Athletic Adaptability: Part 2

In my last post we discussed athletic adaptability in terms of flexibility and versatility. We explored how not respecting our development can lead to compensatory movement patterns and ultimately pain and injury. In this post we are going to look at how we get locked into the sagittal plane, losing our capacity for frontal and transverse plane movements as well as how we can effectively improve the performance of this client type.

Sagittal plane

Being a sagittally dominant animal is only good if we want to move in a linear pattern without a change of direction. However most sports demand athletes to be able to move laterally as well as produce rotational power. Therefore, if an athlete becomes locked in an overly extended pattern (sagittal plane) their performance in a respective sport is going to suffer. So the question becomes how do we get stuck here and can we avoid this from occurring?

The answer is we can absolutely avoid this, but we first have to be an owner of the sagittal plane rather than being owned by it. When an athlete becomes sagittally dominant I immediately consider the sympathetic nervous system and how it may be neurologically causing over-activity within what I call the big three: erector spinae, psoas, and gastroc/soleus complex. I have found over-activity within these muscles tends to lead to poor performance within the posterior chain, or rather athletic chain. The big three can cause a positional change of the pelvis and thorax creating the hamstrings, gluteals, and abdominals to essentially shut down neurologically. So initially, we can see that it becomes about our ability to inhibit the over-activity in the erector spinae, psoas, and gastroc/soleus; so that we can redistribute this neurological energy towards facilitation of the hamstrings, gluteals, and abdominals.

Let’s talk a little bit about functional anatomy and how the big three truly influence the sagittal plane as well as our athlete’s performance in the frontal and transverse planes. Let’s start with the erector spinae, which is a group of 3 separate muscles that are collectively named based off of their function to extend and laterally flex the trunk and neck. If over-active it leads to positionally long and weak hamstrings, gluteals, and abdominals, which presents as an anteriorly rotated pelvis with short and weak hip flexors. This can result in an increase in compressive lumbar forces and general low back pain. Additionally, there becomes a greater challenge to maintain the center of mass because it has been shifted anteriorly.

Now I just mentioned the presence of short and weak hip flexors in an anteriorly rotated pelvis, but these could be over-active. The result again is an anteriorly rotated pelvis with poorly positioned posterior chain musculature. However what does change are the forces at the lumbar, which become more anterior shearing in nature. If we consider Fayette’s law of joint mobility in the lumbar, we know with shear forces comes facet closure via extension, which in turn means less potential for frontal and transverse plane motion. Thus, inhibition of the psoas can not only lead to improved lumbar biomechanics. The fact that it interdigitates with the diaphragm means we have an opportunity to improve respiration and an athlete’s management of air flow during a change of direction.

Don’t think this matters? Let’s look at an average soccer event where there are nearly 1,500 changes

of direction. Think control of the pelvis matters now? If an athlete cannot control their pelvis not only are they having a decrease in performance, but they are wasting energy 2-fold: inefficient respiration and inefficient lower extremity kinematics. The result is an increased injury potential due to a physical stressor beyond the capacity of a positionally weak muscle (hamstring) or beyond the threshold of an over-active one (gastroc/soleus).

Finally, the gastroc/soleus can lead to declines in performance when they become overactive. If these become overactive an athlete may experience limitations in their ankle dorsiflexion. Ankle dorsiflexion seems to be all the buzz in the fitness industry right now, but I believe the resolution is being approached sub-optimally. Right now we see all these posts on improving ankle mobility to improve dorsiflexion and yes in some this is the case, but often from my experience it is the neurological tone within the plantarflexors (gastroc/soleus) that needs to be addressed first. My rationale is that musculature that is already in neurological overdrive is only going to fire more to combat the external stressor of these mobility drills. Will there be improvements? Yes in the short term, but long lasting? Probably not. However, if we can shut down tone first and then attack mobility of the joint it will allow a much greater chance of a lasting resolution. [if !supportLineBreakNewLine] [endif]

Okay, getting off of that tangent and getting back to how the gastroc/soleus can dominant the sagittal plane. If over-active postural changes can be observed, a forward lean will occur and is sustained through an ankle strategy in lieu of the anterior displacement of the center of mass. Now here comes the chicken or the egg; was the anterior displacement from the gastroc/soleus activity causing an anteriorly tilted pelvis or was the anteriorly tilted pelvis the driver of gastroc/soleus overactivity? Regardless of the answer they both need to be corrected for OPTIMAL performance.

To recap, the activity of the big three in the sagittal plane can hugely impact our athlete’s performance for better or for worse. It is our job as performance and movement coaches or as physical therapists to intervene intelligently to create ownership of the sagittal plane. How would you intervene?

To follow is a case example of how I approached an athlete locked in the sagittal plane with pain in multiple body regions.

THE CASE:

John is a weekend warrior who presented with a right shoulder impingement as well as lumbopelvic pain and stiffness. His goals are to resolve all pain as well as return to his recreational activities: basketball, triathlons, and weight lifting. He says anytime he performs reaching based movements: shooting, swimming, or driving he experiences shoulder pain; whereas when he runs his back and hips have pain anytime that he exceeds 2 miles.

Postural assessment:

John presents in an overly extended posture that is illustrates unilateral restrictions in the LE and bilateral in the UE. Grossly he has an anterior left innominate in the sagittal plane with minimal clockwise rotation in the transverse plane. Additionally there is a bilateral rib flare with the left side being slightly more pronounced. The position of the thorax has driven poor scapular position. It is characterized by bilateral scapular abduction with internal rotation as well as anterior tilting via compensatory muscular activity of the lats, pecs, and anterior neck.

Objective Assessment:

Adduction Drop Test: R: -, L: +

Extension Drop Test: R: -, L: +

SLR Hamstring: R: +, L: +

HG IR: + bilaterally, R > L

Shoulder Flexion: + bilaterally, L > R

Apical expansion: + bilaterally, equal

HAdLT: R: 2/5, L: 1/5

Toe touch: +, unable to reverse lumbar curve

So what did I do?

Rehab Objectives:

1.) Create a neutral environment about the sacrum and sternum to allow reciprocal and alternating movement on either side of the body.

2.) Inhibition: bilateral paraspinals, left psoas, bilateral gastroc/soleus as well as bilateral latissimus dorsi and pectoral majors.

3.) Facilitation: right glute max, left adductor, bilateral hamstrings, and bilateral serratus anterior and lower traps

Over the course of 2 sessions we got John to obtain a neutral pelvis and thorax and resolved his shoulder pain and general low back symptoms. We progressed into a resistance training phase to systematically load his tissue to create lasting changes. I gave him a maintenance program including:

1.) 90/90 hip lift/shift with a balloon and right arm reach

2.) Left sidelying knee toward knee

3.) All 4s belly walk

4.) Lat hang with active hamstrings and a balloon

Training Objective:

John's goals:

1.) Maintain shoulder posture and health

2.) Improve level of conditioning

3.) Improve body composition

4.) Achieve a full functional squat

Block 1: sagittal plane ownership (4 weeks)

Blocks 2 & 3: frontal plane flexibility and transverse versatility and power (8 weeks)

To avoid getting too lengthy with this post I only gave the overarching focus of each block. As always, there is more than one way to skin a cat. You can take this model and the concepts discussed to explore how you can create sagittal plane ownership to open up your athlete’s potential. However, if you are interested in the details of John’s program please submit a comment and I will send you what we did to return him to all recreational activity without pain AND at a higher level than before he was hurt.

Remember we must position to perform. Stay moving well!