Chapter 9: Functional Programming For Stability-Mobility And Movement

Question 1

Define Joint Stability

Answer 1

The ability to maintain or control joint movement or position

Achieved by synergistic actions of the muscles, ligaments, and joint capsule
AND the neuromuscular system

Question 2

Define Joint Mobility

Answer 2

Defined as the range of uninhibited movement around a joint or body segment

Achieved by synergistic actions of the components of the joint and neuromuscular system

Question 3

What is arthrokinematics?

Answer 3

Proper joint mechanics

The specific movement of joint surfaces

Arthrokinematic Motion:
Roll, glide, and spin

Question 4

What happens when a joint lacks the appropriate level of mobility needed for movement?

Answer 4

The joint will seek to achieve the desired range of motion by incorporating movement in another plane

Question 5

What causes lack of mobility?

Answer 5

Reduced levels of activity 
Repetitive movements 
Side dominance 
Habitually poor posture
Poor Exercise Technique
Imbalanced Strength Programs

Question 6

What is the result of lack of mobility?

Answer 6

Lack of mobility leads to compensations in movement
and potential losses to stability and subsequent joints

Muscle imbalances altar the physiological and neurological properties of muscles in a way that ultimately contributes to dysfunctional movement

Question 7

What are Length Tension relationships?

Answer 7

A relationship between the contractile proteins (actin & myosin) of a sarcomere and their force-generating capacity

When the sarcomere is stretched slightly beyond its normal resting length, the force-generating capacity is increased

If the sarcomere is stretched too far then the force-generating capacity is reduced

If the sarcomere is shortened beyond normal resting length (such as from immobilization, passive shortening, trauma, and aging) then this reduces the muscle’s force generating capacity

Question 8

What are Force-Coupling Relationships?

Answer 8

Muscles working together by providing opposing, directional, or contralateral pulls at joints to achieve efficient movement

Question 9

How is neural control affected by muscle imbalances?

Answer 9

When muscles are shortened (hypertonic) they may fire prematurely thus inhibiting activation of their antagonist muscle

Example: tight hip flexors may fire prematurely this inhibiting activation of the glutes during hip extension

Question 10

What is synergistic dominance?

Answer 10

When the antagonist muscle is weakened so the body has to call on other synergist muscles at the joint to become the prime movers

Example: dominant hip flexors could weaken the glutes and cause the hamstrings (synergist) to have a greater contribution to hip extension

Since the hamstrings are not designed for this movement it puts them at risk of tightness from overuse, thus increasing the likelihood of dysfunctional movement and injury over time

Question 11

Why is it important for trainers to work to restore and maintain normal joint alignment, joint movement, muscle balance, and muscle function?

Answer 11

Compromised joint movement alters neuromuscular control and function prompting additional postural misalignments and faulty loading at the joints that inevitably increases overload and the likelihood for further injury and pain

Question 12

What are the contributions of slow & fast twitch fibers to joint stability and mobility?

Answer 12

Type 1 (Slow Twitch) Fibers are usually highly concentrated in muscles that act as primary stabilizers AND they enhance a muscle’s capacity for endurance (better suited for high rep low intensity training)

Type 2 (Fast Twitch) Fibers are usually responsible for joint movement and generating larger forces (better suited for higher intensity, lower rep training)

Question 13

Self-myofascial release

Answer 13

Clients perform small, continuous, back and forth movements on a foam roller or a similar device

30-60 seconds on the tender region

2-6 inches

Question 14

What types of pre-exercise warm up is appropriate for deconditioned individuals with poor flexibility and muscle imbalance?

Answer 14

1. Myofascial Release

2. Static Stretches

Question 15

What types of pre-exercise warm up is appropriate for a conditioned client with good flexibility and muscle balance?

Answer 15

1. Myofascial Release

2. Dynamic Stretches

Question 16

What types of pre-exercise warm up is appropriate for a performance athlete with good skill and flexibility?

Answer 16

1. Dynamic Stretches

2. Ballistic Stretches

Question 17

How is it theorized that Myofascial release (SMR) works?

Answer 17

This technique presumably resets the proprioceptive mechanisms of the soft tissue.

Helping to reduce hypertonicity (tightness) within the underlying muscles and fascia, thus improving ROM

Question 18

Static Stretching

Answer 18

Static stretches should be taken to the point of tension, with clients performing a minimum of four repetitions and holding each repetition for 15 to 60 seconds

Question 19

Proprioceptive neuromuscular facilitation (PNF)

Answer 19

Clients can perform a hold – relax stretch, Holding the isometric contraction of the agonist for a minimum of six seconds, followed by a 10 to 30 second assisted or passive static stretch

Question 20

Dynamic Ballistic Stretches

Answer 20

This type of stretching can be effective for individuals participating in sports that require ballistic activities

Question 21

What is the primary function of the core musculature?

