Spastic Muscles: Victim or Perpetrator?

This is perhaps one of the most counter-intuitive questions I have ever asked...and the answer is almost unanimously the same: "The muscles are the bad guys, therefore we need to attack them with an aggressive campaign of stretching...and if that doesn't work we always have botox". I'm exaggerating somewhat, however the only option families are given is overwhelmingly skewed to these drastic measures. As a professional (or as a parent / patient) it is fundamentally critical to examine all other options and not to simply "refer to my favorite textbook to see what the 'experts' say". The fundamental question is: "Are the muscles victims or perpetrators?" To be precise, are they THE problem or are they a SYMPTOM of a problem. In the overwhelming number of cases, muscle tension is SYMPTOMATIC (in both disorders of movement and posture AND the healthy population, by the way). Therefore, by definition the "treatment" protocol should be focused on the SOURCE of the problem. Unlike a common cold or flu, treating the symptoms leads to dead-ends and will result in future problems down the road.

In disorders of movement and posture like Cerebral Palsy, the muscular tension is a reflection of the profound compressional weakness that exists within the entire structure. For a better explanation of compressional weakness refer to my previous post, but in brief, compressional weakness is the absence of fundamental hydraulic strength which is responsible for support under the forces of gravity as well as the weight of the body itself. Essentially, when this vital component is missing, the muscles are asked to take on "double duty". They are actively solicited to compensate for the lack of compressional (passive postural) strength and therefore must be used to maintain balance...AND they are also called upon to perform the dynamic movement-based functions they are originally designed to do. It is no wonder that movement is so chaotic and uncontrolled...imagine using all of your muscles to maintain your balance AND perform movement at the same time.

Don't worry...I'm getting to the point. A strategic and focused protocol to improve compressional strength will subsequently result in a reduction in general muscular tension and rigidity. Period. Therefore my message is simple: STOP FIGHTING WITH THE VICTIMS! It is perhaps the most instinctive and inuitive thing to do, but history shows quite clearly that doing this is is a dead end street filled with false hope and "irresponsible dreaming".

Some of you may be saying "sounds good, but can it be done?" As the response to my previous post is showing...pictures are worth a thousand words. In that light, I have posted more amazing transformations that are an example of the potential to address muscle spasticity / rigidity at its true source. And remember...working with fascia is far from glamorous. It requires a significant amount of time and effort...but it is well worth it!

Cheers.

Analyzing the Source of Muscle Spasticity

The Role of Fascia in Cerebral Palsy...you can't miss this!

I have recently returned from Chile where I was working with another amazing group of children (and their families). It never ceases to amaze me how fortunate I am to be allowed the privilege to enter into their world and contribute to their child's progress. Each and every evaluation provides me with greater insight into the wonders of the human body...and for that I am eternally grateful. For those who have been curious enough to continue reading this blog, you are by now fully aware of my fascination for fascia and all that it implies. Although words (lots and lots of them)effectively convey this message, it is (more often than not) the actual pictures that demonstrate the full power and implication of this wonderful, and highly underrated, structure. I have performed many evaluations with children with disorders of movement and posture over the years...and there is a common thread that binds almost all of their families together: "Gavin, I just want a better life for my child. I want him/her to be happy and healthy and ultimately give them the absolute most that can be given to help them". Something as simple as being able to sit independantly can seem trivial to us, but can mean the world for these special children and special families. Therefore, I put it to anyone who questions the implications that fascia has on movement and posture...look at this example and formulate an intelligent, articulate, and logical reason not to admit the enormous opportunity and potential for improvement that exists. Although I have a plethora of examples, the one I have posted is the freshest in my mind and is also without possibility of mis-interpretation. One year of specific focus and hard work can bring about life-changing results! I hope it inspires you, fascinates you, and most importantly...stimulates some constructive curiosity!


Fascial Strengthening in Cerebral Palsy

Coming Soon: Fascia and Fibromyalgia

I am very excited about this upcoming post because it will be the first look into some innovative techniques using the extended fascial paradigm in the treatment of a specific pathology. I recently stumbled upon an interesting article that outlines the role that fascia plays in Fibromyalgia. More importantly, how it may be a potential source of both the "problem" and the "solution" simultaneously. It is well known that massage has been a largely effective treatment for the reduction of symptomatic pain associated with fibromyalgia. Whereas some believe that the common "villain" is the muscle, there is growing evidence that fascial dysfunction is a more likely culprit. Therefore, any improvements to the delivery, absorption, and effective range of massage will help in relieving discomfort and pain. I will be outlining the Soft Ball Massage Technique in my next post, however I think it would be helpful to have a look at the article itself and get a fundamental look at the rationale behind this proposed technique. Enjoy and stay tuned for Soft Ball Rolling Massage!

