Postural Restoration - Part 1 Behaviour

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Category: Education
     
 

Presentation Description

Introducing the concepts behind postural restoration

Comments

By: dmlthem07 (37 month(s) ago)

I would really like to use your presentation for my students. My name is Dennis Themba in South Africa I am a Lecturer in Physiotherapy at the University of Lipompo.

By: markmckean (37 month(s) ago)

Hi Dennis, (take 2) just tried to find your email at the university of Limpompo website, but could not find your name listed in the faculty academic staff list. Please send me your email address with confirmation of your position and I can email you the presentation. Mark

 

Presentation Transcript

Postural Behaviour : 

Postural Behaviour Mark McKean

Why This Posture Thing? : 

Why This Posture Thing? All inclusive for health Influences all our movements and activity Not static but evolving and dynamic Static posture may have no influence over dynamic posture

What is our role as trainers? : 

What is our role as trainers? First and foremost we are fitness trained with some skills in other areas Shouldn’t try to emulate or take the place of other professionals Devise the very best means for a client to achieve their fitness related goals Become the exercise therapist through smart and appropriate exercise prescription

Stress Affects Posture : 

Stress Affects Posture

Stresses Include : 

Stresses Include Occupations Injury Habits Postural deformity Training Sport Incidental activity Furniture

Muscle Physiology : 

Muscle Physiology

Muscle Components : 

Muscle Components Behaviour Neurology Fibre type Motor patterns

Classification of Muscles : 

Classification of Muscles Muscles are classified by Body reference (local/global) Anatomy (stabilisers/mobilisers) Physiology of motor units (tonic/phasic)

Function of Muscle Classification : 

Function of Muscle Classification LOCAL GLOBAL STABILISER MOBILISER TA Deep Multifidus Psoas VMO Mid/lower Traps Obliques Superficial Multifidus Glute Med Serratus Anterior Rectus A Iliocostalis Hamstrings Lat dorsi Lev Scap Scalene

Stabilisers V Mobilisers : 

Stabilisers V Mobilisers One joint Deep Multipennate / oblique fibres Broad insertions (distribute F, absorb load) Leverage to increase joint compression Closed chain Co-activate with other stabilisers – relationships Anti gravity role to control posture 2 joint/multi joint Superficial Strap like – tendon insertions Leverage for speed joint distraction Open chain Isolated action but overflows to synergists Repetitive, rapid movement role

Local Stabilisers : 

Local Stabilisers Control the neutral position of the joint No or little change in length of muscle Contract continuously throughout movement Pass on proprioceptive details, joint angle, muscle change in length and tension

Local Stabiliser Dysfunction : 

Local Stabiliser Dysfunction Loss of control of the joint position Decrease in muscle control and segmental control Motor recruitment or control is decreased

Global Stabilisers : 

Global Stabilisers Control the joint through movement especially inner and outer range of movement possible Contract only through specific positions of action –i.e. non continuous eccentric control Contraction of muscle is direction dependent Force is generated to control the range of movement Assist in decelerating momentum especially in rotation under low loads

Global Stabiliser Dysfunction : 

Global Stabiliser Dysfunction Decrease in tonic recruitment at low intensities Poor eccentric control of movement Muscles become long Recruitment of muscle is inhibited i.e. not necessarily turned off but altered behaviour (timing, sequence) Inhibited by dominant antagonist

Global Mobilisers : 

Global Mobilisers Generate force to produce movement via concentric contraction Create force especially in accelerating actions eg flexion/extension Activity of contraction is direction specific

Global Mobiliser Dysfunction : 

Global Mobiliser Dysfunction Loss of range of motion or muscle shortening Overactive even at low thresholds Low recruitment loads will bring it into play early Reacts to change with muscle spasm Creates global muscle imbalance

Tonic muscles V Phasic muscles : 

Tonic muscles V Phasic muscles Slow twitch Low freq motor neurons (5-20Hz) Low threshold of activation i.e. gravity stimulates Slow contraction Slow to fatigue Primarily recruited at less than 30% MVC Feedback via CNS Fast twitch High freq motor neurons (30-100+ Hz) High threshold Fast contraction Fatigues quickly Recruited at 40% + MVC Allows feedback after to correct motor patterns –too fast

Muscles which overlap : 

Muscles which overlap Iliopsoas (pictures) Lumbar Erector Spinae Glut Max Rectus Abdominis Hamstrings These may develop problems of both

Neural Network : 

Neural Network

Neurology : 

Neurology Interfered with by illness, alcohol, fatigue, injury, disease, genetic problems Find best possible pattern of recruitment to achieve the movement required depending on postural position and muscle awareness Will alter the behaviour of a muscle if it is not being used regularly Will recruit a muscle more easily if it is used often

Fibre Type Changes : 

Fibre Type Changes Muscle demand influences fibre type If demand is to stabilise it will become tonic in physiology If demand is to mobilise it will become phasic in physiology Muscles change to suit demands ES in Lumbar spine change to more tonic in people with lower back pain

Motor Sequences : 

Motor Sequences Brain finds path of least resistance and efficiency Developed through repetition and demand Recruitment patterns changed according to muscle awareness & vice versa Postural patterns difficult to change due to time spent incorrectly

Identifying Bad Behaviour : 

Identifying Bad Behaviour

Testing Methods : 

Testing Methods Observation – what we see Alignment checks – against reference system Muscle function testing – muscle behaviour and joint range of motion Motor pattern performance – observation of quality of movement

Observation : 

Observation Looking for Asymmetry, symmetry Muscle size – normal, abnormal Muscle feel – soft, toned, tight, spongy Obvious postural changes – pelvic tilt, rounded shoulders, head position etc Changes in movement patterns, recruitment patterns

Alignment Checks : 

Alignment Checks Using a plumb bob or string line to check Vertical alignment of specific markers Pelvic angle in normal range Position of limbs in relation to trunk

Muscle Function Testing : 

Muscle Function Testing Flexibility/joint range of motion testing Strength of muscles tested Muscles ability to recruit on demand

Skill Performances : 

Skill Performances Behavioural changes in movements Changes in skilled performances Performance changes Pain in performing movements Loss of range of motion in an activity Overuse of muscles used out of sequence

Correcting Behaviour : 

Correcting Behaviour

Stretching : 

Stretching Phasic muscles – firmly, PNF, 30s Tonic muscles – antigravity, low pressure, long periods up to 12 minutes Stretch tight muscles before strengthen weak muscles

Strengthening : 

Strengthening Phasic muscles – isotonically, reps, high thresholds within limits of controlling stabilisers Tonic muscles – isometrically, low threshold of activation, correct postural position

Training local stability : 

Training local stability Correct postural position TA and Pelvic floor as basis of ‘core’ Isometric contractions in assumed positions Antigravity effect on local system Stress tonic muscles by moving limbs

Training the Global System : 

Training the Global System Limb disassociation from trunk Low loads within the limit of control before increase stress of load Speed is controlled before becoming specific Range is held within limits of control Achieve normal range of movement

Motor Pattern Retraining : 

Motor Pattern Retraining Establish correct patterns and recruitment sequences Start with basic stabilising and move to dynamic mobilising Use basic tests as start point

Summary : 

Summary Find out what has changed in behaviour or causing pain. Refer to professional for full diagnosis Teach stabilising patterns of control Deal with stability at a level that the trainer can handle under guidance of professional