Answer 21

To effectively control the position and motion of the trunk over the pelvis, which allows optimal production, transfer, and control of force and motion to more distal segments during integrated movements

Question 22

Structure and function of the innermost (deep) core

Answer 22

Muscles: rotatores, interspinali, intertransversarii

Function:
1. Offer some segmental stabilization of each vertebra, especially at end ROM

2. Rich in sensory nerve endings which provide continuous feedback to the brain regarding loading and position of the spine

Question 23

Structure and function of the middle layer of the core

Answer 23

Muscles: transverse abdominis (TVA), multifidi, quadratus lumborum, deep fibers of the internal oblique, diaphragm, pelvic floor musculature, and fasciae

Function:
1. The box like structure allows the sacroiliac joints to stiffen in anticipation of loading and movement

2. Provides a solid, stable working foundation from which the body can operate

Question 24

Structure and function of the outmost layer of the core

Answer 24

Muscles: Rectus abdominis, erector spinae, external and internal obliques, Iliopsoas, Latissimus Dorsi

Function: major muscle movements and generating forces from within the trunk

Question 25

What is the problem with minimal or delayed TVA (transverse abdominis) activation?

Answer 25

Inadequate stabilization of the lumbar spine during movements of the upper and lower extremities. This increases the risk of injury

Question 26

Three phases of training for the CORE

Answer 26

1. Core Function
   (Core-activation exercises and isolated stabilization under minimal spinal loading)
2. Static Balance
   (Emphasizes seated and standing stabilization over a fixed base of support)
3. Dynamic Balance
   (Emphasizes whole-body stabilization over a dynamic base of support)

Question 27

What’s the difference between a mono articulated and biarticulated muscle?

Answer 27

A monoarticulated muscle crosses one joint (example: Soleus muscle

A biarticulated muscle crosses two joints (hamstrings)

Question 28

What happens when the thoracic spine lacks appropriate mobility?

Answer 28

What often results is compensation to mobility within the glenohumeral joint and muscle action within that joint

Question 29

What factors contribute to stability within the scapulothoracic region?

Answer 29

1. Thoracic Mobility
2. Tissue Extensibility (Flexibility)
3. Healthy rotator cuff muscle function
4. Muscle balance within the parascapular muscles
5. The ability to resist upward glide and impingement against the coracoacromial arch during deltoid action

Question 30

How to stretch the inferior shoulder capsule?

Answer 30

OH Tricep stretch

Question 31

How to stretch the posterior shoulder capsule?

Answer 31

Bring arm across chest, place hand on the Tricep of the extended arm and pull

Alternatively, perform the stretch against the wall (facing it with arm crossed over chest)

Question 32

How to stretch the anterior shoulder capsule?

Answer 32

Pectoralis stretch; place forearm against wall, arm at 90 degrees, and turn away to stretch the pec

Question 33

How to stretch the superior shoulder capsule?

Answer 33

Place a rolled up towel 2 inches above the elbow against the trunk, grasp at the base of the elbow and pull it down and inward to stretch

Question 34

What’s the difference between CKG and OKC movements of the scapulothoracic region?

Answer 34

CKG:

• the distal segment is more fixed (pull ups or push ups) and the serratus anterior moves the thorax towards the fixed scapulae
• load and compress joints, mimic daily activities; more difficult to perform for untrained individuals

OKC:

• the serratus anterior controls movement of the scapulae against the fixed rib cage
• isolated; not as effective at restoring coordinated parascapular control

Question 35

Define Static Balance

Answer 35

The ability to maintain the body’s COM within its base of support

Question 36

Define Dynamic Balance

Answer 36

The ability to move the body’s COM outside of its BOS, while maintaining postural control and establishing a new BOS

Question 37

Where is the approximate location of the body’s center of gravity?

Answer 37

2 inches anterior to the spine, at the second sacral vertebra

Question 38

Define LOS (limits of stability)

Answer 38

The degree of allowable sway away from the line of gravity that can be tolerated without a need to change BOS (base of support)

Question 39

Define LOG (line of gravity)

Answer 39

A theoretical vertical line passing through the COG/COM (center of gravity or center of mass)

Question 40

What are two variables that can make balance exercises more challenging (for the sake of progression)?

Answer 40

1. Reduce points of contact
   Example: one leg instead of two
2. Add unstable surfaces
   Example: air discs

Question 41

What’s the difference between “centering” your core and “bracing” it?

Answer 41

Centering: drawing the belly button towards the spine, for example when you exhale. Reflexive action; TVA

Bracing: conscious contraction of the core. Co-contraction of both the middle and outer layer of the core. Used when squatting to pick something up or when someone’s about to punch you in the stomach

Question 42

What is the cause of not being able to efficiently stand/balance on one leg?

Answer 42

Weakness in the hip abductors reflects an inability to control lateral hip shift, which places additional stress on the knee

Clients should first strengthen these muscles in isolation (side-lying leg raise) before incorporating weight bearing compound movements

Question 43

What are the 5 primary movements of ADL?

Answer 43

1. Bend and Lift Movement
2. Single-Leg Movement
3. Push
4. Pull
5. Rotational

Question 44

What is the importance of incorporating the 5 primary movement patterns into a client’s exercise program?

Answer 44

• Promotes overall muscle balance

- Prevents compensations and injuries or pain

Question 45

What is a Myofascial sling (also called anatomy trains)?

Answer 45

Myofascial slings are complex connections of muscle, fascia, and ligament, which help support the inner, stabilising muscles (deep supportive core) of the trunk and significantly contribute to movement and stability of the lumbar spine and pelvis.

Help perform twisting (rotational movements)