----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, December 16, 2001 8:17 PM
Subject: Core Stability Paradoxes
> Mel Siff:
>
> <1. Do these apparently motor or muscle deficient lifters somehow manage
to
> use compensatory mechanisms to cope with their alleged weaknesses?>
>
> Patrick Zerr:
>
>
> <YES, It's possible! Many industrial athletes who lift heavy loads (kegs
> beer distributors come to mind) have great strength with many
compensations
> in flexibility and strength throughout the kinetic chain from head to
toes! >
>
> *** Then, does this not further suggest that certain clinical attempts to
rectify apparent segmental spinal deficiencies may be unnecessary or
> redundant? >
NO!
It certainly is not redundant. Lets say you improve the flexibility of the
spine and hips to acheive the lifting once again. Now, often the person can
not lift much at all because they have lost even more stability that they
gained from compensation.
So, they need that intersegmental control to be able to move in a more
efficient pattern that they did not have before they got injured. Quite
often this is the case with the injured spine in my experience.
**********After all, optimisation of anatomical function does not rely on
producing one unique solution to a motor problem, but the situationally
opportunistic implementation of various other alternatives, one of which may
invoke the clinically "ideal" patterns, timings and degrees of TVA and
multifidus recuitment (in fact, MRI research reported in a recent
'Scientific American' showed that different neural and neuromotor strategies
may be used to control the same motor output).
++++++++++++++
Certainly taking "advantage" of a weak link the Multifidi and TVA is a
viable option in the scope of practice of a physical therapist. Why would
it not be given the references stated on this and other lists recently about
the recruitment of these muscles. Could it be the only reason people recove
r? Most likely not, but it's definately a piece of the "larger picture" when
it comes to rehab.
Mel, what would you propose we do as therapists, ignore training these
muscles? Is there some "super" exercise we should be doing? Please let us
know
Patrick Zerr
www.apluspt.com
The easiest way to prepare for the National PT Exam!
www.summitpt.com
Summit Physical Therapy; Tempe, Arizona
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