Nerdilates (Pilates for Nerds): What is Neutral?

A couple days ago, I was asked a really interesting question by a client in the Pilates Method Fundamentals Class. What is neutral? It took me a second to answer the question. Well, is neutral relaxed? is it in the middle? Is it defined as the lack other movements or displacements like flexion (bending forward) extension (bending backwards), or rotation?

I guess it really depends on what part of the body we are referring to. When we talk about a peripheral joint (joint in an extremity like a leg or arm) being in "neutral" position, we are referring to a position of the joint, in the midrange of that particular joint's range of motion where it demands the least support from ligaments, connective tissue, and other non-muscular tissues around the joint. It is in this "neutral" position, that stress on the joint is at its minimum and the small, deep, local stabilizer muscles that surround the joint are best able to control the joint's movement. Mobilizer muscles are relaxed when a joint is in a supported, neutral position. Ideally, we would like to keep joints at or near their neutral position as much as possible to reduce wear and tear.

The spine is a bit more complicated. The spine can be divided into sections; the cervical (neck) spine, the thoracic spine (upper back, attached to ribs), lumbar (lower back) spine, and sacrum. Neutral means something slightly different for each section of the spine. The cervical and lumbar spine are both curved forward (the anatomical term is lordosis) where there is a space between the spine and the floor when you lie down on your back. The thoracic spine and the sacrum both are curved the opposite way (kyphosis) so that when you lie down on the floor, your upper back and sacrum (base of the spine) touch the floor.

The spine actually requires quite a bit of support to remain "neutral." If we find a position where our ligaments are minimally stressed, muscles of our core have to be "engaged" and working. Neutral alignment in the spine is defined as having the center of C7 (the lowest cervical vertebral body/bone) over the very front, bottom corner of S1 (the very top of the sacrum). In case you don't have x-ray vision, alignment can be approximated by aligning the ear canals over the shoulders over the hips.  

Finally, a "neutral" pelvis indicates that the anterior superior iliac spines (the bony part of your pelvis just above your groin that you feel on either side of your lower abdomen) and pubic symphysis (the bony part of the pelvis in the midline of the body just above the genitals) fall in the same vertical plane/line.

Once you can position your body as close to neutral as you can, I try to distinguish between muscles being "engaged" vs core muscles being rigid. To use volume/sound as an analogy, engaged means that the muscles are working at a hum. Rigid muscles are working at a shout. You want your body to be supported and muscle to be awake, but you don't want to be stiff and full of tension. The goal is to have neutral body position that is supported and still responsive to movement. More on movement in a future posts.

Anatomy Focus: Eye Gaze During Abdominal Work

One of the top concerns that many of my students have when they begin their Pilates education is neck strain during abdominal exercises that require you to lift your head above the mat. Many people think they just have to build more neck strength and endurance, but strength is usually a small part of the equation. More subtle adjustments in head position, head tilt, and eye gaze have a lot more to do with neck strain and are more easily accessible than the elusive neck strength and conditioning that students believe they need.

A small discussion of anatomy is necessary to understand the biomechanics of skull and neck position. The average human head weighs somewhere between 10-13 lbs. It sits on top of the cervical spine which consists of eight cervical vertebrae. Suboccipital joints associated with the top two cervical vertebrae, referred to as C1 and C2, are uniquely shaped to facilitate movement including rotation as well as flexion and extension. In fact, C1 and C2 are responsible for about 50% of your cervical rotation and about 50% of your flexion and extension. This also means that the other 6 cervical vertebrae together are responsible for the other 50%. Developing and maintaining suboccipital joint motion is necessary to optimally position the weight of the skull during supine (lying on your back), forward flexion (curling up), abdominal exercises.

There is a group of eight, small, muscles that connect the base of the skull to the upper cervical vertebrae collectively called the suboccipital muscles. There are two pairs of rectus (straight) muscles and two pairs of obliques (oblique) muscles. These eight muscles function to tilt the skull as you walk over uneven ground to keep your gaze stable. They are considered stabilizer or postural muscles and consist of highly innervated, slow twitch muscle fibers. These muscles relax to allow your skull to flex down relative to your cervical spine and contract to extend or tilt your head up relative to the cervical spine. The oblique muscles alternate contraction and relaxation to tilt the skull to the right or to the left. 

