Functional Programming for Stability-Mobility and Movement Flashcards
the ability to maintain or control joint movement or position
joint stability
the range of uninhibited movement around a joint or body segment
joint mobility
T/F: Movement efficiency involves a synergistic approach between stability and mobility where proximal stability promotes distal mobility.
True
the movement efficiency model
- active systems (muscles), passive systems (ligaments, joints), neural systems (proprioceptors, motor units), arthrokinematics contribute to: - sensory input and motor output leads to: - joint stability and mobility leads to: - movement efficiency
the general term for the specific movements of joint surfaces, such as rolling or gliding
arthrokinematics
joints that promote/favor stability
scapulothoracic
lumbar spine
knee
foot
joints that promote/favor mobility
glenohumeral
thoracic spine
hip
ankle
typical movement compensations that occur when mobility is compromised
1) the joint will seek to achieve the desired ROM by incorporating movement into another plane (e.g., in the birddog (sagittal plane movement), lack of flexibility in hip flexors will cause extended leg and hips rotate into the transverse plane)
2) adjacent, more stable joints may need to compromise some degree of stability to facilitate the level of mobility needed (e.g., someone with kyphosis who attempts to extend the thoracic spine may increase lumbar lordosis as compensation for the lack of thoracic mobility)
T/F: Periods of inactivity when joints are held passively in shortened positions result in muscle shortening.
True
T/F: Prolonged periods of sitting without hip extension shortens the hip flexors.
True
cycle of dysfunctional movement
1) muscle imbalances caused by various factors
2) alters muscle physiological and neurological properties
3) compromises the mobility-stability relationship
4) the body subscribes to the law of facilitation
5) dysfunctional movement
6) inevitable breakdowns
the relationship between the contractile proteins (e.g., myosin and actin) of a sarcomere and their force-generating capacity
length-tension relationship
T/F: A slight stretching of the sarcomere beyond its normal resting length is optimal in increasing force-generating capacity.
True
causes/reasons for shifting the length-tension curve to the left (excess sarcomere shortening/overlap)
1) immobilization
2) passive shortening
3) trauma
4) aging
amount of sarcomeres in a typical muscle myofibril
500,000
amount of time it takes for muscles to shorten when held in passively shortened positions without being stretched or used through full or functional ROM
2-4 weeks
force-generating capacity (increased or decreased) of a shortened muscle in various positions (shortened, normal, lengthened)
shortened: increased
normal: decreased
lengthened: decreased
best way (training method) to restore normal resting length and muscle’s force-generating capacity
strengthen the muscle in normal-resting-length positions, not lengthened positions
best method (exercise) to correct a client’s protracted shoulders (lengthened rhomboids and posterior deltoids)
isometric contraction or limited ROM of high-back rows; do not perform the exercise using full ROM as momentum will be carried through the weaker region, decreasing the ability to strengthen the muscle where it needs to be strengthened
through this, muscles function by providing opposing, directional, or contralateral pulls at joint to achieve efficient movement
force-coupling relationships
T/F: Hypertonic muscles decrease the neural drive to the opposing muscle via reciprocal inhibition.
True
When an antagonist muscle is further weakened due to reciprocal inhibition, other muscles at the joint (synergists) will assume responsibility of becoming the prime mover.
synergistic dominance
T/F: An example of synergistic dominance is a tight hip flexor will weaken the gluteus maximus and force the hamstrings to assume a greater role in hip extension.
True
T/F: Synergistic dominance may lead to overuse/overload and increased the likelihood for tightness and injury.
