Arm swing asymmetry: It can be a huge window of education into your client.

Arm swing asymmetry: It can be a huge window of education into your client, if you can get past the dumb stuff we’ve all done (and believed) for decades.
I have beaten you down with arm swing principles over the past few years, sorry about that, but, the beating will continue because it is important to know what arm swing tells you, and what it does not tell you (hint hint for all those improperly coaching arm swing changes). We did an entire tele seminar on the Stage 1 principles of of arm swing (#218) on www.onlinece.com and www.chirocredit.com if you wish to take that archived lecture. Heck $19, how can you lose (see photo).  Arm swing is intimately dependent upon scapular stability, thoracic mobility, breathing, cervical spine function, pelvis stability and clearly ipsilateral and contralateral leg swing not to forget to mention spinal stability. The first signs of spine pain or instability and the counter rotation of the shoulder and pelvic girdles become more phasic, instead of their normal anti phasic nature (moving in opposite directions). This phasic nature reduces spinal shear loads.

Neurologic diseases in their early, middle and late phases can give us a clearer window into how the nervous system is tied together.
Arm swing asymmetry during gait may be a sensitive sign for early Parkinson’s disease.

Here is what this Plate et al study found :
-Arm swing amplitude as well as arm swing asymmetry varied considerably in the healthy subjects.
-Elderly subjects swung their arms more than younger participants. -Only the more demanding mental load caused a significant asymmetry
-In the patient group, asymmetry was considerably higher and even more enhanced by mental loads.
-Evaluation of arm swing asymmetry may be used as part of a test battery for early Parkinson’s disease.

Some facts you should consider:
Parkinson’s Disease will be well advanced before the first signs of motor compromise occurs. So early detection and suspicion should be acted upon early when possible. Reductions or changes in arm swing may be the first signs of neuralgic disease expression and progression. Dual tasking may bring out neurologic signs early, so talk to your clients or have them count backwards to distract the motor programs. Look for one sided arm swing impairment, and when present, be sure to examine all limbs, especially the lower limbs, for impaired function. After all, the arms are like balasts, they can help with postural stability simply by abducting or modifying their swing.  Arm swing changes can include:
– crossing over the body
– more forward sagittal swing and less posterior swing
– more posterior sagittal swing and less anterior swing
– shoulder abduction during swing (and with attributes of the prior two mentioned above)
– less swing with adduction stabilized with torso
– modified through accentuations or dampening of shoulder girdle rotation oscillations, thus less arm swing but more torso swing to protect the glenohumeral and other joints
– and others of course

Arm swing and arm swing symmetry matter. Don’t be a dunce and just train it out or tell your client to do things to change it before you identify the “why” behind it. If it were that simple Ivo and I would have long grown tails and begun eating more bananas. Or maybe we would have already moved to the islands by now. That was random wasn’t it. That’s what Jimmy Buffett said.

“Now he lives in the islands, fishes the pilin’s
And drinks his green label each day
He’s writing his memoirs and losing his hearing
But he don’t care what most people say.
Through eighty-six years of perpetual motion
If he likes you he’ll smile then he’ll say
Jimmy, some of it’s magic, some of it’s tragic
But I had a good life all the way.
And he went to Paris looking for answers
To questions that bother him so.”  -Jimmy Buffett

Hope this helps, now back to that rum.
-Shawn Allen

Gait Posture. 2015 Jan;41(1):13-8. doi: 10.1016/j.gaitpost.2014.07.011. Epub 2014 Aug 8.
Normative data for arm swing asymmetry: how (a)symmetrical are we?  Plate A1, Sedunko D2, Pelykh O3, Schlick C4, Ilmberger JR5, Bötzel K6.
http://www.ncbi.nlm.nih.gov/pubmed/25442669

The Roll of Breathing and Diaphragm Control in Gait, Running and Human Locomotion

In this video you will see many great things. This video of Rickson Gracie is a testament to free fluid movement and body control.  Great athletes do not just practice one thing.  There is some great demonstrations of breathing and diaphragm control at the 3 minute mark, and we will try to parlay this nicely into today’s brief discussion on the Diaphragm.

