The first in a series of articles
Valgus deformity and fascia.
In this follow up article, I will endeavour
to pick up on some common squatting faults and how they could theoretically
relate to certain categories of back pain seen in my clinic, hopefully taking
you on a journey across some interesting material along the way. First and
foremost all views are my own, however will be corroborated by research/best
clinical practice where applicable, this is also not intended as a “diagnose
yourself workbook” more as an intellectual exercise for PTs, Healthcare
therapists and the educated athlete.
As mentioned in previous articles by Andrew
squatting most certainly not solely hypertrophic exercise, squatting in my
opinion spans a chasm between balance, co ordination, strength, speed and
mental focus. With so many components there is A LOT that can go wrong and
ultimately lead to injuries. Personally I think that the largest amount of
ignorance is to be found with regard to neurological stabilization (balance) within
the squat (as Andrew alluded to in his last article). We constantly train
strength, speed, power, and watch videos on mental focus/motivation, yet if we
have an issue we normally negate the balance/co ordination component. Ignoring
this vital aspect is often a major tripping point for the intermediate lifter.
Looking at the sensory homunculus (a homunculus is a physical representation of
the density of sensory nerves and thus the amount of brain attributed to them)
we can see an inordinate amount of receptors in the hands, the face, the tongue
and then the feet. Ill hopefully touch further on this in following articles,
but these are the main areas of the nervous system that are constantly sending
signals to the brain in order to allow it to modify and stabilize in its
environment, when we squat we should pay more attention to our feet.
Following on from that statement ill begin
on the first category, and one I suffer with myself.
Valgus
deformity.
Valgus deformity refers to an inwards
collapsing of the knees at any point in the squat. I asked Andrew
previously for his opinion on this, and very rightly he concluded a weakness/inhibition
of the glutes (med) leading to a lack of external rotation of the femur. As a
coach he suggested banded hypertrophy work, alteration of my stance, using my hips more (opening up my hips/taint). Some possible solutions to a very common problem in many lifters. Why did this
issue arise though? As we know the body is fond of subconscious shortcuts and
normally utilizes the path of least resistance without you even realizing it.
The body is unfortunately only so smart; this shortcut works great in the short
term, however long term leads to poor motor patterning and unsurprisingly,
injury. Most evolutionary biologists will tell us this is short term compromise
is a neurological adaptation evolved to get us out of sticky situation (cue
being chased by a bear and stubbing your toe followed by a limping gallop) works
great there and then, just not over and over again as in our training. Does
that mean there is a case for a mild vaglus deformity on meet day?
Possibility……
How does this relate to back pain? Just as
I introduced you to some of my favourite functional categorization of the joints
of the body (joint by joint approach by Mike boyle/Gray Cook), ill now introduce
you to my favourite categorization of the human fascial planes.
Thomas Myers introduced “Anatomy Trains” in
2008 and it was a real game changer for manual therapists, Myers realized that
since the inception of anatomy we have always used a knife to dissect the body.
We sliced the arm open to find the bicep
sitting there, from physiology we then deduced that as the bicep contracts it
flexes the elbow. Perfect. This is now the norm, we are still taught this in
school, college and university, it completely makes sense and there isn’t much
point challenging that, or is there?
What keeps us, as big fleshy sacks of meat,
in one piece? We are covered in a an inordinate amount of connective tissue
called fascia, this is a sheet like tissue that covers our muscles, organs,
nerves, skin, etc…..
You may have even heard of from manual techniques
that aim to target it (myo-fascial-release) this tissue is comprised of a
matrix of collagen (a protein) which houses in it a number of cells, chemicals,
proteins and water. This is all referred to as the intracellular matrix, put
simply it’s the spaces in-between every cell in your body. Here is the most
interesting part, for centuries we have imaged fascia to be an inert tissue,
just laying in-between stuff minding its own business, until recently when in an
almost epiphanic moment more and more of the fascias secret began to be
unravelled.
