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Module  2:  Func1onal  Anatomy  

‘Textbook’  Anatomy  vs      ‘Func1onal’  Anatomy  

•  Role  of  the  gluteals  – Textbook  (open-­‐chain)  

•  Hip  Extension  •  Hip  Abduc1on  •  Hip  external  rota1on  

– Real  world  •  Also  resists/controls  hip  flexion,  adduc1on  and  internal  rota1on!  

PaPerns  of  Quality  Movement:    The  Joint-­‐by-­‐Joint  Approach  (Boyle)  

Joint Needs Foot Stability

Ankle Mobility

Knee Stability

Hip Mobility/Stability

Lumbar Spine Stability

Thoracic Spine Mobility

Scapula Mobility/Stability

Gleno-Humeral Mobility

An  Alterna)ng  Series  of  Stable  Segments  Moving  on  Mobile  Joints  -­‐  Charlie  Weingroff  

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The  Spine  

•  Lumbar  vs.  Thoracic  – Movement  

Rota1on  at  the  Spine  Spinal Level Degrees of Rotation

T1-2 9 T2-3 8 T3-4 8 T4-5 8 T5-6 8 T6-7 8 T7-8 8 T8-9 7

T9-10 4 T10-11 2 T11-12 2 T12-L1 2

L1-2 2 L2-3 2 L3-4 2 L4-5 2

L5-S1 0-5

Rota1on  at  the  Spine  

Analysis  of  the  stress-­‐strain  curves  for  the  intevertebral  discs  under  torsion  reveals  an  

inflec1on  point  just  before  3  degrees  of  rota1on,  which  indicates  the  onset  of  microscopic  failure  in  

the  anulus  fibrosus.    

Bogduk,  Clinical  Anatomy  of  the  Lumbar  Spine.  

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Does  this  mean  we  never  move  our  lumbar  spine???  

NO!  

Joint-­‐by-­‐Joint  Training  

Joint Needs Hip Mobility

Lumbar Spine Stability

Thoracic Spine Mobility

The  Pelvis  

•  The  Driver  •  Gets  no  respect!  

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“The  Box”  

•  “Core”  is  defined  as:  –  Diaphragm  on  top  

–  Pelvic  floor  on  boPom  –  Abs  in  front  –  Erectors/mul1fidi  in  back  –  “Muscle”  weight  belt  

•  What  else  plays  a  role?  – Glutes?  – Lats?  

The  Diaphragm  

•  Primary  Func1ons  –  Increases  IAP  – Spinal  stability  

•  Implica1ons  –  Balloon  example  

–  Alignment  

The  Diaphragm  

Diaphragm  

Pelvic  Floor  

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The  Diaphragm  Taken  from  Postural  Restora1on  Ins1tute®  

Transverse  Abdominus  

•  Primary  Func1ons  –  Abdominal  “hollowing”  –  Forced  expira1on  

•  Implica1ons  –  TIMING!!!!  

–  Unless  you  have  a  specific  issue,  don’t  worry  about  training  the  TVA  

Transverse  Abdominus  

“In  fact,  our  clinical  experience  suggests  that  efforts  to  isolate  the  TVA  is  problema1c  –  

there  is  more  important  abdominal  training  that  really  maPers  for  the  

athlete.”  -­‐  McGill    

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Transverse  Abdominus???  

Bracing  With  a  Belt  

Spinal  Erectors  

•  Primary  Func1ons  – Trunk  Extension  

•  Implica1ons  – The  “Unknown”  Role  

•  Superficial  •  Deep  

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Toe  Touch  Stretches?  

Mul1fidi  

•  Primary  Func1ons  –  Segmental  stabiliza1on  –  Spinal  propriocep1on  

•  Implica1ons  –  Fine  motor  control  

–  Atrophy  at  injured  areas  (Hides  1994)  

Quadratus  Lumborum  

•  Primary  Func1ons  –  Side-­‐bending  –  Resis%ng  side-­‐bending  

•  Implica1ons  –  Frontal  plane  movement  and  stability  

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Rectus  Abdominus  

•  Primary  Func1ons  –  Trunk  flexion  –  Depresses  rib  cage  –  Posterior  pelvic  1lt  

•  Implica1ons  –  Dominant  anterior  stabilizer  

–  How  many  of  you  only  perform  crunches?  