The most common posture I encounter in the studio is head forward posture, otherwise known as slouching. In head forward posture, the suboccipital muscles tend to be chronically tight. In anatomic terms, head forward posture consists of cervical spine flexion combined with suboccipital extension. The head is brought forward by flexing the neck. However, simple cervical flexion will orient the face (and the eyes) looking downwards towards the floor. In order to restore our forward facing gaze, the suboccipital muscles shorten to point the face and gaze forward. If the client is constantly slouching, the suboccipital muscles never really get a chance to relax contributing to neck tension and strain. In Pilates terms, we will often call this shortening through the back of the neck.

One the the fundamental Pilates skills is restoring normal alignment in the head and neck. The tricks Pilates instructors can use to work with clients with head forward posture include placing a foam pad or pillow under the occiput (back of the skull) to compensate for lower cervical spine flexion which displaces the skull forward of the body. The client can then be coached to flex the suboccipital joints by "lengthening through the back of the neck" or sliding the occiput away from the body which results in a gentle "chin tuck" or head nod downwards which requires suboccipital muscle RELAXATION.

Now apply this to an Ab Prep (Pilates abdominal crunch) or other ab exercise like the Hundred or Roll Up. When the client lengthens through the back of the neck, flexing through their suboccipital joints this naturally lowers their gaze. One habit some of my client have when they do an Ab Prep or the Hundred is directing their gaze on the ceiling. When the gaze is high up on the ceiling, the suboccipital muscles are shortened and tense and the client returns to their head forward, tension generating postural patterns. When the gaze is lower, say on the clients knees or thighs, the suboccipital muscle relax and the skull is tilted so that its center of gravity is directly over the flexed cervical spine.

Only once the client has developed the ability to lengthen through the back of the neck to flex the suboccipital joints and relax the suboccipital muscles does it make sense to introduce "strengthening" and "endurance" exercises to the picture, i.e. the Hundred. The Hundred requires maintaining thoracic and cervical flexion and a lifted head and shoulders for 100 counts which will require deep neck flexor muscle strengthening. However, it makes no sense to attempt the exercise if the client falls back into suboccipital extension and their gaze lifts to the ceiling as their head falls back as this position will reinforce their head forward posture pattern and create unnecessary discomfort and strain. 

So try keeping cueing eye gaze away from the ceiling because praying to the sky will not help you in the Hundred......

Nerdilates: What causes tight muscles?

One of the more common issues our clients deal with when starting an exercise program is chronically tight and sore muscles. If your muscles are tight and sore, then you are not going to move comfortably and fluidly. We at SOMA Movement Studio believe that you should first relax those muscles, then proceed to challenge yourself athletically. There many situations and scenarios that can lead to tight muscles, but all have a unifying theme: some type of stress whether it is mechanical or perceived, causes a unconscious and reflexive contraction who's goal is to protect the muscle and the structures in the body that are associated with it.

Voluntary, or intentional movement originates in the cortex of the brain. Involuntary movement, may not involve the brain at all. Instead reflex loops may be mediated by the spinal cord and nerves in close proximity of the muscle.

A basic understanding the functional anatomy and physiology of the neuromuscular system is necessary to understand chronic, tight muscles. There are main two systems that can initiate muscle contraction; the brain mediated (conscious voluntary system) and the spinal cord mediated (unconscious reflex system). The conscious voluntary system is that one that carries a message from the cortex, or outer layer of the brain, through the spinal cord and nerves, to the muscle to initiate a movement that you thought of. For example, it is this system that moves your arm to pick up a pencil when you want to write something on a piece of paper.

The unconscious reflex system is used when there is not enough time to "think" about a movement. In this system, sensors (neural receptors) in the muscles or skin sense pain, muscular stretch, or other "danger" signals and send those signals to the spinal cord. If the danger message is strong enough, the spinal cord converts this sensory information and sends a message back to the muscle to contract, thus protecting the part of the body in danger. This system does not require input from the brain. An example of this system is when you touch a hot stove and your arm pulls back before you've even realized you've burned yourself.

