Don’t assume your muscles need work (Kinetic Control Part 4)

Posted on April 8, 2015

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Other parts for my notes on Kinetic Control: The Management of Uncontrolled Movement can be found here.

I mentioned I have few hang ups with this book. I also mentioned one of the things I enjoyed about it was the lack of anatomy referenced. While this is true for most of the book, there are some pages given to anatomy, and in a way which causes a big hang up for me.

Common in the lower back pain world is addressing excessive lumbar flexion. This really isn’t a good movement example to use because barely anyone, besides younger, and usually taller, men have this problem. (Rotation, then extension, are the more common issues.) But the authors use this example as well to describe their system of treatment.

One aspect, if needed, is to address the “local” muscle system:

“Retraining of the lumbar spine local stability muscles to retrain control of translation (e.g. the integrate inner cylinder, transversus abdominus, segmental lumbar mulitifidus, posterior fasciculi of psoas, diaphragm, pelvic floor)”

Next aspect, the “global” muscle system:

“Retraining of the lumbar global stability muscles to regain control of range (e.g. retrain efficiency of superficial multifidus and spinalis to control flexion and produce extension)

I believe the authors were essentially discerning between smaller and larger movements. Lumbar flexion at one segment -local- versus the entire lumbar spine flexes too much -global.

This distinction of small and large dysfunction is true though, and it’s kind of wild when you see it. Sometimes you’ll see the exact location a person flexes their back too much. Their whole back will be fine, but one vertebrate will poke out. Looking at it is painful. More often, you see someone whose entire back flexes too much. Again though, overall, rotation and extension is more a problem for everyday people.

Another aspect is addressing myofascial restriction:

“Regain extensibility of hamstrings and superficial myofascial gluteus maximus.”

Summing up, the “management planning outline”:

  • Local muscle system
  • Global muscle system
  • Myofascial restriction
  • Articular restriction

Here is the big hang up with the above approach:

You could have faulty movement and not have any need for any muscular training.

Just because someone rounds their back too much when they lean over does not, in anyway, categorize them as needing to train their lumbar extensors, needing any stability, needing to increase extensibility of the hamstrings or glutes. None of that is a given. It could be true, but it is not a given.

(By “training” here I mean dedicated strengthening, stretching, etc. for a particular muscular area.)

You almost always can get someone to correct how they lean over in about 30 seconds, if that. Because nothing is too weak or too stiff. What *is* happening is a nervous system which is telling the person to round their lower back too much. This often is not necessarily the brain; it can be more a reflex. A habit.

When the brain tells the person to not do that, to not round the lower back when leaning over, voila, the lower back doesn’t round too much. The hamstrings and glutes are suddenly not restricted. They weren’t to begin with.

The nervous system needs work here, not the muscular.

Of course, a lot of times the muscular system does need work. These are the people that no matter what, can’t get a certain movement right. It’s not a matter of concentration, it’s a matter of muscles which can’t do the work. (Too weak, stiff, etc.) They need things to be regressed, then progressed, building their way to that particular movement. Their muscles need time to adapt. The nervous system can adapt much quicker. 

The nervous system may need time for the new movement to be inculcated as well, like learning to ride a bike, but that’s not the point. The point is you can’t assume your muscles need work. That they need stretching, or strengthening. You need to find that out. Is the kid truly too weak to pedal a bike, or is it a matter of learning a new skill?

Something like leaning over without your lower back rounding requires such little strength, odds are you already have plenty of it. (Odds are a kid already has the strength to pedal a bike. Coordination is a different matter.) As well as posterior leg flexibility. I’m not sure I’ve ever seen someone who couldn’t lean over properly within a minute of instruction. But I have seen people try to lean over with too much weight in their hands -deadlifting- and their lower back rounds. For them, it can be no matter the effort given to proper form, they need more time to get things stronger. (And lessen the weight in the meantime.)

I think the authors overall get this. They just seem to miss it in delineating their system.

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