To  Crunch…Or  NOT  to  Crunch???  

•  Ask  yourself  WHY?  

•  Top  Down  vs.  BoPom  Up  Stability  

•  External  Obliques  are  typically  weak  

•  Depresses  rib  cage    Shoulder  and  upper  extremity  issues  

Crunches  and  Neck  Pain???  

•  Superficial  Front  Line  Anatomy  Trains  

•  Fascia  connects  everything  

•  Shorten  RA    Shortening  of  SFL    Head  Forward  Posture  

Reproduced  with  Permission  Tom  Myers/Elsevier  

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Rectus  Dominance  

How  do  you  get  your  stability?  

External  Obliques  

•  Primary  Func1ons  –  Trunk  flexion  (bilateral)  –  Trunk  rota1on  (unilateral  w/

opposite  IO)  

–  Posterior  Pelvic  Tilt  without  a  pull  on  the  rib  cage  (posterior  fibers)  

•  Implica1ons  –  Gets  us  back  to  pelvic  neutral!  

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External  Obliques  

“The  origin  of  this  muscle  from  the  rib  cage  and  its  inser1on  into  the  pelvis  are  

consistent  with  the  most  effec1ve  ac1on  of  this  muscle,  that  is,  the  posterior  1lt  of  

the  pelvis.”  -­‐  Sahrmann  

Psoas  •  Primary  Func1ons  

–  Hip  flexion  (esp.  above  90!)  –  Hip  lateral  rota1on  –  Lumbar  extension  

–  Lateral  rota1on  of  lumbar  spine  

–  Lumbar  spine  stability  via  axial  compression  and  eccentric  control  

•  Implica1ons  –  Tight  hip  flexorsWeak  glutes  

–  Anterior  1lt  +  Lumbar  extension  =  LBP  

Glute  Max  

•  Primary  Func1ons  –  Hip  extension  –  Hip  abduc1on  –  Hip  external  rota1on  –  Closed  chain!!!!!  

•  Implica1ons  –  Lengthened/weak  due  to  APT  –  Weakness/inhibi1on  leads  to  

an  assortment  of  lower  extremity  issues  (hamstring  pulls,  groin  pulls,  LBP,  etc.)  

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Trunk  Extension  

Hip  Extension  

Func1onal  Anatomy  Bringing  it  all  together….  

•  Work  together  to  promote  movement  

•  The  concept  of  force  coupling  –  Muscles  on  opposing  sides  of  the  body  

working  together  to  produce  movements  

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SagiPal  Plane  Force  Coupling  

Anterior Force Couple Posterior Force Couple

Psoas Rectus Abdominus

Rectus Femoris External Obliques

TFL Gluteals

Spinal Erectors Hamstrings

The  BaPle  for  Pelvic  Alignment  

External  Obliques/Lower  Abs  

Hip  Flexors  

Spinal  Erectors  

Glutes  &  Hamstrings  

Pelvic  Alignment  –  Anterior  Tilt  

External  Obliques/Lower  Abs  

Hip  Flexors  

Spinal  Erectors  

Glutes  &  Hamstrings  

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Pelvic  Alignment  –  Posterior  Tilt  

External  Obliques/Lower  Abs  

Hip  Flexors  

Spinal  Erectors  

Glutes  &  Hamstrings  

Anterior  Pelvic  Tilt  

•  Increased  shear  forces  on  low  back;  increased  likelihood  of  trunk  extension  vs.  hip  extension  

•  Increased  likelihood  of  hamstring/groin  strains  due  to  weak  glutes/poor  hip  extension  

•  S1ff/short  rectus  femoris  and  hip  flexors  

Posterior  Pelvic  Tilt  

•  FlaPening  of  lumbar  curve  leads  to  increased  risk  of  disc  hernia1ons