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Posterior oblique subsystem (POS) POS. The role and function of the latissimus dorsi, gluteus maximus, and thoracolumbar fascia in the stability, strength, and power production between the lower and upper body. Summary of the function, arthrokinematics, integration between individual subsystems, behavior in postural dysfunction, exercise selection for the POS, and examples of subsystems exercises and progressions.

Posterior Oblique Subsystem 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

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This course describes the posterior oblique subsystem (POS). The posterior oblique subsystem may also be referred to as the posterior oblique sling, oblique sling, posterior oblique myofascial synergy, and is similar to the concepts of muscle synergies, myofascial lines, myofascial trains, anatomy trains, myofascial meridians, functional line, spiral line, and the serape effect. This course covers a detailed analysis of the posterior oblique subsystem (sling) including anatomy, research, integration techniques, and a sample routine.

The Posterior Oblique Subsystem (POS) is comprised of:

Thoracolumbar Fascia (Superficial Posterior 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: Posterior Oblique Subsystem

Brookbush Institute Posterior Oblique Study Guide

Study Guide: Posterior Oblique Subsystem Integration

Lecture: Review of Core Subsystems

Introduction

Illustration of the Posterior Oblique Subsystem with Muscles Labeled

Function

Signs of Under-activity

Introduction: Posterior Oblique Subsystem Integration

Research Corner Thoracolumbar Fascia

An image of the thoracolumbar fascia which connects the latissimus dorsi and contralateral gluteus maximus

Thoracolumbar Fascia

Research Corner Gluteus Maximus and Medius

Gluteus maximus muscle connecting on the posterior pelvis, thoracolumbar fascia, iliotibial band, and hip

Gluteus Maximus and Medius

Research Corner Latissimus Dorsi

Latissimus dorsi muscle attaching into the thoracolumbar fascia, pelvis, thoracic spine and humerus

Latissimus Dorsi

Research Corner Lower Trapezius

The trapezius muscles including the upper, middle and lower traps

Lower Trapezius

Research Corner 

Summary of Research Findings

TLF is continuous with the fascia of the latissimus dorsi, serratus posterior inferior, gluteus maximus, lower trapezius, and gluteus medius via the gluteal fascia.

Investing muscles can displace/shear TLF tissue layers.

The POS may aid in stabilization of the lumbar spine and SIJ.

Low back pain may reduce shear between fascial layers of the TLF.

The latissimus dorsi and contralateral gluteus maximus are recruited together during gait.

The POS is comprised of large muscles that may not be recruited for low-level (unresisted) tasks. Note: the POS is comprised of the largest scapular muscle (trapezius), largest shoulder muscle (latissimus dorsi), and largest hip muscle (gluteus maximus).

A functional advantage of POS recruitment (and less DLS recruitment) may be pulling and/or rotation without significant lumbar extension.

The gluteus maximus, gluteus medius, and lower trapezius are prone to relative under-activity and a maladaptive increase in length.

Specific interventions are effective for improving gluteus maximus, gluteus medius, and lower trapezius strength/activity.

More research is needed to determine compensatory changes in length and activity and specific intervention for the latissimus dorsi. By Anatomist90 - Own work, CC BY-SA 3.0, 

https://commons.wikimedia.org/w/index.php?curid=17900177

More on Function

The overhead squat assessment showing arms fall

More On Function

Influence on Intervention

Practical Application

Squat to Row

Step-up to Row

Static Lunge to Row

Reverse Lunge to Row

Single Leg Squat to Bilateral Cable Pull Down

Power Squat to Row

Videos

Tibialis anterior activation (no equipment)

Sample Program: Lower Extremity Dysfunction

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

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Movement, Stability & Lumbopelvic Pain (Second Edition)

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Macintosh, J. E., Bogduk, N., & Gracovetsky, S. (1987). The biomechanics of the thoracolumbar fascia. 

McGill, S. M., & Norman, R. W. (1988). Potential of lumbodorsal fascia forces to generate back extension moments during squat lifts. 