This unconscious reflex system also responds to stress and chronic mechanical trauma in addition to acute situations. One way to look at stress is that it is a perceived or anticipated danger or fear. Emotions and the ability to anticipate the future predispose us to initiating our body's "danger" response in reaction to stress and anxiety, just the same as we would if we were to encounter dangerous situation, requiring us to defend ourselves. The end result is tight shoulders, necks, backs, etc from constant stress.

The average human head weighs between 10-12 pounds. Head forward posture greatly increases the amount of strain on the neck as the head moves in front of the body. This leads to poor biomechanics, compensatory patterns, and discomfort during exercise.

Additionally, mechanical injuries can initiate muscle contraction. The average human head weighs somewhere between 10-12 lbs. Displacement of the head forwards or backwards due to poor posture, even just a few inches, can put an incredible amount of stress on the spine and the muscles that support the spine.  This is analogous to carrying a heavy bucket; everyone knows that it is easier to carry a bucket next to your body than it is to carry it on an outstretched arm. The extra work that bad posture puts on your skeleton and muscle causes them "defend" themselves by contracting. The same applies for repetitive injuries such as pounding the knees with running or typing with unsupported wrists.

There are many causes of chronically tight muscles, and only a few are described here. If you do experience chronic muscle contraction, it is important for you to attempt to address the cause(s) in order to avoid discomfort especially before starting an exercise program where you will be putting even more stress on your body. Improving posture, managing stress, working and functioning in an ergonomic environment, and increasing your fitness level can all help alleviate chronic tightness. Ultimately, you must be aware of the way your body moves and the way you feel, and identify your limitations in order to address them. Then you are moving efficiently and freely, challenging your fitness in a progressive and logical way.

Nerdilates (Pilates for Nerds): A bit on Spine Mobility from different perspectives

Lower back tightness and discomfort is one of the most common issues our clients deal with when they come to our studio. We offer a few different movement disciplines and I want this post to clear up some of the confusion with regards to the different approaches to developing spinal mobility and stability. At first glance, Somatics' Arch and Flat, Pilates' Neutral and Imprint, and GYROTONIC's Arch and Curl seem very similar, but I assure you that their intentions and the muscle activation patterns that generate the movement are very different.

Hanna Somatic Movement

The primary goal of Hanna Somatic Movement, also known as Hanna Somatic Neuroeducation is to gain voluntary control of your skeletal muscles tension. One way to do the Arch and Flat exercise is done in a supine position (lying down on your back) on a carpet or blanket on a hard/smooth floor (rubbery Yoga mats are generally designed to generate traction so you don't slip and fall during Yoga so they restrict movement and aren't great for Somatics). Lie down with knees bent, feet on the floor about hip width apart, arms falling away from your body in a comfortable position at your side with palms up towards the ceiling.

Start in your most comfortable individual natural position of your spine. This may be slightly extended (arched) or flexed (flattened) depending on your posture. Breath naturally and fully so that your ribs and belly swell full of air and you aren't holding any tension in your abdominal muscles. Place a hand on your abdomen and feel your hand rise and fall smoothly like the waves in a calm ocean. When you are as relaxed as you imagine yourself to be, proceed to movement.

Schematic representation of the spine during the basic Hanna Somatic Movement, Arch and Flat where the position of the spine is changed based on coordinated contraction of the back and abdominal muscles combined with breath.

From here, on an inhale, attempt to contract your back muscles SLOWLY lifting your lumbar spine into more extension, a deeper arch. The space we call the "small of the back" between the lower back and the floor gets larger and the pelvis tilts away (extends) from you so the sacrum becomes more vertical. Reach the apex of your arch with deepest engagement of your back muscles when you ribs and belly are at their fullest with air, abdominals are relaxed.

Then, as you initiate your gentle and slow exhale, begin to relax and release your back muscles, allowing your spine return towards the floor in a controlled decent, passing through your starting position. As you pass your "neutral" spine, begin to engage the abdominal muscles to flex your back further towards the floor until the small of your back all but disappears. Try to time the ending of your exhale when your back reaches a fully flat position. Begin to inhale again relaxing and releasing the abdominal muscles, allowing your back to return to its "neutral" starting position.

