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Tuesday, June 6, 2023

Muscular System Question - What can we isolate and why would we want to?

Brent Brookbush

Brent Brookbush


Panel Discussion: Muscular System Question - What can we isolate and why would we want to?

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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 June 1st, 2013

Ryan Crandall While isolation to a certain extent can be done and often is done in rehab its not exactly how we are designed to move. We all know the brain does usually think of individual muscles instead it moves to perform a function, ie gait, lifting, squatting, weight shifting, etc. So, retraining individual muscles to turn on and off is a good idea when necessary, but we should always funnel it back into why and let's get some real life function back…reacting to gravity, ground reaction forces,& mass&momentum.

June 1 at 11:32am

Mark Jamantoc It is tough but not impossible to isolate the multifidi muscles of the spine. Guided verbal and tactile cues can help as well as diagnostic ultrasound feedback. I have found that firing these muscles help so much with either neck pain (neck deep muscles) or low back pain (multifidi).

June 1 at 11:35am via mobile

Brent Brookbush Hey Ryan Crandall and Mark Jamantoc,

I am with you… although Mark's example brings up an issue in our paradigm for activation - is it just the multifidi, or all of the transverse spinalis muscles, and what are the function of these muscles… is it increased proprioception or stabilization that we are looking for?

June 1 at 11:45am

Ken O'Neill I keep hearing the 'how we are designed to move' position from varying sources, often ones antithetical to one another! Millions of years of evolutionary adaptation has literally 'in-formed' our basic movements.

However, I fail to understand why one would preclude isolation movements outside of rehab. Supersets of isolation movements followed by compound movements, or five sets of isolation movements prior to another 3-5 sets of compounds work better for me than any other choices. For example, decline flyes 50,40,30,30, then 10 or a drop set of 5,5; next 3-5 sets of decline presses. Fabulous workout.

It seems the missing ingredient in most training is that of focused mindfulness of movement. Certainly body work such as Feldenkreis and Alexander Technique both foster explicit conscious awareness of movement then move into voluntary control of movement rather than movement as habit. The same works with resistance training.

June 1 at 12:40pm

Ryan Crandall I'd be happy if I never do chest flys, leg extensions, leg curls, use a bench, or do bicep curls. Sure the above are fine, but certainly not necessary for health. Different strokes for different folks.

June 1 at 12:57pm

Dave Bonk It's impossible to truly isolate a muscle unless you take the nerves out of the other muscles.

June 1 at 1:48pm

Anthony Carey I'd submit that the term "emphasize" is more accurate than isolate. Even if neurologically you could completely isolate (doubtful), you could not isolate the contractile components from the surrounding structures. In Ken's example there is an emphasis but a long way from isolation. Semantics?

June 1 at 1:52pm

Dave Bonk I agree

June 1 at 2:05pm

Brent Brookbush Hey Anthony Carey… I do think "emphasize" would be a more accurate term for activation exercise. If the goal is to improve motor unit recruitment of an under-active structure I am not sure that isolation of the contractile component is necessary. In the activation exercises I use I am careful to reciprocally inhibit over-active synergists via reciprocal inhibition and any affect that has on fasciogenic receptor activity (I think I just made up a word), is fine. The goal is to improve somatosensory input and muscle activity - that does not assume isolation of the contractile component of muscle tissue. Great stuff kats.

June 1 at 4:46pm

Brent Brookbush Hey Ken O'niell,

I am personally against isolated movement for strength and resistance training because they do not optimally address most goals associated with this type of exercise. We can improve performance, enhance hypertrophy training, and increase weight loss by using larger movement patterns.

As a rule (research would support), muscles become more active after being worked, not less. If the goal is to improve human movement quality we have to be careful using isolated movement patterns because it may set up a change in recruitment pattern that is less than optimal. A great example of this would be doing single joint pec flye that increases neural drive of the anterior deltoid before doing bench press changing the optimal mechanics and potentially setting up a change in the arthrokinematics of the glenohumeral joint.

June 1 at 4:51pm

Melinda Reiner Isolation doesn't truly happen. The word "emphasize" could be used when an exercise attempts to target a specific muscle.

June 1 at 5:52pm

Ken O'Neill semantics and deconstruction. isolation has been used in training discourse for a good half century or longer, taking on particular emphasis 40+ years ago with Arthur Jones' invention of Nautilus machines, and later the pre-exhaust protocol. Within that paradigm single joint or isolation movements are used to directly tax a muscle without the aid of other powerful helpers: for example, a set of flyes or pec deck relatively isolating pecs followed immediately - no rest allowed - of bench presses. Experientially one's pecs feel a far deeper pump, burn, fatigue in such a protocol.

