Panel Discussion: Most commonly addressed muscles
What muscle do you find yourself releasing, stretching and/or using some other relaxation technique - most often? What muscle do you find yourself activating, strengthening and/or integrating most often? And for my licensed professionals, what joint or joints do you find yourself mobilizing most often?
Moderated by
Brent Brookbush DPT, PT, MS, PES, CES, CSCS, ACSM H/FS
This Panel Discussion was originally posted on my facebook page - https://www.facebook.com/brent.brookbush - on 4/13/2013
which I used to do). It might be why Tai Chi and Yoga has worked for centuries (although tough for westerners to get as it's hard for them to be interoceptive). Good questions! Off to school
April 13 at 10:09am
Brent Brookbush So Ryan Crandall, is someone has a tight calve you wouldn't stretch it? If someone has a weak gluteus medius you wouldn't activate? If they had an anteriorly shifted talus you wouldn't mob it? You kind of subverted the question in order to promote one very narrow way of approaching an issue?
April 13 at 10:15am
Jeff Hartford I find the most focus on releasing and stretching is equal between pec minor, TFL and calf complex(specifically lat. gastroc. And peroneals). Activation tends to be rhomboid and mid trap, glute max and med gastroc. By no surprise most of my clients have a job that entails sitting in some form. I'm currently pursuing my LMT so I look forward to being a little more hands on in the release techniques I can offer.
April 13 at 10:51am
Brent Brookbush Awesome Jeff Hartford…
So we have pec minor, TFL, calves and peroneals on the over-active side
Mid traps, rhomboids, glute max and med gastroc on the under-active side
I might disagree with the rhomboids, but that get's into a much more technical discussion on what is happening in Upper Body Dysfunction -
Since we are talking about muscles though… what observations have lead you to investigate these structures and how much time do you spend studying your anatomy and looking for other potential structures involved?
April 13 at 11:08am
Melinda Reiner Releasing: gastroc-soleus complex, piriformis. Activating: glute medius.
April 13 at 11:16am
Jeff Hartford Well being back in school or my LMT I just finished A&P 1 and K&M 1 so I spent quite sometime studying that above just what I do on the job with my clients. In using the OH squat assessment I identify a protracted shoulder girdle that leads me to release/stretch pec minor then activate mid trap/ rhomboid in and effort to gain some retraction back to a neutral shoulder girdle. I identify lumbar extension that leads to releasing/ stretching TFL and activating glute max. And I identify externally rotated feet generally with some pronation as well to focus on releasing/stretching lat. gastroc & peroneals and activatin med gastroc.
I add in rhomboids simply because they are a scapular retractor with mid trap…
Often times with the protracted shoulder girdle we see some elevation too so I work on some locator scap and upper trap release/stretch and activate lower trap for depression
April 13 at 11:16am
Brent Brookbush Nice Jeff Hartford…
I like how you keep adding more pieces to the puzzle, and I think it is important that we all continue our education whether in school, or out of school with multiple degrees.
My thoughts on the Rhomboids involve my Predictive Model of Upper Body Dysfunction
I'm with you Melinda Reiner, although there is some new research that infers that piriformis may not be as bad as we originally thought… I find myself releasing and stretching the piriformis less than ever (except in cases of knees bow out, and SI joint dysfunction) - after all that little guy does help to keep our knees from caving in.
As far as Glute Med… well you know my motto - "Everyone could use a bigger Butt "
Upper Body Dysfunction (UBD) |
Barbara Kay For me, everything in the neck, shoulder, and upper back area needs to be stretched a lot. This is due to stress and a lot of time spent in front of the computer. Most people are very tight in these areas because of poor posture and tension. This is why so many suffer from frequent headaches and migraines.
April 13 at 12:04pm
Brent Brookbush Definitely a tough area Barbara Kay, and from a functional anatomy standpoint a complex one… there are many muscles in the neck, many joints, and the relationships between them are quite complex. Neck Dysfunction is one of my proposed predictive models; however, I am still working out the kinks and have been for years.
