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PHYSIO  December 2001

PHYSIO December 2001

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Subject:

Re: Core Stability Paradoxes

From:

"Beatus, Joseph" <[log in to unmask]>

Reply-To:

- for physiotherapists in education and practice <[log in to unmask]>

Date:

Mon, 17 Dec 2001 15:12:48 -0500

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (150 lines)

Ladies and gentlemen: The assumption that all muscles are an important
evolutionary structures reminds me of an essay by Stephen Jay Gould in
Nature (a few years ago) re the Panda's extra toe? nail? Are you sure
you need the transversus? do you all have palmaris longus, 2 flexors of
the 5th? Well, if this is annoying, let me remind you that in bovines or
quadruped with large abdomens the muscle will sub serve a quite
different role than in true bipedal  (unless you sing arias-so was I
told by a singer, attempting to explain his girth?) by and by , how many
joints are crossed by a single muscle? the work of Basmajian re single
fiber control has not been demonstrated except possibly in the hand (if
there). too much space to a vestigial structure? Joe


-----Original Message-----
From: John Spencer [mailto:[log in to unmask]]
Sent: Monday, December 17, 2001 2:43 PM
To: [log in to unmask]
Subject: Re: Core Stability Paradoxes


OK Mel,

Now I am getting confused again. In an earlier post you said:

***While this research was carried out under static laboratory style
>conditions, there has, been to my knowledge, been no research that has
>examined Transversus Abdominis involvement during complex, dynamic or
>ballistic daily and sporting actions.

But in your last post you said:

>***Before we focus a little later on some specific references on
laboratory
>subjects, maybe someone could explain the apparent paradox that various
>weightlifters and powerlifters who have no back pain or disability are
not
>infrequently shown by clinical tests to have deficient TVA timing or
>multifidus action, yet they have lifted dauntingly heavy loads for many
years
>without any apparent musculoskeletal injury.

Surely, if such research has been carried out it belies the truth of
your first statement that no such research has been carried out
examining "Transversus Abdominis involvement during complex, dynamic or
>ballistic daily and sporting actions".

If you have read/carried out such research, how did you measure TA
timing (ie what equipment did you use and how were you sure of picking
up TVA - it being such a deep muscle?) Also, how did you measure
'dysfunction' - ie what parameters lead you to conclude  a lack of
normal function. Such measurements would be a really interesting
contribution to the literature on TVA - has it been published? Can you
supply an abstract?

Secondly, even if the research does indicate dysfunction in TVA in
people without pain this does not confound the TVA researchers
conclusion. In fact Paul Hodges has said that we need to carry-out a
huge prospective study in people without LBP to see if TVA dysfunction
leads to back pain or back pain leads to TVA dysfunction.

>
>How is it possible for someone who is squatting over 350kg (770lbs) or
clean
>and jerking over 150kg above the head not to spontaneously and strongly
>activate the so-called deficiently acting muscles, especially if they
are
>vigorously eliciting the Valsalva manoeuvre and placing exceptional
>stabilisation demands on the whole kinetic chain from hands to feet?
>
>This issue has always intrigued me every time that weightlifters or
>powerlifters whom I have trained with or coached have visited various
>therapists for occasional episodes of back pain.   All too often the
back
>pain was attributed to "intersegmental", TVA or multifidus problems,
but in
>virtually every case, the pain resolved itself when the lifter reduced
his
>period of back inactivity and returned to actions such as cleans,
loaded
>'prone reverse hypers' (over the edge of a high bench) and loaded bench
prone
>back extensions or 'hyperextensions'.

There are many dangers, as you know, of drawing conclusions from
anecdotal evidence Mel. Would you be convinced if a researcher in colour
therapy said:

"All too often the back pain was attributed to "intersegmental", TVA or
multifidus problems, but in virtually every case, the pain resolved
itself when the lifter spent more time tuning his vibrations into the
relevant aural and non-spatial colour elements that complimented his
chakras".

I'm not trying to make fun of what you are saying (just trying to
introduce a lighter note) but my point is that you have always been such
a great (and worthy) defender of the scientific principle it seems
contradictory of you to try and refute well-researched evidence of the
efficacy of a rehabilitation protocol such as core stability by saying
that the weight-lifters you have worked with seemed to do very well
without it. (maybe they wouldn't have had recurrent back pain at all if
they were more willing to undertake effective core stability rehab.)

>
>Every single one of those lifters dogmatically refused to use specific
>methods to "educate" or "activate" TVA during training or competition
(yes,
>typical of many athletes, they refused to see the point of such
apparently
>trivial undemanding activities), yet very few of their careers ever
ended due
>to back pain or dysfunction.  Subsequent clinical tests not involving
the
>imposition of heavy external loads still showed the same "imbalances",
yet
>the lifters all went on to lift even heavier weights.   This raises a
few
>questions:
>
>1.  Do these apparently motor or muscle deficient lifters somehow
manage to
>use compensatory mechanisms to cope with their alleged weaknesses?

### Well, it looks like they are failing to compensate very well if they
had recurrent bouts of back pain.
>
>2.  Do existing clinical tests fail to give meaningful information on
dynamic
>spinal stability in sport?

### It is true that clinical tests at the disposal of most therapists do
not give the information using sophisticated EMGs that the researchers
use.
>
>3.  Is the role of these muscles exaggerated in certain situations?

###Do you mean exaggerated by the researchers?
>
>4.  ..... Any other suggestions?
>
>The answers to these questions undoubtedly will lead quite well into a
>discussion of clinical studies on spinal stabilisation and function, so
let's
>see what we come up with.
>
>Dr Mel C Siff
>Denver, USA
>http://groups.yahoo.com/group/Supertraining/

--
John Spencer

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