In that sense, relative isolation does occur since triceps are removed from the flye or pec deck movement, while with the compound or multi joint movement the relatively already fatigued pecs are pushed further with aid of triceps.

Delts are the most daunting example since delt compound movements can employ either biceps or triceps. Try doing several intense sets of lateral raises, then go immediately to shoulder width upright rows to sternum followed by high seated W presses.

Just a technique, a training option.

June 1 at 7:48pm

Brent Brookbush But that's exactly what I was discussing, and recent research has disproved. Muscles that are worked have an increase in neural drive… they are not fatigued as previously thought. Nautilus equipment has decreased in popularity due to the lack of transference from the strength gained on this equipment to functional activity, including sport. Whether or not the discussion was had 40 years ago, it should be addressed again with the perspective of new research. "A routine is only as effective as the exercises selected" and we can do better than nautilus machines, falsely assuming pre-fatigue, isolated movement patterns with no transfer to functional activity, and the inclusion of specific exercises for the increase in neural drive of under-active structures. "It is not enough to simply move more, if you can also choose exercises that help people move better." In essence, the body-building model of resistance training is being replaced just as the calculator replaced the abacus, and I hope in time our programming reaches a sophistication analogous to the multivariate computation power and solution production of a super computer. At the end of the day, the brain is still a far more powerful tool than any machine to date (although, they expect to build machines with an equivalent level of computing power in the next decade - sorry for the geek-out, but that is an astonishing feat). I hope 10 years from now my programming is far more sophisticated than my current model, and hope that the industry as a whole adopts a similar paradigm.

June 1 at 8:08pm

Brent Brookbush P.S. kats… if you just cut and paste the link above into your browser you will have access to my forum. Its only if you click on the link that it redirects. Stupid facebook security ;-(

June 1 at 8:12pm

Melinda Reiner Brent, great point regarding Nautilus equipment. Back in "my day," I never liked it and always went back to my standard Universal and free weights. Sometimes, practical experience is better than some of the research out there.

June 1 at 8:29pm

Brent Brookbush That's true as long as the "practical experience" includes some consistent measure of outcomes, and for me "I feel like…" just doesn't cut it. For example, I would consider that practical experience of a physician who has spent years evaluating, taking notes and comparing outcomes as very valuable information… I would not consider the practical experience of a shotgun approach to fitness based on "muscle confusion" and a few "incredible testimonials" as anything more than "something is better than nothing." With that being said there are a great group of professionals in all facets of human movement science (including the personal training industry) who with or with out the oversight of 3rd party payers really do take notes and compare the outcomes of a variety of methods across a large array of clientele. It's getting away from "it worked for me" and moving toward "this technique resulted in successful outcomes for the majority of individuals." It may not sound as sexy, but it is the right way to move forward.

June 1 at 8:42pm

Melinda Reiner Agreed. Important to truly "sift" through what and who is legitimate or not. And, that's what I'm really liking about the NASM OPT model, with some variation.

June 1 at 8:47pm

Ken O'Neill Science, as always, is not uniform except when reductionistic scienticism, that bane of intellectual integrity! We're far from definitive conclusions effecting training protocols, as varied as ever. I'm particularly taken by the successors to Digby Sales of the McMasters labs, and, of course, the n-state models of Brad Schoenfeld. Brad's thrown a wide net, resulting in the best work I've seen in the past 55 years - best, insofar as the science is finally taking into account and catching up with the practical and pragmatic wisdom of generations of bodybuilding coaches whose business was peak performance.

June 1 at 8:55pm

Brent Brookbush Hey Ken,

My point is this… if it works there is a reason and we need to use research and science to find that variable. Often a program is not effective for the reasons we think that it is, and the variable that is working could be emphasized if we had a better understanding. I am fine with casting a big net, but when we get research and validate an outcome comparing techniques or explaining a particular aspect of human movement science it is our job to use that information to refine our practice. Gross over generalization is the "bane of my existence" in the sense that people will use an entire program to prove a point, ignoring the fact that 1 of 100 variables in that program could have contributed to the successful outcome, none of which have anything to do with the discussion at hand. The study I referenced above was well done, is more congruent with what we understand of the human movement system, and marries the concepts of activation and isolation work - in the sense that they both do the same thing - that is much stronger evidence that "it worked for me". As you appreciate philosophy, maybe you are aware of Aristotle's logical falacy - "Argumentum ad antiquitatem" - an appeal to antiquity or tradition - Just because something has been done for 50 years does not mean it is right. If that was the case poor Dr. Melinda Reiner would have been taught to blood letting in medical school. Now, you can use research and science to refine your programming or you can dismiss it because some guy using a multivariate program has success. This is not reductionist scientism - this critical evaluation and deductive reasoning.

