00:00:0500:00:10
We're going to go superficial to deep. So
00:00:0500:00:10
let's start with the external obliques.
00:00:1000:00:17
Now your external obliques fiber direction, which way does it go? This way
00:00:1700:00:23
right. The way your fingers would be if you put your hands in your front pockets.
00:00:2300:00:29
So you guys can write external obliques front pockets, to help you guys out a
00:00:2900:00:33
little bit. How many of you guys look at pictures of bodybuilders and fitness
00:00:3300:00:38
models, and you know you've seen a muscle and fitness magazine or a shape magazine,
00:00:3800:00:43
and people get all striated in here right, you see the lines. Which direction
00:00:4300:00:49
do those lines always go? Right because your external obliques are external
00:00:4900:00:53
right, they're the ones that are most superficial that's what we're seeing. So
00:00:5300:01:00
if the fiber direction is this way alright this muscle goes like this,
00:01:0000:01:09
what joint actions is it going to cause? Yeah which rotation is it? If this
00:01:0900:01:20
muscle shortens what's gonna happen to my spine? It's going to rotate this way?
00:01:2200:01:28
Alright if this muscle shortens it's going to twist me this way right, which
00:01:2800:01:37
would be contralateral rotation. So we got external obliques
00:01:4900:02:02
contralateral rotation, what else might they do? Okay so we got we got the
00:02:0200:02:05
obliquity thing, I told you guys muscles with a diagonal usually do
00:02:0500:02:09
rotation, we got rotation out. There's got to be a couple other things this muscle
00:02:0900:02:16
will do though. It's going to help with flexion right, because the obliques do lie in
00:02:1600:02:22
front of the lumbar spine right, this is the joint that they cross there in front
00:02:2200:02:34
of it. So external obliques flexors of the spine. I'm gonna say yeah. What else
00:02:3400:02:42
might they do? Lateral flexion. How many of you guys think lateral flexion? Yeah I
00:02:4200:02:45
mean how do people try to work their external obliques
00:02:4500:02:50
a.k.a their love handles, because they're trying to spot reduce the fat over their
00:02:5000:02:53
external obliques which absolutely doesn't work, and then they do an
00:02:5300:02:57
exercise which is kind of ridiculous we already talked about this yesterday. They
00:02:5700:03:02
do this one right we talked about this. Well your external obliques actually are
00:03:0200:03:05
not your primary lateral flexor of the spine,
00:03:0500:03:11
but do they lie lateral to the spine? Sure so they'll definitely help a little
00:03:1100:03:16
bit, it will definitely help.
00:03:2200:03:29
Now the other thing you have up on that chart there and this is more just some
00:03:2900:03:34
extra information for you guys, we were talking about connective tissue this
00:03:3400:03:38
morning right, when you open up a cadaver you don't see all these pretty red
00:03:3800:03:44
muscles, you see a lot of white connective tissue that is especially
00:03:4400:03:53
true in this area. The most superficial thing here on your six-pack is not your
00:03:5300:03:58
rectus abdominis, but this abdominal connective tissue. And
00:03:5800:04:02
you guys see a little evidence of that because what actually makes the 6-pack?
00:04:0200:04:08
You have the Linea Alba which is the connective tissue in the middle and
00:04:0800:04:13
then all of this these transverse little separations, which are also made of
00:04:1300:04:18
connective tissue. They're probably there because connective tissue with its
00:04:1800:04:25
rigidity and strength, probably improve the overall strength and ability for the
00:04:2500:04:30
rectus abdominus to prevent what? What don't we want to do with the lumbar
00:04:3000:04:37
spine? Forceful hyperextension right. So we have a nice nice bit of connective
00:04:3700:04:42
tissue here to help help the rectus abdominus to its job. Just reinforce it a
00:04:4200:04:45
bit. I think that's one of the next muscles up here, yeah rectus abdominus.
00:04:4500:04:52
This one should be pretty easy for you guys right. Rectus abdominus runs, which
00:04:5200:04:57
way does its fibers run? Up and down.
