My Principle
Hello everybody!
After reconsidering many of my treatment methods I’ve come to form a principle I want to talk about. It’s a simple thought, but it carries weight through almost all injury rehabilitation and treatment. The principle is, “I can never affect your body as much as you can”. I’ll discuss how I came to realize this and I’ll provide a few examples of how it works.
The idea first came into my head when I was researching Blood Flow Restriction therapy (BFR) as part of applying for a grant to purchase a couple BFR units. The science stands for itself with BFR. But the basic concept is that by restricting blood flow to a limb during light load exercise we cause the body to release hormones similar to when performing a maximum effort lift. In my opinion, this works like a “life hack” for weight training especially in the rehabilitation setting where most athletes are unable to perform a max-out lift. A former mentor of mine once told me that despite all of the technology we have in the athletic training room, we are incapable of healing the body. At best, all we can do is create the most optimal environment within and around the body to allow for healing but really the body will take care of itself. So what if I can get the body to do the work for me beyond just healing tissue? That’s where BFR comes in and that’s where I started to form this principle of mine.
Now let’s apply the principle to the age old element of every warm-up routine since forever, static stretching. The basic theory of stretching is that we are lengthening contractile tissue (sometimes we target non-contractile tissue too) to allow for a greater range of motion. After stretching, there is no doubt that range of motion can be increased. Therefore the theory must be correct, right? Well, I’m not so convinced it works exactly like that. The vast majority of stretching is far below the threshold necessary to physically lengthen tissue. Muscle actinomycin molecules are built to contract, but in a fully relaxed state they do not lengthen further. Stretching does not lengthen tissue, it increases your tolerance to being in a new position (it’s all about the nerves). You could argue an exception for somebody who has a history of muscle strains where the tissue has lost its original elasticity and is therefore more rigid and resistant to movement. However, we hold a lot of passive tension in our muscles for a number of reasons; muscle guarding, compensation patterns, lack of activity, etc. By stretching we can change our muscles’ “homeostasis” to allow for more movement by decreasing some of that passive tension. After considering that stretching does not actually lengthen tissue but rather changes our proprioception of a joint, I wondered if there is a better alternative to achieve an increase in range of motion.
Reciprocal inhibition is the key here. If muscle A is the agonist of a joint and muscle B is the antagonist, then the shortening of muscle A would cause a neurological down-regulation of muscle B. This is vitally important in the body's’ creation of movement. The biceps brachii contracts to flex the elbow, therefore the triceps brachii has to relax otherwise the elbow will not move. The same effect happens in regards to passive tension within the muscle. If there is tension held in muscle A due to something like a compensation pattern (these will be discussed more in-depth in another article), then muscle B will be down-regulated. If we work backwards by getting muscle B to activate and contract then muscle A will relax. I try to avoid cranking on an athlete’s leg to increase hip flexion range of motion where they might not like it and consciously or subconsciously resist the motion. Proprioceptive Neuromuscular Facilitation (PNF) stretching can help, but I’ve found that when an athlete is in a compensation pattern they do not fire the correct muscles during a hold-relax or a contract-relax-antagonist-contract pattern to cause reciprocal inhibition (these patterns are still very effective at increasing range of motion). I would rather put the athlete into positions that require control and activation of one muscle to cause relaxation of its antagonist. Again, “I can never affect your body as much as you can”.
Do you agree with this principle? What are some techniques you use in your practice that relate to this principle? Do you have examples of when the opposite is true?
More next time,
Mark D.
@MarkDomATC
After reconsidering many of my treatment methods I’ve come to form a principle I want to talk about. It’s a simple thought, but it carries weight through almost all injury rehabilitation and treatment. The principle is, “I can never affect your body as much as you can”. I’ll discuss how I came to realize this and I’ll provide a few examples of how it works.The idea first came into my head when I was researching Blood Flow Restriction therapy (BFR) as part of applying for a grant to purchase a couple BFR units. The science stands for itself with BFR. But the basic concept is that by restricting blood flow to a limb during light load exercise we cause the body to release hormones similar to when performing a maximum effort lift. In my opinion, this works like a “life hack” for weight training especially in the rehabilitation setting where most athletes are unable to perform a max-out lift. A former mentor of mine once told me that despite all of the technology we have in the athletic training room, we are incapable of healing the body. At best, all we can do is create the most optimal environment within and around the body to allow for healing but really the body will take care of itself. So what if I can get the body to do the work for me beyond just healing tissue? That’s where BFR comes in and that’s where I started to form this principle of mine.
Now let’s apply the principle to the age old element of every warm-up routine since forever, static stretching. The basic theory of stretching is that we are lengthening contractile tissue (sometimes we target non-contractile tissue too) to allow for a greater range of motion. After stretching, there is no doubt that range of motion can be increased. Therefore the theory must be correct, right? Well, I’m not so convinced it works exactly like that. The vast majority of stretching is far below the threshold necessary to physically lengthen tissue. Muscle actinomycin molecules are built to contract, but in a fully relaxed state they do not lengthen further. Stretching does not lengthen tissue, it increases your tolerance to being in a new position (it’s all about the nerves). You could argue an exception for somebody who has a history of muscle strains where the tissue has lost its original elasticity and is therefore more rigid and resistant to movement. However, we hold a lot of passive tension in our muscles for a number of reasons; muscle guarding, compensation patterns, lack of activity, etc. By stretching we can change our muscles’ “homeostasis” to allow for more movement by decreasing some of that passive tension. After considering that stretching does not actually lengthen tissue but rather changes our proprioception of a joint, I wondered if there is a better alternative to achieve an increase in range of motion.
Reciprocal inhibition is the key here. If muscle A is the agonist of a joint and muscle B is the antagonist, then the shortening of muscle A would cause a neurological down-regulation of muscle B. This is vitally important in the body's’ creation of movement. The biceps brachii contracts to flex the elbow, therefore the triceps brachii has to relax otherwise the elbow will not move. The same effect happens in regards to passive tension within the muscle. If there is tension held in muscle A due to something like a compensation pattern (these will be discussed more in-depth in another article), then muscle B will be down-regulated. If we work backwards by getting muscle B to activate and contract then muscle A will relax. I try to avoid cranking on an athlete’s leg to increase hip flexion range of motion where they might not like it and consciously or subconsciously resist the motion. Proprioceptive Neuromuscular Facilitation (PNF) stretching can help, but I’ve found that when an athlete is in a compensation pattern they do not fire the correct muscles during a hold-relax or a contract-relax-antagonist-contract pattern to cause reciprocal inhibition (these patterns are still very effective at increasing range of motion). I would rather put the athlete into positions that require control and activation of one muscle to cause relaxation of its antagonist. Again, “I can never affect your body as much as you can”.
Do you agree with this principle? What are some techniques you use in your practice that relate to this principle? Do you have examples of when the opposite is true?
More next time,
Mark D.
@MarkDomATC
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