Sunday, April 24, 2005

Neck sensory feedback.

The neck is a very fragile structure which depends on a large amount of muscle coordination to perform its function properly. There are sensors within the joints,ligaments and muscles which aid in the detection of the proper position and movement of head in "space". The most widely known trauma to the neck is called "whiplash" syndrome. The term is very vague as it does not give away any clues as to which structures are affected. The problem with any injury is that if we are only concerned with the ability of our tissue to heal themselves we will fail in the long run. Once the continuity of tissue structures have healed they may again start to perform their designated roles, however the programming has been corrupted and need to be reinstalled for proper performance. I know the body is not a computer but the above is true, we need to reprogram the muscles to control the neck in an appropriate way.
I read an interesting study where they tested the ability of an individual to move the head in various patterns with a laser pointer to show where the movement took place and then to repeat the same movements with eyes covered. Subjects with neck trauma had altered proprioceptive awareness and control over neck movement, thus a retraining program had to be implemented. Strengthening of the neck may be important, but if the core muscles are not activating properly no progress will be made. The reason being that with the lack of core muscle control- the other muscle groups tend to work too hard and end up with muscle spasm and "knot's" MTRP etc.
Training the core is not Physically hard, its mentally tiring as the brain has to focus on the task and has to relearn a "motor skill".
Motor skill and function is more important than strength!
It is therefore time that the proper attention and focus on rehab following neck trauma focused more on activating and stimulating the right nerve response and action before a full fledged strengthening regime starts.
Train smarter not harder!


Sunday, April 17, 2005

Posture and back pain.

Most people experience back pain at some time during their life, and sometimes the pain seems to appear out of nowhere! Back pain does not always stem from specific trauma, it can occur as a result of prolonged unhealthy postural habits. Let me explain. The spine is made up of spinal vertebraes which are separated by a cushioning disc and behind that 2 joints called facet joints (which help to guide and control the motion of each segment) then we have capsule and ligaments which are passive restraints which help protecting us from going too far, and to exceed the normal range of motion in our spine. And lastly there is a cover of muscles which controls the fine tuning and larger movements of the spine. Pain could not exist without nerve supply, but pain is not the reason for nerves being there. In a healthy back the ligaments and muscles containing small nerve receptors sends signal back and forward through our spinal cord to inform the body of which actions to take to perform its function. This sensory input is called proprioception, which helps us maintain balance and to coordinate the effort of our muscles. Without the proper input it would be easy to exceed to normal limitations of our spine which could lead to sprains and strains of the muscles and ligaments. Poor posture could cause overstretching of ligaments and muscles and thus proprioceptive control may be affected and pain could be the result, as lack of segmental control could cause excessive spinal segmental mobility and wear and tear and inflammation could set in.
Ergo posture is more important than we think and we ought to look after our backs as improper control of segmental motion could cause unnecessary pain and suffering.