with muscular dsyfunctions/imbalances, tissue scarring, adhesion, poor biomechanics, etc. It will also help reduce the risk of injuries, especially for those who are fitness enthusiasts, professional athletes or even people who are just playing recreational sports. Others apply this routine as part of lactic acid flush during post workout. It is very important, if you want to improve mobility and performance relating to sports, training, or even daily functional movement. In my program, I use it regularly with my clients. Think of myofascial release as servicing a car, and workout/exercise as on the road car driving/racing. 

Heavy/Resistance ropes, amongst the most popular tools in 2013

Personal training 1 on 1 top the chart as the most popular type of training offered in 2013.

Bodyweight leverage equipments still top the chart, most popular tools.