Controlled mobility is more than just what?
Strength of superficial and big muscles
What are the four variables of stabilization?
- Joint Integrity (ex: cartilage)
- Passive Stiffness (ex: ligament)
- Neural Input
- Muscle Function
What are the characteristics of a local muscle?
- Closer to the axis of motion
- Often deeper
- Stabilization > Rotary forces
- Postural
- Aerobic > Anaerobic
- More often Type 1 fibers
What are the characteristics of a global muscle?
- Further away from the axis of motion
- Often superficial
- Rotatory > stabilization forces
- Spurt muscles
- Anaerobic > Aerobic
- More often type 2 fibers
What are examples of local muscles in the thoracolumbosacral area?
- Psoas: frontal plane stabilizer
- Quadratus Lumborum: frontal plane stabilizer
- Pelvic Floor and Transverse Abdominus: increases contraction of multifidus
- Multifidi/ Rotatores: if smaller there is a higher injury rate and LBP
What are examples of global muscles in the thoracolumbosacral area?
More superficial muscles
What happens to local and global muscles in our patients and why?
- Why: pain is the big thing… longer it has been there the more issues we are going to have (most likely)
- Pain, swelling, joint laxity (will inhibit muscles) and disuse
Pain, swelling, joint laxity and disuse lead to what?
- Decreased and delayed motor performance and control of local muscles (ex: transverse abdominus, multifidi, etc.)
- Inhibition preferential to type 1 muscles
- Local muscle atrophy, specifically multifidus, and strength declines along with loss of every other muscle function
- Increased stress on non-contractile structures (ex: ligament, cartilage, capsule… muscle is not doing its job)
Pain, swelling, joint laxity and disuse can also cause?
- Increased and inefficient motor activity of global muscles (ex: external abdominal obliques/ erector spinae, etc)
- Atrophy leads to fatty infiltration, >50% of muscles cross-sectional area is fat in local and global muscles in those > 60 years of age
- Fiber transformation: type 1 change to 2
When fibers transform from type 1 to type 2 what does this mean?
They lose their endurance and stabilizing functions
Does muscle function normalize automatically once symptoms are improved? (yes or no)
No - Normal muscle activity does not return spontaneously just because the pain is gone
What percentage of muscle activation is sufficient to keep stability and is suitable to improve muscular endurance so it doesn’t take a lot for improvement?
30%