June 1 at 9:09pm

Ken O'Neill Young man, you're preaching to the choir and getting somewhat close to unearned, unjustified arrogance. Reading research is fraught with likely error without good grounding in hermeneutics - something virtually lacking in published medical research, while much of exercise science is not far behind.

June 1 at 9:15pm

Brent Brookbush Another logical fallacy is to assume that age and education are a linear relationship, I am humbled by every great professional I meet but whether an actual fallacy or a fallacy in perception of your argument I highlighted a potential logical misstep that I am confronted with often. What that has to due with my justified or unjustified confidence is not an issue relevant to this argument. Research is what it is - a yes or a no to a direct question (a hypothesis),a single dot in a mosaic of data points that create a complete picture - I understand the limitations but we would fools to dismiss this tool. This argument started with the purpose of isolation, and pre-fatigue is a myth that does not account for an increase in neural drive. That's it, that all I am willing to state. I am not insinuating that the individuals you mentioned are any less great for using it, only that it is an opportunity for refinement. I find little things all the time that are errors in my practice. I don't look to my outcomes and say - "Well I'm still successful," I look at it as an opportunity to be more successful. Always growing, never dismissive, always inclusive, but always ready to admit fallacy where refinement can be had.

June 1 at 9:24pm

Rick Richey That's called "getting Brookbushed"! I've been in the path of that train before too. Bottom line in arguments with B2 (and anyone in a professional debate) is to use logic, science, and unemotional rational without attacking character. And, whenever possible, peer reviewed research. Brent is a rare combination of being educated in Human Movement Science and Logic. My logical arguments have sharpened greatly by working with, educating with, and arguing with B2 for nearly 10 years. Keep it up you arrogant savant!!!

June 1 at 10:12pm

Melinda Reiner Brent, are you trying to tell me that I am a "fallacy" due to my "linear relationship" between my age and my education? Confused by your last "argument."

June 1 at 10:29pm

Melinda Reiner PS anyone who is successful at what they do, has the intent to continue growing, learning, and hearing all points of view and making educated decisions based on such along the Way of Life. Word.

June 1 at 10:32pm

Brent Brookbush Oh not at all Melinda Reiner, only that it is a false assumption to assume that because someone is older they are better educated, or because someone is younger they are less educated. At the extreme, there are fantastic professionals in their 30's and terrible professionals who have 30 years experience. Most importantly, you do not have to have more information or more experience to have a well supported argument or possibly a better argument… or an innovative perspective that adds to the body of knowledge. Sometimes we are faced with individuals who are right where we are wrong, not because they have more knowledge, but because they have different knowledge.

June 1 at 11:43pm

Ken Mahadeo If it's on the net it has to be true.

June 2 at 1:26pm

Brent Brookbush LOL Ken Mahadeo

June 2 at 8:21pm

Inez Sahadevan A very educational thread… Thank you! May i share this on my page?

June 2 at 9:40pm

Brent Brookbush Of course Inez Sahadevan… I agree, it was a great discussion.

June 2 at 11:23pm

Brent Brookbush Please share

June 2 at 11:23pm

Melinda Reiner Thanks for the clarification, above, Brent. I think what you are trying to say in simpler terms is that everyone has something to offer. And, some people think they are more important than others.

June 2 at 11:47pm

Brent Brookbush So true Melinda Reiner

June 3 at 6:40am

Joshua Morton Wow! I spend a few days moving and this is what I come back to?!?!? Since you directed me here Ill put in my perspective. No program is complete without "emphasized" and functional movement. The body is only as strong as the weakest link. If you patient has glut med/min weakness and you have them doing functional movements such as squats, lunges etc etc the strong muscles are going to do the bulk of the work. Much like you posted in another discussion. Begin with something relatively easy like clam shells and advance as your patient is able to straight leg hip abduction. The progression slowly works towards greater "emphasis" on the muscles you desire to make strong again. Once they have achieved a measure of stability and endurance with those, finally you move onto whatever functional exercises are most relevant to your patient.

June 3 at 12:02pm

Joshua Morton Id also like to say a word or many about some of the posts Ive seen in the discussion. People are talking about doing 5 sets of this followed by 5 sets of that, sometimes without recovery time. This sort of activity will often result in scarred tissue. That is not nearly optimal for someone in the "rehab" status. In fact I dont think it is optimal for anyone. If you have the correct weight and rep you can work out multiple times a day even without soreness. You will realize quick gains in stability, flexibility endurance and power. All that we want and need for function. Sure if you are training for something in particular (running for a marathon or being Mr Universe) you have to harden your body to it and soreness/injury will ensue. But, if you dont have the correct recovery program in place you are likely doing more harm than good in the long run. Scarred tissue is never desired, it is weak, poorly vascularized, creates restrictions in ROM and sets your patient up for more problems down the road.

