By Jason Nelson. NASM – MT, CPT, CES, PES, SFS.
Human movement happens in the sagittal, frontal and transverse planes. Due to effects of modern living and technological advances, most of our daily movements occur predominantly in the sagittal plane. Sitting at work, typing and the ever smarter smart phones, to name a few, greatly contribute to our activity levels or lack thereof, reducing our functional capacity leading to dysfunction. When we do decide to move, poor neuromuscular control, muscular imbalances caused by pattern overload, shortened and weakened muscles all contribute to the cumulative injury cycle.
Let’s take a closer look at this. The body is a survival mechanism and will initiate self-repair. Pattern overload causes muscular imbalances which then leads to soft tissue trauma. This is the first step in the cumulative injury cycle. An example of pattern overload can be seen in distance runners who experience Iliotibial band tendonitis also known as runners’ knee. Sitting for prolonged periods as seen in office employees shortens the hip flexors which can eventually lead to altered reciprocal inhibition of the gluteus maximus which may contribute to lower back pain not only while exercising but also while performing normal everyday tasks. Trauma then creates inflammation in the body which activates the body’s pain receptors. For example in runners’ knee pain is felt at the knee because of higher concentration of pain receptors at the joint.
This is a protective mechanism is designed to limit movement at the affected area. The pain receptors increases muscular tension or may cause a muscle spam.. Muscle spindle activity creates a microspasm which then leads to muscle adhesions ( knots) in the soft tissue. If left untreated, these adhesions decreases normal elasticity of the soft tissues leading to altered length tension relationships, altered force couple relationships and arthrokinematics dysfunction. This can lead to synergistic dominance, altered force couple relationships and altered movement patterns. For example, if there is altered joint movement at the knee it will affect structures both inferior and superior across the entire kinetic chain.
For instance will be how does this affect the average “gym goer”? They will omit exercises mainly at the hip weakening the posterior chain In turn this will further alter length tension relationships and causing trauma and injury to surrounding structures. Core strength and stability during functional movements will be compromised. Now put some high heels on and tilt the pelvis anteriorly and the stage is set for lower crossed syndrome.
In conclusion the cumulative injury cycle can limit exercise selection and those who push through the pain will develop trauma in one or more structures. Improper exercise technique in the absence of kinetic chain dysfunctions can also lead to cumulative injury. Normal everyday tasks will be accompanied by pain and the human body will always choose the pain free path and the path of least resistance. It is also imperative that fitness professionals through an integrated fitness assessment address the components of the cumulative injury cycle. A properly designed integrated flexibility program coupled with the appropriate exercise selection and progressions can restore extensibility in the entire normal soft tissue complex and correct muscular imbalances.