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Symptoms associated with abdominal pressure dysregulation can include back pain, hip pain flank pain (kidney region), bloating, heartburn, vomiting and diarrhoea. The abdominal musculature should fire in response to lower limb movement. Notably the transverse abdominus muscle, but also the obliques, rectus abdominus and lower multifidus (back muscles) are active, ready for lower limb movement (The core). When the transverse muscle doesn’t work with the multifidi muscles then the quadratus lumborum (QL) tries to take over. The QL (a back muscle) is a notoriously overactive muscle in the experience of acute and chronic back and hip pain. The QL can also be found commonly involved in chronic recurrent lower back and or hip pain. Essentially the QL tells us that our core is not functioning well, in particular the automatic readiness of the transverse, obliques, and multifidus muscles to our normal lower limb movement is dysfunctional.
The QL is the help or aka compensation. Treatment to reduce the tightness of the QL is in fact taking away ‘the help’ the body is providing for itself and thus unhelpful in the long run. However such a strategy may be symptomatically relieving in the short term.
‘Abdominal Pressure Dysregulation’ Symptoms were published in the New York State Journal of Medicine 54:1324-1330, 1954
Thought has been described as neural activity in the human brain. All brain activity is not thought, just certain (brain) neuron interaction is considered individual thought. If thought is the interaction of nerves in the human brain, then when we change thinking patterns, we are also changing the way neurons interact in our central nervous system.
A particular type of thought; metaphorical thought is particularly influential over the interaction of brain neurons. When a person exclaims that their back has gone – where did it go? Normally the person’s back is exactly where it previously was, so what has changed? The metaphor of a back ‘going’ describes the human experience of having a body as seen by a human brain. An experience that relies upon the spinal communication from the body to our brain and confirmation from brain to body. The back can diminish or disappear from the map of the body in the brain. That aside… If I think my back is there then it is not, I will change the interaction of the neurons in my brain, about my back, giving the impression that my back has ‘gone’.
When I alter my metaphorical thought/ ideas/ perspectives I will change the chemicals at my nerve synapses. Chemicals are molecules and molecules are physical entities. Thus sustaining a change of chemistry in a physiological system will end up with a physical change first, in the type of molecules found at nerve synapses.
A change in molecular uptake in the brain will result in different neurons downstream becoming active. What fires together wires together. Thus we begin neuroplasticity; the changing of our brain’s ‘neural net’. A physical rewiring of the human brain over time.
In the human body it takes 4 months for people to learn new muscular co-ordination and unlearn their old pattern of muscular firing / activity. Physical change in musculature has been shown to occur in just 6 weeks from thought alone – no exercise or movement required! A change in muscle mass then must lead onto a change in muscular co-ordination, (Firing) as we continue along the same thought path.
If you enjoy the idea of facilitating a desired change in your body start with your thoughts about your body e.g. What does my body mean about me? Do I have a good body? Am I in a position of freedom in my life circumstances? Is my view of my body in anyway compatible with my relationship with food?…
A new Cochrane review of the best exercises for people with chronic back pain has been published this year (Jan 2016). The review is a meta analysis showing that there is no one best exercise for back pain yet it is important to exercise to help yourself. The type of exercise may well come down to your preference or possibly your practitioners experience or preferences.
How long do you continue until you throw in the towel; how long is long enough to know if your current type of exercise is helping? According to the new Cochrane review exercise programmes can last up to 12 weeks.
When I think about forming a habit I see that it takes humans between 29 and 230 days to form a psychological habit. When I see that body tissues can take 3 months to co-ordinate with each other in a new movement pattern I think 12 weeks seems that is only stage one of an exercise programme. When we first kinesthetically understand a movement in our body we are looking at a 12-16 week time frame. 12 weeks cannot include strength (posture), endurance, speed or co-ordination.
The internal arts of exercise such as Tai Chi, which has been shown to help chronic back pain is said to take 1000 hours of practise to become a beginner and 10000 hours to become adept. The internal arts help you to develop an representation of your body in your imagination. We actually have several body maps in our brain e.g in the basal ganglia (brain stem), the cortex, thalamus and cerebellum. This means that our internal perspective of our body can be altered by stimuli that does not originate from the body. This perhaps is why yogis have many different representations of their body; physical body, emotional body, spiritual body etc…
An exercise programme needs to make sense, be worthwhile affordable and accessible. Starting out with fascia first chiropractic to help your body get there quicker and to educate and reassure you that pain is not something to automatically fear; you could be embarking upon a realistic plan of rehabilitation. Walking the fine line of adaptation and neuroplasticity.
