Biomechanics and REAL function

I have been an Osteopath since 1999 and part and parcel of being an osteopath is having a thorough understanding of anatomy, biomechanics as well as medicine and pathology.

This year I had the privilege of doing a mentorship with the Gray Institute called GIFT. This was a 40 week course working with the world legends Gary Gray and Dave Tiberio. They created ‘Applied Functional Science’ or AFS. This is the real science behind movement and not what is says in the anatomy books! Gary Gray has been a US physical therapist for more than 35 years and has been working with Dave Tiberio since then. They look at REAL function and how everything changes when your foot hits the floor.

Assessment and rehabilitation is all done in 3 planes and mostly standing, using the full impact of gravity and ground reaction! This uses correct neurological pathways as your proprioception is ‘switched on’ and so you are able to assess what the body is able to ‘functionally’ achieve. This is very different from feeling and seeing what a back, hip or knee does while lying on a table.

Very few people REALLY look at the body in the way they (or I do now) do. Some will look at the tri-plane movement of the foot and sub-talar joint, but they don’t link this to the hip or scapular or cervical spine in gait, hitting a golf ball or bowling. Gary Gray and Dave Tiberio teach all this to the extent of how your psoas affects your scapular or foot! Quite brilliant!

GIFT has been inspirational and an amazing journey and it has set me alight! It has given me more passion to further the osteopathic and functional model. GIFT is a huge investment both financially and in your time. But I looked at it as just that…. an investment. An investment in me and an investment in my patients. So worth it!

If anyone is interested in doing something like this, look at their website and if you cannot manage something so big as GIFT, look at one of their Chain Reaction courses or their online content.

Get Wise for CrossFit – and keep safe!

The first affiliated CrossFit (CF) gym was opened in Santa Cruz in 1995 and was founded and developed by the coach Greg Glassman.  Over his years of watching the fitness industry, his idea was to create versatile athletes (gymnastics and weightlifting) through primal movements and intense training.  It has since gained worldwide momentum and a huge following.

The typical workout or WOD may involve intense drills of weightlifting (squats, deadlifting and carrying odd objects or kettlebells etc) box jumps, burpees, sprinting and using gymnastic rings to name a few.  Most activities are all well and good and with a structured and progressive integration into your lifestyle and using the basic premise of not walking before your can crawl and not running before you walk.  This puts in place not just the neurological inputs that are needed to perform and function, but embeds some firm foundations of the chain reaction needed for movement and structural control.

I see and treat a fair amount of injuries sustained through CrossFit and whilst injury is often seen to be part of any intense exercise, I do feel some of these could be avoided.

CrossFit is massively intense and with that comes excitement and vigor and over time, a body that develops in power, coordination and agility.  But I feel that with this excitement and vigor often comes lack of care for ones self and the idea that if your push yourself harder, you get faster results.

Let me use the example of running again.  If we have a basic level of fitness, most of us assume we should be able to run.  Running is composed of lots of hops and leaps.  When treating/rehabbing athletes, I am often asked “am I ready to run yet?”…… and I ask them “can you repeatedly hop and leap?” and then depending on their answer we watch and see…… and we see if they can or if they fail.  That gives us the answer and often, they cannot hop and leap!  So surely, they should not run!

My point of this is much more about creating the foundations much deeper than you think you need.  To enable Mo Farah’s fabulous achievements at the 2012 Olympic Games, he would have run around those tracks hundreds if not thousands of times and known that if he gets a PB, it will probably be within a certain amount of time.

So doing 25 squats with 100kgs if you have only ever twice before would be foolish.  Doing 25 squats with 100kgs should ok if you are regularly doing 25 times 90kgs.

To enable good technique with power moves such as deadlifts and squats you don’t just need good technique, you really need good functional mechanics such as sufficient ankle, knee and hip movement and these need to be able to load the weight correctly.  If they cannot do this, somewhere else will take the hit….and this hit maybe your lower back, shoulder or neck!

Over the next few months I will be working with Tom and Harri Bold from CrossFit Bold and other coaches from Athletic Alliance to develop some easy strategies to enhance movement and control, which we will be sharing with all the members.  All with the idea injury avoidance!  But in the meantime, please be careful of your form and technique and keep your ego in check and don’t find yourself where you are trying to push your body to a place where it has not been before too quickly.

Ignore the figures but, think of it like an iceberg – 70% underneath and 30% on top…..

Functional Exercise and Training – The Why and the What!

Tri-Plane Movement and Functional Training, these are both current words used to describe movement and training by the personal training and allied health professions (osteopath, physiotherapist, exercise physiologist and chiropractor). The health and fitness industry is going through yet another change, just like the swiss ball was the man of the moment in the 90′s, pilates and the core were the trend of the early 2000′s, many trainers and health professionals are now focusing on training movement rather than muscle, training functional exercises rather than non functional exercises, training groups of muscles rather than muscles in isolation.

What this means in simplistic terms is that trainers and health professionals etc are now moving away from the body building approach to training and conditioning (that is isolated weight training) and moving towards training that integrates movement with resistance that mimics upright function such as gait and other movement patterns that we perform on a daily basis i.e. squat, sit to stand, step up and down, push, pull & rotate. Trying to use gravity as the driver by doing exercise on your feet or upright, rather than on your back or in a machine stimulates your proprioception much more effectively than fixing an area, therefore creating the correct chain reaction needed for full and appropriate muscle function.