Fibromyalgia and the Fascia Effect

Myth, Madness, or New Frontier?

Once again...another posting of an article on fascia. To be honest, it has been difficult to hold back on posting all of the wealth of existing study, research, and scientific evidence of the significance of fascia and connective tissue. I promise more original material, however I think my recent postings of Myers, Van der Wal, and Schleip will greatly enhance the general understanding that this is no myth...this fascia "stuff" is important! So it begs the question: is this myth, madness, or a new frontier? Some would agree that connective tissue is a simple "shrink wrap" for the muscles and just basically holds things in place and therefore considering it as an "active player" in musculoskeletal dynamics is pure MADNESS. Others, in their infinite ignorant wisdom, would tell you that it's purely MYTH..."studies are pure speculation and inconclusive". The reality is that connective tissue is not only the focus of increased in research protocols, but is proving to be quite relevant in the human organism. The potential implications give it the well deserved title of NEW FRONTIER. This was one of the first articles I read regarding fascial properties and it stuck with me throughout my formulations and developing understanding of the role of connective tissue and fascia. Paste it into your mental hardrive. Cheers.

Active Fascial Contractility

Fascia and the Locomotor Apparatus

What is the "Locomotor Apparatus"? It seems like a fancy word for the human body, but it is more appropriate than you think. Indeed, the human body performs thousands of distinct functions every second of every day of your life. Locomotion (movement) is only one specific function...but one that defines our everyday life and is undetachable from our very existence. Therefore, by definition, anything that regulates locomotion has an undeniable impact on our health and well-being.

One of the big pioneers in the scientific study of fascia is Jaap Van der Wal MD, PhD. He has been "on the fascia bandwagon" since the 80's and is one of the leading resources for the current scientific studie being implemented today. In his article "The Architecture of the Connective Tissue in the Musculoskeletal System" is a fascinating and equally relevant examination of the global implications of connective tissue "skeleton". In addition, it demonstrates that the traditional "anatomists" perception of human movement is somewhat primitive and is a simplistic attempt to explain a complex system.

There are some very enlightening points made in his article:

a) Connective tissue has separate paradoxical functions: It connects AND disconnects

Connection and Disconnection—Two Types
of Fasciae
This view of two types of connectivity is also applicable
to the anatomy of fasciae. In general, fasciae in
the musculoskeletal system exhibit two different mechanical
and functional types:
• There exist muscular fasciae adjacent to spaces
that are filled with loose areolar connective tissue
(“sliding tissue”) and, sometimes, adipose tissue.
They enable the sliding and gliding of muscles
(and tendons) against each other and against other
structures.
• There also exist intermuscular and epimysial fasciae
that serve as areas of insertion for neighboring
muscle fibers, which, in this way, can mechanically
reach a skeletal element via those fasciae
without necessarily being attached directly to the
bone.(9)

b) Connective Tissue has 2 functional appearances:

CONNECTIVE TISSUE IN THE
MUSCULOSKELETAL SYSTEM: TWO
FUNCTIONAL APPEARANCES
Not Only Anatomy, but Also Architecture
In principle, only two kinds of forces have to be transmitted
over synovial joints between the articulating
elements in the locomotor apparatus: forces of compression
and of tension. Compression forces between
the articulating elements are transmitted via the articular
surfaces of the adjacent bone elements. The tractive
forces and mechanical stresses over the synovial joints
are assumed to be transmitted both by passive and by
active components in the musculoskeletal system. Regular
dense connective tissue structures such as ligaments
convey (transmit) those forces “passively.”

As with my previous post, this article is lengthy...but well worth the read. Consider it as another essential addition to your library!

The Architecture of the Connective Tissue in the Musculoskeletal System - An Often Overlooked Functional Pa...