April 13 at 12:07pm
Melinda Reiner Thanks, Brent. I think a lot of what we deal with is also associated with the population of folks we're helping out. If one primarily sees runners/triathletes, it's predicatable what we'll see. People who primarily work sitting down, another; men, who work too much anteriorly, are another population; as well as, athletes in very focused skill sports.
April 13 at 12:08pm
Barbara Kay I actually had a masseuse ask me if I did manual labor for a living since the knots were worse than a construction worker she had just worked on that day. Welcome to my world B2!
April 13 at 12:10pm
Micheal Zwack I think one thing we are omitting is that the CNS must be along for the ride if we are going to use any of these "releasing/inhibiting" techniques.
If a person does not know how to relax and just breathe as Ryan Crandall mentioned, these techniques are completely pointless. Through my experience both personally and professionally; if a person just goes through the motions it does work very well and can end up with them getting frustrated and completely writing off "corrective exercise" all together.
The majority of clients we will interact with have minimal if any body awareness. Asking them to just relax and breathe while doing nothing at all may be a challenge. To add stretching/releasing something that may hurt like hell is a difficult or sometimes even impossible task.
Not to say rolling and releasing do not work, it does sometime, but not all of the time.
Again the point I want to drive home is that most people can not be present or mindful enough to do what we are asking. It starts from with in, just like we are taught.
It takes repetition and more repetition to get a individual to achieve this relaxed state. More emphasis needs to be placed and relaxation and breath before we do anything.
Personally I feel once we can get them there (relaxed, aware, supported, what ever you want to call it..) some of those "tight" muscles are no longer "tight" because maybe, just maybe something else was responsible for their "tightness", like a bad day at work or a fight with a spouse.
I think micromanaging movement if great for a Physical Therapist, but not optimal for the average Personal trainer. IF person has REAL PAIN or injury a trainer should not be working with them anyways. Then their movement sessions need to be more scrutinized
In summary, while all this sounds good on paper and with someone who can actually breathe and relax into an inhibitory technique most people are incapable of doing this. In most cases these days I have people just move through functional patterns, have fun, laugh, and just try to get them a little more aware of their bodies each session or class. Like most things these days I like to fall somewhere in the middle. Both techniques have worked for me personally, with clients, and students who I teach BOTH techniques to. I am always sure to point out there is more than one way to skin cat. However, I am finding the less I micromanagement movement the better I feel. So just move with intent and purpose, that may include a little rolling, stretching, and activating or it might not………..
Hopefully this adds a different perspective
“One of the painful things about our time is that those who feel certainty are stupid, and those with any imagination and understanding are filled with doubt and indecision” - Bertrand Russell (1951)
April 13 at 12:41pm
Jeff Hartford Michael, I totally respect where you're coming from and I'm always open to new ideas and techniques. To play devils advocate however, as important as breathing is, and you're right without relaxation many if not all of these techniques are pointless. The act of breathing alone, in my professional opinion, won't be enough to get an over active muscle with clear adhesions to properly release.
April 13 at 12:51pm
Micheal Zwack Jeff,
Agreed, breath alone will not get you there, but it has to be there to get the ball rolling!
April 13 at 12:58pm
Melinda Reiner Barbara, I'm in that boat now. Severe spasms in vastus lateralis, piriformis, glutes, quad lumborum. Not pretty. I think a lot of us learn from our own bodies and its challenges.
April 13 at 1:05pm
Brent Brookbush Hey Micheal Zwack,
To play devil's advocate as well… This post was specifically "designed" to highlight the importance of knowing your functional anatomy… however, let's talk about the CNS for a second. What does your example have to do with the CNS (other than breathing is an autonomic function of the CNS), and why is release and stretching not a CNS thing when it is in fact spinal cord level reflexes that are hypothesized to be responsible for the response?
