Switching over to Working Out On Free-Motion Equipment?

Within the overall category of strength training equipment, machines may be characterized as fully stabilized or unstabilized.  Fully stable devices, either fixed path or cable-based, offer full body support in the presence of a seat or a bench.  Unstabilized devices offer no supporting element.  These devices are cable-based machines, typically with pulleys that adjust in a vertical direction.  Users may elect to employ a seat, bench, or other support platform along with an exercise on an unstable device, but typically, exercises on these machines are performed in a free-standing fashion, with only the ground for support.

One of the advantages of the stable environment is that it can support high work loads, thus encouraging significant gains in strength.  By contrast, free-standing exercises, such as the cable chest press, have been shown to limit the amount of load that can be managed, largely because of the need to maintain balance throughout the movement (Santana, et al, 2007).

Advocates of the free-standing exercise claim that the unstable nature of the task raises activation levels in the core musculature to a greater extent than stabilized exercise.  Santana and colleagues (2007) did report higher abdominal muscle activity during a free-standing cable chest press as compared to a fully supported bench press.  But, the authors measured a unilateral cable press against a bilateral bench press, and differences in muscle activity were seen only on one side of the abdominal wall.  Thus, it is unclear as to whether the differences in muscle activation were due to the apparatus or the uneven loading conditions.

Other studies comparing abdominal muscle activity during chest pressing during stable or unstable conditions do indicate an increased level of activation associated with the unstable environment (Lehman, et al, 2006; Marshall and Murphy, 2006).  These conditions, however, involve supine positions on inflated balls, as opposed to free-standing postures.  Little other research exists, unfortunately, wherein free-standing configurations were evaluated.

Additionally, the research to date has explored differences between an unstable environment, either free-standing or set upon a moving surface, and a fully stabilized context, with bench or seat.  No comparison, thus far, has been made between the two extreme conditions and a partially stabilized state.  In this context, a partially stabilized chest press would involve a standing posture which is supported at some point along the back by an adjustable support pad, creating a base of support that is larger than the free-standing position, yet smaller than the seated or supine position.  This partially stabilized position may span the gap between stable and unstable cable exercises.

The purpose of this investigation, therefore, was to examine the effects of horizontal support on the amount of weight lifted (load) as well as abdominal muscle activation when performing a cable chest press exercise under three conditions: free standing; fully stabilized, with the support placed between the scapulae; and partially stabilized, with the support positioned at the sacrum.


Twelve subjects, five men and seven women (averaging 22.6 ± 6.4 years of age), participated in this study.  Participants had to be healthy, with no known injury that would have been aggravated by, or affected the outcome of this study.  Prior to participation, each subject was debriefed on the study protocol and signed the informed consent document.

Each subject was required to perform a ten repetition maximum (10RM) exertion test, followed by three, temporally regulated repetitions, in three conditions: 1) free standing with torso in a vertical position and feet staggered at a distance relative to the subject’s height (FS)

2) standing fully stabilized, with horizontal support between the shoulder blades (Sup S), and

3) standing partially stabilized, with horizontal support on the pelvis (Sup P).  All exercises were performed using the Cybex Bravo Functional trainer.

Setting the Angle of Convergence

In order to insure consistent force application by the cable apparatus, the angle of convergence of the cable was adjusted to twenty-five degrees for all subjects.  The angle of convergence is the angle formed between the line of the cable and a line, perpendicular to the trunk, in the sagittal plane.

The padded support was positioned at the level of the subject’s sacrum, with the length of the support arm initially at the shortest setting.  The pulleys were placed in a vertical position, and their height was set so that the cable came as close as possible to the subject’s acromion process.  With the weight of the machine at the lowest setting, the subject lightly grasped the handles, wrists pronated, with the humerus abducted to 60° and with the forearm parallel to the floor.

On cue, the subject pushed the handles forward horizontally, and in a straight line, until their arms were extended, with their hands shoulder width apart.  This position was maintained while the tester measured the angle of convergence with a goniometer.  If the angle of convergence varied above or below 25° by 1° or more, the horizontal position of the padded support was adjusted until the correct angle of convergence was established.

