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Self Passive Mobility Corrections
Cade Jones
Exercise Science B.S.Ed.
CSCS, NASM-CPT
Graduate Assistant Strength and Conditioning Georgia College and State University
Objectives
Identify Mobility Problems Identify Modalities to Gain Mobility Overview of Tissues and the Extracellular
Matrix Overview of Myofascial Meridians Physiology of a Trigger Point Integrating Soft Tissue Work into the Warm-
Up
Where Does This All Fit?
The first step in restoring fitness Mobility must come first!
– Mobility Static Stability Dynamic Stability Fitness
Self Passive Mobility Corrections Defined
Include – Static Stretching– Self Mobilization – Roller Stick Work – Foam Rolling – Any maneuver that produces improved mobility or
flexibility through lengthening and manipulation – Not considered active exercise
Basic Mobility Corrections
Structural Integrity – Pain free structures without deficiency or deformity
Sensory Integrity – Uncompromised reception and integration of sensory input
Motor Integrity – Uncompromised activation and refinement of motor output
Freedom of Movement – Mobility adequate to perform within functional ranges
Mobility Problems
TED- Tissue Extensibility DysfunctionJMD- Joint Mobility Dysfunction
Tissue Extensibility Dysfunction identifies tissues that are multi-articular. These tissues span more than one join and therefore exert influence over more than one joint.
Joint Mobility Dysfunctions identify spinal articular segments having reduced mobility. The articular surfaces and the contractile and non-contractile tissues that connect them demonstrate reduced mobility with segmental testing and observation.
Tissue Extensibility Dysfunction
Examples of TED-– Active or Passive Muscle Insufficiency– Neural Tension– Fascial Tension– Muscle Shortening– Hypertrophy– Trigger Point Activity– Scarring and Fibrosis
Joint Mobility Dysfunction
OsteoarthritisUni-articular Muscle Spasm and Guarding
Fusion SubluxationAdhesive CapsulitisDislocation
Stability Motor Control Dysfunction
Examples of SMCD:– Motor Control dysfunctions– Mechanical breathing dysfunction– High Threshold strategy– Prime mover or global muscle compensation behavior or
asymmetry– Local muscle dysfunction or asymmetry– Poor static stabilization, alignment, postural control,
asymmetry and structural integrity– Poor dynamic stabilization, alignment, postural control,
asymmetry and structural integrity
Take Home Points
If a mobility problem is present you are either..– Stuck (JMD)…refer out– Tight (TED)– Not doing it right (SMCD)
Modalities to Gain Mobility
If you are tight or have poor tissue quality..– Foam Rolling– Lacrosse Ball– Stick Roller
Four Basic Classes of Cells
In our tissues:– Neural (Cells that best conduct along their membranes)– Muscular (Cells that best utilize actin to undergo
contractions)– Epithelial (Cells that line surfaces, secrete chemical
products such as hormones, enzymes, and messenger molecules)
– Connective (Cells that build strong pliable “stuff” which holds us together via secretion of a variety of products to form bones, cartilage, ligaments, tendons, and fascial sheets)
According to Gray’s Anatomy
Connective tissues play several essential roles – Structural (ECM elements possess special
mechanical properties)– Defensive (Role which has a cellular basis)– Trophic and Morphogenetic roles in organizing
and influencing the growth and differentiation of the surrounding tissues
The Extracellular Matrix
Connective Tissue cells introduce a wide variety of structurally active substances into the intercellular space
– Collagen – Elastin– Reticulin Fibers – Glue like ground substances (Interfibrillar proteins) known
as glycosaminoglycans or proteoglycans – Defined as the Extracellular Matrix
Sum total of extracellular substance within the connective tissue
The Extracellular Matrix
Insoluble protein fibrils and soluble complexes composed of carbohydrate polymers linked to protein molecules
Mechanically, ECM distributes stress of movement and gravity while maintaining shape of our body
Physico-chemical environment of cells embedded within Forms framework to which cells adhere and on which they can
move Maintain an appropriate porous, hydrated, ionic milieu through
which nutrients and metabolites can diffuse freely
Linked Together
Virtually all molecules within the human body are linked together
Connective tissue is our “Organ of Form”
The Fascial Net
“Large sheets and woven fabric that invest or surround individual muscles”
The Fascial Net is the Extracellular Matrix Binds every cell in the body Connects inner network of each cell to the
mechanical state of the entire body Stores and communicates information across
the entire body
Anatomy Trains
Thomas Myers Seeks to move away from Musculo-Skeletal
(Isolated) model – Muscles attach from bone to bone, and their sole function is
to approximate the two ends together, or resist being stretched apart
– Classic Kinesiological Model Product of Reductionism Gives a purely mechanical model of movement Ignores Fascia!