Abnormal stabilizing function of the diaphragm may be one etiological factor in spinal disorders.  Today we have included a link to an abstract by the great and brilliant Dr. P. Kolar who we have studied under.  It considers the correlation between the dynamics of the diaphragm in posture and chronic spinal disorders.  What they found seemed to indicate that poor diaphragm positioning, posturing and control correlated well in their sampling of chronic low back pain clients. The study found smaller diaphragm movements and a higher diaphragm positioning/posturing.  The study found maximum changes in the rib (costal) intervals and middle areas of the diaphragm which asks one to consider the absolute critical importance of thoracic mobility. Extension, lateral flexion and rotation are frequently reduced in chronic back pain clients but we find it rampant in many clients and athletes.  We also find and encourage you to look for, assess, and normalize your clients abdominal oblique, transverse abdominus and rectus abdominus control.  Failure to properly and adequately anchor the lower rib cage to the pelvis via the abdominal wall (the whole wall, circumferentially around the entire torso to the spine) will result in asymmetrical breathing patterns.  And abnormal breathing patterns lead to abnormal spine motion and mobility. We frequently have to treat and instruct proper breathing patterns to help normalize lateral and posterior rib cage expansion and decent in athletes and clients, particularly those with low back issues but that is not an exclusive group to this problem. Tomorrow we will show you some simple but great videos showing rolling patterns and we will want you to think back to today’s blog post here on how loss of thoracic mobility in extension, rotation and lateral bend as well as loss of symmetrical abdominal skill and strength can impair a primitive movement pattern like rolling. This is a pattern that is first developed as a child to learn to turn over. It is a precursor to pressing up the torso like in a push up, which is of course a precursor to crawling, then cruising and then walking.

See, we were finally able to come full circle !  From breathing and the diaphragm to gait…… it is all connected.  Any faulty strategy or pattern driven into the body, even breathing, can impair gait.  Because with gait we have to attach anti-phasic arm swinging with leg swinging. Anything that disturbs this anti-phasic patterning, such as low back pain, will drive contralateral arm-leg swing to phasic patterning. Don’t think this is important to athletes and humans ? Well, you must have missed our 2 part blog series on Arm Swing.  We provide those links here. Part 1 link and Part 2 link

If you are an athlete, coach, or in the medical movement assessment or gait analysis field……heck, if you study the human body at all and you are not looking at or into arm swing you are not doing what we are doing. And you are missing the bigger boat. So many “gait specialists” and “gait analysis” programs are not even capturing the arm swing let alone looking at it and discovering its critical importance. Did you miss our dialogue on frozen shoulder and impaired contralateral hip dysfunction ?  If you look for it, which many in the therapy world are not, you will see why we treat that opposite lower limb.  Maybe the rest of the folks around the world will catch on in time.  We are slowly getting there, we now have readership in 23 countries, and growing.  If only we had more time, the apocalypse of December 21, 2012 is coming on fast !

The article also found maximal changes in the middle diaphragm areas which suggests looking at the psoas, quadratus lumborum and crus because of their fascial blending into the diaphragm from below.  Thus, investigation of many muscles from below must also be a part of your assessment or training.  But we will save this discussion for another blog post.

We hope you can see that after a year of blog posts (over 500) that you can begin to see the method of our obvious madness.  That being that everything is important for human gait. Remember, we will blend this blog post into the roll assessments you will see on tomorrows post.  So ya’ll come back now……. ya hear ? 

In closing, it is blog posts like this one that we always hope will go viral on the internet. Especially because it has links to two previous articles we wrote on arm swing which we feel are so very important and commonly overlooked.  And we have more arm swing stuff to share, we just need more time.  Consider linking this article to your website, sending it to friends in the fields we discussed. This information is important. It is why we take the time every day to write and share our 40+ years of clinical experience for free. Because the world needs to know this stuff so more people can be helped all over the world.  Consider sharing this with someone or linking it to your Facebook page or website or slap it up on someones forum to create dialogue. Thanks.

The leg bone is connected to the thigh bone…. as the song goes…….

Shawn and Ivo

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here is Kolar’s abstract……

J Orthop Sports Phys Ther. 2011 Dec 21. [Epub ahead of print]

Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain.

Abstract

OBJECTIVES:To examine the function of the diaphragm during postural limb activities in patients with chronic low back pain and healthy controls.

BACKGROUND: Abnormal stabilizing function of the diaphragm may be one etiological factor in spinal disorders, but a study designed specifically to test the dynamics of the diaphragm in chronic spinal disorders is lacking.

METHODS: Eighteen patients with chronic low back pain due to chronic overloading, ascertained via clinical assessment and MRI examination, and 29 healthy subjects were examined. Both groups presented with normal pulmonary function test results. A dynamic MRI system and specialized spirometric readings with subjects in the supine position were used. Measurements during tidal breathing (TB), isometric flexion of the upper or lower extremities against external resistance together with TB (LETB and UETB) were performed. Standard pulmonary function tests (PFT) including respiratory muscles drive (PImax and PEmax) were also assessed.

RESULTS: Using multivariate analysis of covariance, smaller diaphragm excursions (DEs) and higher diaphragm position were found in the patient group (p’s<.05) during the UETB and LETB conditions. Maximum changes were found in costal and middle points of the diaphragm. In one-way analysis of covariance, a steeper slope in the middle-posterior diaphragm in the patient group was found both in the UETB and LETB conditions (p´s<0.05).

CONCLUSION: Patients with chronic low back pain appear to have both abnormal position and a steeper slope of the diaphragm, which may contribute to the etiology of the disorder. J Orthop Sports Phys Ther, Epub 21 December 2011. doi:10.2519/jospt.2012.3830.