Establishing Stance for Free-Standing Position

The base of support was normalized for the free-standing condition so that the distance from heel to toe was one-third of the subjects’ height.  Using the horizontal pad position established while setting the convergence angle, a plumb line was employed to mark the center of stance on the floor.  Once the heel-to-toe distance was calculated, in centimeters, marks were placed on the floor, equidistant from the center of stance indicator, denoting foot position in the sagittal plane.

EMG Electrode Placement

Surface electromyography (EMG) was used to measure activation levels in the rectus abdominis and external oblique muscles. The skin was prepared by shaving the area of electrode placement (if necessary), followed by wiping the site with a cotton ball and abrasive skin gel.  Lastly, the skin was cleansed with rubbing alcohol.

Electrode position for the rectus abdominis was determined by palpating the abdomen close to the umbilicus.  A pair of bipolar electrodes was placed laterally on both the left and right sides of the umbilicus at a distance of approximately 2 cm.  The electrodes were oriented in parallel to the muscle fibers, and placed 2 cm apart on center.

Electrode position for the external oblique was determined by palpating the iliac crest and locating the anterior superior iliac spine.  A pair of bipolar electrodes was placed 2 cm apart above the anterior superior iliac spine, halfway between the iliac crest and the ribs on both the left and right sides of the body.  The electrodes were placed at a slightly oblique angle so that they ran parallel to the muscle fibers.  The placement of EMG electrodes over the rectus abdominis and external obliques is illustrated in figure 1.

Testing Procedures

Subjects performed a pre-testing warm-up on the Powerline Chest Press machine, according to the guidelines outlined in the ACSM’s Resources for the Personal Trainer, 2nd Edition.

Subjects completed two sets of 10 repetitions at a prescribed resistance of 40 lbs for men and 20 lbs for women.  The repetitions were performed at an established pace of 45 beats per minute, where 2 beats indicated one complete repetition.  Each set was separated by a 2-minute rest interval.

10 Repetition Maximum Testing

In order to determine the amount of weight that could be lifted while in each support position, ten repetition maximum testing was conducted.

The pulley height and convergence angle were established first.  For the fully stabilized and partially stabilized conditions, the support arm was positioned in accordance with the convergence angle setting, and the subjects stood with their feet directly beneath their hips.  For the free-standing condition, the support pad arm was lowered, and subjects assumed the position as outlined above in setting stance for the free-standing position.

With cable handles in hand, the subjects kept their torsos in a vertically oriented position.  Their arms were abducted to 60°, and their forearms were held parallel to the floor.  Subjects were instructed to begin with their shoulders as far into horizontal extension as comfort would permit.

This position was established and checked for each subject prior to strength testing in the free- standing (FS), partially stabilized (Sup P) and fully stabilized (Sup S) positions.

Description of the Movement

During the 10RM exertion test participants performed the chest press exercise to a set cadence of 45 beats per minute.  This was important, not only in normalizing the manner in which strength was determined, but also in creating a constant stimulus to the trunk in order to accurately measure the amplitude of abdominal muscle activity.

At the first beat, the arms were to be fully extended, and at the second beat the arms were to be at the start position.  The testing configurations for the three test conditions are illustrated in the figures below.

Figure 1. Abdominal EMG electrode placement
A relatively low initial workload, established at the discretion of the tester, was selected so that subjects could become familiar with the task.  Weight was gradually added so long as the participant could perform the lift correctly for a maximum of 10 consecutive repetitions at a set pace of 45 beats per minute.  If at any point during the 10RM exertion test a subject was unable to maintain the cadence, the test was terminated.  The 10 repetition maximum was considered to be the greatest load that could be lifted ten times at the prescribed cadence.  Subjects attempted to achieve their 10 repetition maximum load within five trials, with approximately 3-5 minutes of recovery between each trail.

After determining their 10 repetition maximum, the subjects were given a rest period of approximately fifteen minutes while the EMG electrodes were applied and tested for functionality.  Once the EMG system was deemed to be functioning correctly, the subjects performed three repetitions at the established workload, following the 45 beats per minute cadence. Ten minutes of rest was given between strength tests, after which subjects repeated the procedures at a different degree of stability.  The three stabilizing conditions were counterbalanced across all subjects in order to eliminate sequencing effects.


