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Intrinsic stabilization subsystem. The role and function of the transverse abdominis, multifidus, pelvic floor, and diaphragm in the stability and control of the lumbar spine, pelvis, and ribcage. Summary of the function, arthrokinematics, integration between individual subsystems, behavior in postural dysfunction, exercise selection for the intrinsic stabilization subsystem (core/TVA), and videos depicting exercises and progressions.

Intrinsic Stabilization Subsystem (ISS) Integration

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Brookbush Institute

I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

I recently completed the CPT course. It was demanding yet practical. I would highly recommend it for anyone wanting an education about human movement.

I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

The H.M.S. is the most valuable certificate I have earned and was a fraction of the the cost of my others. Define the best bang for your buck!

Brookbush is the most efficient Personal Training Certification I have ever come across. All the lessons are well thought out and very straight to the point.

I am getting my Master's degree in Kinesiology, and I would like to say that I have benefited greatly from the rich, comprehensive, well-documented scientific content of Brookbush Institute that links theory to practical applications. Proudly I've got my CPT certificate, and I am on my way to get my HMS certificate.

Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



I have been a member of BBI for years and every course I have taken has been incredibly informative. I learn more from these courses than I do at local CEU courses for my PTA license. I also earned my CPT and HMS certifications through the platform. It was so convenient and the content was top notch! Forever member.

We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

Totally loving the convenience and affordability of this program with my crazy lifestyle! I feel like I am getting a quality education without a massive cost! My favorite part is the videos I can watch in the courses. I learn so much better that way. Once I really spent more time on the site, I figured out how to maneuver around a lot better! I enjoy the sense of humor, as well as the easy explanation, and short tests. And if I am really tired, I can have the computer read me the lessons. 😁

Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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Human Movement Specialist

This course describes the intrinsic stabilization subsystem (ISS). This subsystem may also be referred to as intrinsic core muscles, deep core muscles, intrinsic stabilizers, stabilizing system, local stabilizers, lumbar stabilizers, and is related to the terms muscle sling, myofascial sling, myofascial synergy, oblique sling, core subsystem, myofascial lines, myofascial trains, anatomy trains, myofascial meridians, and deep front line. This course covers a detailed analysis of the intrinsic stabilization subsystem (deep core muscles) including anatomy, research, integration techniques and a sample routine.

The Intrinsic Stabilization Subsystem is comprised of:

Pelvic Floor (Levator ani, coccygeus, and associated fascia)

Rotatores, Interspinales & Intertransversarii

Continuous with investing fascia of Diaphragm and Pelvic Floor

Thoracolumbar Fascia (TLF) (anterior and middle layer)

The concepts and techniques described in this course may be particularly beneficial for neuromuscular re-education, coordination, motor pattern integration, whole-body strength, functional strength, and sports performance. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) should consider adding these exercises to their repertoire to improve the outcomes of their integrated exercise programs, sports performance programs, and therapeutic (rehabilitation) interventions.

For additional self-administered joint mobilization techniques check out:

Course Description: Intrinsic Stabilization Subsystem

Intrinsic Stabilization Subsystem Study Guide

Study Guide: Intrinsic Stabilization Subsystem 

Lecture: Review of Core Subsystems

Introduction

The muscles of the intrinsic stabilization subsystem

Function

Dr. Brent Brookbush demonstrating an asymmetrical weight shift during an overhead squat assessment

Signs of ISS Under-activity 

Introduction: Intrinsic Stabilization Subsystem

Anterior Thoracolumbar Fascia (TLF), Posterior Abdominal Fascia & More:

A rendering of a cross section of the torso showing the location of the trunk musculature

Transverse Abdominis

Image of the transverse abdominis running from the midline of the body to the pelvis and ribcage

Internal Obliques

The attachment of the obliques on the pelvis, abdominal fascia, ligamentum nuchae, and ribcage

Diaphragm

Pelvic Floor

Muscles of the hip, lumbar spine, pelvis, and pelvic floor

Multifidus

Rotatores, Intertransversarii, and Interspinales

The location and boney attachments of the multifidi of the back

Quadratus Lumborum

Psoas

The psoas and iliacus muscles attaching into the lumbar spine, pelvis, and femur

Research Corner

Summary of Research Findings

The fascial component of this myofascial synergy may be a spherical sheath that includes the anterior and middle layers of the TLF fascia, the posterior abdominal fascia, the investing fascia of the diaphragm, and the fascia of the pelvic floor muscles.