True
pain compensation cycle
1) muscle imbalance
2) altered length-tension and force-coupling relationships
3) altered joint mechanics
4) altered neuromuscular control and function
5) postural misalignments and faulty loading
6) excessive musculoskeletal loading
7) pain, injury, and further compensation
8) further muscle imbalance (cycle starts over)
pre-exercise stretching techniques for deconditioned clients with poor flexibility and muscle imbalance
stability and mobility (restorative flexibility) =>
myofascial release, warm-up, static stretches
pre-exercise stretching techniques for conditioned clients with good flexibility and muscle balance
maintain active flexibility =>
myofascial release, dynamic stretches
pre-exercise stretching techniques for performance athletes with good skill and flexibility
functional flexibility =>
dynamic stretches, ballistic stretches
stretches during exercise
dynamic stretches
post-exercise stretching techniques
myofascial release, proprioceptive neuromuscular facilitation (PNF), static stretches
client performs small, continuous, back-and-forth movements on a foam roller or similar device, covering an area of 2-6 in (5-15 cm) over a tender region for 30-60 seconds
self-myofascial release (SMR)
stretches taken to the point of tension, performing a minimum of 4 reps, and holding each rep for 15-60 seconds
static stretching
a hold-relax stretch, holding the isometric contraction of the agonist for a minimum of 6 seconds, followed by a 10-30 second assisted or passive static stretch
proprioceptive neuromuscular facilitation (PNF)
stretching that is effective for individuals participating in sports that require explosive movement
dynamic and ballistic stretching
beginning routine/phase of a progression model aiming to strengthen weakened muscles
2-4 reps of isometric contractions, each held 5-10 seconds, at less than 50% maximal voluntary contraction (MVC), in a supported, more isolated environment
purpose of the deep (innermost) layer of the core
small muscles that are rich in sensory nerve endings that provide continuous feedback to the brain regarding loading and position of the spine
purpose of the middle layer of the core
provide a solid, stable working foundation from which the body can operate
purpose of the outermost layer of the core
responsible for generating movement and forces within the trunk
muscles contained in the outermost layer of the core
rectus abdominis, erector spinae, internal and external obliques, iliopsoas, and latissimus dorsi
muscles contained in the middle layer of the core
transverse abdominis (TVA), multifidi, quadratus lumborum, deep fibers of the internal oblique, diaphragm, pelvic floor musculature, and the adjoining fasciae
T/F: Delayed activation of the transverse abdominis may inadequately stabilize the lumbar spine during movements of the upper and lower extremities, increasing the potential for injury.
True
percentage of the US population affected by low-back pain
80%
core training phase should begin with what protocol
establishing the stability of the lumbar spine with exercises that emphasize TVA activation and the re-education of faulty motor patterns
terms used to define the activation of the TVA which draws the abdomen inward toward the spine
centering, hollowing, or drawing-in
T/F: Bracing ensures a higher degree of stability than centering (or hollowing, drawing-in).
True
the co-contraction of the core and abdominal muscles to create a more rigid and wider base of support for spinal stabilization
bracing
T/F: Clients should master bracing before being introduced the concept of centering.
False
centering should be mastered first before bracing is introduced
3 stage model for core and balance training
1) core function
2) static balance
3) dynamic balance
focus of core function training
core-activation exercises and isolated stabilization under minimal spinal loading
focus of static balance training
seated and standing stabilization over a fixed based of support
focus of dynamic balance training
whole-body stabilization over a dynamic base of support
Core and balance training (3 stages) occur within what ACE IFT training phase?
2nd phase - movement training
list of core function exercises that promote proximal stability
1) supine drawing-in (centering)
2) quadruped drawing-in (centering) with extremity movement
purpose of the supine drawing-in (centering) exercise
re-educate faulty neural pathways
exercise progression for supine drawing-in (centering)
- pelvic floor contractions (Kegels): 1-2 sets, 10 reps, 2-second tempo, 10-15 seconds rest b/w sets
- TVA contractions (drawing belly button toward the spine): 1-2 sets, 10 reps, 2-second tempo, 10-15 seconds rest b/w sets
- cominbation of the above 2 contractions: 1-2 sets, 10 reps, 2-second tempo, 10-15 seconds rest b/w sets
- contractions with normal breathing: 1-2 sets, 5-6 reps with slow 10-second counts while breathing independently, 10-15 seconds rest b/w sets; progress to 3-4 sets, 10-12 reps
purpose of quadruped drawing-in (centering) exercise with extremity movement
reestablish core control with minimal loading on the spine during hip and shoulder movements
a muscle that crosses one joint
monoarticulate (uniarticulate) muscle
a muscle that crosses two joints
biarticulate muscle
T/F: The soleus is an example of a biarticulate muscle.
False
monoarticulate (uniarticulate)
T/F: The hamstrings are an example of a biarticulate muscle.
