Sarah,
Initially, I get the patient to do what is called the Potty Exercise.
Basically, you get the patient to put their fingers above the pelvic rim and
get them to pretend they are doing a poo (in supine). What you should feel
is a swelling under the fingers. Once you feel the swelling is as much as
you contract (since you don't want to activate the accessory muscles,
especially the obliques). The difficult part is getting the patient to
breath at the same time - this is why you must do it very gently!!! Once
they become good at this in supine, progree to sitting and then to standing
- the key is able to breath while maintaining the contraction. Once they are
good at this, then you can progress by isolating TrA as taught by Dr Hodges,
Richardson and Ass Prof Gwen Jull. This is usually the path I follow, but
every patient will differ in how they react to the exercise.
Finally, I use a theraball and do stability and mobility exercises on the
ball whilst activating the TrA muscles consciously. This basically explains
what I do for lumbar stability.
Henry***
>From: Sarah Fern Striffler <[log in to unmask]>
>Reply-To: [log in to unmask]
>To: [log in to unmask]
>Subject: Re: TrA activations
>Date: Sat, 07 Oct 2000 14:02:07 -0400
>
>Henry,
>
>Please describe your combination ex. I have a hard time conceptualizing
>how on could co-activate all those mm w/o performing Valsalva.
>
>Thanks.
>
>Sarah
>
>
>Henry Tsao wrote:
>
> > I agree, TrA muscle is a long endurance muscle, and hence low intensity
>high
> > repetition is the way to retrain these muscles. However, I do not agree
>on
> > isolating the TrA contraction:
> > 1. It is very difficult to teach and do
> > 2. The muscles in the human body work as a whole, and isolating a single
> > muscle contraction seems to ignore the fact that other muscles are
>involved
> > in the equation.
> >
> > What I teach my patients is a combination of activating the TrA, pelvic
> > floor muscles, multifidus and diaphram, hence forming a box to stabilize
> > IntAb pressure and stabilizing the back. It is much easier to do and
>more
> > functional in my opinion.
> >
> > Henry***
> >
> > >From: "Al & Pete" <[log in to unmask]>
> > >Reply-To: [log in to unmask]
> > >To: <[log in to unmask]>
> > >Subject: TrA activations
> > >Date: Sun, 8 Oct 2000 01:50:01 +1000
> > >
> > >My understanding of the reason for having patients perform an isolated
> > >contraction is this:
> > >When you perform a sit-up or cough etc, TrA is activated phasically,
>and an
> > >isolated contraction is the only way to induce a tonic activation,
>which is
> > >the only way to affect the automatic activation of the muscle.
> > >I am happy to be proved wrong if people know otherwise.
> > >
> > >Allison Franks, Physiotherapist, Brisbane, Australia.
> > >
> > >
> > > >Interesting thing... TA is activated during sit up and coughing, but
>I
> > >guess
> > > >you also activate other muscles as well. What what Dr Richardson says
>is
> > > >that the aim is to control TA contraction at the correct time hence
> > >avoiding
> > > >back pain.. and not neccessarily strengthening it.
> > > >
> > > >Henry***
> >
> >
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