Fascial Fitness: Training in the Neuromyofascial Web

This is an excellent article written by Thomas Myers who is one of the pioneers of the "fascial movement". His book called Anatomy Trains is another essential text that every practitioner should own. It is through his work that the role of fascia in the human body is now being understood as fundamentally critical. It is also the scientific basis for the formulation of the Soft Plyometric concept. It is a lengthy article, but if you read it in chunks, it is more digestible. My thanks to Mr. Myers for a well-explained and comprehensive document.

Fascial Fitness Training in the Neuromyofascial Web

Fitness in the Extended Fascial Paradigm

I have gone ahead and posted a more "reader friendly" version of my first post regarding fascia and its role in athletic conditioning. This small pdf is actually intended to be true introduction to the fascia approach from which the Soft Plyometric concept is based. I should have posted this first, but I am sometimes over-anxious and don't pay attention to the order at which things are delivered...sorry about that. The second part of the Soft Plyometrics introduction and the future definition of specific concepts will all be based in the basic theory and central belief system within this document.

Coming Soon: A look into the analytical approach to muscle soreness and muscle stiffness. What is it? Where does it comes from? Are there any other approaches to rehabilitation? How do I approach it from a fitness perspective? Hopefully it will be informative!

Cheers!


Fitness in the Extended Fascial Paradigm - Copy

Breaking News

Although it will never make CNN anytime soon, I consider the following very positive and encouraging news. As per the blog description, my intention is to stimulate dialogue and the exchange of intelligent ideas between fitness and rehabilitation professionals. I am indeed happy to announce that the first step towards a joint pilot project has been confirmed today between yours truly and Rebecca Foss, owner and “Head Lunatic” at Fitness Asylum near Tampa, Florida USA.

Just what is Fitness Asylum? I can tell you quite confidently that it isn’t a place for those who consider fitness as a “social activity”. Don’t plan on reading a magazine while you are doing your cardio…and don’t bother with doing your hair before you go. It’s serious cutting edge fitness and “only serious applicants need apply”! Go the website http://www.fitnessasylumweb.com/ and you’ll see why: Kettlebells, training ropes, and medicine balls (among others) are the order of the day.  Paradoxically, it is well equipped with Special Population Training Programs as well. This is precisely the professional attitude and superior frame of mind that separates the true fitness professional from the rest…and I am glad to have the opportunity to share some of my ideas with the “lunatics” who roam the halls of Fitness Asylum.

The pilot project revolves around the implementation of the Soft Plyometrics concept and techniques into the protocols of the serious athletes at Fitness Asylum. As the project evolves, I will be sharing the observations and conclusions on this blog and using this valuable information to formulate improvements and new applications. In order to move forward, you need to push the envelope and step “outside the box”…ask the questions and seek the true answer…and most of all, work just outside your comfort zone.

Much more to come!

Gavin (newly admitted Lunatic)

Introduction to Soft Plyometrics

I have spent the last few years trying to formulate a way to bridge the gap between some of the rehabiliation based experiences I have had and the field of fitness and high performance training. What is the gap? Why is this gap relevant? These are two very good questions that lead to a fundamental response: People who exhibit weakness and injury provide the professional with an "inside look" into the structural, biomechanical, and physiological environment of the high performance athlete. It is through these people that we can observe measurable impact and effect of external stimulus on the tissues. Therefore, it is fundamentally essential to examine the entire spectrum of human performance. The examination and understanding of human performance at its weakest inevitably provides the professional with the intrinsic tools necessary to effect positive potential change in the "strong" individual.
This is an introduction to Soft Plyometrics...a term I have coined for the simple reason it has similar targets and objectives as plyometrics but at different points in the periodizaed program or fitness protocol. Specific exercises and application guidelines will follow in a second posting called Essentials of Soft Plyometrics. Cheers!

PS: I have used an external site called Scribd which is very useful...however you will need to allow a second or two to let the slide load as you flip through them.

Soft Plyometrics© - Copy

Coming Soon: Soft Plyometrics

For all the gym rats, fitness buffs, and intellectual fitness practitioners...I am currently generating a new post that will introduce what i call "Soft Plyometrics". I have spent some time formulating a way to introduce the fascial paradigm into the fitness world, and I think that Soft Plyometrics finally solves that problem. Keep an eye out for the next post which will hopefully be complete and readable next week. Although its "release" is hardly worthy of a motion picture analogy, consider this a teaser trailer! Cheers.

