Saturday 14 March 2015

Why do I insist on making sure people can touch their toes?

As a number of my client's will attest to, I am always adamant on ensuring that people can touch their toes from a standing position. "What has this got to do with my sore knee" is a common question I get asked when exposing this fundamental limitation in one's movement pattern repertoire. You see, our current knowledge of how the body works is growing exponentially. It is now widely acknowledged, thanks to the ground breaking work of pioneers in the field such as Gray Cook and Lee Burton, that the brain and the central nervous system does not tend to activate individual muscles in isolation when performing a designated movement - this would be simply inefficient and require an expansive amount of work and energy. Rather, the brain relies on movement patterns (or patterns of movement if you like). These movement patterns are developed on a hierarchical model, and are actually learnt through growth and development. As a newborn, you are lying supine. One of the first movements that your perform is cervical spine flexion and rotation (i.e. lifting your head up off the floor and looking left or right). This movement pattern then evolves into rolling left to right, as you learn to bring your arm across your body to faciltate this movement. Next, you are on your stomach - you prop up onto bent elbows and learn how to creep. This then becomes crawling. Before you know it, you can sit. Standing is the next progression. This forms the building blocks for walking, which progresses to running, etc. This is a drastic oversimplification of neurodevelopmental kinesiology - but the overarching theme here is that you need to develop one movement pattern to a proficient standard prior to progressing to the next milestone. Have you ever seen someone progress from sitting to walking bypassing standing in the process?

What does this all have to do with touching your toes??? The most common explanation I get from clients who cannot touch their toes is that their hamstrings are 'tight' and they need to stretch more. Whilst this can be true for a small minority of people, anecdotally, I find that the issue is not that of a lack of muscle length or flexibility - it's simply a 'software' issue where the client is not reflexively (i.e. automatically) engaging their core in a feed-forward manner. This causes the brain and central nervous system to adopt a compensatory strategy to ensure equilibrium when one attempts to touch their toes from standing in order to prevent them face planting into the ground. A common strategy that is employed is to activate the hamstring and calf musculature to act as 'brakes' to prevent this from occurring. The way to address this 'dysfunctional' movement pattern is remarkably simple (I will post a common strategy very soon). In essence, the client is not engaging their core quick enough (note that it is not a lack of core 'strength' - which is one of the most common myths out their today, witnessed by the number of people who implement core 'strengthening' into their exercise routine; rather it is simply a timing and coordination issue - which we refere to as 'motor control.' No amount of planks, sit-ups, crunches, etc. will get your core muscles to engage in an anticipatory manner - which is the essence of their functional role).

Now, if we reconsider the above mentioned concept of a neurodevelopmental hierarchy, the client has a core 'timing' issue whilst standing. Remember that standing forms the building blocks to walking, which is imperative prior to running and other higher level activities. Put simply, if your core is not engaging properly with both feet statically on the ground in standing, there is no way in hell it will be working properly when running - which is much higher up the movement pattern chain thanks to its dynamic alternating single-leg support nature with a plyometric flight phase between.

Take home message here: touching your toes in standing is essential for a normal, healthy and functional movement pattern repertoire. Rarely is stretching the answer (in fact, I would controversy say that stretching will likely cause you far greater harm than not stretching in this situation) - fixing the 'software' issue of a mis-firing core is the first step, prior to reintegrating this function back into your more complicated movement patterns higher up the movement tree.

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