Friday, March 18, 2011

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Instability Lumbar Cervical Vertigo (Part III) Lumbar Instability



The analysis of movement dysfunction is a system of assessment and treatment in a manual (whose name I remember) is directly related to dysfunction of stability.

This measurement system evaluates the effectiveness of the recruitment of stabilizers by the ability to make a move correctly and without causing movement in an adjacent area (to be stable diamonds).

As an excess of movement, a movement pattern is altered not in itself a dysfunction of stability, whether it is a dysfunctional process compensatorio.La adaptatorio instability involves a change of control engine that generates a symptom, usually pain.

The same test to assess the stability serve as exercises: Keep the column "neutral" while performing movements such as knee extension (without lumbar flexion occurs), hip external rotation (no rotation occurs back), thoracic extension, hip extension and knee flexion in the prone position (without causing lumbar extension) ...


Panjabi neutral zone defined as the place within the ROM (Range of motion or joint range) where resistance to joint movement is minimal. In other words, the ROM before coming to R1 (the first tough) in any direction.

spontaneous position for many patients show an increase in the neutral zone. The area of \u200b\u200bleast resistance is more extensive due to laxity (passive component failure of osteo-capsule-ligament), muscle imbalance (failure of active component: extensibility / relative stiffness) and neural (poor motor control).


Here, a model of objectivity and measurement of the neutral zone.


" recently an Australian group showed that the TrA is not always active and symmetrical prior to limb movement and uphold the answers in advance of TrA are directionally specific and act asymmetrically (GT Allison et al 2008).
For example, Hodges et al. (1999) showed that 3 out of 8 control subjects without pain, had no anticipatory responses in 70% of studies during the bilateral lifting of the arms. Allisson G and Morris (2008) suggested that this was due to a less than optimal stability, but being a normal variant of motor control. The studies of Dr. Stuart McGill are also in line with these findings.
In summary, we can not say that the inner core (TrA, multifidus, diaphragm and pelvic floor) is activated before the outer core (erector spinae, rectus abdominis, obliques) or other muscles if you look at the evidence " .


Translated from Bret Contreras Blog In an interview with Jurdan Mendigutxia

In one study at McGill, it was found that the contraction of TrA did not provide greater stability, and instead co -contraction of all abdominal muscles if he did. However, it is considered that the co-contraction generates excessive rigidity and is not stable enough for the role.

The culture of GYM and fitness section of the industry have reduced the Stability core training to get tummy and strengthen your abs in an isometric fashion, and some authors caution that excessive rigidity can cause back pain, incontinence and respiratory blockage. Stability of core Critics argue that not only help relieve back pain but can increase if done at high load.

For others, no exercise progression is able to create exercises connection with activities of daily living, and indeed, the exercises at low load, it falls short on a sporting level. It is necessary to use high-load exercises. Strengthening the core can be appropriate if the function requires that rigid stability, as is the case with boxers, for example.

Some experts have serious doubts about whether we can retrain the neuromuscular system to improve the timming of the stabilizers, at both low and high load.

in gyms is still used to strengthen the abdominals, but not used as dynamic exercises as classic muscle shortening, more trains on the role of stabilization in the line of Mc Gill .






 




Some references of comments through the investigation of Lederman:

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