The results of this study support the findings of Santana et al (2007) that performing a cable chest press in a free-standing position limits the amount of weight that can be lifted.  In this case, subjects were capable of lifting only 32% as much weight as they could if they were provided some degree of postural support.

Interestingly, there was no difference is workload capacity between the fully and partially supported conditions.  One might have expected a difference here, since the support pad, in the partial stability condition, was placed at the sacrum.  This would have left the trunk without support, potentially resulting in reduced workloads.  The results suggest, however, that despite the absence of trunk support, there was enough torso stability to accommodate the same high workloads associated with a fully stable postural set.  This finding is consistent with the EMG data, and the level of muscle activation arising during this task.

As revealed in this study, abdominal muscle activity during the partially stabilized condition was 184% greater than the fully stabilized condition.  This is not altogether unexpected.  With the support pad placed at the sacrum and the line of force located at the shoulders, a significant torque was applied to the trunk.  This torque loading would evoke higher levels of muscle activity in order to provide stability for the trunk, thus also providing support for increased workloads.

A finding that was surprising, on the other hand, was the similarity in muscle activity between the free-standing and fully supported positions.  It is a common belief that free-standing cable activities are advantageous because they evoke higher levels of core muscle activity than traditionally stabilized exercises, such as the supine bench press.  These findings contradict that theory.

A possible explanation for these results is that subjects, in order to perform the free-standing cable press, have to displace their weight forward, while simultaneously pushing down and back into the ground through their legs.  The combination of forward lean and backward push creates a balanced condition around the lumber spine, with little net torque.  Consequently, with little load applied to the spine, there is a reduced need for abdominal muscle activity.

One could argue, therefore, that in the context of overall strength development, there is little advantage to exercising in a free-standing posture, since there seems to be no additional core muscle activity, and workloads are substantially lower.  Stable conditions, on the other hand, involve the same degree of core muscle activity, but at much higher workloads.

In conclusion, the data herein reveal that the position which best combines workload capacity with core muscle activity is a standing cable press with partial postural support.


ACSM’S Resources for the Personal Trainer, 2nd Ed. (2006) P 398.  Lippincott Williams & Wilkins, Philadelphia.

Lehman, G.J., MacMillan, B., MacIntyre, I., Chivers, M., and Fluter, M. (2006). Shoulder muscle EMG activity during push up variations on and off a Swiss ball.  Dynamic Medicine. 5: 7.

Marshall, P.W. and Murphy, B.A.  (2005). Core stability exercises on and off a swiss ball.  Arch Phys Med Rehabil.  86: 242-249.

Santana, J.C., Vera-Garcia, F.J., and McGill, S.M. (2007). A kinetic and electromyographic comparison of the standing cable press and bench press.  Journal of Strength and Conditioning Research. 21(4): 1271-1279.

Are Movement Dysfunctions Not Dysfunctional At All?

Health and exercise professionals that apply corrective exercise strategies to their clients should ponder upon the following question: are movement dysfunctions really dysfunctional at all? If we look up the definition of the word dysfunctional, we soon realize that all it means is “not operating normally or properly.” Now, what is normally or properly – what is the norm referring to movement? If we then look up the word functional, the question becomes even more interesting as it often means “designed to be practical or useful.” What does that mean?

Where is he going with this analysis you might think?

Now, imagine this, you and I are walking around in Africa on a vacation trip. Suddenly out of nowhere a hungry lion runs at us looking for an easy lunch. Thank goodness there are some trees ahead of us and hell over heels we sprint to them to save our lives. Unfortunately while sprinting I step in a hole and sprain my ankle – what are my options now? A., I become lunch meat or B. I keep going, right? Now, after I hurt myself, I will probably be limping, causing a movement dysfunctional gait, but I am functional at the same time as I keep on going, right – I am functional by running to save my life.