Book Of the Month Club

Perhaps I should say BOOKS...because there are 2 books I would highly recommend for 2 very different reasons. The first one could be perhaps the most enlightening text I have come across to date. Not only does it put human development into perspective, but it essentially bridges the gap between most therapeutic challenges and therapeutic solutions. It has proven to be a major eye-opener and I can comfortably classify it as my "new bible". This text is called "The Endless Web".



I am obviously a big fan of having a well-defined rationale for any and all rehabilitative protocols...therefore having a text such as this, in my personal and professional opinion, is essential in establishing solid fundamentals.

My second recommendation is more of a personal one. I have had the pleasure and honour of working with an amazing family from the U.S. who not only inspire me greatly, but have my utmost respect and admiration. People are shaped by their experiences...both good and bad...and subsequently have an effect and influence on those they meet. The family I am refering to is the Dzialo family. Although I only see them once a year, they continue to impress me with their work ethic, their attitude, and their superior frame of mind. Their story has recently been published in a book called "Ceramic To Clay".



This is Adam's story written by his mother, Sharon Dzialo, in the most thoughtful and insightful way. It isnt just a good read...it is a glimpse into the life of an amazing person and family that will teach you a good lesson (or lessons, to be precise) in life. It was indeed an honour when I recieved a copy of Sharon's book (sent all the way to my home in Argentina!) and I can't thank her enough for sharing her story with me. Everyone should upgrade their library and pick it up...I have read the book AND met the people, and I can tell tell you neither disappoint!

Happy reading!

Trainer’s Corner: Back to Basics

I think the title “Trainer’s Corner” is very applicable for two reasons: 1) This friendly post is coming directly from one of your trainers, and 2) It is analogous to a boxer’s trainer. A boxer’s trainer will do his best to provide the boxer with all the skills necessary to succeed. Your ABR trainers are charged with a similar task, so the analogy should resonate pretty well.

Round 1: Before going out into the ABR world, you should have a solid grasp of the fundamentals. In the ABR context, these fundamentals are numerous and sometimes overwhelming…however I will bring you through some of them step by step (round per round). During the majority of my evaluations, there is a common thread that weaves its way all the way through each family unit…they forget that this is a PROCESS. Process is “a systematic series of actions directed to some goal”…therefore by definition it should be clear that things have to go in sequence and in phases. The fact that you cannot skip over phases is not an arbitrary decision, rather a reality you have to understand and integrate.

Each phase is designed in preparation for the next phase and is structurally predetermined by the human motor developmental pattern…not by ABR. We are bound to this developmental path by mother- nature so any questions that relate to more complex developmental skills should be automatically answered.



In the past, I have found it useful to help parents differentiate between chronological age and developmental age. To be more precise, in healthy individuals the chronological age comes with some predictable developmental milestones. In effect, you can accurately estimate the chronological age by knowing (seeing) the developmental phase they are in.

In the above image, the developmental age (stage of development) is typically achieved at a certain age (for example: sits without support between 5-8 months). This type of chart can be somewhat confusing to many parents. Statements like “he / she is 4 years old so we have to stand them to help them develop the hips” come from this well-ingrained developmental chart. However, as mentioned before, if the previous stages have not yet been achieved (lifting and holding the head, rolling over, from prone position lifts chest with arm support, etc..) then any discussion (or statements) regarding more advanced skills is unproductive. Therefore, more emphasis and focus on the developmental age will be, not only helpful in understanding the big picture, but more accurate in assessing your child’s current progress.

If you have ever seen any of the Rocky movies, you can appreciate the image of the grizzled trainer, Mickey, yelling at Rocky and trying to motivate him through a seemingly insurmountable challenge. Although I obviously won’t yell and scream, the intensity is still there: “Get back to basics!! Remember the fundamentals, Rock!” The road is long and there will be challenges…however you have a trainer in your corner who will slap a towel around your neck in between rounds, sit you down, throw water on your face, and give it to you straight.

See you soon for round 2!

Los Fundamentos del Desarrollo Profesional...mi “desahogo” personal.

