The hips and t-spine are hot topics in the fitness industry right now - and justifiably so; really, almost all of the issues I see in the gym, or even among friends and co-workers who don't go to the gym, come down to these two areas.
In this wonderful textbook for the fitness professional looking to serve his/her clients better, Evan Osar has covered the common disfunctions and syndromes that will plague both their sedentary and athletic clientele. Evan begins by providing a framework for understanding movement function and development, then describes the issues and how they'll manifest themselves in common movements, postures, and compensations, and finally provides principles for (and possible contraindications of) the application of corrective exercises, movements, and patterns.
The following passage discusses functional anatomy - a subject that many coaches and trainers grossly oversimplify. It is not "light" reading (though the beautiful illustrations, pictures, and summary sections help), but it's extremely interesting for gym rats like myself that have been around long enough to see the pendulums swing from "weights will make you muscle-bound", to "getting strong is all that matters", back to the more reasonable "thought-less strength training could actually exacerbate or cause an issue..."
Photo courtesy of this site
...adopted from the child development model, is the idea of using the upper extremities to drive trunk motion. During the crawling pattern, the child uses one arm to stabilize the upper extremity and spine as the opposite arm reaches forward. This patterning helps the child develop stability in the fixed arm and corresponding side of the thorax, while the free arm helps maintain thoracic mobility. There are two key points here to help in making sense of these actions.
1. The majority of scapular stabilizers - including the latissimus dorsi, rhomboids major and minor, as well as all three divisions of the trapezius - have spinal attachments. While these muscles have never been assigned a spinal function, their attachment to the spine suggests they play a role in spine function. The rhomboids, trapezius, and latissimus dorsi collectively function to rotate the spine towards the fixed upper limb. With elbow support, as in crawling or plank position, the triceps and biceps brachia can draw the scapula toward the fixed elbow...[see picture above] This function can be seen in the developing child - the prone elbow, support position stabilizes the child's upper extremity. As they reach with the contralateral arm, the scapular stabilizers of the supported arm help to rotate the spine.
2. As the child stabilizes on his left upper extremity and reaches with his right arm, the left scapular stabilizers aid rotation of the spine. The child stabilizes his trunk with his left arm, while the motion of the free arm helps mobilize the right side of their spine and thorax. This is an important consideration in exercise, as traditional resistance exercise can often create rigidity of the thorax. The main reason for this is that bilateral patterns require the arms be moved over a fixed thorax. In the developing child this patter rarely occurs and when it does, it is usually not performed with significant resistance or in a repetitive fashion.
Bilateral patterns such as chest presses, upright rows, and curls require the thorax to be used as the stable point, as the loaded extremities are moved around the thorax. Additionally, patterns such as barbell squats, deadliest, and farmer's walks can also drive thoracic stiffness because the thorax is used as a stable point for lifting. While the thorax should be fixed during these types of patterns, perpetual use of these patterns can drive rigidity and stiffness of the thorax. Although this type of rigidity may be useful for muscle hypertrophy and certain athletic activities, hypertrophy of the muscles of the thorax can lead to stiffness of these muscles, and the resultant hypo mobility is often responsible for the onset of several of the more common dysfunctions of the movement system. Two examples are:i. Rigidity of the thorax results in decreased motion and compensatory hyper mobility of the cervical and lumbar regions of the spine. This is a common cause of spinal instability in these regions and resultant pathologies of the disc and tissue structures of the spine.ii. Rigidity of the thorax decreases the client's ability to achieve three-dimensional expansion of the thorax during respiration. This leads to increased activity of the accessory muscles of respiration - mainly the scaliness, sternocleidomastoid, and pectorals minor - to assist elevation of the thorax during breathing. This causes global reactions in the body, including driving the forward head and shoulder positions, contributing to headaches and anxiety, poor overall levels of oxygenation, and rises in blood pressure.
If bilateral patterns will be performed or have to be performed as part of an athletic training program, they should be followed with patterns that help mobilize the thorax. Unilateral and alternating patterns can help restore thoracic mobility by using the free arm to drive rotation of the thorax while the free arm stabilizes the shoulder complex and ipsilateral of the thorax.
Is Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction a "must-read"? If you are trainer or coach with athletes and clients who have shoulder and hip issues, then the answer is YES!
Is it a "must-have"? If you are a head-trainer or strength coach, then the answer is YES.
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