00:05:0300:05:08
So it runs up and down in front of the spine. What plane do you think it's
00:05:0800:05:13
probably going to work best in? It's a sagittal plane muscle, being that it's a
00:05:1300:05:17
sagittal plane muscle and it's in front of the spine, what do we think it's going to
00:05:1700:05:22
do as far as joint actions? Flexion. I
00:05:2700:05:33
always love every once in a while I get these calls from like a writer for like one of
00:05:3300:05:39
the magazines or whatever, and of course what do they always ask what's the best
00:05:3900:05:44
exercise for the abs. And of course what are they talking about when they say abs
00:05:4400:05:49
rectus abdominus, and my answer is always the same.
00:05:4900:05:58
What's the best exercise for the rectus abdominus? Flexion. Do you have anything
00:05:5800:06:07
other than flexion? No that's what the rectus abdominus does well. What else
00:06:0700:06:10
could the rectus abdominus do a little bit of? Does anybody know? Like think
00:06:1000:06:16
about your tilts, you remember your pelvic tilts right, it'll do this. Isn't
00:06:1600:06:19
this still spinal flexion though? Yeah you have to do spinal flexion to
00:06:1900:06:25
posteriorly tilt. So they'll be like so so the the rectus abdominus just is flexing?
00:06:2500:06:30
Yeah and it'll posterior tilt your pelvis. But what do you mean? Oh you can
00:06:3000:06:35
do a crunch, or you can do a reverse crunch.
00:06:3500:06:44
I guess isometrically you could do a plank. Would anything else really affect
00:06:4400:06:51
the rectus abdominus all that much? No. No the truth is when we look at EMG studies
00:06:5100:06:58
guess what has the highest activity for the rectus abdominus? Crunches, reverse
00:06:5800:07:03
crunches, like those things that actually do the action of really not that
00:07:0300:07:07
complicated right. What keeps most people from having a 6-pack, is it the
00:07:0700:07:13
exercise they chose? It's diet. How do you get a six-pack?
00:07:1300:07:19
Shut your face, move your glutes right.
00:07:2000:07:24
You want to get that tattooed, that was actually the original title of my first
00:07:2400:07:30
book, and the agents were like you can't have shut your face and move your ass as
00:07:3000:07:39
the title of your book, that's not going to work, and I was like why not. Internal obliques,
00:07:3900:07:44
internal obliques. So we talked about external obliques being this way right,
00:07:4400:07:49
those are the muscles you can see, it's fiber direction as if you put your hands
00:07:4900:07:55
in your front pockets. Guess which way the internal obliques go? This way all
00:07:5500:07:59
right. So it's like the direction your fingers would be if you put your hands
00:07:5900:08:04
in your back pockets. You guys cool with that.
00:08:1000:08:21
Internal obliques, so which way, what what joint actions are we looking at? Rotation.
00:08:2100:08:24
We got the obliquity, we know it's on a diagonal. We know it's probably going to
00:08:2400:08:28
contribute to rotation. You got to tell me ipsilateral or contralateral though.
00:08:2800:08:36
If it's this way and it's going to shorten, and you guys see how that would shorten.
00:08:3600:08:56
Exactly exactly ipsilateral, all right. What else might it do? Lateral, lateral
00:08:5600:09:00
flexion. Yeah it's on the side of the, it's on the side of the lumbar spine.
00:09:0000:09:12
I'll say lateral flexion. You guys think this can contribute to a sagittal plane
00:09:1200:09:18
motion, like you can contribute to flexion or extension.
00:09:2000:09:28
Flexion, why flexion? It's still in front of the lumbar spine right. Now remember
00:09:2800:09:33
your lumbar spine is way back here, so all these anterior core muscles that
00:09:3300:09:38
we spend so much, that we give so much attention right in the popular media,
00:09:3800:09:42
they're pretty much all flexors.
00:09:5000:09:53
Everybody's got this.
