I thought I would have a bit of a Jerry Maguire moment with my latest blog post!

Over the last few months I have certainly gone through a period of change with regards to how I understand the human body. Anybody who regularly reads my blog may have sensed that! I have begun to appreciate the brain as the command centre for all that we do, moving away from a more functional/biomechanical approach I had previously. This has been facilitated by some pioneering characters around me who I am thankful to for opening my eyes, even if it can feel sometimes that they don't want others to come along for the ride! I have certainly suffered my own bouts of cognitive dissonance along the way.
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This is just a quick blog that was inspired by taking my son to the park yesterday. It is more anecdotal than scientific but something that I wanted to get across.

My son is developing so fast at the moment and it is amazing to watch. He is now 16 months and the two biggest areas I see his development in are movement and speech. It got me thinking about how we correct peoples movement problems and teach them to move better.
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In the first part of this 3 part series we looked at patterns and how the brain recognizes patterns of information to then be able to recall or auto-associate a response from stored memory.
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So I have seen various variations on Gary Gray’s view that muscles are reactors. I think this is spot on. Muscles ARE reactors.

I think what Gary meant by this was that generally we see muscles as concentric force producers. Actually during movement we tend to need to decelerate motion by eccentric contraction first. Think walking first we flex to attenuate gravity, ground reaction forces, mass and momentum before creating force to move. So we are reacting to forces acting on the body before we create concentric force.
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Now this post equally could have been hip pain, knee pain or foot pain when running. The available motion in the big toe or hallux will affect the operation of all of these body structures during integrated movement.
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Things have been really busy with Cor-kinetic recently and I have not had a lot of time to blog. This post stems from a case I have been dealing with recently and I wanted to give an idea of our thought process at Cor-kinetic and how the symptom and cause of a problem are not always one and the same.

The patient in this case has been having Achilles problems on the left side and also lateral foot pain on the same foot. Interestingly the pain reduced the quicker he ran but more about that later.
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At Cor-Kinetic one of our foundational concepts is that of the relationship between stability and mobility.

Stability is a component part of mobility. The body needs to move in a mobile AND stable manner. Stability without mobility is RIGIDITY. Rather than a sign of functionality of the system I would see it more as a sign of dysfunction. The inability of our motor system to effectively control movement will create a rigidity in the system as the body chooses stability over mobility and closes down the system's ability to move.
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What are we training for??

I have been reading The Talent Code this week by Daniel Coyle and have enjoyed it immensely. One passage in the book stood out to me. It describes the difference between how we teach football and how we teach musical instruments, specifically the violin.

"The ideal soccer circuit is varied and fast, changing fluidly in response to each obstacle, capable of providing a myriad of possible options that can fire in liquid succession: now this, this, this and that. Speed and flexibility are everything; the faster the more flexible the circuit, the more obstacles can be overcome, and the greater that players skill"


Now that sounds pretty cool. So if we want to help improve someones soccer (football) circuit then our training for that sport should help increase the sphere of the players movement, speed and flexibility. To be dynamic, variable and increase the brain/body connection would seem prerequisite for such an activity. This would be a functional approach to training!

BUT in fact Coyle goes on to talk about how we teach people to play instruments, in this case the violin.

"This circuit is not a vinelike tangle of improvisation but rather a tightly defined series of pathways designed to create-or more accurately, recreate-a single set of movements"


This struck me as a more accurate description of how we teach people to exercise in the gym. A set way of performing a movement not to be deviated from. A series of movements that lack the variability of any sporting or movement skill that we may want to enhance, in fact a completely different skill set.

When we build neural circuits and fire them repeatedly they get larger, stronger and after time and repeated use through practice they get myelinated. The Myelin insulates the circuit allowing the signals to travel faster and more efficiently. These circuits are specific to the practice or training the we do. Playing the violin does not increase my skill or ability to move or produce force for football.

The generic nature of exercise and strength training in particular would lead us to believe that strength and movement are generic.  By practicing a defined pathway movement such as a squat this will enable me to improve the incalculable movement and strength/force production variations involved with football. The deadlift and bench press, movements that do not move my centre of mass away from the vertical, will enable me to explode in various directions and apply my force against another body in the horizontal plane. Studies have shown very limited crossover from training one specific movement to another specific movement!

The variables involved in applying your force against a moving external object are huge. From the foot positions taken to the change in position of the opposite body and the angle both bodies are moving in.

During a specific functional activity the feedback loop from the nervous system will define the appropriate response in terms of movement and ability to apply force. If the circuit is not variable then can it respond to a varied input?

Mel Siff states:

"The rate and number of fibres firing depends on voluntary and involuntary processes....the involuntary ones to the feedback of the proprioceptive system"

Involuntary would be more subconscious processes that are involved in sporting activities. They would also apply to the stretch reflexes involved with eccentric before concentric contraction! Something else involved with sporting force production.