The muscles investing in this fascial sheath include the transverse abdominis (TVA), internal obliques, pelvic floor (levator ani and coccygeus), diaphragm, multifidus, rotatores, interspinales & intertransversarii, and potentially the quadratus lumborum and psoas.

The ISS is a stabilization subsystem that does not function in isolation, but in synergy with subsystems better suited for movement.

 enhance stability by increasing tension in the TLF, compressing the (force closure) SIJ, and decreasing intra-abdominal volume which may increase intra-abdominal pressure.

Lumbo Pelvic Hip Complex Dysfunction (LPHCD)

 results in a decrease in TVA and internal obliques activity.

Although the internal obliques can function as the external obliques, they behave like the TVA.

The diaphragm may adopt a higher average activity level and lower position in response to stability demands (likely contributing to an increase in intra-abdominal pressure)

Pain and dysfunction result in the diaphragm adopting a lower average activity level, higher relative position, more rigid stabilization strategy, and faster time to fatigue.

The pelvic floor muscles (PFM) are recruited with the TVA, internal obliques, and diaphragm.

Contracting the PFM during ISS exercise may increase TVA activity.

The multifidus function like other stabilizing muscles of the spine (including the TVA, pelvic floor, and diaphragm)

The compensatory pattern adopted by the multifidus in those exhibiting dysfunction suggests a muscle that is short/over-active.

The rotatores, intertransversarii, and interspinales may act as a sensory organ, initiating a reflexive increase in activity of the muscles of the ISS when lengthened.

Recovery from multifidus atrophy is best accomplished via stabilization exercise, not loaded extension.

The quadratus lumborum and psoas are recruited and compensate (short/over-active) similar to the multifidus, and show the same atrophy and morphological change in those with chronic low back pain.

The ADIM and quadruped (stability exercise) are effective for enhancing the recruitment and hypertrophy of ISS muscles.

The Muscles of the ISS can be separated into 2 categories:

 (Less or latent recruitment, a relative increase in length, decrease in force production, quicker to fatigue)

Pelvic floor (levator ani and coccygeus),

 (Higher average activity, prone to spikes, higher activity level for longer after lifting, loss of bilateral activation in response to load, may show marked atrophy in those with chronic low back pain)

Rotatores, interspinales & intertransversarii

Dr. Brent Brookbush demonstrating a dynamic quadruped (bear crawl), which is an activation exercise for the TVA

More on Function

Influence on Intervention

Signs of ISS Underactivity

Best-use and Progressions

Quadruped Progressions

Reactive Activation Progressions

Practical Application

Transverse Abdominis Isolated Activation (Quadrupeds)

Gali-Peds (Quadrupeds with Stability Ball)

Quadruped Crawl (Dynamic Quadruped)

Additional Quadruped Crawl Progressions

Transverse Abdominis and Deep Cervical Flexor (DCF) Activation

Transverse Abdominis and Gluteus Maximus Activation Progression

Hardest Quadruped Progression Ever

Videos: Isolated Activations

Crunch and Catch

Crunch and Catch Progressions

Videos: Reactive Activation 

Tensor fascia latae (TFL) and glute minimus vibration release

Self-administered Hip Mobilization (Anterior to Posterior with Flexion)

Sample Program: Anterior Pelvic Tilt

Andry Vleeming, Vert Mooney, Rob Stoeckart. Movement, Stability & Lumbopelvic Pain:

Willard, F.H., Vleeming, A., Schuenke, M.D., Danneels, L., Schleip, R. The thoracolumbar fascia: anatomy, function and clinical considerations. Journal of Anatomy, 2012. 221, 507-536.

Bogduk, N., & Macintosh, J. E. (1984). The applied anatomy of the thoracolumbar fascia.

Bogduk, N., and Lance T. Twomey. “Clincical anatomy of lumbar spine.” (1987).

 Clinical anatomy of the lumbar spine and sacrum 

Willard, F. H. (1997). The muscular, ligamentous, and neural structure of the low back and its relation to back pain.

Barker, P. J., & Briggs, C. A. (2007). Anatomy and biomechanics of the lumbar fasciae: implications for lumbopelvic control and clinical practice. In

 Movement, Stability & Lumbopelvic Pain (Second Edition) 

Gracovetsky, S. (1990). Musculoskeletal function of the spine.