00:10:0600:10:10
So yeah so this does get a little confusing, the contralateral versus ipsi-
00:10:1000:10:16
lateral thing. So if you guys, let's pick two points right. These both, both these
00:10:1600:10:19
muscles have pretty broad origins, pretty broad insertions, but let's take
00:10:1900:10:25
the external obliques first, since we covered those first. Put one finger on
00:10:2500:10:34
your ASIS okay, and then put one finger back on your ribs all right. Now try to
00:10:3400:10:47
bring those two fingers closer. Which which direction did I rotate? I ended up
00:10:4700:10:53
rotating a little bit to the left right, so that's rotation to the opposite side.
00:10:5300:10:59
the muscle is on. Contra means against, right against our away, so that's
00:10:5900:11:04
contralateral rotation. Now let's do the same thing with the internal obliques.
00:11:0400:11:10
Let's pick a point, let's let's pick this little angle of your ribs here right, and
00:11:1000:11:16
all the sudden changes let's do that one. Point on your posterior ilium and now
00:11:1600:11:22
try to bring your fingers closer together. Yeah you guys see how that
00:11:2200:11:29
works. So now we have a muscle on the right is rotating me which direction? To
00:11:2900:11:34
the right. So that's the same side that would be ipsilateral. You want to totally
00:11:3400:11:42
freak yourselves out? When I rotate to the left, which oblique am i working?
00:11:4300:11:56
Oh yeah right external oblique right, but my left internal oblique. Muscles work
00:11:5600:11:59
best in the direction of their fibers. Isn't it kind of true that if I rotate
00:11:5900:12:06
this way, that this external oblique and this internal oblique kind of have the
00:12:0600:12:18
same fiber direction, and then if I go the other way its. Transverse abdominus,
00:12:1800:12:22
how many of you guys have heard of this muscle? Definitely a muscle a lot of
00:12:2200:12:30
people talk about. Definitely a muscle of a lot of controversy. But the transverse
00:12:3000:12:33
abdominus is an interesting one, because
00:12:3600:12:43
what joint action based on its fiber direction do you guys think this muscle
00:12:4900:12:57
Which is the fiber direction is is what? It's transverse right, that's why it's
00:12:5700:13:02
called the transverse abdominus because its fibers are orientated transversely. Its
00:13:0200:13:07
origin and insertion is basically the thoracolumbar fascia.
00:13:0800:13:11
It's a little different than that in textbooks but you guys get what I'm
00:13:1100:13:14
saying. The attachment goes from here, it
00:13:1400:13:19
wraps all the way around and goes right back into here. So when it contracts what
00:13:1900:13:29
actually happens? It's basically your weight belt right. You guys remember like,
00:13:2900:13:33
you guys seen the big guys with like the, and they do, they have the big weight
00:13:3300:13:35
belts and they it's like pull them as tight as they can before they get
00:13:3500:13:42
underneath something like a squat, that's what this muscle is supposed to do. it's
00:13:4200:13:50
supposed to cinch everything up ,which what that ends up doing is increasing
00:13:5000:13:54
intra-abdominal pressure.
00:14:1000:14:17
It also tightens this piece of fascia back here right, this thoracolumbar
00:14:1700:14:22
fascia, it pulls it like this really tight. Is that gonna help stabilize my
00:14:2200:14:27
lumbar spine? A little bit - yeah. It's like having guy wires on each side just
00:14:2700:14:32
getting pulled really really tight So it'll increase stiffness in the
00:14:3200:14:34
thoracolumbar fascia.
00:14:4600:14:54
TLF not to be confused with the TFL right, we think that these two things
00:14:5400:15:04
together increase the stabilization of the lumbar spine so that make sense.
00:15:2100:15:24
Now there's some varying opinions on how effective that is,
00:15:2400:15:29
but if you guys want to write down a couple researchers there's, I know
00:15:2900:15:36
some of you guys are way into the core you got Richardson Hodges and Heinz, so
00:15:3600:15:44
I'm gonna put Richardson et al. Then there's another guy named McGill who has
00:15:4400:15:52
a little different theory, and then another guy named Liebenson who has
00:15:5200:16:01
more research and a different approach. A lot of stuff out there. You guys heard of
00:16:0100:16:04
your multifidi.