More and more evidence shows that movement dysfunctions associated with pain happen reflexively and are probably related to very old survival mechanisms like running away from the lion as explained above. These movement dysfunctions have allowed us to survive and complete our tasks at hand in the past, and although we don’t have too many lions chasing us these days, we have other tasks to accomplish, such as going for a jog after sitting down for several hours at our jobs. KI believes that not only do movement dysfunctions occur after injury, but they actually also occur because of repetitive movements like typing on a keyboard, moving improperly when for example we move boxes incorrectly as a UPS delivery person and when we have a sedentary lifestyle.

The Functionality of Dysfunction

The old saying holds that there are only two certainties in life: death and taxes. This can be accurately expanded to include the word “adaptation.” We humans adapt from the cradle to the grave. We adapt to both internal and external forces as we grow, mature, develop and interact with our environment and the tasks of daily life.

It was Selye who identified adaptation as the feature that characterizes our development, and mal-adaptation as the feature that characterizes our eventual failure to adapt adequately, leading to collapse – in response to the stresses of life. He noted that anything that makes a demand for adaptation could be labeled as ‘stress’. Stress in this context can be seen as being potentially beneficial, and only harmful when the demands it makes cannot be met. Since all therapeutic endeavors – ranging from manipulation to dietary change, medication to insertion of an acupuncture needle – make demands for adaptation, all therapy is axiomatically a form of stress. Whether outcomes are beneficial or harmful ultimately depends on the interaction between the stress demand and the abilities of the individual to respond (Selye 1976).

If an individual, with its unique inborn attributes and characteristics is unable to appropriately compensate for, and adapt to the stresses of life, symptoms appear. And when adaptation processes are in action, symptoms are also apparent. Some symptoms represent a failure to adapt, and some represent adaptation in action. The healing process is itself a process of adaptation to a dysfunction or illness, which is itself is an example of a failure of the organism to adequately adapt to current demands, with symptoms simply being the signposts indicating where the adaptation process is at any given time.

Can dysfunction be functional? Are there times when apparent musculoskeletal dysfunction represent changes, which are, in fact, potentially or actually beneficial? Can painful spasm be protective? Undoubtedly. Without it the area would be moved, and frank tissue damage might occur, for example in
the case of an imminent disc rupture, or of a fragile osteoporotic spinal joint. This does not mean that all spasm, or all pain, is helpful/protective, but that in some instances they certainly appear to be.

Could hypertonicity sometimes be a useful adaptive response, where increased tone is required to stabilize a region? Without question. Take for example the paraspinal tissues of a hypermobile individual. This does not make all hypertonicity useful, but suggests that at times it may be, and should be respected. In both the spasm and the hypertonicity examples therapeutic attention should ideally focus on offering other ways of supporting the structures requiring protection, so easing the need for these often painful and limiting protective responses.

Could a trigger point, producing as it does increased tone in the muscle housing it, as well as in tissues to which pain is being referred, be offering an energy-efficient way of protecting a vulnerable joint? It would seem highly probable. Take for example a hamstring trigger point creating increased tone in that muscle group, and by doing so placing additional load on the sacro-tuberous ligament, so protecting a vulnerable sacro-iliac joint from excessive movement. Since trigger points are outside of neurological control, with the phenomenon being chemically mediated, this makes this mechanism super-efficient in terms of energy usage. Even if this functional example of an apparent dysfunction (a useful trigger point) is valid, it does not mean that all trigger points are helpful and undeserving of therapeutic attention, since some may be residual entities, left over from past stresses, unable to resolve, while newly developed trigger points are commonly the inevitable result of the effects of already active trigger points (Simons et al. 1999).

It does, however, mean that there may be situations where trigger points serve useful roles, where therapeutic input should be toward removal of the need for their presence, rather than deactivating them without thought as to what defence processes they may be involved in. Might the responses of the tissues of the body to overuse, misuse, and abuse often be both predictable and appropriate – often with pain and inflammation as the end result? Many of these responses are well recognized to be essential aspects of the recovery and healing processes, to be interrupted only if clinically essential. Where would we be without spasm and inflammation? Almost certainly we would be moving and using areas that are in need of immobilisation, so that repair processes can progress. Where would we be without pain?