Systems: Biomechanics and Movement Organization

Juker, D., McGILL, S., Kropf, P., & Steffen, T. (1998). Quantitative intramuscular myoelectric activity of lumbar portions of psoas and the abdominal wall during a wide variety of tasks.

 Medicine and science in sports and exercise 

Andersson, E., Oddsson, L., Grundström, H., & Thorstensson, A. (1995). The role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip.

 Scandinavian journal of medicine & science in sports 

McGill, S., Juker, D., & Kropf, P. (1996). Quantitative intramuscular myoelectric activity of quadratus lumborum during a wide variety of tasks.

Brown, S. H., & McGill, S. M. (2009). Transmission of muscularly generated force and stiffness between layers of the rat abdominal wall.

Folkow, B., Gelin, L. E., Lindell, S. E., Stenberg, K., & Thorén, O. (1962). Cardiovascular reactions during abdominal surgery.

Vleeming, A., Volkers, A. C. W., Snijders, C. J., & Stoeckart, R. (1990). Relation Between

and Function in the Sacroiliac Joint: Part I: Clinical Anatomical Aspects.

and Function in the Sacroiliac Joint: Part II: Biomechanical Aspects.

Vleeming, A., Schuenke, M.D., Danneels,Willard, F.H. The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. Journal of Anatomy, 2014. 225, 447-462

Stevens, V.K., Vleeming, A., Bouche, KG., Mahieu, N.N., Vanderstraeten, G.G., Danneels, L.A. Electromyograhpic activity of trunk and hip muscles during stabilization exercises in four-point kneeling in healthy volunteers. European Spine Journal, 2007. 16: 711-718.

DeRiddler E., Oosterwijck, J., Vleeming, A., Vanderstraeten, G., Danneels, L. (2013). Posterior muscle chain activity during various extension exercises: an observational study. BMC Musculoskeletal Disorders, 14: 204.

Hodges, P. W., & Richardson, C. A. (1997). Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement.

Hodges, P. W., & Richardson, C. A. (1997). Contraction of the abdominal muscles associated with movement of the lower limb.

Hodges, P. W., & Richardson, C. A. (1999). Transversus abdominis and the superficial abdominal muscles are controlled independently in a

Saunders, S. W., Rath, D., & Hodges, P. W. (2004).

and respiratory activation of the trunk muscles changes with mode and speed of locomotion.

Crommert, M. E., Ekblom, M. M., & Thorstensson, A. (2011). Activation of transversus abdominis varies with

Barker, P. J., Briggs, C. A., & Bogeski, G. (2004). Tensile transmission across the lumbar fasciae in unembalmed cadavers: effects of tension to various muscular attachments.

van Wingerden, J. P., Vleeming, A., Buyruk, H. M., & Raissadat, K. (2004). Stabilization of the sacroiliac joint in vivo: verification of muscular contribution to

Vleeming, A., van Wingerden, J.P., Buyruk, H.M., Raissadat, K. Stabilization of the sacroiliac joint in vivo: verification of muscular contribution to force closure of the pelvis. European Spine Journal, 2004. 13: 199-205

Vleeming A, Pool-Goudzward AL, Stoeckart R, et al. The

Layer of the Thoracolumbar Fascia: Its Function in Load Transfer from Spine to Legs. Spine 20:753-758, 1995

Richardson, C., Snijders, C., Hides, J., Damen, L., Pas, M., Storm, J. (2002) The Relation Between the Transversus Abdominis Muscles, Sacroiliac Joint Mechanics, and Low Back Pain. Spine. 27 (4), 399-405

Hodges, P. W., Cresswell, A. G., Daggfeldt, K., & Thorstensson, A. (2001). In vivo measurement of the effect of intra-abdominal pressure on the human spine.

Hodges, P. W., Eriksson, A. M., Shirley, D., & Gandevia, S. C. (2005). Intra-abdominal pressure increases stiffness of the lumbar spine.

Stokes, I. A., Gardner-Morse, M. G., & Henry, S. M. (2010). Intra-abdominal pressure and abdominal wall muscular function: spinal unloading mechanism.

Morris, S. L., Lay, B., & Allison, G. T. (2013). Transversus abdominis is part of a global not local

Morris, S. L., Lay, B., & Allison, G. T. (2012). Corset

rebutted—Transversus abdominis does not co-contract in unison prior to rapid arm movements.

Hodges, P. W., & Richardson, C. A. (1997). Relationship between limb movement speed and associated contraction of the trunk muscles.