Gluteus Medius and Maximus and Motor Behavior

Kim, T., Yoo, W., An, D., Oh, J., Shin, S. (2013). The effects of different gait speeds and lower arm weight on the activities of the latissimus dorsi, gluteus medius, and gluteus maximus. 

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.

Barker, PJ., Hapuarachchi, K.S., Ross, J.A., Sambaiew, E., Ranger, T.A., and Briggs, C.A. (2013) Anatomy and biomechanics of gluteus maximus and the thoracolumbar fascia at the sacroiliac joint .

Gibbons, S.G.T. (2004) The anatomy of the deep sacral part of the gluteus maximus and the psoas muscle: A clinical perspective. Proceeds of: The 5th Interdiciplinary World Congress on Low Back Pain. November 7-11, Melbourne, Australia.

Franettovich, S. M., Honeywill, C. O. N. O. R., Wyndow, N., Crossley, K. M., & Creaby, M. W. (2014). Neuromotor control of gluteal muscles in runners with achilles tendinopathy. 

Medicine and science in sports and exercise

Noehren, B., Scholz, J., Davis, I. (2011) The effects of real-time gait retraining on hip kinematics, pain, and function in subjects with patellofemoral pain syndrome. Br Journal of Sports Medicine. 45:691-696

Ireland, ML ., Wilson, JD., Ballantyne, BT., Davis, IM. (2003). Hip Strength in Females With and Without Patellofemoral Pain . J Orthop Sports Phys Ther 2003. 33: 671-676

Hungerford, B., Gilleard, W., Hodges, P. (2003) Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 28(14), 1593-1600

Grimaldi, A., Richardson, C., Stanton, W., Durbridge, G., Donnelly, W., & Hides, J. (2009). The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles. 

Cooper, N., Scavo, K., Strickland, K., Tipayamongkol, N., Nicholson, J., Bewyer, D., Sluka, K. Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. J Euro Spine. 26 May 2015

Padua, D. A., Bell, D. R., & Clark, M. A. (2012). Neuromuscular characteristics of individuals displaying excessive medial knee displacement. 

Mauntel, T., Begalle, R., Cram, T., Frank, B., Hirth, C., Blackburn, T., & Padua, D. (2013). The effects of lower extremity muscle activation and passive range of motion on single leg squat performance. 

Journal Of Strength And Conditioning Research / National Strength & Conditioning Association

Smith, J. A., Popovich, J. M., & Kulig, K. (2014). The influence of hip strength on lower limb, pelvis, and trunk kinematics and coordination patterns during walking and hopping in healthy women. 

Journal of Orthopaedic & Sports Physical Therapy

Tateuchi, H., Taniguchi, M., Mori, N., Ichihashi, N. Balance of hip and trunk muscle activity is associated with increased anterior pelvic tilt during prone hip extension (2013) 

Teng, H. and Powers, C. (2016) Hip Extensor Strength, Trunk Posture , and Use of the Knee-Extensor Muscles During Running. 

Bell, D. R., Padua, D. A., & Clark, M. A. (2008). Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. 

Archives of physical medicine and rehabilitation

Ramskov, D., Barton, C., Nielsen, R. O., & Rasmussen, S. (2015). High Eccentric Hip Abduction Strength Reduces the Risk of Developing Patellofemoral Pain Among Novice Runners Initiating a Self-Structured Running Program: A 1-Year Observational Study. 

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Snyder, K. R., Earl, J. E., O’Connor, K. M., & Ebersole, K. T. (2009). Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. 

Kim, T., Yoo, W., An, D., Oh, J., Shin, S. (2013). The effects of different gait speeds and lower arm weight on the activities of the latissimus dorsi, gluteus medius, and gluteus maximus.

Bogduk, N., Johnson, G., & Spalding, D. (1998). The morphology and biomechanics of latissimus dorsi. 

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. 