00:16:0600:16:12
Yeah so your multifidi are interesting little muscles, they're
00:16:1200:16:24
fairly deep and they go from spinous process to transverse process. Spinous
00:16:2400:16:28
process-transverse process, spinous process-transverse process. Very
00:16:2800:16:33
segmentally. They're on the back of the lumbar spine
00:16:3300:16:41
so what joint actions do you think they do? Extension, sure they have an obliquity
00:16:4100:16:47
so what else might they can contribute to? Rotation.
00:17:0300:17:23
So we got extension, rotation, and what we believe that's really important about
00:17:2300:17:27
these muscles, these aren't the big extensors of the lumbar spine right.
00:17:2700:17:32
These little tiny muscles that you see in those pictures, but they have
00:17:3200:17:35
something different than the other extensors we're about to talk about,
00:17:3500:17:42
which is they're segmentalIy innervated. They cross only a couple segments at a
00:17:4200:17:48
time, so we think they're important for what we call segmental stabilization.
00:17:4800:17:55
Which is basically, if you thought of your lumbar spine like Jenga, you guys
00:17:5500:18:01
know the game Jenga, right you got to keep all your bricks stacked up, So if
00:18:0100:18:11
these were the bodies of my lumbar vertebrae right, I got my five little
00:18:1100:18:19
blocks there, what we think these muscles do is when movement or pathology or
00:18:1900:18:27
dysfunction cause our blocks to be this way,
00:18:3200:18:40
it might be these muscles that aren't doing their job. When movement causes us
00:18:4000:18:44
to do something like that, one of our blocks to move out of place, we think
00:18:4400:18:52
that these muscles doing their job will cause these blocks to do what? Straighten
00:18:5200:18:59
back out again, does that make sense .So your multifidus
00:18:5900:19:06
basically keep your blocks aligned. You guys ever heard the term segmental
00:19:0600:19:13
stabilization? No. You would. That's segmental stabilization. All we're
00:19:1300:19:17
talking about is keeping our block stacked on. It's a pretty bad thing right,
00:19:1700:19:23
if one block slides over the other starts moving out of place, instinctively
00:19:2300:19:29
guys do you think that's a good thing? No probably not. So we think the multifidi
00:19:2900:19:36
have a big role in this. This is the joint actions they'll help with, but
00:19:3600:19:39
this might be their more important function. Just like when we talked about
00:19:3900:19:42
the rotator cuff, we talked about the rotator cuff doing external rotation,
00:19:4200:19:47
internal rotation, abduction. But what was their important function? Dynamic
00:19:4700:19:51
stabilization of the shoulder right. Same thing with the multifidi and the
00:19:5100:20:01
TVA, they have an action, but their function-stabilize the lumbar spine.
00:20:0200:20:07
Alright let's look at another big mover.
00:20:1100:20:19
No no so the multifidi are very deep and lie right against the the facet joints
00:20:1900:20:25
of the lumbar spine. Your TVA actually more or less stops at the thoracolumbar
00:20:2500:20:32
fascia. Your multifidi there's layers to the thoracolumbar fascia it lies with,
00:20:3200:20:38
sandwiched between a couple of those layers. Does that kind of make sense? I got a
00:20:3800:20:41
bunch of pictures online, if you guys go to those muscular Anatomy articles, you
00:20:4100:20:45
look up multifdi, you look up transverse abdominus; I have tons and
00:20:4500:20:48
tons of pictures showing like cross-sections and stuff, so you get a
00:20:4800:20:57
good idea of where all of this stuff exists relative to something else. The
00:20:5700:20:59
erector spinae.
00:21:0200:21:07
Alright I'm going to ask a question knowing that I'm probably going to get
00:21:0700:21:14
twelve-year-old laughs out of it, what does it mean to erect something? To
00:21:1400:21:32
stand it up right. So if my erector spinae will erect me or stand me back up
00:21:3200:21:37
and I started down here, what joint action is that for the spine?
