Don’t Blame the Muscles…

I recently started a small group six week program that meets Sunday mornings. I unofficially call it “Church of Core”.

Its a program designed under the premise that, being that there is so much misinformation on the internet, in the media, and from people at the grocery store on what we should be doing to “train the core”, there should be a class to help people understand the truth of how the body moves so they can make their own informed choices on what to do at the gym.

And honestly, do whatever you want at the gym. It’s all good. Do what makes you happy.  Just make sure your body possesses and understands the mechanics to cope with those choices.

I wanted to share a little case study from a participant in the program who was having some issues.

Twist and shout (ow)

Nancy (not real name) is a dancer in the program. We had just finished day two, in which we’d explored sagittal plane spine movement and stability, and she asked me if we were going to look at rotational movement next, because she was having some issues that and she had a big dance workshop weekend coming up. I said, yeah, come early to church next week and we’ll take a looksie.

Nancy’s primary complaint was that left ribcage rotation caused a straining painful feeling through her left side from her pelvis up to her ribcage. This is obviously an issue for a dancer because rotating is kind of a big deal in a lot of dance movements. She got the same symptoms with right pelvis rotation- Pain and tension through left obliques. So it’s not just a left spine rotation issue, its a transverse cog issue.

In AiM, “cogs” refers to the role in gait of structures moving in opposition against each other, like turning cogs. In gait, the pelvis and ribcage have a cog-like motion in that they should always oppose each other’s movement in all three planes of motion: In normal walking, when the the pelvis rotates right, the ribcage should rotate left.

In the case of Nancy’s symptoms, it was not just a ribcage rotating left issue, but an issue with any part of the gait cycle in which her left leg is forward (pelvis right) and her upper body is swinging to the left (ribcage left).

It’s nice when things make sense like this because they sure as hell don’t always do.

Her chiropractor identified that her issue was her left external obliques. Let’s look at why her obliques might be complaining about this rotational pattern. 

Obliquing, long and short

If we’re going to blame a muscle, it stands to reason that we should know if its sore because of concentric shortness/compression, or it is locked long, under eccentric load.

Left ribcage + right pelvis rotation will lengthen the left external obliques, as the left EOs rotate the spine to the contralateral side

So, we could infer that the muscle is not happy with being loaded eccentrically to decelerate left spine rotation. 

In the case of many muscles strains, the tissues have become locked long and because they are already loaded and lengthened they will have trouble decelerating joint movement because they’re already stuck doing that all the dang time.

In Nancy’s case we want to know WHY left spine rotation has become an issue to manage. Why are the obliques being lengthened all the time? Perhaps there is something NOT happening in this rotational pattern that the left obliques are picking up the slack for?

Time to stop thinking about muscles

I’m not telling you what to do, but muscles are confusing and chaotic. Looking at joint motions makes things much less noisy.

To quote Gary Ward, “Would you rather look at 13 muscles that connect to the knee or look at the 4 movements it can do?”. 

I’d rather work on 4 things than 13, personally.

What stood out in interviewing her body was that her right talus was positioned internally rotated, everted, and could not externally rotate and invert. The chances of her right foot being able to supinate were pretty slim. This turned out to be key for helping her access left ribcage rotation with much less discomfort.

In the Flow Motion Model™, whenever the talus goes right, the ribs and spine go left, and when the talus rotates left, the ribs and spine go right.

This is because the rearfoot and pelvis always move in the same direction in transverse plane in gait (in all planes, actually), and recall that the ribcage and spine always oppose the pelvis.

So we could infer that the ribcage and spine should always oppose the talus*.

Therefore, if the talus can’t go right, another structure might have to go right MORE in order to accomplish every phase of gait in which the right foot supinates (and that’s most of the gait cycle, FYI).

In Nancy’s case it seemed to be the spine/ribs trying to rotate excessively to make up for a lazy right talus. And what might get tired of decelerating this motion over and over? The left external obliques.

Supinate the shit out of it

So we got Nancy’s foot to experience supination with her foot tripod grounded on the floor. With a little nudging and wedging, her right talus obliged and started inverting and externally rotating. Sweet.

We then integrated it into a pattern that required her to do left spine rotation and right pelvis rotation (we chose right propulsion phase). What was cool was that as long as her right foot was supinating, she could access left spine rotation with almost no discomfort. 

When she retested her rotations there was significantly less discomfort than before. Her right talus was also sitting less everted and internally rotated at rest.

The entire process took about 20 minutes. Then we hugged and went to church.

*Talus and ribcage always oppose… Except for that fraction of a second in which gait is homolateral!

Conclusions?

Few things, I guess:

1. Learning to work with the FMM and AiM philosophy makes connections like this possible.
   
2. Blaming muscles for issues doesn’t provide enough useful information. I was not thinking about what muscles were tight or overworking of facilitated or inhibited while I was working with Nancy (which would have driven me crazy back when I used to do a ton of Neurokinetic Therapy® testing). Saying “it’s my oblique that’s the problem” doesn’t tell you why. Muscles react to joint movement. The answer will show in the structures, their position, and the movements they can and cannot do.
   
3. Thinking about her oblique pain in terms of concentric muscle action might not have led to the same resolution, but thinking eccentrically made a lot of sense in this case.
4. The “talus drives the bus”, and its useful to know how movement of the foot affects movement up the chain.
5. Knowing how to palpate the talus is a useful skill (that I didn’t have until very recently, thanks to “Foot Dating” on an AiM course).
6. It really is true that one of the most powerful experiences for the body is just to help the feet to experience true pronation and supination.