April 13 at 1:06pm
Brent Brookbush Hey Melinda Reiner,
I am not sure if it is as population specific… even when I was in the hospital dealing with older very sick individuals the compensation patterns were still there. Athletes develop the same dysfunctional patterns that desk jockey's do… and there are even some similarities between those with "normal" postural dysfunction and those that are traumatically induced - the only place I have seen this go a bit awry is in neural impairment…
April 13 at 1:13pm
Jason Erickson As others have already stated, there are levels and levels to this, and my process varies considerably depending on whether I am functioning as a massage therapist or as a personal trainer.
As a trainer, I use reciprocal inhibition instead of direct inhibition, with anterior hip (psoas, iliacus, and proximal quads) the most common area in need of attention. Activation of the glutes usually accompanies that.
As a massage therapist, I work on the issues already mentioned by others, but something else I have been spending time on is improvement of midfoot function. Most of the feet I see are not functioning well, with the proximal metatarsal joints extremely stiff and impairing normal function of the entire lower body. Using soft-tissue techniques, I usually see dramatic improvements in the mobility of midfoot joints, and the pain/tightness of areas associated with calf, shin, heel, "plantar fasciitis", and knee pain usually improve immediately (not to 100%, but much closer). I teach clients how to work with their own feet and ankles to maintain the improvements and achieve long-term results.
The areas that I most frequently teach clients how to stretch are the hip flexors, calves, pecs, biceps, and glutes. I mainly use Active Isolated Stretching for this, but use other forms of dynamic stretching too.
Right now I feel that posture is a symptom, not a cause, of underlying issues. I don't treat posture, but I do expect to see changes over time.
April 13 at 3:46pm
Micheal Zwack Hey Brent,
Not discrediting the importance of functional anatomy at all!
It so important!
I did not mean releasing and stretching is not a CNS thing.
I apologize if I was unclear
We all know the CNS controls all of that.
What I am saying is a disrupted breathing pattern will cause a shift in the sympathetic/parasympathetic response which can cause added tension to HMS if not optimized.
April 13 at 3:48pm
Brent Brookbush Hey Micheal Zwack,
My problem with the CNS stuff is I rarely if ever see an immediate effect, and all of the exercises I have seen that are supposed to affect the CNS stand on the very shaky ground of hypothetical adaptations of the brain… As in, "i…See More
April 13 at 6:25pm
Brent Brookbush Just wanted to take a second to thank everyone for their participation and hard work in this discussion. You kats are awesome!!!
April 13 at 10:32pm
Jason Erickson I agree with Brent that changing habitual breathing habits can take quite a bit of time and practice, but in some cases simply coaching a client to exhale upon effort will provide some immediate relief. This then needs to be reinforced with practice.
What I have found remarkable are the immediate benefits of neuro-oriented methods such as positional release techniques and dermoneuromodulation. Within minutes, most clients have reduced pain and increased ROM and coordination.
For example, one of my clients was bench pressing and something funky was happening with her right shoulder, along with all kinds of weird "fish-flop" compensatory movement. I had her rack the bar and sit up, then did a little DNM and AIS for her pecs and shoulders. During this time, she got some rest, which helped, but her coordination of the movement was improved beyond what the rest alone could explain.
In other cases, while helping someone stretch, we find that their AROM simply won't move beyond a certain point. After a short application of PRT and/or DNM, their AROM improves by 10-30 degrees.
These few examples, while neuro-based, also somewhat support Brent's position, as they focus on specific areas of the CNS/PNS rather than whole-body sympathetic/parasympathetic response.
April 14 at 12:37pm
Brent Brookbush I definitely agree that much of what we are doing is receptor oriented Jason Erickson, this includes release, stretching and activation techniques. Although we are often seduced by purely mechanical models of movement, it is an integrated system. This is also the reason why no one technique can ever be an ideal treatment strategy. By improving length tension relationships, soft tissue rigidity, arthorkinematics, etc… it is as likely that it improves the quality of the "signal" being sent to the CNS from our muscle spindle, GTO, ruffini endings, arthrokinematic receptors, etc… that result in improvements in performance, integration, and coordination…
I look at a lot of what I do as taking the "beer goggles" off the CNS.
That's right… I just discussed "receptors," "sensory integration," and "beer goggles" in the same paragraph - Bringing human movement science education to soaring lows