True
list of exercises that promote mobility of the hips and thoracic spine
1) cat-camel
2) pelvic tilts
3) supine bent-knee marches (pelvic tilts progression)
4) modified dead bug with reverse bent-knee marches (pelvic tilts progression)
5) lying hip flexor stretch
6) half-kneeling triplanar stretch (hip flexor mobility progression)
7) lying hamstrings stretch
8) shoulder bridge (glute bridge)
9) supine 90-90 hip rotation stretch
10) spinal extensions and spinal twists
11) rocking quadriceps
objective of this stretch/movement is to improve the mobility of the lumbar extensor muscles
cat-camel
objective of this stretch/movement is to improve hip mobility in the sagittal plane
pelvic tilts
objective of these 2 stretches/movements is to improve hip mobility in the sagittal plane without compromising lumbar stability during lower-extremity movement
1) supine bent-knee marches (pelvic tilts progression)
2) modified dead bug with reverse bent-knee marches (pelvic tilts progression)
objective of this stretch/movement is to improve hip flexor mobility in the sagittal plane without compromising lumbar stability
lying hip flexor stretch
objective of this stretch/movement is to improve hip flexor mobility in all 3 planes without compromising lumbar stability
half-kneeling triplanar stretch (hip flexor mobility progression)
objective of this stretch/movement is to improve hamstrings mobility in the sagittal plane without compromising lumbar stability
lying hamstrings stretch
objective of this stretch/movement is to improve hip mobility and stability and core stability by activating the gluteal muscle groups
shoulder bridge (glute bridge)
objective of this stretch/movement is to improve hip mobility in the transverse plane
supine 90-90 hip rotation stretch
objective of this stretch/movement is to promote thoracic extension
spinal extensions
objective of this stretch/movement is to promote trunk rotation, primarily through the thoracic spine with some lateral hip mobility
spinal twists
objective of this stretch/movement is to promote hip and thoracic mobility while simultaneously maintaining lumbar stability
rocking quadriceps (posterior mobilization)
purposes of improving proximal stability of the scapulothoracic and glenohumeral joints
improvement of upper extremity movements (e.g., push and pull movements)
T/F: The glenohumeral joint is a highly mobile joint that is contingent upon the stability of the scapulothoracic region.
True
most problematic movements of the upper extremity due to the shoulder girdle favoring mobility over stability and bad posture
1) arm abduction
2) scapular stability during push and pull movements
factors that promote stability within the scapulothoracic region
1) thoracic mobility
2) tissue extensibility (both active and passive structures)
3) healthy rotator cuff function
4) muscle balance within the parascapular muscles
5) ability to resist upward glide and impingement against the coracoacromial arch during deltoid action
stretches to enhance tissue extensibility in the shoulder capsule
1) stretch inferior head of the shoulder capsule using an overhead triceps stretch
2) stretch posterior capsule by bringing the arm across and in front of the body
3) stretch the anterior capsule using a pectoralis stretch
4) stretch the superior capsule by placing a rolled-up towel 2 inches above the elbow against the trunk, grasping the base of the elbow and pulling it downward and inward
T/F: Closed-kinetic chain (CKC) movements are generally more functional, as they closely mimic daily activities.
True
OKC movement to kinesthetically improve awareness of good scapular position, improving flexibility and strength of key parascapular muscles
shoulder packing
OKC and CKC rotator cuff exercises that promote scapulothoracic stability
1) internal and external humeral rotation
2) diagonals
3) reverse flys with supine 90-90
4) prone arm lifts
5) CKC weight shifts
objective of internal and external humeral rotation
improve rotator cuff function while maintaining good scapular position
objective of diagonals
to improve rotator cuff function with 4 integrated movements (in 2 diagonal patterns) at the glenohumeral and scapulothoracic joints
objective of reverse flys with supine 90-90
strengthen the posterior muscles of the shoulder complex
objective of prone arm lifts
strengthen the parascapular muscles
objective of CKC weight shifts
stabilize the scapulothoracic joint and lumbar spine in a CKC position
T/F: Within the distal segments of the body, the gastrocnemius and soleus muscles are often problematic, exhibiting tightness and limited mobility.
True
another name for the two-headed gastrocnemius and the soleus muscles
triceps surae
nature/method of static balance exercises
1) engage the core musculature (centering, hollowing, or drawing-in)
2) performed in seated positions using stable surfaces or unstable surfaces to impose small challenges to the balance centers
3) progressively manipulate training variables to challenge the body’s balance centers and limits of stability (LOS)
4) more static nature, implying that once the balance challenge is imposed, postural control must be maintained for approx. 5-10 seconds
2 additional challenging variables to static balance exercises
1) reduce points of contact (e.g., move from balancing on 2 feet to 1)
2) add additional unstable surfaces
training regimen (variables) for static balance
- perform 2-3 times a week
- perform at beginning of workout (before onset of fatigue)
- perform 1 set, 2-4 reps, 5-10 seconds each rep
training conditions for static balance
- Narrow BOS (wide to narrow)
- Raise COG (e.g., raising arms overhead)
- Shift LOG (e.g., raising arms unilaterally, leaning or rotating trunk)
- Sensory alteration (e.g., shifting focal point to a finger 12 in. in front of one’s face, performing slow hand-eye tracking)
- Sensory removal (e.g., closing eyes)
stance-position progression
- narrow stance and hip-width stance
- split stance and staggered stance
- tandem stance (one foot directly in front of the other)
- single-leg stance
T/F: Weakness in the hip abductors reflects an inability to control lateral hip shift, placing additional stress on the knee.