Siff also states:

"there will usually be changes in centre of gravity, moments of inertia, centre of rotation, centre of percussion and mechanical stiffness of the system that will alter neuromuscular skills required in the sport"

If we believe that the mechanical/neurological skill process is vital to specific functional force production or strength and that during sport this is a constantly changing and evolving landscape then to train for this process we must involve variability. It must be more like teaching someone to play football than the violin. More variable than defined.

We must allow the body and mind to process information and create a response based on that information. Instead we try to create a robotic series of defined motions that offer a limited response. Even worse at an elite level of training we have created governing bodies that advocate training protocols with exceptionally limited variation in exercise. None of which ever come away from the vertical, none of which involve rotation. Sound like sport?, look like sport? Seems to me it is more like playing the violin than football!

How many sports only involve moving the centre of mass in the vertical? The ability to decelerate and accelerate in the horizontal plane is pretty much sport! Throwing, kicking and hitting all involve rotation. They also all involve strength, flexibility, speed, stability and power during the same split second periods of play! Not as individual components.

A similar rationale maybe applied to the world of rehabilitation from injury also. Do we want to prepare our clients for a limited range of specific movements or the variability of the world that we function in. This would be a personal choice.

On a final note, Malcolm Gladwell in his book 'Blink' describes a complex war game in which he felt the protagonists over analyzed the scenario in front of them.

"They were so focused on the mechanics and the process that they never looked at the problem holistically. In the act of tearing something apart you lose its meaning"

I believe that this can happen in our approach to the body. By reducing it to components we lose the magic of integration that creates movement. This also leads us to understand why injury site and source may be different!  If we focus solely on the injured component then the cause will never become apparent. This is in part why we have chronic problems.

As usual this is my own take on a complex subject. More opinion than fact! Although with supporting evidence.

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I have read a lot of stuff on movement screens recently and specific "functional tests" such as overhead squats and single leg squats. People both extolling their virtues and others maybe less sure about their validity.

I thought I might chime in with my thoughts on these "screens".  Firstly part of the problem is we are trying to shoe horn function into a handful of assessments. Given the incalculable number of functions this is a pretty tall order. Another problem is that we are trying to 'define' Peoples function. This has always been the problem with 'functional' training, trainers tend to define the clients function rather than the other way round. A more successful approach, although less easy, is to have a thought process that allows us to understand the biomechanics behind someones function and be able to design a test to tell us how well someone interacts with their functional activity. At Cor-kinetic this forms a cornerstone or principle of how we approach the body and teach people to approach the body.

So are you testing the test? Or are you testing someones functional needs? That is a question you have to ask yourself! If the test has nothing to do with the needs of the client or player then what validity does the answer have? We are simply testing a test.

All movement is a specific skill. Many sporting movements are very specific skills honed over a number of years. Is a poor test on a movement we have not practiced just poor skill at the movement as we have spent no time refining it? Are the improvements in the movement skill based? If so then would it not be better to spend the time practicing a skill that we really need for our sport? These are all questions we need to ask.

As movement patterns live in the brain and we have between 100-120 billion neurons each with around 10,000 connections each I am pretty sure we have the neural real estate to hold more than a handful of movements that define how we function.

Does a tennis look like rugby? If not then we need to find a way to screen them specifically.

The single leg squat test does go a little way to incorporating a functional thought process. The fact that a person during gait spends between 50-85% on a single leg depending who you listen too has a sprinkling of specificity. I think more towards the first figure for walking and more towards the second figure for running! However the amount we squat during walking gait would be minimal.

This is the inverse pendulum model of human walking gait, this means we are able to be efficient and use gravity to transfer our COM (centre of mass). This is in opposition to the spring mass model of running. The aim of walking gait is to not overly squat and lower our COM. (Farley 1998)

So a single leg squat maybe more 'functional' for running but not walking gait. Although the depth of the squat may still not be large. We can see the variation in function here and a single test to define our 'functionality' may be of limited value. A much more valid process may be to understand the variation in function of the client stood before me.

The major factor in both functions (walking and running) is being able to effectively move our COM. The ability to translate as well as rotate is a massive component of human movement. Nearly all 'functional' tests seem to assess our ability to move in the vertical component of the sagittal plane rather than the horizontal which is at least as important if we ever want to get any where. The art of transferring and controlling our COM dynamically should be a principle part of any 'functional' testing screen or protocol.

This is something that the S/L squat does not tell us but is one of the most important 'functional' tests we can have. Also would a more effective adaptation to a S/L test to find out how our pelvis is able to rotate over our femur creating relative IR at the hip whilst in a S/L stance?? This would be more 'functional' for both walking and running. The stability we crave in a S/L stance maybe generated through eccentric tension of the numerous external rotators and adductors (many of which are lengthen in IR)! Without the pelvic rotation this stability could be compromised, so testing stability without pelvic rotation on a S/L for gait maybe a bit like a driving test with 3 wheels!!! Function is specific and if we want to be 'functional' we must learn to be more specific also.