Undoubtedly, we would be actively employing tissues and structures that should not be used. But while it is standard practice to rest inflamed and damaged tissues in their early healing stages, following trauma or surgery, a similar degree of recognition is not always offered to features of self-repair/defence such as spasm, hypertonicity and trigger point activity. Moving away from musculoskeletal health to general health, it takes little thought to recognise that a fever is life saving when a person is infected. It requires little imagination to conceive that vomiting and diarrhoea can save a life when a person has food poisoning. Many symptoms therefore clearly represent health enhancing processes, albeit uncomfortable ones, in action.

The random selection of symptoms listed above represent only a fraction of beneficial responses on the part of the defense and repair mechanisms of the body, that we classify as ‘symptoms’. And yet health-care providers, over-the-counter retailers, and the majority of the population spend inordinate amounts of time, money and effort trying to remove or modify these signs and symptoms of adaptation, recovery and repair. To be sure there are times when symptoms are extremely unpleasant, and in some instances life threatening. At such times, it makes sense to attempt to modify, modulate and/or ease the intensity of the symptoms. At other times it makes more sense to focus on why the symptom exists, and to aim to remove or modify what causes can be removed or modified, and/or to enhance the adaptive capacities of the body (rehabilitation training, re-education in use patterns, etc.) – as well, perhaps, when appropriate and helpful, to focus attention on the signals the body is sending, the symptoms on display.


  • Selye H 1976 The Stress of Life. McGraw-Hill, Toronto, Simons D, Travell J, Simons L 1999
  • Myofascial Pain and Dysfunction: The Trigger Point Manual, Vol. 1, Upper Half of Body, 2nd edn. Williams and Wilkins, Baltimore

Lumbar Multifidi With Low Back Pain

Several studies have been performed pertaining the lumbar multifidi (MT) in individuals with LBP. Starting 1994, Hides et al. reported finding significant ipsilateral atrophy in the lumbar multifidi in this population. Hides followed-up with similar subjects for 10 weeks and found that those that were treated with a specific exercise program had more substantial recovery of the MT muscle mass than others.

The literature makes a solid case that MT recovery after LBP does not spontaneously occur, even 5 years later. Based on this, the speculation is made that if the MT provides a key role in spinal stability, its inactivity could increase the chance of reinjury.

Spinal Stability

Wilke et al. have shown that the MT contributes to spinal stability, a finding that is supported by the recent work of others. Also, a significant body of research is emerging that associates significant changes in the composition and neurologic responses in the MT if LBP is present. An example is the influence of the MT on local spinal segmental control. Couple this with the nerve-muscle relationship and you can understand that this has led to the proposition that inhibition of the MT limits the ability of the CNS to fine tune the control of the lumbar intersegmental movements. Many of times my clients that have suffered low back pain are surprised that they cannot feel their MT contract, that it contracts later than their MT on their non-injured side and that atrophy is obvious in the regional musculature.

Now, why is this muscle inactivity and atrophy happening we should ask ourselves. More and more it seems that reflex inhibition is the major contributing factor for local segmental MT atrophy following LBP. For example,

  • Reflex inhibition protects the body from injury by turning muscle activity off when others are activated. For instance, when you flex your bicep, the triceps needs to be turned off in order for the arm to bend, and this in summary, is reflex inhibition.
  • Muscle inhibition describes the failure to completely activate all motor units in a given motor neuron pool. Muscle inhibition is an important component of motor control during human movement and is vital for proper functioning.
People with LBP commonly exhibit weak or unbalanced trunk muscles and tend to experience a quicker rate of fatigue during sustained lumbar extension exercise. This muscular deficiency may impose lower extremity muscular adaptations during fatiguing exercise to maintain stability and preserve normal function.


Based on the research above, through its specific restoration and augmentation exercise methods KI restores neuromuscular control of the MT and other local and global stabilizers and mobilizers. Through its advanced training methodology KI also intervenes to repair the MT reflex control.