It is really important to remember that the primary goal of this movement is about engagement, release, and coordination of the abdominal and back muscles. Range of motion, the extent that you are able to arch and flatten your spine and the distance your lumbar spine ultimately moves, is secondary and happens AS A RESULT of muscle engagement. If you find yourself tensing up in your shoulders or neck, or pressing into your feet and glutes as you TRY to arch further or flatten further than your abdominals/back muscles allow you to, then you are missing the point of the exercise. The arch and flatten motion of the spine will increase as you gain greater control of your core.

Pilates

Cartoon representation of the average degrees of curvature of the spinal column. Notice that the cervical and lumbar spine are both lordotic and the thoracic spine and sacrum are kyphotic. We seek to "lengthen" or flex the  lordotic curves when we imprint.

Pilates is a mind body exercise system that works to develop a strong and stable core from which movement can then occur. Pilates referred to the core muscles of the abdomen, the lower back, pelvic floor, and a few others as the "Powerhouse." At SOMA Movement Studio we teach contemporary Pilates so we teach clients to exercises in neutral and imprinted spine positions

The neutral spine is just that, the natural curvature of your cervical (neck), thoracic (upper back, attached to ribs), lumbar (lower back), and sacrum/pelvis as an extension of the spine. There are "normal ranges" for spinal curves that are measured by the angles your vertebral bones make when measured off of x-rays, but that is too detailed for this discussion. What is important is to realize that just because the spine is neutral does not mean that it is relaxed. This one way that the neutral spine in Pilates differs from the neutral spine in Hanna Somatic Movement. Pilates teaches that the core should be engaged to support the spine in its most neutral position. That means that when you do a Pilates exercise, your core is never "off." It is always engaged.

These are muscles of the "core" including the three layers of abdominal muscles, the external oblique, internal oblique and the transversus abdominus. What is not illustrated is the differing direction of muscle fibers that result in compression of the abdominal contents and support of the spinal column.

So, how do we engage the core? There are different types of muscles that make up the core musculature; some of which can be voluntarily (i.e. you can engage/contract them by thinking about it) and others that are at least in part, engaged through involuntary, or reflexive signals from the nervous system. The abdominal wall is made up of three layers of muscles from outer to inner being the external obliques, internal obliques, and the transversus abdominus (TVA for short). The external and internal obliques are easy to find and activate, the pull your rib cage and pelvis towards one another. The fibers of the TVA encircle your abdomen like a corset with fibers running all the way from your back, around your sides, to just a few inches shy of your midline in the front. The TVA is best engaged through active, slow exhalation against resistance (imagine flowing up a balloon or breathing out through pursed lips) to compress the abdominal cavity contents while your lungs deflate. This compression by the TVA provides support to the lumbar spine and works best in conjunction with pelvic floor activation to further support the abdominal contents. Core activation is a lot of work, right? And we still haven't moved.

Now to imprint. Imprint is similar to flattening in Hanna Somatics as the lumbar spine flexes as a result of abdominal muscle activation. However, as the goal of imprinting is to place the spine in a stable, protected position for exercise, rather than mobilizing and gaining dynamic control of the core muscles as in Somatics. The degree to which the lumbar spine flexes (flattens) is less so the goal is not to press your back into the floor. If neutral is zero, the arch in Somatics is +10 and the flatten in Somatics is -10, then Imprint moves from a neutral spine (position) zero to a -5 to -8 position depend on how much of an imprint the exercise requires.

Portrait of Joe Pilates with "scooped" abdomen where the transversus abdominus and obliques are activated, the abdomenal muscular corset compressed and lifted in and up.

To return to neutral the mobilizing abdominal muscles (obliques/rectus abdominus) release slightly to allow the lumbar spine to return to its neutral posiition in space, however, the goal is to maintain TVA and pelvic floor activation throughout, even when in neutral. Easier said than done.

