Panel Discussion: How do you allow "core subsystems (core slings)" to influence your thought process?
How do they affect your assessment, modality selection, exercise selection, treatments, routine and program design?
If you are not familiar with this concept (originally proposed by Vleeming and Colleagues) check out these articles
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 January 18th, 2014
Kenneth E. Hoover Going to have a read and get you some feedback Brent Brookbush. Top of mind subject matter for me right now as I start a new group of HS student/athletes programming the end of this month. Timely…..
January 18 at 12:27pm
Brent Brookbush Thanks Kenneth, Love it when stuff is not only beneficial but timely as well.
January 18 at 12:32pm
Brent Brookbush So to start off,
I use a basic template for creating an Integrated Warm-Up/Corrective Routine:
1. Release
2. Lengthen
3. Mobilize
4. Isolated Activation
5. Core Activation
6. Stability Integration
7. Reactive Integration
8. Subsystem (Whole body) Integration
Core subsystems influence my programming in 4 key ways:
1. The selection of Subsystem Integration Exercises at the end of the routine above.
2. The selection of Core Exercises (both what to stay away from, and what exercises to choose)
3. They provide my predictive models of dysfunction with a more congruent assessment of core activity related to movement dysfunction
4. The selection of whole body exercises during a resistance/strength training program
Postural Dysfunction & Movement Impairment | Brent Brookbush
brentbrookbush.com
This section aims to refine predictive models of postural dysfunction & movement…See More
January 18 at 12:39pm
Maurice D. Williams Great question Brent. It's a major influence in not only my clients program design, but my personal workouts too. I'm appreciative of the fact that NASM teaches this in the CES and later versions of the CPT book. It makes a lot of sense and brings out the importance of understanding myofascial lines/slings as they relate to human movement and our exercise selection.
January 18 at 12:40pm
Brent Brookbush Can you give some specific examples Maurice D. Williams. The reason I started this discussion is because the subsystems are usually considered in a very vague, conceptual way with little discussed on the actual techniques one uses to affect them. If everyone on this panel wrote one sentence that filled in the "blanks" in the following, that would be awesome.
"The sign ________, during ____ assessment, leads me to believe ______ about ______ subsystem, and choose_____ during a routine."
January 18 at 1:47pm · Edited · Like
Fabio Comana Brent - as they are part of gait, and various exercises already emphasize them (if coached and understood correctly) they should be / are am integral part of assessment and design. I break down the 4 key slings though movement screens (disguised as warm-up exercises) for those apprehensive about assessments, then adopt a segmented(part-to-whole$ approach with programming to improve each, educate clients to his each correlates to the LE primary movements, then move towards integration
January 18 at 2:43pm
Yusuf Boyd In reference to the subsystems one that always shows up in my diagnosis is the POS and how it connects the contralateral. Typically there is a ROM deficit in at least one ankle and the contralateral hip/low back and sometimes shoulder is affected…..I approach this in the same manner as you Brent Brookbush have outlined above….if I am working with an athlete this of course always precedes any SAQ/sport specific protocol
January 18 at 3:24pm
Brent Brookbush Great stuff Fabio Comana and Yusuf Boyd, since the posterior oblique subsystem is the "universal under-active subsystem" can each of you give a couple of your favorite exercises for our readers to try?
January 18 at 4:29pm
Eric Nelson Regardless of their complaint, I always check the intrinsic subsystem first on all my patients. In fact, I check it in relation to the complaint. For example, if a patient has neck pain and headaches I will check the neck muscles in relation to the TrA. Is the TrA under active and are the suboccipitals (for example) compensating. If so, I know where my soft tissue work will be (suboccipitals) and where my corrective exercises will be (TrA).
January 18 at 4:36pm
Yusuf Boyd Brent Brookbush I am a fan of positional isometrics for Glute Med, Rhomboids, and mid/lower trap for activation….integration wise I do not think you can find a better exercise than the squat to row…
January 18 at 5:18pm
Maurice D. Williams Sorry for my delay: "The sign, feet flatten, during the NASM OH Squat assessment, leads me to believe that there could be some disconnect in the deep longitudinal system (DLS) since it provides reciprocal force transmission from one's trunk to the ground. Therefore, I would choose to inhibit & lengthen the short head of the biceps femoris, peroneals & TFL and activate the glutes and tibialis anterior. One of my favorite integration exercises for this system would be a single leg squat and reach or single leg deadlift."
January 18 at 6:02pm
Brent Brookbush Nice Maurice. Thanks for the quick strategy based on assessment.
January 18 at 6:00pm
Brent Brookbush Squat to Row is the "universal" integrated exercise… the only dysfunction that it is not appropriate for is the "inadequate forward lean" which is relatively rare. Thanks again Yusuf Boyd.
January 18 at 6:01pm
Brent Brookbush Hey Eric Nelson,
Great point, stability of the spine is a very integrated thing from lumbar to cervical… you could almost consider the deep cervical flexors as part of our intrinsic stabilization subsystem.
January 18 at 6:02pm
Yusuf Boyd Always a cheap shot Brent Brookbush so here ya go…Single-arm ball cobra done properly also is great for the POS, it really stresses the contralateral
fascial connection from foot to shoulder and requires a great deal of intrinsic core stability as well. Depending on the severity of the dysfunction, one would not choose the ex mentioned above for a novice as it is high on the stabilization progression continuum….instead opt for a quadruped beginning on a ball with arms only, then legs, then both, then no ball, then 2 arm ball cobra then single arm.
January 18 at 7:10pm
Maurice D. Williams As a progression Yusuf Boyd, I'd do a standing contralateral single leg, single arm db cobra w/ a 1-2-4 tempo for 1-2 sets of 10-15 reps. Talk about ultimate stabilization & muscular endurance for the POS!
January 18 at 7:17pm
Yusuf Boyd Maurice D. Williams that would def be the
January 18 at 7:22pm
Yusuf Boyd The next step
January 18 at 7:23pm
Jason Erickson I don't think about any of those "core subsystems" in my work. I work with assessing, treating, and training a variety of tissues in the legs, pelvis, thorax, back, etc., both in isolation and in integration with other tissues. I don't currently subscr…See More
January 19 at 12:17am
Tony Susnjara I have designed circuits and intervals using my freeFORM Board. In what I describe as a holistic general workout (not focused on any segment, fitness parameter, dysfunction etc.) I would have 4 upright stations that work the anterior and posterior, the lateral and rotational / spiral chains slings / lines etc. ( because lateral and rotational are symmetrical and anterior / posterior are not) I then replicate this on the floor with exercises that load the front, back, sides and rotators. I then alternate between the floor and upright exercises allowing for local recovery. There is quite a bit more to it but that's a general intro. Of course working with postural imbalances etc. is another issue that is tailored to the individual. I think of the slings as subsets of a greater bio-tensegrity structure. One of the goals is restore or maintain the structural balance of the system.
January 19 at 6:12am
Brent Brookbush Hey Yusuf Boyd,
I was not taking a cheap shot, more like reinforcing that the "squat to row" is a must now exercise if you are going to integrate "subsystems" into your training model; however, with that being said I love the progressions and Maurice D. Williams addition to that progression.
January 19 at 6:59am
Yusuf Boyd Brent Brookbush I know you weren't bro but I couldn't help me self
January 19 at 7:47am