  • Laasonen EM. Atrophy of sacrospinal muscle groups in patients with chronic, diffusely radiating lumbar back pain. Neuroradiology 1984;26:9-13.
  • Zhu XZ, Parnianpour M, Nordin M, et al. Histochemistry and morphology of erector spinae muscle in lumbar disc herniation. Spine 1989;14:391-7
  • Mattila M, Hurme M, Alaranta H, et al. The multifidus muscle in patients with lumbar disc herniation. A histochemical and morphometric analysis of intraoperative biopsies. Spine 1986;11:732-8
  • Ford D, Bagnall KM, McFadden KD, et al. Analysis of vertebral muscle obtained during surgery for correction of a lumbar disc disorder. Acta Anat (Basel) 1983;116:152-7
  • Stokes M, Young A. The contribution of reflex inhibition to arthrogenous muscle weakness. Clin Sci (Lond) 1984;67:7-14

Training Ourselves Into Movement Dysfunctional Patterns?

Kinetic Integrations emphasizes that Movement Dysfunctions are not only caused by pain or injury, but also because of a sedentary lifestyle, repetitive movements as well as incorrect movements. Although athletes and active individuals are not sedentary at all they are definitely prone to repetitive or incorrect movements.

Most athletes are under the impression that the adaptations their bodies make to the training or the sports activities they constantly are exposed to are good ones. Any baseball pitcher that has a shoulder problem will convincingly argue against that point. When they train hard in spring training, when they throw in the bullpen, when they perform medicine ball upper body drills they are imposing a demand on their bodies. Their bodies then adapt to these demands – often the hope is to get stronger, more fit, faster and throw harder. Unfortunately, training programs and human bodies are not always perfect, so often we don’t adapt the way we want to. Our training and the stresses involved may actually take us out of balance as they may cause movement dysfunctions.

Off course these  problems are not exclusive to athletes; the weekend worrier or physically active is dealing with the same issues. Often these individuals think that by mimicking their sports movements (like pitching) in the weight room is helping their “game.” Consequently they do not understand why they have more pain than they did before they started working out.

Many sports require our bodies to repetitively go through postural dysfunctional positions numerous times. Let me refer again to the baseball pitcher – for example, they have to twist and rotate their spine, externally rotated their throwing shoulder and always land on the same foot. If they keep repeating those stresses over and over again, the body will break down.

By performing virtually the same motion repeatedly the body’s central nervous system drives the body to accomplish the goal by any means necessary, even if it creates movement patterns that are dysfunctional and will likely lead to pain.

Link Sources

Direction of Motion With Low Back Pain

After Cresswell study on abdominal pressure, the Australians Hodges and Richardson studied the activation pattern of the trunk musculature associated with upper extremity movement. Subjects without low back pain (LBP), showed that the TrA was the first muscle activated and contracted before arm movement, regardless of the direction of motion. The other investigated muscles tended to have firing patterns that were distinct for the direction of motion. The investigators suggested thereby that the TrA provides stability for the lumbar spine in anticipation to movement. Out of this conclusion, the term “feedforward mechanism” was born in the world of low back pain and muscle activation mechanisms.

Interesting enough though, individuals with LBP, showed that the contraction of the TrA was significantly delayed and followed direction-specific patterns. Hodges and Richardson concluded that this is indicates a potential for decreased spinal stability and motor control problems. Later, similar muscle firing patterns were noted when lower extremity movements were applied.

In Sum

The above studies basically revolutionized on how to train or rehabilitate our spinal stabilizers. Suddenly healthcare providers ans later on exercise professionals were asking their clients to activate their TrA by sucking in their belly button.

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Squat a Little

It’s hard to dispute that our so-called modern western world has adopted a far more sedentary lifestyle compared to the previous generations.  This sedentary lifestyle has lead to an epidemic of not only metabolic disorders such as obesity, but also musculoskeletal injuries.  One of the most common musculoskeletal injuries associated with this lifestyle is low back pain. It’s no coincidence that the rise of this problem has occurred at a time when the seated position has become the most common worldwide working posture. College students are not immune to this posture as they often spend hours a day in a sitting position in class, when studying and during their leisure time.