In Classical style Pilates, students are taught to "scoop" the abdomen rather than imprint. The scooping maneuver is a more pronounced version of the imprint where on an exhalation, the TVA is activated, compressing the abdomen down and then additional contraction to pull the abdomen up and in towards the rib cage. The flattening of the lumbar spine (more often referred to the lengthened lumbar spine in Classical Pilates) is more pronounce as the abdominal muscles allow your spine to relax into a deeper flexion which allows for greatest activation of the "powerhouse."

GYROTONIC Expansion System

The GYROTONIC Arch and Curl actually refers to the position of the pelvis rather than the spine. The pelvis is made up of three bones; two ilia (plural of ilium) on either side and a sacrum in the back with is a curved, keystone shaped bone that connects the spine to the pelvic ring. In a sitting position, when you extend your pelvis the pubic symphysis (the middle front part of your pelvis, right above the genitals) rotates downwards and the sacrum lifts. As the sacrum is an extension of the spine, the spine follows suite and also extends (arches) while the rest of your spine lifts up and lengthens. The curled position refers to flexion of the pelvis where the pubic symphysis rotates upwards and the sacrum rotates down downwards towards whatever you are sitting on and the lumbar spine flexes to follow the sacrum. There is a lot more that goes into creating the Arch and Curl movement, but that is the bare basics of how the bones of the pelvis move.

Schematic representation of some of the musculature around the pelvis that is utilized for the GYROTONIC basic, seated Arch and Curl movement. Notice the involvement of the core muscles, psoas, as well as muscles of the legs all of which are used to maximize mobilization of the pelvis and spine.

If neutral position of the lumbar spine is zero and Somatics took your lumbar spine from  a +10 arch to a -10 flat, GYROTONIC methodology will take you +20 arch to a -20 curl (the goal being to reverse the curve of the lumbar spine). Because the GYROTONIC methodology utilizes the full pelvic floor, gluteal muscles, and position of the legs to rotate the pelvis from the arch to curl (extended to flexed) positions, the range of motion achieved through the lumbar spine (and the rest of the spine for that matter) is greater. Additionally, the basic arch and curl is done in a seated position rather than supine (lying on your back) so the floor does not get in the way of movement (conversely, you have to support yourself through the exercise, rather than the floor supporting you). 

Summary

Hopefully this summarizes some of the similarities and differences between the some of the movement disciplines that are offered at SOMA Movement Studio. In general if someone is really tight though their lower back it is generally most efficient for clients to start with Hanna Somatic Movement to gain voluntary control of their core muscles and the ability to coordinate movement with breath before moving on to Pilates and the GYROTONIC Expansion System. We find that Hanna Somatics, Pilates, and GYROTONIC methodology are wonderfully complementary techniques for achieving strength, flexibility, and freedom of movement through the spine. As Joe Pilates said, You're only as old as your spine feels.

SOMA Movement Studio does not "treat" acute low back pain or injuries nor can we accept health insurance as a form of payment. We will however work with your physical therapist, chiropractor, or other health care professional to develop a post rehabilitation exercise program to meet your individual needs. If you have questions about integrating movement-based fitness into your post-rehab recovery, give us a call at (860) 470-MOVE (6683).

Nerdilates (AKA Pilates for Nerds): Reciprocal Inhibition and the Illusive Psoas Release

We are going to geek-it-out for this post and talk a bit about how movement happens and conversly, what happens to our bodies when we don't move normally.

Let's talk about something simple first; elbow flexion and extension. The ulno-humeral joint (humerus is the upper arm bone, the ulna is one of the two forearm bones, the one on the side of your pinky) of the elbow is a simple, hinge joint. Your biceps contracts, the elbow flexes (think bicep curl). Your triceps contracts, your elbow extends.

What we don't normally think about is something called reciprocal inhibition. In order for your elbow to flex when your biceps contracts so you can do a biceps curl, your triceps ALSO has to SIMULTANEOUSLY relax and lengthen to allow the motion to happen. When you then go to extend the elbow and your triceps contracts and shortens to pull your arm straight, the biceps has to SIMULTANEOUSLY relax and lengthen to allow the elbow to straighten/extend. The signal from your brain to the relaxing muscle is referred to as reciprocal (opposite) inhibition. In otherwords, the antagonist muscle is inhibited to allow the agonist muscle (the muscle causing the movement) to contract.