True
objective of single-leg stands
promote stability within the stance-leg and hip during a single-leg stand
single-leg stand exercise protocol
- hip-hinge 10-15 degrees, transferring body weight into the heels
- contract abductor and adductor muscle groups in the left thigh then slowly raise the right heel 1 in (do not raise entire foot yet)
- briefly hold above position then lift entire foot 1 to 3 in
- briefly hold the above position then slowly extend the hips and stand vertically; the torso should not move and the stance-leg should remain stable
- perform 1-2 sets, 5-10 reps per leg, resting 30 seconds between sets
ligament that connects from a posterior-lateral part of the femur to an anterior-medial part of the tibia within the knee joint
anterior cruciate ligament (ACL)
important stabilizer of the femur on the tibia during knee extension and prevents the tibia from sliding forward and rotating excessively inward during walking
anterior cruciate ligament (ACL)
ligament located on the medial surface of the knee
medial collateral ligament (MCL)
a key mechanism to protect the knee that is directly related to a group of powerful and large posterior-lateral muscles at the hips, the gluteal group, which functions to decelerate hip rotation
medial collateral ligament (MCL)
objective of the hip-hinge movement exercise
to emphasize “glute dominance” over “quad dominance” during the initial 10-15 degrees of movement
objective of the lower-extremity alignment movement exercise
to promote alignment among the hips, knees, and feet during the bend-and-lift movement
objective of the Figure-4 position
to promote optimal alignment between the trunk and tibia, as well as optimal position of the spine
bend-and-lift movement patterns
- hip-hinge
- lower-extremity alignment
- Figure-4 position
single-leg movement patterns
- half-kneeling lunge rise
- lunges
- lunge matrix
objective of the half-kneeling lunge rise movement pattern
to teach the proper mechanics of the rising portion of the lunge
objective of the lunge movement pattern
to teach the proper mechanics of the full lunge
objective of the lunge matrix (different directional lunge movements)
to promote stability and mobility throughout the kinetic chain using variations of the standard lunge movement
degrees of rotation required of the glenohumeral and scapulothoracic joints to achieve 180 degrees of rotation in shoulder flexion (e.g., front raise) and overhead press (e.g., dumbbell press) movements
glenohumeral: 120 degrees
scapulothoracic: 60 degrees
pushing movement patterns
- bilateral and unilateral presses
- thoracic matrix
- overhead press
objective of the bilateral and unilateral movement patterns
to execute open-chain pushing movements in unsupported environments without compromising stability in the scapulothoracic joint and lumbar spine
objective of the thoracic matrix movement pattern
to promote multiplanar thoracic mobility with drivers (e.g., arms, lightly-weighted bar) while stabilizing the kinetic chain
objective of the overhead press movement pattern
to provide additional stability to the shoulder capsule during the lowering phase of overhead pressing movements
a common mistake when performing the overhead press movement
not controlling the downward (eccentric) phase of the lift/movement
pulling movement patterns
bilateral and unilateral rows
objective of bilateral and unilateral rows
to execute open-kinetic-chain pulling movements in unsupported environments without compromising stability of the scapulothoracic joint and lumbar spine
two key rotational movement patterns
- wood chops
2. hay balers
objective of the wood chop and hay baler spiral movement patterns
to introduce basic spiral patterns with small, controlled forces placed along the spine
objective of the wood chop and hay baler movement patterns (not spiral)
to add external resistance from a cable or elastic resistance to the full wood chop and hay baler patterns
this exercise involves a pulling action to initiate the movement down across the front of the body, followed by a pushing action in the upper extremity as the arms move away from the body
wood chops
this exercise involves a pulling action to initiate the movement up across the front of the body, followed by a pushing action in the upper extremity as the arms move away from the body
hay balers
the basic principle of a programming sequence that promotes stability and mobility
proximal stability promotes distal mobility
next step after establishing stability in the lumbar spine
address mobility in the pelvis and thoracic spine
role of serratus anterior during OKC movements
control movement of the scapulae against a more fixed rib cage
role of serratus anterior during CKC movements
move the thorax toward a more fixed, stable scapulae