Aunque el titulo pueda ser muy interesante, la primera pregunta que viene a la mente es “¡quién se cree este tipo que es…instruyéndonos en los fundamentos del desarrollo profesional!”. La respuesta a esta pregunta es bastante simple: "Soy un hombre sencillo que conozco, no la cantidad de conocimiento que poseo, sino más bien la gran cantidad de conocimiento que aún me falta poseer”. Esto puede considerarse tanto una bendición como una maldición. Por un lado, el sentimiento de “iluminación” y claridad es de alguna forma liberador; por el otro, el darse cuenta de que "wow, realmente tengo mucho más que aprender" puede ser abrumador. La realidad es que este descubrimiento le abre la puerta a un pensamiento más analítico, fundamental y eficiente, el cual a su vez estimula los procesos de pensamiento que resultan en aumentos exponenciales en nuestra habilidad de aprender y entender.

Luego de graduarme en la universidad, pensé ingenuamente que mi “carrera de aprendizaje” había terminado y que ya sabía casi todo acerca de la rehabilitación y la evaluación. Quizás había todavía algún que otro curso o certificado que podría obtener para mejorar mi “comercialización”, pero más allá de eso ya había adquirido con éxito todo el conocimiento relevante posible. Me encantaría poder decir que me di cuenta de que esto era una noción absurda bastante rápido…pero para ser honesto, ¡no lo hice hasta 6 o 7 años más tarde! Estaba en una reunión cuando recibí una alusión muy sabia y perspicaz la cual fue bastante reveladora. Parecía ser una alusión bastante irrelevante a “como debemos aprender" y como éste conocimiento puede mejorar nuestro desarrollo profesional drásticamente. Esta pizca esencial de gran sabiduría era La Competencia Consciente de la Matriz del Aprendizaje. Es esencialmente una teoría que se desarrolló en los años 70 que describe las 4 fases del aprendizaje y la adquisición de nueva habilidades. ¿Por qué es esto relevante Gavin? Esta teoría apunta directo a mi previa manera de pensar “peligrosamente ingenua”. La misma establece que al comienzo nosotros somos inconscientes de lo poco que sabemos en realidad, y que al darnos cuenta de nuestra incompetencia, podemos entonces adquirir nuevos conocimientos y habilidades.

Las Cuatro Fases del Aprendizaje.

1. Incompetencia Inconsciente
El individuo no entiende o no sabe como hacer algo y no reconoce necesariamente el déficit. Podría aún negar la utilidad de la habilidad. El individuo debe reconocer su propia incompetencia, y el valor de la nueva habilidad, antes de proseguir a la próxima fase. El tiempo que un individuo pasa en esta etapa depende de la fortaleza del estimulo por aprender.

2. Incompetencia Consciente
Aunque el individuo no sabe o no entiende como hacer algo, el o ella reconoce el déficit, además del valor de una nueva habilidad en como tratar ese déficit. El cometer errores puede ser integral al proceso de aprendizaje en este punto.

3. Competencia Consciente
El individuo entiende o sabe como hacer algo. Sin embargo, demostrar la habilidad o conocimiento requiere concentración. El proceso puede dividirse en diferentes pasos, y hay una fuerte participación consciente al ejecutar la nueva habilidad.

4. Competencia Inconsciente
El individuo ha tenido tanta práctica con esta habilidad que se ha convertido en una “segunda naturaleza” y puede ser realizada con facilidad. Como resultado, la habilidad puede realizarse mientras se ejecuta alguna otra tarea. El individuo puede ser capaz de enseñar esta habilidad a otros, dependiendo de cómo y donde fue aprendida.


(¡Gracias Wikipedia por la descripción clara!)

Es importante recordar que este proceso es progresivo y que solo se puede pasar de la etapa 1 a la 2, luego de la 2 a la 3, y luego de la 3 a la 4. Con respecto a algunas habilidades más avanzadas (como por ejemplo evaluación y rehabilitación) puede haber en realidad algún tipo de regresión. Para ser mas especifico, de la etapa 4 a la 3 y a veces de la 3 a la 2…sin embargo, cuando esto sucede, el proceso debe volver a comenzar. Hay incluso algunas teorías vigentes de que puede existir la fase 5 la cual identifica “la habilidad de mover de manera activa a los individuos de etapa a etapa”.