Hodges, P. W., Cresswell, A. G., Daggfeldt, K., & Thorstensson, A. (2000). Three dimensional preparatory trunk motion precedes asymmetrical upper limb movement.

Hodges, P., Richardson, C. (1996). Inefficient Muscular Stabilization of the Lumbar Spine Associated With Low Back Pain: A Motor Control Evaluation of Transverse Abdominis.

Hodges, P. W., & Richardson, C. A. (1998). Delayed

contraction of transversus abdominis in low back pain associated with movement of the lower limb.

Hodges, P. W., & Richardson, C. A. (1999). Altered trunk

recruitment in people with low back pain with upper limb movement at different speeds.

 Archives of physical medicine and rehabilitation 

Hodges, P. W. (2001). Changes in motor planning of feedforward

responses of the trunk muscles in low back pain.

Hodges, P. W., Moseley, G. L., Gabrielsson, A., & Gandevia, S. C. (2003). Experimental

Hodges, P. W., & Moseley, G. L. (2003). Pain and motor control of the lumbopelvic region: effect and possible mechanisms.

Unsgaard-Tøndel, M., Nilsen, T. I. L., Magnussen, J., & Vasseljen, O. (2012). Is activation of transversus abdominis and obliquus internus abdominis associated with long-term changes in chronic low back pain? A

Marshall, P., & Murphy, B. (2010). Delayed abdominal

onsets and self-report measures of pain and disability in chronic low back pain.

Jansen, J., Weir, A., Dénis, R., Mens, J., Backx, F., & Stam, H. (2010). Resting thickness of transversus abdominis is decreased in athletes with longstanding adduction-related groin pain.

Ferreira, P. H., Ferreira, M. L., Maher, C. G., Refshauge, K., Herbert, R. D., & Hodges, P. W. (2010). Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain.

Hides, J. A., Boughen, C. L., Stanton, W. R., Strudwick, M. W., & Wilson, S. J. (2010). A magnetic resonance imaging investigation of the transversus abdominis

of the abdominal wall in elite Australian Football League players with and without low back pain.

 journal of orthopaedic & sports physical therapy 

Hodges, P., Richardson, C., & Jull, G. (1996).

of the relationship between laboratory and clinical tests of transversus abdominis function.

Bjerkefors, A., Ekblom, M. M., Josefsson, K., & Thorstensson, A. (2010). Deep and superficial abdominal

activation during trunk stabilization exercises with and without instruction to hollow.

McGalliard, M. K., Dedrick, G. S., Brismée, J. M., Cook, C. E., Apte, G. G., & Sizer, P. S. (2010). Changes in transversus abdominis thickness with use of the abdominal

Pinto, R. Z., Ferreira, P. H., Franco, M. R., Ferreira, M. L., Ferreira, M. C., Teixeira-Salmela, L. F., & Maher, C. G. (2011). Effect of 2 lumbar spine

Intrinsic Stabilization Subsystem (ISS) Integration

Related Courses:

Course Description: Intrinsic Stabilization Subsystem

Study Guide: Intrinsic Stabilization Subsystem

Lecture: Review of Core Subsystems

Introduction: Intrinsic Stabilization Subsystem
2 Sub Sections

Research Corner
9 Sub Sections

Summary of Research Findings

Practical Application
5 Sub Sections

Videos: Isolated Activations
7 Sub Sections

Videos: Reactive Activation
2 Sub Sections

Sample Program: Anterior Pelvic Tilt

Bibliography

Related Courses:

Comments

Guest

Intrinsic Stabilization Subsystem (ISS) Integration

Related Courses:

Course Description: Intrinsic Stabilization Subsystem

Study Guide: Intrinsic Stabilization Subsystem

Lecture: Review of Core Subsystems

Introduction: Intrinsic Stabilization Subsystem2 Sub Sections

Research Corner9 Sub Sections

Summary of Research Findings

Practical Application5 Sub Sections

Videos: Isolated Activations7 Sub Sections

Videos: Reactive Activation 2 Sub Sections

Sample Program: Anterior Pelvic Tilt

Bibliography

Related Courses:

Comments

Guest

Introduction: Intrinsic Stabilization Subsystem
2 Sub Sections

Research Corner
9 Sub Sections

Practical Application
5 Sub Sections

Videos: Isolated Activations
7 Sub Sections

Videos: Reactive Activation
2 Sub Sections