Ill stick to the most applicable one
however, otherwise this article could go on for pages. So this assumable inert fascia has been
actually found to be a remarkably responsive tissue, that when stressed is able
to reinforce itself, when stretched it reflexively relaxes (only at 4% stretch,
at 8% it has an adverse effect showing the subtle delicate nature of the
tissue) when left alone it dehydrates horribly (thixotropic nature) becoming
stiff and bogged down in metabolic toxicities (part of the reason why you
“stiffen up” with immobility).
Myers found that by eliminating the callus
nature of the knife out of the dissection process we are left with a very
different corpse, the body is wrapped in layers of fascia, layers that
distribute the push and pull of daily life, and of course – squatting. These facial
paths he named trains, they are predicable lines of stress that aid the action
of the muscle in moving joints. No longer should we think of the bicep as an elbow
flexor… yes it is the engine of the steam train providing the force, however it
is the superficial arm line that provides the tracks for the engine to run on,
its line of pull is far further reaching and all encompassing.
Superficial arm line:
Dissected facial lines (using a knife…..)
This paradigm shift is still slow to take
hold, however its truth is infallible and as manual therapists and athletes we
should be aware of these principals. Why is this relevant, well coming full
circle back to the valgus collapsing in the squat, we remember Andrew proposing
the glute inhibition as the principal fault, which I totally agree with. One of
Myers most applicable lines for lower limb power lifting is the spiral line.
Now following this line we can see the
perfect theoretical reason for valgus collapse. Glute switches off (goes slack)
vastus lateralis/ITB tension increases (increased pull) knees cave (slack)
fibularis near have a heart attack and lock up (severe increased pull) trying
to perform the job of the far far far larger glute muscles (also leading to a
transfer of weight to the medial foot – pronation which is a whole different
issue).
This
spiral line slings around the sacroiliac joints providing them with support and
stability they need, take away the sling by inhibiting certain areas in it, and
often we are left with a irritated and unstable sacroiliac joint (pain in the
low back just of the centre). No matter how much physio/chiro/massage you get
on that SI (sacroiliac) joint, every time you go to squat BANG its back within
a couple of weeks like a stabbing toothache. Make sure you see a healthcare
professional who will address all the issues, not just the obvious ones!
Thanks again to Andrew for the guest spot,
until next time.
Thank You Luke for another Great Post
Andrew Richardson, Founder of Strength is Never a Weakness Blog
I have a BSc (Hons) in Applied Sport Science and a Merit in my MSc in Sport and Exercise Science and I passed my PGCE at Teesside University.
Now I will be commencing my PhD into "Investigating Sedentary Lifestyles of the Tees Valley" this October 2019.
I am employed by Teesside University Sport and WellBeing Department as a PT/Fitness Instructor.
My long term goal is to become a Sport Science and/or Sport and Exercise Lecturer. I am also keen to contribute to academia via continued research in a quest for new knowledge.
My most recent publications:
My passion is for Sport Science which has led to additional interests incorporating Sports Psychology, Body Dysmorphia, AAS, Doping and Strength and Conditioning.
Within these respective fields, I have a passion for Strength Training, Fitness Testing, Periodisation and Tapering.
I write for numerous websites across the UK and Ireland including my own blog Strength is Never a Weakness.
I had my own business for providing training plans for teams and athletes.
I was one of the Irish National Coaches for Powerlifting, and have attained two 3rd places at the first World University Championships,
in Belarus in July 2016.Feel free to email me or call me as I am always looking for the next challenge.
Contact details below;
Facebook: Andrew Richardson (search for)
Facebook Page: @StrengthisNeveraWeakness
Twitter: @arichie17
Instagram: @arichiepowerlifting
Snapchat: @andypowerlifter
Email: a.s.richardson@tees.ac.uk
Linkedin: https://www.linkedin.com/in/andrew-richardson-b0039278
Research Gate: https://www.researchgate.net/profile/Andrew_Richardson7
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