00:21:3700:21:49
It's extension. I like the erector spinae. I like the
00:21:4900:21:53
little muscles of the back the erector spinae, even the multifidi, I just like
00:21:5300:21:57
the way they're shaped, I think they're shaped cool, you know what I'm talking about? Looks
00:21:5700:22:01
like an upside down Christmas tree.
00:22:0100:22:07
Alright so if only this side of the erector spinae contracted, what would
00:22:0700:22:15
happen to my spine? Yeah contribute just a little bit to lateral flexion.
00:22:2900:22:37
You guys realize how long your erector spinae are? Yeah exactly, so just keep in
00:22:3700:22:43
mind all the way down to your sacrum, all the way up to your mastoid process,
00:22:4300:22:48
depending on which of the erector spinae muscles we're talking about. Another
00:22:4800:22:51
thing to keep in mind, something once you guys start digging a little deeper into
00:22:5100:23:01
your Anatomy is, is there one erector spinae muscle? Yeah, is there only one
00:23:0100:23:06
erector spinae muscle? Yeah there's actually three, and they all do a
00:23:0600:23:13
slightly different thing. So you have your spinalis, your iliocostalis and
00:23:1300:23:20
your longissimus. You know at this level your okay calling it the erector spinae.
00:23:2000:23:25
Like I said your next level once you guys get into graduate school, you start
00:23:2500:23:29
tearing things apart, maybe do some cadaver work, you're gonna start needing
00:23:2900:23:35
to know all of the different erector spinae muscles.
00:23:4000:23:54
How many pushups per ring? I'm going to make you start dancing if it happens again.
00:23:5400:24:01
You have to dance until you get your ringer to stop. Alright so what do I mean
00:24:0100:24:07
by bilaterally and unilaterally, great question. So bilaterally means what? Both
00:24:0700:24:14
sides. If both sides of my erector spinae fire at the same time, what are they
00:24:1400:24:17
going to do? They're going to pull down on my spine,
00:24:1700:24:21
pull down on my ribcage and I'm going to do this. But if only one side
00:24:2100:24:26
unilaterally right, like unicorn one horn right, unilaterally pull down, what's
00:24:2600:24:36
going to happen to my spine? This. Well we could see, this is where the layers come
00:24:3600:24:41
in right, if we start dividing out these erector spinae muscles we'll see that at
00:24:4100:24:46
least one of them will contribute a little bit to rotation, and that's one of
00:24:4600:24:52
the larger erector spinae muscles being your iliocostalis. Usually when you see
00:24:5200:25:01
that word cost, C O S T, costa, costol right it has to do with the ribs. Iliocostalis
00:25:0100:25:05
is the big erector spinae muscle which goes into the ribcage, and it probably
00:25:0500:25:09
can cause a little bit of that rotation.
00:25:1400:25:20
Yes yeah it kind of looks like a Christmas tree depending on which one
00:25:2000:25:28
we're talking about, but it'll be like the iliocostalis does this right. The
00:25:2800:25:34
spinalis just goes from spinous process to spinous process like this.
00:25:4000:25:44
The function of this class guys is to is to get down the joint actions. I'm
00:25:4400:25:48
excited though because you guys are starting to ask deeper and deeper questions. But
00:25:4800:25:52
as I kind of mentioned earlier when we were just warming up and going through
00:25:5200:25:57
our Q&A today, this doesn't ever stop. It's one of the exciting things about
00:25:5700:26:03
getting into this field is, like there are, we keep calling rabbit holes right.
00:26:0300:26:07
There are rabbit holes to jump down forever, you find something you're into
00:26:0700:26:11
you can just keep going, as I mentioned those those functional Anatomy articles
00:26:1100:26:18
that I have up on my site, talking like six seven pages of text on one muscle,
00:26:1800:26:26
and then pictures, and videos and illustrations and diagrams, and research.
