Deep muscles – Stomach deep muscles training

Deep muscles – Stomach deep muscles training is vital while treating patients with lower back dysfunctions. Before undertaking complex actions oriented towards improving the efficiency of deep and global muscle system, we have to focus on regaining the full performance of deep muscles (by means of the rotational and straightened exercises model). The exercises should be focused on transverse abdominal muscle stimulation, as it is a part of the internal muscle group (deep muscles). The deep muscle group allowing for the maintenance of stability of the pelvic girdle and lower back incorporates: multifidus muscle, thoracic diaphragm, and pelvic floor muscles. The deepest of the muscles, the transverse abdominal muscle together with its lower back joints, thoracolumbar fascia, and contralateral fibers near the middle of the body, can be considered the representatives of a local system in the stomach area. The activation of deep muscles by means of stimulating the transverse muscle does not exceed 30% tension threshold. It is also quite similar in the case of the rectus abdominis muscle. Deep muscle exercises are performed on the border of neutral position of the spine and the pelvis. We do not try to cross the said line – all the sensory changes within global muscles (caused by a higher performance of the rectus abdominis muscle) may disrupt the functionality on the level of local torso muscles. Deep muscle exercises - transverse abdominal muscle activation 1.In order to stimulate the muscle, one has to properly specify the neutral position of both one’s spine and pelvis. 2. Move your pelvis forwards and backwards, always trying to start the movement in the neutral or „zero” position. The exercise will, among others, increase your neutral zone control capability. You will react to all the spine movements quicker. The movements in question have to be eliminated while activating the transverse abdominal muscle

 

Specifying the neutral position before deepened closure, part 1

Specifying the neutral position before deepened closure, part 2

   

Deep muscles - transverse abdominal muscle activation. „Deepened closure” – Introduction


 

Specifying the neutral position before deepened closure

Specifying the neutral position before deepened closure

   

Muscles - transverse abdominal muscle activation. „Deepened closure” Deep muscles – How to identify the proper activation of the transverse abdominal muscle? One of the most important issues while approaching deep muscle stimulation is the correlation between the coordinated stimulation of the transverse abdominal muscle and multifidus muscle and the tension in fascia system inclosing the thoracolumbar fascia complex. In the case of people who do not suffer from any pain-related disorders, muscle corset is formed automatically as a response to simply holding in their stomach (without stimulating lower back). What is important, holding one’s lower stomach causes symmetrical activation of the transverse abdominal muscle One has to remember about the necessity to eliminate all spine movements!!! Deep muscles - transverse abdominal muscle activation – Examination Palpation allows for checking individual transverse abdominal muscle activation patterns and the ability to keep isometric tension. The most promising area of contact is located centrally and caudally in relation to the anterior superior iliac spine as well as at the back of the rectus abdominis muscle.  Hand position during the palpation Thumb and three middle fingers have to go gently, rather than deeply, into stomach layers. The technique can be utilized by an instructor or a patient. The position indicates the lower part of the stomach to the patient. If the transverse abdominal muscle is tensed properly, the client will feel a slowly increasing pressure under his or her fingers. In the case of an improper activation, three major responses can be noticed. Firstly, there may be no activity at all. Secondly, there may be a dominant or substitutive abdominal oblique muscle tension (similar to the one taking place during childbirth) which can be identified as a sudden tension increase in stomach layer (outer muscle tension). Thirdly, fingers performing the palpation procedure may be pushed back by oblique muscles, which will result in the increase in intra-abdominal tension. Deep muscle activation (transverse abdominal muscle) – recognition While holding in one’s stomach, several characteristic phenomena may occur. In the optimal stimulation case: - Transverse abdominal muscle retracts and tenses the anterior stomach fascia. - Transverse abdominal muscle slightly increases in diameter, indicating the ongoing contraction. - The muscle in question covers internal organs of the stomach more tightly, creating a muscle corset. - Oblique muscle size remains unchanged. - Pattern is symmetrical on both sides of the body.   In the global stimulation scheme, the following phenomena may be identified: - Simultaneous, rapid muscle size increase of: transverse abdominal muscle, oblique muscles, and rectus abdominis muscle. - Noticeable lack of tension and shortening of the anterior stomach fascia, despite of the visible transverse abdominal muscle tension. - The said muscle does not cover internal organs of the stomach more tightly, stomach becomes wider instead of shrinking. - Stimulation pattern may be asymmetric in character. While exercising deep muscles (deep muscle corset) one has to remember about the elimination of any spine movements!   How to explain the transverse abdominal muscle activation to the client? As mentioned earlier, all he or she has to do is to hold in his or her lower stomach without moving his or her spine. The task seems to be undemanding, but it may be otherwise… Ask the client to make a "gentle" breath in through his or her nose before proceeding to the exercise. Why is it so important? While laying on one’s back, it is hard to specify how deeply should this stomach be held in. It is difficult to tell apart stomach layers. During inhalation, the chest moves up and to the sides. Stomach layers start to stretch. How can the client hold in the back of his or her stomach when there is nothing to hold in? Then, he or she may overdo the exercise and exceed the 30 % threshold. It may also happen that the stomach is held in so strongly that the patient cannot breathe during the exercise, and the entire pattern is above the norm (the isometric tension of the transverse abdominal muscle should not be higher than 30% )  Before the exercise -  specify the neutral position - move your pelvis forwards and backwards - place your index finger and middle finger on iliac spines, move the fingers 2 cm across towards the pubic symphysis (you will feel a small hole). The fingers should be in contact with the body, do not push them inside. - The client should hold in his or her lower back, imagining that he or she cannot cross the navel line -  during the procedure, the spine cannot move closer to the mat.  Exercise proper -  specify the neutral position - move your pelvis forwards and backwards - place your index finger and middle finger on iliac spines, move the fingers 2 cm across towards the pubic symphysis (you will feel a small hole). The fingers should be in contact with the body, do not push them inside. - The client should hold in his or her lower back, imagining that he or she cannot cross the navel line -  during the procedure, the spine cannot move closer to the mat. - take a breathe in through your nose    - while exhaling, do not move your back and hold your lower stomach in gently.  - you should feel a small change (a swell) under your fingers. It is the point where we frequently make a mistake. I was making it for many years as well. I did not explain to the client that he or she was going to feel a swell rather than A TENSION! What would the client do to feel the tension? He or she would tense the abdominal rectus muscle. What is even more, I asked the patient to do so myself! Remember about the subtle difference between feeling the swell and feeling the tension. What to do if the exercise has been explained properly, but client’s deep muscles are weak and he or she cannot perform the exercise properly? In the case of individuals with spine problems and women after childbirth, the very first step has to be the activation of the pelvic floor muscles. The description technique and exercise performance remain the same. The only change is that visualization is added. - Take a deep breath while at the same time imagining that you stop the flow of urine and hold in your lower stomach without crossing the line of the navel (not doing any rapid spine movements). Keep the mobilization and breathe freely for 5-10 seconds. - For even better effects: imagine that your try to wring out a small sponge located inside your vagina (or you move the syringe plunger to 1/3 of its maximum height) while at the same time holding in the bottom stomach.  What to do in the case of men who have problems with activating the transverse abdominal muscle? Gentlemen should imagine that they want to move their testicles upwards while at the same time holding in the bottom stomach. In some rare cases, females after childbirth cannot stimulate their transverse abdominal muscles. I personally have encountered few cases where the strategy has not yielded satisfactory results. What to do in such a case? The said topic is going to be discussed in detail in next publications. DO YOU KNOW THAT? Deep stomach muscles - myths busted! Author: Anna Ścisłowska, MA; BBPilates school director

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