News Letter

Sunday, January 2, 2011

review of article by Masi, MD, DrPH
1st quote: The lumbar spine is stabilized and moved by sets of muscles that have varying biomechanical roles(67–70). Circumferentially, the paralumbar muscles are arranged from those closest to the spine (“local” or “core”) to those located peripherally in the pelvic and abdominal perimeters (“global” or “shell”). Optimal function requires a balanced coordination of all core and peripheral muscle groups. The core muscles provide mainly segmental stability; the more peripheral muscles control mainly global movements and general stabilization of the trunk(61,79). An insufficiency of one group, such as the core multifidus, places excessive demand on the peripheral muscles to provide chronic stabilization.
Translation: If the muscles in the spinal column and those most closely attached to it do not keep your posture balanced then the muscles further out like the abdominals will try to do it. [I have a pain under the edge of my ribs. or I have a pain at the top of my hips {ilium}]
Application: Structural Relief Therapy balances the muscle response. Typical tension train of peripheral core muscles is through the iliacus and is balanced by the adductors and peraformis. In SRT the position of the tender point on the border of the ilium indicates the level of spinal disturbance.
2nd quote: The concentration of spindles in small, short muscles acting across a joint in parallel with vastly larger and longer muscles may serve an important sensory feedback role and may function as “kinesiologic monitors”(85–87). The spindle concentrations in the small muscles of such parallel muscle combinations were estimated to be greater than those in the larger and longer muscles by a factor of between 5 and 7(86). The deepest fibers of the multifidus may serve such a proprioceptive function(87). Deep, short fibers such as these may also act as biomechanical stabilizers of movement at the joint surface and may behave as “dynamic ligaments”(76). The multifidus has a greater density of muscle spindles in the fascicles closer to the facet joints(86). Accordingly, compared with other back muscles, the lumbar multifidus is suited to provide passive and active stability to the lumbar spine(88).
Translation: If the spine is chronically twisted at a specific segment the posture reflexes are triggered to balance that position.
Application: The shortest of these muscles the rotatori have the mechanical advantage of pulling directly lateral across one segment. The others pull obliquely across multiple segments. Observation if the psoas minor is hypertonic on one side and hypotonic on the other it creates a rotational force at T11/12. This is balanced by the rotatori which becomes chronically shortened. With the client prone there will be a palpable tonicity of the multifidus over the hypertonic psoas minor trying to balance the apposing rotatori. Similar patterns will be found for levels of the psoas and coastal complexes.
Massage of the superficial layers usually will not correct the problem and may lead to a painful rebound of the problem. The correct protocol is to shorten the rotatori until it stops reporting the strain. [90 seconds in the lumbar, 2 minutes in the thoracic] This will usually improve the enervation of the involved muscle and allow an interactive retraining of the posture reflexes. A good example of this is the head nodding technique taught by Eric Dalton for the thoracic region.

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