So, what happens when reciprocal inhibition does not work normally. We will use another pair of agonist/antagonist muscles as an example. Say for some reason, your pecs (pectoralis major/minor) and chest muscles got really tight from working on the computer. The muscles that oppose the pecs should be receiving a signal to relax as a result of the constant signal the pecs are receiving to stay tight. So, your rhomboids, muscles of the back that function to bring the shoulder blades together towards the spine, get a signal to relax. What happens next? The pecs continue to tighten, pulling your shoulders further forward, sending more reciprocal inhibitory signals to the rhomboids to relax, which in turn allow the shoulder blades to slide outwards and forwards, eventually leading to rounded, tight shoulders. More on posture in a future post.

The psoas major is an interesting muscle that attaches to the vertebrae of the lumbar spine, travels through the pelvis to attach to the upper femur. Its position in the body contributes to stabilization of the lumbar spine.

Now for the subject of this blog post. The psoas major is a relatively long muscle that connects the lumbar (lower) spine to the femur (thigh bone). The function of the psoas is traditionally thought to flex the hip, though this action has been called into question by modern anatomists and kinesiologists (people who study how muscles move) and now it is thought to have more of a stabilizing effect on the lower back/lumbar spine. In some people (actually lots of people), the psoas muscle is shortened and tight.

The psoas muscles is really hard to isolate and work on eiher through exercise or bodywork. It lies super deep relative to other muscles so any type of psoas massaage is usually uncomfortable and painful because the therapist has to get WAY deep in your groin and belly to access the fibers of the psoas. Even if you can get to the psoas muscle with massage, the psoas is ofen very tender to the touch so psoas massage is uncomfortable to put it mildly. Many muscles function in concert with the psoas so it is near impossible to isolate the psoas through exercise.

However, the psoas can be accessed and relaxed indirectly through reciprocal inhibition. Try this. Lie down on your back with your feet a little more than shoulder width apart and a low pillow or mat supporting your head. Have a clock or a stopwatch near by that you can see without moving or sitting up. Now that you are comfortable, squeeze/contract your tush as hard as you can and hold it for a minute. That gluteus maximus needs to be contracted to the MAX. This is easier said than done. If you are really squeezing hard, your butt should really be burning by 15 seconds. After 30 seconds, re-engage your glutes, squeeze harder. You should really be hating the fact you found this article by 45 seconds. When you reach a minute (if you can), you can relax.

The psoas major and gluteus maximus work together as an agonist/antagonist pair of muscle to balance the pelvis relative to the lower (lumbar) spine. When the psoas is tight and shortened, the gluteus maximus is often weak and lengthened. By strengthening and using the glutes, we can send an inhibitory signal to the psoas to begin to re-establish balance.

Get up now and walk. If you really did a good job squeezing your glutes, your psoas should have gotten a strong inhibitory signal from your brain, and you should have a wonderful, open feeling through the front of your hips as you walk. This is the reciprocal inhibition psoas release.

This open feeling will go away unless you then follow up this posas release with some kind of gentle, coordination movements to take advantage of your newly discovered, lengthened psoas and learn how to control it so it does not get tight again. Whatever you do, do not try and "strengthen" the psoas once you've released it. You're poor psoas has been tight and contracted for who knows how long, it finally gets a change to relax and rest so they last thing it needs immediately after being released is vigorous exercise.

At SOMA Movement Studio, we use Hanna Somatic Movement to gain control of the lengthened/relaxed psoas (more on that in future posts) followed by equipment/spring-assisted Pilates to condition and use the psoas without it going back into its shortened, tight state (notice I did not say strengthen). Otherwise, use the reciprocal inhibition psoas release whenever you want that open feeling in the front of your hips.

The first time I tried the reciprocal inhibition psoas release, I made it to 40 seconds of glute contraction and had delayed onset muscle soreness (DOMS) the next day. After a week or two, I was easily able to go a minute or two of glute contraction. I do this exercise while brushing my teeth with my electric toothbrush, which pauses every 15 seconds, which I use as a cue to contract my glutes harder. This is a wonderful and gentle way to release/relax the psoas and other hip flexors without having to undergo uncomfortable and invasive massage/bodywork.