June 3 at 12:04pm

Dave Bonk You guys should define your made up terms. Remember if you truly understand something well you can relate it simply

June 3 at 12:53pm

Brent Brookbush Dave Bonk, I haven't seen any "made up" terms… in fact the panel has been pretty good about using common terminology and even defining some of those terms. I would be happy to give a better explanation of any term if you would give me a couple of specifics.

June 3 at 8:18pm

Brent Brookbush Hey Joshua Morton,

I believe the acute variable for activation exercise is 10-20 reps, 1-3 sets, done anywhere from 2 - 5 days per week. It is very close to the acute variable for endurance training. Some manual activation protocols differ a bit, but these are very specific techniques. Although I would agree that many do not pay attention to acute variables nearly enough, and you certainly do not have to be sore to see results (I actually discuss volume, and soreness at great lengths in my book), some types of training require a higher number of sets to be effective. For example, the rep range and volume per set are so low during max strength and max power training it is likely that 3 sets are the minimum number of sets required to see continued gains with an upper limit of 6 sets… maybe 8 sets in the most elite athletes (division 1 to pro athletes). Is this pretty congruent with your thoughts?

June 3 at 8:22pm

Joshua Morton Similar to my thoughts. Though it seems some people cannot swing 10-20 reps without being sore, even at low weights. So I ask them to divide it up into many sets throughout the day. The end total is similar though if they follow my advice. I am glad to hear you address the soreness issue in your book. It is overlooked or misunderstood in my opinion and experience.

June 3 at 9:48pm

Brent Brookbush I was actually surprised to find some great research on the topic… both proving that you do not have to be sore to get results, and that working out while sore does not prevent further gains.

June 3 at 10:17pm

Joshua Morton hmmmm it does not prevent further gains….? IF you have not recovered sufficiently, how can you not prevent further gains? Are they speaking strictly about strength? What about ROM? What about long term? Have they followed these people over the course of months if not years? A snap shot of something like this does not seem adequate to base a conclusion on.

June 4 at 11:53am

Brent Brookbush The study was based on gain made during soreness in strength… it is also a fallacy that resistance training has any impact on flexibility. Overloading a compensation pattern will make your flexibility worse, but strength training alone will not. I guess you are going to have to buy my book to get all of the research

June 4 at 7:05pm

Barbara Kay Shameless plug

June 4 at 7:10pm via mobile · Like

Brent Brookbush Not all together shameless Barbara Kay, but definitely opportunistic

June 4 at 7:11pm

Joshua Morton I understand there is research to support your statement, but I have seen countless times in my own body as well as clients body's that over doing training create decreased ROM.

June 4 at 8:32pm

Brent Brookbush Consider my statement above… if you train on top of compensation you will reinforce compensation patterns and make them worse - hence the decrease in range. Over-training may lead to fatigue and adopting compensatory patterns during training - in essence compensation can also equal bad form… so we could postulate that bad form during resistance training will also lead to a reduction in ROM.

June 4 at 8:34pm

Joshua Morton Yes, I was too quick to type my response. Though you bring something else to mind. If lets say anterior head carriage is present. Pecs are overly tight in relation to rhomboids. Would you strength train pecs? Personally I wouldn't. I would focus on the training that will reverse the compensatory patterns. No need to tighten what is already tightened. Even if form is correct in the lift, further tightening will further bad pattern. Also on that note, what about when a muscle gets so tight it can no longer create power and strength diminishes?

June 4 at 8:41pm

Brent Brookbush Overall, I try to stay away from training short overactive structures, but I won't prevent individuals from training major movement patterns - Push, Pull, Triple Extension - In my humble opinion dysfunction is more complicated than front/back and the rhomboids are actually short/overactive - the lats are also over-active - are we going to keep people from doing rows? Note: I will not do single joint exercise for over-active muscles

June 4 at 9:03pm

Joshua Morton It seems like we have similar ideas for strengthening. Rhomboids short though? They usually seem at a constant stretch to me, being puled forward by the anterior tissues…. More often than not my patients are winging slightly or significantly… From my perspective, if they are over active it is due to always trying to stabilize the scups but not having the strength to do so. Similar to lats, traps and serratus.

June 5 at 11:42am

Brent Brookbush I think you would find my article on Upper Body Dysfunction interesting… I have a very different take on what the common impairment of this segment is and I think you will find it far more congruent with your clinical findings. Further, I think you will notice that the implied corrective strategy from this model to be more refined - http://b2cfitness.com/cpt_blog/upper-body-dysfunction-ubd/

© 2014 Brent Brookbush

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