Sitting for long periods doesn’t help people feel good naturally but is this really a problem or are some people moaning?! When we sit we sit on our gluteal muscle group as well as the backs of our legs (Hamstring muscles), possibly sit bones and greater trochanter (hips). Recent findings about the gluts has changed professional opinion about the gluteus maximus in humans. It was thought to be different to monkeys but now is thought to be very similar to that of monkeys with almost identical origin (where the muscles starts) and insertion (where the muscle goes to).
What I can deduce from our current anatomy is that we’d have had a functional element to the gluteus maximus other than a cushion way before even the first chair or log was sat upon. Our anatomy suggests that we have a sling system (roughly) incorporating the tensa fascia latae, gluteals and sacroilliac ligaments; meaning we have the tools within our body to squat down and be supported by a sling of tendon know as the IT Band or Tensa Fascia Latae (TFL).
The ‘natural squat position of a child and that of a monkey are very similar. When we use a chair we do not need to hang supported on our natural sling and thus do not have the muscular co-ordination required to hold the body in the seated shape (within Earth’s gravitational field). Thus the brain will be getting ‘bum(!)’ information and given enough time will not be able to coordinate sit down or stand from sitting efficiently. It is common thought that people who have had more time on the planet cannot sit to stand or stand to sit due to age; this concept I dispute. We simply do not practise or reinforce the co-ordination of movement required to sit down and stand up efficiently and thus we will over time go more and more wrong. When we go wrong we cause wear and tear, pain and tight or slack musculature.
By squatting down we are resembling how monkeys will ‘sit’ and how our anatomy can increase circulation in our hips rather than reduce circulation by sitting on our gluteus maximus. It is a medical norm to expect to see some wear and tear (coxarthrosis) and reduced circulation in a man of only 40 years of age! I think this is a medical norm because medics are looking at the smallest parts of physiology and have not yet begun to understand the machinery (anatomy) of the body.
I believe that when we become uncoordinated it will be the cause of pain in cases where there is no obvious injury 97% of the time. An insidious onset for back pain is presumed to be due to age. Medicine falls so far short in understanding the body mechanics that it would be like going to see a caterer to help you put up a marquee. There are some overlooked aspects of muscles that can lead to musculo-skeletal dysfunction which are easily explained without having to describe a primary injurious mechanism. People who have had back pain or treat people that have low back pain are often fixated on the cause. This day and age if it isn’t cause and effect then it must be a trick or something sinister! Whilst almost every western person is having to perform sit to stand and stand to sit I suspect that very few are practising how to perform this movement. To condition our body to be strong in a particular way we need to repeat the action in an intensity that is enough to create adaptation but not enough to injure. The best posture to sit in is a squat. How you get to a squat position in my opinion is through the Qi Gong wall squat technique as this enables us to integrate our body from head to toe. Other variations on a squat movement may concentrate force at particular points of the body. Ideally for health one would look to integrate their whole body in a given movement. Through integration we reduce thixotropy and improve proprioception.
The time it takes you to learn the wall squat techniques can vary from a few weeks to a few years depending upon your current ability. The point of the exercise is to coordinate your whole body within the movement and not to simply reach the lowest point. If you can only squat down a very short distance like many out there will find, then begin with a short distance and with practise within your chosen personal limits increase the distance you can squat. The only thing to improve against is your previous ability. If you are not improving then you are likely getting worse as our dynamic body and brain do not hold static ability. The art of integration of your body is much more important than copying the full movement. If it doesn’t feel right then odds are it isn’t! consult an expert who can help you to reach the goal of always being able to sit to stand and stand to sit in a whole body integrated way so that you are aware of how your body works together through your own internal representation of your body through your mind’s eye. The internal art of movement is something being slowly lost from the human race which will lead to more focus on accumulating stuff and experiencing more pain. Movement and a chiropractor like me is what your body wants …