This does not suggest that one training approach or philosophy is better than the other, it fundamentally comes down to what the specific individuals goal is. For a body builder looking to compete, then traditional weight lifting techniques that have been proven to produce muscle gain is required. For the olympic power lifter, olympic lifts are practiced. For the sporting indivdiual, there will be likely a combination of functional movement exercises as well as some strength, olympic and powerlifting techniques. For the individual wanting to improve their overall wellbeing, strength and mobility, there is also likely to be a combination of the above.

So what does Tri-plane movement, functional training etc etc mean. Tri-Plane movement simply refers to movement in the three planes (sagittal, frontal and transverse planes). If we look at the individual who is standing upright, the best way to describe movement in the sagittal plane is forwards and backwards movement. Movement in the the frontal plane refers to side to side movement (that is laterally stepping or performing a lateral lunge). Movement in the the transverse plane is when movement occurs with rotation. That is, whilst standing you twist and turn to move or lunge backwards and laterally. Everyday movement occurs in all three planes at a bone and joint level and this is why there is this growing change in the way that training is being carried out. Previously most gyms and training programs were focused on training muscles in machines and/or functional training was restricted to movement purely up and down i.e squat movement or forwards (anterior lunge). As our understanding of functional biomechanics and movement improves, so does our training approaches and philosophy. Now days we are seeing more and more clients perform movements that involve all three planes of movement, involving less equipment and with movements that mimic real life activity.

Functional Training is probably one of the biggest buzz words in the health and fitness industry at this particular moment. There are many indivdiuals out there claiming to provide functional training. Functional training is certaintly not something that is new, rather it has been around for many many years and simply relates to training that mimics how we function. How this training relates to how we function will depend totally upon what and why we are training. For an individual who sits for their job for their entire life and wants to improve this, then training should focus on improving their ability to sit whilst working. For those individuals who are wanting to improve their everyday movement, that is sit, stand, walk, step up and down, squat, lunge etc etc, then training should reflect this. For the sporting individual, the training should mimic the sporting requirements, movements or athletic components that are that sport. So functional training has many meanings and therefore can be interpreted in many different ways.

For the general public, when we look at the body and how it functions, the most common movements or positions we are in involve walking (gait), sitting, standing, squatting, lunging, stepping up and down, single leg balancing, pushing, pulling and twisting. All of these movements are impacted by gravity and ground reaction force and these are two other factors that should be taken into consideration when prescribing a program. Gravity is something that we are always working against to remain upright. Therefore gravity is something that can easily be used to increase or decrease the degree of difficulty of an exercise. Ground reaction force relates to Newton’s laws and how force in one direction results in an equal and opposite amount of force in the opposite direction. This can be related to jumping and landing on the ground whereby an amount of force is exerted downwards and then the force will be transferred back into the legs and must be either shifted or absorbed by the body. So when it comes to functional training and tri-plane movement training, hopefully now you will have a little bit more of an understanding of what, why and how this might be prescribed in relation to yours or anyone else’s training program.

In our opinion, functional exercise should be used more and more when rehabilitating injuries or with patients post surgery. The more you get patient’s bodies working proprioceptively and in 3 planes, their bodies can start to ‘switch on’ to allow them to recover better and stronger.

To find out more about changing your training program, making it a little bit more functional in relation to your specific goals, incorporating exercises that involve training in all three planes, then contact Back to Back – The Earlsfield Osteopath on 020 8605 2323 or click here

Adductor Function

I just LOVE this muscle!

It does most things other than adduct your hip!! If you lie on the ground on your side and lift you lower leg… sure… your adductors adduct your hip…..BUT during function, it does a fabulous job at not adducting your hip.

They are the adductor brevis, longus, magnus oblique and magnus vertical. The brevis and longus attach onto the posterior medial part of the femur, not just on the medial part as most people talk about.

A great and massively overlooked thing about this group of muscles is that they work with their opposite adductors. The right and left adductors are turned on in gait (differently) but at the same time.

If the right leg is forward the right adductors are stretched in the sagittal plane and they slow hip flexion. They are lengthened in the transverse plane (TP) and they help to internally rotate the femur. They are also shortened in the frontal plane (FP) with hip adduction.

As we walk, and as the left leg swings forward, the right leg becomes the back leg and the right adductors are lengthened by hip extension (posterior medial attachment). They are then lengthened in the FP by the pelvis leaning towards to the left leg causing hip adduction. It is then shortened in the TP are they externally rotate the femur. The facilitates top-down external rotation of the tibia and calcaneal inversion…. and locks out the mid tarsals ready for push off!

As I have said – both sets of adductors work as a pair…. The right adductor works with the left adductor to slow the movement of the pelvis to the left and visa versa. If the adductors and tight in any plane, they will inhibit other planes.

But they can also be responsible for other dysfunction. If the adductors are short or not permitting good function, your pelvis will be unable to move correctly in 3 planes of motion and so your lower back, mid back or neck may take the hit instead. You might end up seeing someone for your back pain all because of you adductors. This is why it is SO important to not always treat the symptom, but to go to the cause!!

If you have just injured yourself (especially after the marathon) or need to be assessed for injury or need treating, do give us a call at Back to Back on