Along the lines of previous discussions on this list of Transversus etc. I have an observation to put to Mel and the list for comment.
As I have said, I was trained at the University of Queensland where much of the TA research has been based, thus it was hammered into me how important it is. As I also have said I do not believe it to be the "guru" concept it has been suggested it is.
Last year I had a patient who presented with severe back pain, radiating into both legs, almost nil lumbar flexion, two centralised disc bulges etc.
I spent about six months all up supervising a rehab program consisting of gluts, abdominals, erector spinae, and supposed transversus exercises without being paranoid about the isolation component of these exercises - thus they were more generalised abdominal exercises.
He attained a significant level of relief, could walk for 40 minutes, had very little leg pain, but was still in discomfort with certain activites such as sitting, standing and high levels of physical activity. I suggested he continue his exercise program and join a gym to continue an overall fitness and strengthening program.
I saw him at the movies last night, and he is still at the same level as when I last consulted him, though he did not take my advice about the gym program. He has been to a back clinic set up here in Brisbane which ultrasounds transversus and shows its activation/isolation during isolated contraction. Apparently he is in the worst 10%.
I would have thought that generalised exercise would have improved the recruitment of TA - therefore why is he supposedly in the worst 10%? Secondly, does actively isolating a muscle necessarily mean that you use it during movement etc and vice versa, does inability to isolate and contract it mean that you don't recruit it during movement? Does Mel or the likes have references supporting this?
Any comments would be welcome.
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Scott Epsley
PHYSIOTHERAPIST
Northside Sports Injury Centre
Brisbane, Australia.
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