Granata, K. P., & Marras, W. S. (1995). Coactivity on Dynamic Spinal Loads. 

Vakos, J. P. (1990). EMG activity of selected trunk and hip muscles during a squat lift: effect of varying the lumbar posture (No. AFIT/CI/CIA-90-111). Air Force Inst of Tech Wright-Paterson AFB OH

Danneels, L. A., Vanderstraeten, G. G., Cambier, D. C., Witvrouw, E. E., Stevens, V. K., & De Cuyper, H. J. (2001). A functional subdivision of hip, abdominal, and back muscles during asymmetric lifting. 

Carvalhais, VO., Ocarino, Jde M., Araújo, VL., Souza, TR., Silva, PL., Fonseca, ST. (2012). Myofascial force transmission between the latissimus dorsi and gluteus maximus muscles: An in vivo experiment.

Scovazzo, M.L., Browne, A., Pink, M., Jobe, F.W., and Kerrigan, J. (1991). The painful shoulder during freestyle swimming: An electromyographic cinematographic analysis of twelve muscles. 

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Ludewig, P. M., & Cook, T. M. (2000). Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. 

Ballantyne, B. T., O'Hare, S. J., Paschall, J. L., Pavia-Smith, M. M., Pitz, A. M., Gillon, J. F., & Soderberg, G. L. (1993). Electromyographic activity of selected shoulder muscles in commonly used therapeutic exercises. 

Kwon, J. W., Son, S. M., & Lee, N. K. (2015). Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders. 

Weon, J. H., Oh, J. S., Cynn, H. S., Kim, Y. W., Kwon, O. Y., & Yi, C. H. (2010). Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. 

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Wegner, S., Jull, G., O’Leary, S., & Johnston, V. (2010). The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. 

Harvey, R., & Peper, E. (1997). Surface electromyography and mouse use position. 

Smith, M., Sparkes, V., Busse, M., & Enright, S. (2009). Upper and lower trapezius muscle activity in subjects with subacromial impingement symptoms: is there imbalance and can taping change it?. 

Cools, A. M., Declercq, G. A., Cambier, D. C., Mahieu, N. N., & Witvrouw, E. E. (2007). Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scandinavian Journal of Medicine and Science in Sports, 17, 25–33.

Lin, J. J., Wu, Y. T., Wang, S. F., & Chen, S. Y. (2005). Trapezius muscle imbalance in individuals suffering from frozen shoulder syndrome. 

Cools, A. M., Witvrouw, E. E., Declercq, G. A., Danneels, L. A., & Cambier, D. C. (2003). Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms. 

Wadsworth, D. J. S., & Bullock-Saxton, J. E. (1997). Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement. 

Cools, A. M., Witvrouw, E. E., De Clercq, G. A., Danneels, L. A., Willems, T. M., Cambier, D. C., & Voight, M. L. (2002). Scapular muscle recruitment pattern: electromyographic response of the trapezius muscle to sudden shoulder movement before and after a fatiguing exercise. 

Cools, A. M., Witvrouw, E. E., Declercq, G. A., Vanderstraeten, G. G., & Cambier, D. C. (2004). Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms. 

Petersen, S. M., & Wyatt, S. N. (2011). Lower trapezius muscle strength in individuals with unilateral neck pain. 

Day, J. M., Bush, H., Nitz, A. J., & Uhl, T. L. (2015). Scapular muscle performance in individuals with lateral epicondylalgia. 

Lawrence, R. L., Braman, J. P., LaPrade, R. F., & Ludewig, P. M. (2014). Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: sternoclavicular, acromioclavicular, and scapulothoracic joints. 

Thigpen, C. A., Padua, D. A., Michener, L. A., Guskiewicz, K., Giuliani, C., Keener, J. D., & Stergiou, N. (2010). Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. 

Journal of Electromyography and kinesiology

Tsai, N. T., McClure, P. W., & Karduna, A. R. (2003). Effects of muscle fatigue on 3-dimensional scapular kinematics 1. 