Modern Day Life

Modern day life has made most of us adopt different sustained postures and movement patterns then to what our body is made to do. If you have spent some time in Asia or Africa you would have seen the locals sitting in full squat position talking, waiting for the bus or drinking tea. When you compare the joint angles at the hips, knees and ankles in this position compared to sitting in a seat a big difference can be noticed. Although there is some suggestions that Asians have hip structure than suits a full squat position more than Westerners our young ones show us that we do indeed have the ability to squat all the way down to the ground. As adults we just lose it because we don’t use it.

Workout Sessions

Incorporating a few deep squats at the end of your workout sessions can be a great way to restore some range to creaky ankle, knee and hip joints.  A bonus is that by sitting in this position allows you to stretch all these areas at the same time. You may need to hold onto something to stop yourself falling backwards when you first start doing this – that’s OK.

  1. Start with a wide-open stance and work the feet closer together and straighter as this gets easier.
  2. Focus on the weight being through the middle of the feet.
  3. Aim for a tempo of 4 seconds down, 1-2 seconds up, 10-12 repetitions and repeat 1 to 4 sets depending on the level of fitness.
  4. If your hips feel tight at the bottom of the squat, you may want to hold the exercise for 1 to 2 seconds to help increase the stretch of tight tissues.

Old Rule Applies

Deep squatting may not suit everyone.  If you have knee or back pain in this position there may be a problem that requires medical care.  The old rule applies. If it hurts don’t do it.  Go slow and work your way down within your limits.

Breathing Patterns Become Dysfunctional After Low Back Pain

Kinetic Integrations has observed that clients who have suffered from low back pain will reflexively change their breathing pattern and will become abdominal breathers, creating a breathing movement dysfunction. Associated with this incorrect breathing pattern is a deactivation of the lumbar spine multifidus muscle.  As that muscle aids to the local stabilizing task of the spine while also assisting in giving proprioceptive feedback to the brain it is critical that normal breathing gets restored. KI actually believes that correct breathing patterns are a necessity not only to restore MT action and function, but that its corrective exercise strategies are the foundations of optimal lumbo-pelvic stability. Directly related to this is the TrA muscle dysfunction in the same population.

For example, in non-injured individuals activity of the diaphragm and TrA muscle is initiated prior to rapid limb movement such as throwing a ball. Research has found that if a client holds their breath while contracting their abdominal muscles, activation of the TrA is delayed; this breath-holding pattern is often seen in clients with back pain as well.  Since activation of the TrA is necessary for spinal stability-thus effecting posture-respiration during exertion reinforces this stabilizing function. Health and Exercise Professionals should be aware of this and correct their clients breathing movement dysfunction through the KI corrective exercise strategies.

Intra-Abdominal Pressure With Low Back Pain

In the early 1990’s, a number of researchers looked at the role and activation patterns of the trunk muscles as they related to the concept of spinal stability. In Sweden, Cresswell et al. reported a series of studies indicating that intra-abdominal pressure was increased during functional tasks. Specifically the activation of the TrA was correlated with this:

  • Fine-wire electrodes were used to assess TrA, internal oblique (IO), external oblique (EO) and rectus abdominis (RA) activity while intra-abdominal pressure was measured through the stomach. Does not sound like a fun test, does it?  The TrA muscle activity was most consistently related to changes in intra-abdominal pressure.
  • Unexpected and expected, self-induced perturbations were delivered to the trunk by suddenly loading a vest strapped to the torso of six male subjects. Again, also in this study the TrA was always the first muscle active in both conditions.
  • During isometric trunk flexion, IAPs were increased with accompanying high levels of activity from the abdominal muscles. In contrast, little activity from those muscles occurred during isometric trunk extension, although levels of IAP were similar. When adding valsalva with isometric trunk extension, activity from EO and IO was reduced while IAPs remained fairly constant.

In Sum

These studies suggest that increase in IAP is a mechanism designed to improve the stability of the trunk through a stiffening of the whole segment. Activation of muscles such as the diaphragm and TrA is suggested as helping provide control over the level of IAP during controlled trunk tasks.

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