There are hundreds of tasks your body repeatedly does that stem from your brain. The brain is the center of your central nervous system and is the control center for movement. It controls the firing, relaxing, and pausing of movement in a specific sequential order. There is a series of things that must happen when you take a step, breath, or blink. Unfortunately, the role of the nervous system as a contributing factor for musculoskeletal pain also exists. This can be the skipping of a step, such as a muscle not firing or the inclusion of an extra step such as an extra muscle adding a step in the process. But how does this happen?
These issues can be controlled by teaching the person to control subtle movements by conscious effort. Many people believe that since we can do so many things reflexively, we should also have the ability to make corrections reflexively, and that just isn’t so. A study by Hodges and Richardson identifies that the recruitment of the transverse abdominis muscle, one of the deep core muscles located in the abdominals, is delayed in the person who experiences back pain. Another study by Hides has shown that patients with low back pain are experiencing a delayed engagement from the multifidus muscle (another deep core muscle). Both are examples of a motor control problem. It’s not an issue of having strong muscles, but rather teaching the muscle to fire correctly. Drills such as the bird-dog, dead bug, chops, and lifts with all their variations use proprioceptive neuromuscular facilitation (PNF) to teach the body how to stretch, contract, and relax in the correct sequence. If you train at the studio, you are bound to have these exercises in your workout.
It doesn’t stop with only back pain, as a study from Babyar explains that the source of shoulder pain from some patients is due to excessive shoulder elevation during shoulder flexion to 90 degrees. These people are hyper and overactive in the upper trapezius. These people tend to perform exercises with the appearance that their shoulders are connected to their ears. When coaching people like this I tend to frequently remind them to drop their shoulders. Verbal reminders help them to quickly depress and drop their shoulders. The only problem is that as soon as I walk away to coach someone else, they instantly raise them back up. The good news is that the person can fix the problem, the deeper issue is that they need constant reminding. A frequent comment I get is, “Doug, you need to walk behind me all day and remind me to drop my shoulders.”
Changes in muscle firing can also happen in gait. Another study, by Mueller and associates, shows that people with diabetes have limited range of dorsiflexion, and decreased power of push-off from the big toe and instead excessively use the hip to swing a leg forward. The hip flexion phase tends to be exaggerated. Drills that address ankle joint mobility will include motor control and can carry over to insuring a person does not overuse their hip flexors.
When addressing muscular pain, understand that it may not be strength or lack of flexibility. Mobility and strength can solve a lot of ills, but not everything. The problem may be tied to motor control and the organ that lies between your ears.
I’ll see you at the studio.