00:26:2600:26:30
Depending on what muscle you talk about you may have hundreds of research
00:26:3000:26:38
studies to look at. Fun stuff. Quadratus lumborum,
00:26:4600:26:59
how many of you guys have heard of this muscle before? Cool, so this muscle goes
00:26:5900:27:07
from my 12th rib to my posterior ilium. The thing I want you guys to keep in mind
00:27:0700:27:14
though, this isn't a superficial muscle like out here,
00:27:1400:27:19
it's a twelfth rib to posterior ilium with some connections into these
00:27:1900:27:25
transverse process; it's actually a very deep muscle, comparatively. Your erector
00:27:2500:27:31
spinae are on top of them, your latissimus dorsi, transverse abdominus,
00:27:3100:27:36
internal and external oblique, on top of them. So it's fairly deep it's like just
00:27:3600:27:42
like this. What joint action do you think it's going to cause? Lateral flexion.
00:27:4200:27:52
Anything else? Where would it have to be to cause extension? They'd have to be
00:27:5200:27:54
here right, they'd have to be somewhere behind
00:27:5400:27:59
the lumbar, at least on the spinous process, be behind the bodies of the vertebra,
00:27:5900:28:05
this is right here. No rotation, what would it have to have to do rotation?
00:28:0500:28:10
Some sort of obliquity, come forward a little bit, this is this is lateral
00:28:1000:28:17
flexion. In fact your quadratus lumborum is your primary lateral flexor. This
00:28:1700:28:23
exercise -quadratus lumborum exercise, a little bit of oblique but quadratus
00:28:2300:28:30
lumborum. Sure quadratus lumborum is very important for stability. It is
00:28:3000:28:33
one of those muscles we've kind of talked about though like the iliacus,
00:28:3300:28:42
that has a propensity to get tight. If the quadratus lumborum got tight,
00:28:4400:28:52
what is that going to do? It could pull you this way if it's one side, if it pulls on
00:28:5200:29:00
both sides what's it going to do? Yeah it could, it could start to compress and
00:29:0000:29:04
give you a little soreness, eventually contribute to maybe some pain and
00:29:0400:29:11
dysfunction, you guys see how that would work. I'm not, I totally agree that the
00:29:1100:29:15
quadratus lumborum is important to stabilization. Is this a muscle that I'm
00:29:1500:29:21
going to write down and exercise for in a routine? Probably not. I don't think
00:29:2100:29:25
this is something we have to individually strengthen, and I think
00:29:2500:29:30
targeting it too hard might help contribute to that cycle of
00:29:3000:29:35
this muscle getting a little overactive, a little tight, and contributing to some
00:29:3500:29:42
of that low back pain that we see in so many individuals. This exercise
00:29:4200:29:48
we'd never give anybody, and not just because it makes people look silly, like
00:29:4800:29:52
they're trying to impersonate a wheel wobble, I think it contributes to low
00:29:5200:29:59
back pain. Oh you guys didn't think you'd go a whole hour without doing a graph
00:29:5900:30:08
did you? You know what that means though, we just did, you guys just finished all
00:30:0800:30:14
the muscles for functional anatomy one. So the one thing I think I mentioned
00:30:1400:30:19
there guys is the TVA, although it will play a role in all joint actions, it
00:30:1900:30:24
doesn't have a joint action so it's not going to end up on this graph. Don't forget
00:30:2400:30:31
about it though, that's what that little box at the top says. Action, plane, muscles,
00:30:3100:30:37
exercise that includes that joint action. So this one's a little bit more like the
00:30:3700:30:42
scapular graph we did. Whats that?
00:30:4300:30:55
TVA what about it? TV, TV-transverse abdominus. I'm sorry did I not define
00:30:5500:31:01
that? TVA, yeah TVA is transverse abdominus. Occasionally you'll see
00:31:0100:31:14
it as TA, what's the problem with that one? Tibialis anterior. Your transverse
00:31:1400:31:30
abdominus right, does that make sense? It just wraps around like this. he hasn't,
00:31:3000:31:33
he yes exactly.