Myofascial Meridians
Fascial net that unites bones, muscles, origins, and insertions
Provides a holistic understanding of the mechanical role of fascia or connective tissue as an entirety
Myofascial Meridians
Anatomy Trains in Rehab and Fitness – https://www.youtube.com/watch?v=CpKooVJjI8M
Cells of the Connective Tissue System
Red Blood Cells White Blood Cells Fibroblasts Mast Cells Glial Cells Pigment cells Fat Cells Osteocytes
– The Fibroblasts and close relatives produce most of the fibrous and interfibrillar elements
Connective Tissue Elements
Three Basic Types via Fibroblasts – Collagen– Elastin (Elastic component of areas such as the
ear, skin or particular ligaments where elasticity is required)
– Reticulin (Immature collagen fiber the predominates the embryo, but replaced by collagen in adults)
Collagen
Easily most common protein in the body Predominates the fascial net 20 Different types Focus is Type I Collagen fibers
– Composed of amino acids that are assembled in an orderly fashion in the endoplasmic reticulum (ER) and Golgi complex of the fibroblast
Collagen
Ground substance of collagen is made up a watery gel composed of mucopolysaccharides or glycosaminoglycans
– Hyaluronic Acid – Chondroitin Sulfate – Keratin Sulfate – Heparin Sulfate
Function to bind water in such a way that it allows easy distribution of metabolites, form a part of the immune system barrier due to resistance of spread of bacteria
Key Points
In an active area of the body, the ground substances changes its state constantly to meet local needs
In a “held” or “still” area of the body, it tends to dehydrate to become more viscous, more gel-like, and to become a repository for metabolites and toxins
So the key is…..Movement!
Take Away Points
When body segments are pulled out of place and muscles are required to maintain static positions either
– Stretched/Contracted (“Locked Long”)– Shortened/Contracted (“Locked Short”)
We see increased fascial bonding and thixotropy of the surrounding ECM
“Thixotropy is a time-dependent shear thinning property. Certain gels or fluids that are thick (viscous) under static conditions will flow (become thin, less viscous) over time when shaken, agitated, or otherwise stressed (Time Dependent Viscosity). “
Integrating New Knowledge for Practical Purposes
Soft Tissue Treatment is a Stimulus – Stress produces a chemical response. This
response leads to healing Soft Tissue Mobilization leads to the formation of
fibroblasts Take immature and randomly aligned Type 3 Collagen
fibers (As seen in tendinosis) and changes it back to stronger parallel mature Type I collagen
Integrating New Knowledge for Practical Purposes
In other words, soft tissue treatment changes the quality of the muscle fibers
A muscle with a trigger point can be viewed as a band with a knot in it
The Soft Tissue Mobilization unties the knot This is what gives us tissue length and what
allows us to stretch
Integrating New Knowledge for Practical Purposes
Athletes are encouraged to search for tender areas or trigger points
Treat these areas to decrease tissue density and over-activity
If you are going to stretch…roll first!!
A Component of the Warm-up
Soft tissue structures (tendons, ligaments, fascia, muscles, and nerves) need tissue quality treatments – Fascia may be bound – Nerve Conduction impeded – Blood Flow impeded
Due to soft tissue structural damage! (Stress of training)
A Component of the Warm-up
Trigger Points in muscle (Small knots of scar tissue) hinder contraction speed, coordination, and overall power
Athlete may need muscle quality instead of muscle length!! – Don’t make this mistake!
A Component of the Warm-up
Self Myofascial Release increase flexibility and ROM due to a process known as autogenic inhibition
Pressure applied to the tissue stimulates mechanoreceptors called Golgi Tendon Organs
Send message to brain, letting it know that substantial pressure is being applied, which causes the brain to relax that muscle to prevent it from tearing!
Must be non-threatening Use deep breathes to calm CNS
A Component of the Warm-up
Athletes can spend 30-60 seconds on each muscle group
Progress to more stiff modalities – PVC Pipe– Lacrosse Ball – Golf Ball