Mell said
<The therapeutic and fitness training worlds still seem to place a heavy
emphasis on an isolationist approach to physical testing and conditioning,
without carefully identifying the situational limitations and scope whenever
such as approach is used.
Attempts are made to test and train muscles individually. Few days pass
without comments being made on isolating the upper or lower abdominals for
training, selectively training the core of the body, activating transversus
abdominis to 'stabilise the trunk', .....stuff deleted>
I agree with Mel about the isolationists concepts when one looks at the
issue in terms of muscles and how they move joints - specifically the
development of muscle force and joint torques etc (Most of what people
talk about when it comes to exercise or resistance training etc). However,
I would like to point out that in the group of "The therapeutic and
fitness training worlds.." isolation of transversus / multifidis may have
a therapeutic impact.
There is a body of information which argues that isolation of specific
muscles reflects a diversity of motor control strategies. In my experience
this applies to, yet is far from the only area of rehabilitation /
exercise, some forms of episodic low back pain.
This diversity or lack of it has been associated with certain types of
episodic Low Back Pain.
There is Evidence that isolation of specific muscle function as a precursor
to functional training decreases levels of disability in individuals with
specific lumbar spine pain syndromes. (Of course there is evidence for
general exercise as well... but I argue the case of isolation).
There is less evidence as to the mechanisms of these isolation exercises.
In my opinion, the role of specific abdominal muscles (& deep fibres of
multifidis) is as much about their afferent role as to their efferent
capability (i.e to generate torques, maintain IAP or tension the Thoracic
Fascia).
What is common to all is the science of motor control and motor learning -
from which many professions and sub-groups have common ground.
If one wants to activate Transversus - cough
If you want transversus to stabilise the spine, trunk etc by generating a
large torque - then don't hold your breathe (;-)).
If part of the re-education program to facilitate segmental stability is to
isolate Transversus (& multifidis) then this has some potential in certain
populations under therapeutic guidance. It is the start of a functional
rehabilitation program not the program. Of course this is all driven by
some form of clinical reasoning not just exercise prescription.
(For comfirmation - the isolation activity is VERY small - it can't even be
considered as any form of a resistance training program. If such jargon
is being used then we are talking about different things.)
cheers
Garry.
________________________________________________
Garry T Allison (A/Professor of Physiotherapy)
The Centre for Musculoskeletal Studies http://www.cms.uwa.edu.au/
Department of Surgery, The University of Western Australia.
Level 2 Medical Research Foundation Building
Rear 50 Murray Street
Perth Western Australia 6000.
email <[log in to unmask]>
ph: (618) 9224 0219
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