An overhead squat test is another 'functional' test and very rarely in functional activity do we do things bilaterally or over head for that matter!

If we go back to the pretty universal function of gait, we can see that the two arms are doing different things. One is flexing, one extending. One externally rotating, one internally. This means that the scapulae will also be doing different things. elevating and depressing, retracting and protracting. In fact any function which involves rotation (pretty much all of them!) this will be occurring at the glenohumeral and scapulothoracic joints. Can a test that fails to take any of this into account be reliable for predicting any movement pattern dysfunction in the body away from a single plane overhead squat?? In everyday function we rarely squat from a contrived position defined by someone else. Squat down to do the gardening or get something from the fridge I guarantee it will not be in the pelvic neutral, toe out and linear fashion we do in the gym. To assess and train like this and define it as 'functional' may not be accurate in both thought process and application. The variation in foot position, and therefore hip position, in all three planes in functional squatting is huge. Dysfunction or pain could be occur away from this one contrived position and a thought process that allows us to test a wider variety of positions in a movement may give us more information.

Lastly muscular range in one plane of motion may be naturally mitigated when three-dimensional tensile or compressive force is acting on the fibres. Simply a structure may not be able gain as much length in one plane when also being pulled in another direction or plane. So a test that only tests a single plane at a time may also give information not consistent with three-dimensional functional muscle movement. This is similar to single plane force production (isolated) not being applicable in a three dimension environment where force has to balance across three planes.

As always this is my opinion on a complicated subject that has no definitive answer, only more questions!!!

I have read a few blogs recently on fascia. All of them giving a different perspective on what is a very prevalent topic at the moment.

One was based around the significance of fascial contraction and the biomechanical influence it could exert on the body. This made me think of the a pair of articles and an audio presentation I wrote for PTontheNet. In these articles I posed the question "how would fascia contract".

As far as I am aware fascia seems to mainly afferent, sending information to the CNS, rather than being able to efferently regulate tension through the feedback loop of muscle spindles and motor units. So if fascia does actively contract then why and is an active biomechanical influence helpful??

Chemical contraction has been noted in vitro (out of the body) in rat fascia (schliep 2006). These changes in response to chemical factors were in this case due to calcium chloride, calcium being involved in both skeletal and smooth muscle contraction although in different ways.

I think the link between the biochemical and biomechanical is an important one. Stress creates significant biochemical changes in the body. Hormones associated with stress such as cortisol are also involved in energy regulation. The body in response to long term stressors and increased energy expenditure may choose to decrease movement to conserve energy. This could be looked at as another way of interpreting the law of energy conservation on a metabolic level!!

One way of decreasing movement could be to increase the stiffness of the body. Fascia in its various forms being ubiquitous in the body could certainly play a role in this longer term stiffness regulation that would require less instantaneous neurological control than involved in active muscle contraction.

Now this maybe good for the body on one level (energy), maybe not so good on another (movement). So the biomechanical impact of stiffness regulation for fascia may be detrimental for our movement, especially if it becomes a learned response of the body and becomes the 'default' tension even when under less stress as I believe can happen.

Some may argue that increased compression through contraction of fascia at the lumbar spine is helpful. However this may not be the case if the movement at our hips is also reduced. The ball and socket joint of the hip is designed to have a large movement potential especially in the transverse plane. If this motion is reduced, through fascial stiffness, more motion may have to come from the lumbar area to achieve function related movement. Lumbar rotation is limited (by facet orientation) to 5 degrees collectively  in all the 5 vertebrae!!

This could be a recipe for increased articular surface compression if the superior segment rotation (driven by top down movement) is not in close sequence with inferior segment rotation. If both rotate similar amounts then less compression. If one is blocked then this will increase compressive force between the two segments. If we put our hands one in front of the other and rotate them together we feel less compression. Try moving one and keeping the other still, this will increase compression.  If the pelvis is not able to rotate on the femur then the inferior lumbar segment closest to the hip will be blocked. This will lead to increased compressive forces and possibly also to pain!

It does however give an insight into why some people have chronic movement dysfunctions that cannot be treated by biomechanical intervention alone without looking at biochemical, nutritional or emotional factors.

I also think we overlook the passive role that fascial stiffness plays in the body. Is passive resistance to movement as important as active contraction?? I personally think so. Our passive stiffness controls the range, speed and energy consumption of our movement. This seems to be overlooked in a similar way to eccentric muscle contraction controlling our movement by decelerating our momentum and controlling forces.

The differing types of collagen contained in different fascia may give slightly different interactions with energy. Some stiffer varieties maybe able to store and return energy whilst others may exert their stiff properties before plastically deforming and having their shape reset by muscle force.

This model would be quicker and more energy efficient than active contraction, neurological or chemical. The force of the movement (hopefully) dictating the correct response of the tissue.

As always this is merely my simple opinion on a complex clinical subject. I have also tried to give a perspective using a functional movement context.