Volviendo entonces a la pregunta original “quién se cree este tipo que es “...Puedo decir con confianza y comodidad que soy alguien que se encuentra dando vueltas en las fases 3 y 4 con algunos viajes regulares de vuelta a la fase de la incompetencia consciente. El paso de una etapa a la otra se siente como un “despertar" y cuando las cosas comienzan a “hacer clic” tu curiosidad y entusiasmo aumentan. Incluso puede ser considerado como “intelectualmente intoxicante” porque una vez que estas en este camino(o circulo), podes intencionalmente resetearte en este circulo de información y lograr regularmente este sentido de despertar. Como profesionales en el campo de la rehabilitación, esta implicado (quizás ingenuamente) que ya estamos en este camino. Sin embargo, la verdad encubierta es que la mayoría no lo estamos. Las motivaciones extrínsecas o externas (dinero, fama, posición) sólo te van a sostener por un periodo a corto plazo. Tu deseo intrínsico de realmente querer aprender te va a sostener por siempre...es por eso que cualquier profesional que se aprecie como tal tiene este ímpetu y por naturaleza va a empezar intencionalmente este viaje a través de las etapas del aprendizaje.

Esta publicación es mi intento inicial para que nos dirijamos a la fase 5 al “estilo Yoda” (de La Guerra de las Galaxias). ¿Tendrán éxitos mis esfuerzos para dirigir a algunos profesionales hacia esta matriz? Como Morfeo le dijo a Neo mientras sostenía las píldoras azules y rojas, “Estoy tratando de liberar tu mente, pero solo puedo mostrarte la puerta…tu eres el que tiene que atravesarla".


Gracias por leer!

Fundamentals of Professional Development...my personal rant.

As interesting as the title may be, the first question that may come to mind is "who does this guy think he is...schooling us in the fundamentals of professional development?!".  The answer to this question is relatively straightforward:  "I am a simple man who has a good understanding of, not the amount of knowledge I have, rather the significant amount of knowledge I have yet to attain".  This can be considered both a blessing and a curse.  On one hand, the feeling of "enlightenment" and clarity is somewhat liberating...on the other hand, the realization that "wow, I really have a lot more to learn" can be overwhelming.  The reality is that this realization opens the door for more analytical, fundamental, and efficient thinking...which in turn stimulates thought processes that results in exponential increases in your ability to learn and understand. 

Upon graduation from University, I naively thought that my "learning career" was over and I pretty much knew everything there was to know about rehabilitation and assessment. Perhaps there were a few courses or certifications that I could get that would enhance my "marketability", but beyond that I had successfully uploaded all the relevant knowledge possible.  I would love to say that the realization that this was an absurd notion came to me relatively quickly...but to be honest, it came to me almost 6-7 years later!  I was in a meeting and a very wise and insightful reference was given to me that was quite "eye opening".  It was a seemingly irrelevant reference to "how we learn" and how this knowledge can drastically improve our professional development.  This essential bit of sage wisdom was the Conscious Competence Learning Matrix.  It is essentially a theory developed in the 1970's that outlines the 4 stages of learning and the acquisition of new skills.  Why is this relevant, Gavin?  This theory shoots directly into my previous "dangerously naive" way of thinking.  It states that we are intially unaware of how little we actually know...and that upon the realization of our incompetance, we can acquire new knowledge and skill. 

The Four Stages of Learning



1. Unconscious Incompetence
   

   The individual does not understand or know how to do something and does not necessarily recognize the deficit. They may deny the usefulness of the skill. The individual must recognise their own incompetence, and the value of the new skill, before moving on to the next stage. The length of time an individual spends in this stage depends on the strength of the stimulus to learn.





2. Conscious Incompetence
   

   Though the individual does not understand or know how to do something, he or she does recognize the deficit, as well as the value of a new skill in addressing the deficit. The making of mistakes can be integral to the learning process at this stage.





3. Conscious Competence
   

   The individual understands or knows how to do something. However, demonstrating the skill or knowledge requires concentration. It may be broken down into steps, and there is heavy conscious involvement in executing the new skill.





4. Unconscious Competence
   

   The individual has had so much practice with a skill that it has become "second nature" and can be performed easily. As a result, the skill can be performed while executing another task. The individual may be able to teach it to others, depending upon how and when it was learned.

(thanks Wikipedia for the clear descriptions!)

Its important to remember that this process is progressive and can only move from stage 1 to 2, then 2 to 3, and then 3 to 4.  For some more advanced skills (such as assessment and rehabilitation) there can actually be some regression!  More specifically from stage 4 to 3 and sometimes 3 to 2...however when this happens, the process must begin again. There is even some current theories that there may even be a 5th stage which identifies the "ability to actively move people from stage to stage". 

