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