McQuade, K. J., Dawson, J., & Smidt, G. L. (1998). Scapulothoracic muscle fatigue associated with alterations in scapulohumeral rhythm kinematics during maximum resistive shoulder elevation. 

Ludewig, P. M., Cook, T. M., & Nawoczenski, D. A. (1996). Three-dimensional scapular orientation and muscle activity at selected positions of humeral elevation. 

Lucas, K. R., Polus, B. I., & Rich, P. A. (2004). Latent myofascial trigger points: their effects on muscle activation and movement efficiency. 

Journal of Bodywork and Movement Therapies

Falla, D., Farina, D., & Graven-Nielsen, T. (2007). Experimental muscle pain results in reorganization of coordination among trapezius muscle subdivisions during repetitive shoulder flexion. 

Hsu, Y. H., Chen, W. Y., Lin, H. C., Wang, W. T., & Shih, Y. F. (2009). The effects of taping on scapular kinematics and muscle performance in baseball players with shoulder impingement syndrome. 

Journal of electromyography and kinesiology

Alexander, C. M., Stynes, S., Thomas, A., Lewis, J., & Harrison, P. J. (2003). Does tape facilitate or inhibit the lower fibres of trapezius?. 

Selkowitz, D. M., Chaney, C., Stuckey, S. J., & Vlad, G. (2007). The effects of scapular taping on the surface electromyographic signal amplitude of shoulder girdle muscles during upper extremity elevation in individuals with suspected shoulder impingement syndrome. 

Morin, G. E., Tiberio, D., & Austin, G. (1997). The effect of upper trapezius taping on electromyographic activity in the upper and middle trapezius region. 

Cools, A. M., Witvrouw, E. E., Danneels, L. A., & Cambier, D. C. (2002). Does taping influence electromyographic muscle activity in the scapular rotators in healthy shoulders?. 

Cleland, J., Selleck, B., Stowell, T., Browne, L., Alberini, S., St. Cyr, H., & Caron, T. (2004). Short-term effects of thoracic manipulation on lower trapezius muscle strength. 

Liebler, E. J., Tufano-Coors, L., Douris, P., Makofsky, H. W., McKenna, R., Michels, C., & Rattray, S. (2001). The effect of thoracic spine mobilization on lower trapezius strength testing. 

Arlotta, M., LoVasco, G., & McLean, L. (2011). Selective recruitment of the lower fibers of the trapezius muscle. 

McClure, P. W., Bialker, J., Neff, N., Williams, G., & Karduna, A. (2004). Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. 

Ekstrom, R. A., Donatelli, R. A., & Soderberg, G. L. (2003). Surface electromyographic analysis of exercises for the trapezius and serratus anterior muscles. 

Posterior Oblique Subsystem Integration

Related Courses:

Course Description: Posterior Oblique Subsystem

Study Guide: Posterior Oblique Subsystem Integration

Lecture: Review of Core Subsystems

Introduction: Posterior Oblique Subsystem Integration
2 Sub Sections

Research Corner
4 Sub Sections

Summary of Research Findings

Practical Application
3 Sub Sections

Videos
6 Sub Sections

Sample Program: Lower Extremity Dysfunction

Bibliography

Related Courses:

Comments

Guest

Posterior Oblique Subsystem Integration

Related Courses:

Course Description: Posterior Oblique Subsystem

Study Guide: Posterior Oblique Subsystem Integration

Lecture: Review of Core Subsystems

Introduction: Posterior Oblique Subsystem Integration2 Sub Sections

Research Corner 4 Sub Sections

Summary of Research Findings

Practical Application3 Sub Sections

Videos6 Sub Sections

Sample Program: Lower Extremity Dysfunction

Bibliography

Related Courses:

Comments

Guest

Introduction: Posterior Oblique Subsystem Integration
2 Sub Sections

Research Corner
4 Sub Sections

Practical Application
3 Sub Sections

Videos
6 Sub Sections