So back to your initial question "who does this guy think he is"...I can confidently and comfortably position myself as someone who is circling in the eddys of stage 3 and 4 with some regular trips back to the conscious incompetence stage.  The movement from stage to stage feels like an "awakening" and when things "start to click" your curiousity and enthusiasm build.  It can even be considered "intellectually intoxicating" because once you are on this path (or in the loop), you can intentionally reset yourself in the loop and regularly achieve this sense of awakening.  As professionals in the field of rehabilitation, it is implied (perhaps naively)that we are on this path...however the hidden truth is that most are not.  Extrinsic or external (money, fame, status) motivations will only sustain your in the short term.  Your intrinsic desire to truly learn will sustain you forever...therefore any true professional worth their salt has this drive and by definition will intentionally start the journey through the stages of learning.

This post is my initial attempt to steer into that "Yoda-like" 5th stage.  Conscious introspection and self-examination are under-appreciated and sometimes purposely avoided...but it is always productive!

Cheers!

The Extended Fascial Paradigm and its Implications in Athletic Conditioning: Part 2

FASCIA AS A SENSORY ORGAN
One of the primary characteristics for any functionally relevant tissue to have is the ability to deliver some form of sensory stimulus. The specific tissue will need to be sensitive, not only the environment, but to its relative position and status. Fascia is highly innervated and is a very powerful sensory organ (4).

Golgi Tendon Organs
Senses extension and triggers appropriate nervous system reaction (firing rate)
Sensitive to muscle contraction
Will restrict motion in risk of failure
Will decrease tonus in motor fibers as a result of stimulation
10% found in tendon
90% found in muscular portion

Pacini Receptors
Responds to compressive velocity or vibration stimulations
Increases local proprioceptive attention
Variable morphology

Ruffini Receptors
Responds to lateral stretch
Increase local proprioceptive attention
Inhibition of sympathetic activity

Interstitial Receptors
High and low threshold pressure units
Increase local proprioceptive attention
Stimulation of high threshold pressure units may induce pain and thus increase plasma extravasation





The fact that fascia is highly innervated suggests that, by definition, it is able to respond and adapt to stimulus. This adaptation will be in the form of a local response or, to be precise, remodelling. Fascia will remodel by means of mechanotransduction. The term mechanotransduction is defined as the molecular response of cells to mechanical input. Many physiological responses have been observed in response to force: (5)

• In cartilage, cells secrete more glycosaminoglycan-rich matrix when stimulated with force
• In the lining of the cardiovascular system, endothelial cells change shape and properties in the presence of altered shear stress
• Cardiomyocytes get larger and generate more force when subjected to a greater demand
• Bone density increases (more osteoblast action) in response to elevated stress levels
• Tendons and fascia mechanical properties (size and strength of fibers) respond to stress

The process of mechanotransduction will solicit what is called the piezoelectric phenomenon within the targeted tissues.

• Fascia is primarily made up of collagen proteins
• Collagen has dipole characteristics (positive and negative ends)
• Deformation of tissue causes alterations in the electrical potential throughout
• Deformation creates a measurable electrical field
• This field stimulates fibroblast activity to produce new collagen deposits


As with all physiological tissues within the body, fascia will respect Wolf’s Law.

• If a tissue is submitted to more demanding conditions it will remodel to meet the demands more efficiently
• If a tissue is submitted to less demanding conditions it will resorb



This process is governed by the tissue mechanotransduction which, in turn, is governed by the stress (force) input. Therefore the mode of stress applied (speed of application) and the amount (total force) is essential to the resultant adaptation. In order to achieve positive long term adaptation, the application of the stimulus must be relatively slow and repetitive.

• Induce multiple deformations / impacts of 1-2% of initial tissue length (60 minutes)
• Creates permanent remodeling without harming health of membrane (6).

The Extended Fascial Paradigm and its Implications in Athletic Conditioning: Part 1

The Extended Fascial Paradigm and its Implications in Athletic Conditioning

Gavin Broomes B.Sc.

ABSTRACT

In the field of Strength and Conditioning, the ultimate goal is to extract the best possible results of human athletic performance and reduce the potential for injury.  Consequently, the Strength and Conditioning professional is charged with the formulation and implementation of very specific protocols that are designed to meet these goals.  The precise formulation of training protocols is significantly easier if all of the training variables are known which will therefore result in a profoundly more efficient and effective plan.  The emerging study and research into fascia has resulted in the medical community, clinicians, and strength and conditioning professionals taking a more in-depth look into the contribution of fascia across the entire human organism.  These investigations extend not only to mechanical and orthopaedic contribution, but to systemic and metabolic contribution as well.  It is this emerging interest and scientific study that lead to the investigation of the role of fascia in the development, maintenance, and rehabilitation of the high performance athlete.  There is a significant amount of research that is currently available that identifies fascia as an important sensory organ as well as a prominent contributor to force production and transfer.  Based on these facts, the implications of increased focus on the development of the extended fascial system is significant and has a direct positive effect on the desired goal of maximum potential performance.   

INTRODUCTION

The field of Strength and Conditioning has made some important progress in achieving maximum performance in the high performance athlete.  These progresses have been made on many important levels from the analytical perspective (for example, Gray Cook’s Functional Movement screen) and from the developmental / implementation perspective as well.  It is these progresses themselves that have amplified the fact that dynamic human performance is a vastly complex and comprehensive function that has a lot of untapped potential for improvement.  A large portion of the scientific focus regarding athletic training has been directed towards the skeletal muscle paradigm, that is to say that much attention is given to what is perceived to be the primary contributor to dynamic movement.  One can consider this as a specific scientific paradigm which by definition means that everything surrounding athletic training (program design, implementation, rehabilitation, and conditioning) is governed and shaped by the specific set of established protocols and beliefs.   The strength and conditioning professional is therefore guided by the specific scientific foundation and uses it as his / her platform on which the rationale of their philosophy and approach sits.  As the research and study into athletic performance increases, the number of new questions increases as well.  This triggers the search for answers that may exist outside of the established paradigm resulting in a potential paradigm shift.  Paradigm shifts typically occur during a time of crisis (1) or, to be more specific, when the number of growing questions increases at a rate much faster than the rate of answers provided by the established paradigm.  The intent of this article is not to suggest that we are in a “time of crisis” within the field of strength and conditioning, rather that there is a potential “paradigm-like”  approach to training that, not only presents realistic opportunities to improve maximum athletic performance, but ABSORBS AND INTEGRATES the current established paradigm.  Therefore, the intent of this article is to present the Extended Fascial Paradigm as a potential important approach that will result in significant improvements in the analytical approach to strength and conditioning and consequently result in profound gains in human athletic performance.

THE EXTENDED FASCIAL PARADIGM DEFINED

The term “extended” is used to highlight the vast and varied implications that fascia has on the human body and therefore athletic performance. Fascia is typically used as a group term that is meant to generalize a given set of structures; however it can be categorized as many functionally distinct tissues (2):

Superficial fascia

-Serves as storage of fat and water

-Found on face and neck while it fills unoccupied place in the body

-Composed of areolar connective tissue

Deep fascia

-Fibrous connective tissue (elastin and collagen)

-Surrounds muscles, bones, nerves, and blood vessels

Visceral fascia

-Wraps and fixes organs in position

The Extended Fascial Paradigm suggests that the reason fascia plays such an important role in dynamic performance is because it has 2 specific functional appearances: anatomical and architectural (3).  The anatomical appearance is the one that we are most familiar with; fascia as the tissue that serves as the simple “wrapping” for the more sophisticated structures such as muscle and internal organs.  The architectural appearance is what clearly identifies fascia as an important contributor to dynamic movement.  Fascia, or to be more precise connective tissue, exhibits two functionally paradoxical tendencies; it “connects” and “disconnects” (3).  The connective tendencies are the ones we are more familiar with and typically have a relatively good understanding of.  The “connecting dimension” allows for mechanical interaction of different body segments and therefore contributes to movement (fig.1 and fig.2).  The “disconnecting dimension” is somewhat more elusive and counter-intuitive.  Fascia also separates individual muscles allowing them to slide independently without interference with adjacent muscle bellies and structures (fig.3 and fig.4).  This disconnection is vital for the efficient performance of athletic movement.  The implications of fascia are far-reaching and therefore should be considered as an important focus or training variable on its own. 

Welcome to One Giant Leap!

This blog is a pilot project intended as a vehicule for intellectual debate and discussion regarding cutting edge theories and concepts in the field of human performance and rehabilitation.  I hope that it both educates and stimulates the mind! Enjoy!