What’s wrong with this picture? (Besides the fact that you probably shouldn’t run with your dog on asphalt) 

There’s been a lot of incongruency in the media as of late. This particular gal, with your head rotation to the right is going against the harmony of neurology and physiology. Let me explain…

 This particular gal, with her rotated to the right is going against the way the nervous system is designed to work.

In a post  in the last week or so (the massage cream one and  incongruent movement) we talked about tonic neck responses. When the head is rotated to one side, that upper and lower extremity should extend while the contralateral side should flex. This poor gal is fighting her own neurology! 

 Also note that she really doesn’t have that much hip extension on the right and increases her lumbar lordosis to compensate. Gee whizz. You’d a thought they would have done better…

 So much for the photo op : -) 

What’s wrong with this picture?

 The model is obviously well sculpted and hopefully will paid for the toll that this exercise will be taking on her nervous system overtime. Take a close look at the picture above on the left. Look carefully and what do you notice? Do you see it?

This exercise is neurologically incongruent.  Her right arm is flexed at the same time as her right hip. When does this ever happen in gait?

 Do you remember crossed extensor responses or tonic neck reflexes? If not, see here and here. When we walk the right arm and left leg or flexed while the left arm and right leg are extended. During a tonic neck response, and that is rotated to one side the upper and lower extremity (upper greater than lower) should extend on that side with flexion on the contralateral side.

During a tonic neck reflex, the head is rotated to one side the upper and lower extremity (upper greater than lower) should extend on that side with flexion on the contralateral side. In the picture above her torso is rotated to the left while looking straight ahead which is effectively right neck rotation and her extremities are flexed on that side.

 In the picture above her torso is rotated to the left while looking straight ahead which is effectively right neck rotation and her extremities are flexed on that side.

Who thinks of these things? Certainly not folks that are paying attention to appropriate neurology and physiology!  Oh yeah, and the ad was for massage cream. Jeez…

More Tricks for stretching, part 3

We have been talking about ways to enhance stretching, talking about taking avvantage of reciprocal inhibition (please see part 1 here) and autogenic  (or post isometric) inhibition (please see part 2 here). 

Before we talk about this next one, we need to give you a little background (neurologically speaking). 

Take a look at the picture above and note the posturing of the baby in the 2 positions. These neurological reflexes (or postures) are called symmetrical tonic neck reflexes or responses (STNR’s for short) and were described in animals and men by Magnus and de Kleyn in 1912 (1). This work was later studied and reported by by Arthur Simons in 1916  (2) and later by Francis Walshe in 1923 (3). These were later made popular by Berta and Karl Bobath in the 70’s (who studied Walshes work), whom they are often attributed to (4). 

You next question is “Do these persist into healthy adulthood”? and the answer is a resounding YES (5).

Take a look at the picture above again and note the following: 

  • When the neck is flexed, the fore limbs flex (and the muscles facilitating that, bicep, brachialis, anterior deltoid are contracting) and the hind limbs are extending (relatively), with the glutes maximus, quadriceps, foot dorsiflexors contracting.

  • Note that when the head is extended, the forelimbs are extended and the hind limbs flexed. Think about the muscles involved. Upper extremity tricep, anconeus, posterior deltoid, lower back extensors, hamstrings and foot plantar flexors facilitated.

The reflex is based on the mechanoreceptors in the neck articulations and muscles and are frequently used by us and many others in the rehabilitation field. Generally speaking, looking up facilitates things which make you extend above T12, and flex below T12. Looking down facilitates flexion above T12 and extension below. 

We would encourage you at this point to “assume” these positions and feel the muscles which are active and at rest.

So, how can we take advantage of these while stretching? 

Think about your head position:

  •  If you are standing up and hinging at the hips to stretch your hamstrings (notice we did not say “bent at the waist”; there is a BIG difference in shear forces applied to your lumbar spine) you would probably want your neck bent forward, as this would fire your quads which would in turn ALSO inhibit your hamstrings, in addition to the STNR inhibiting the hamstring. 

  • If you were in a hip flexor stretch position, you would want you head up, looking at the ceiling to take advantage of the reflex. 

We are confident you can think of many more applications of this reflex and trust that you will, as it can apply to both upper and lower extremity stretches. Just remember that this reflex is symmetrical and will affect BOTH sides. Of course, there are reflexes that only effect things unilaterally, but that is the subject of another post. 

The Gait Guys. Helping make you better at what you do for yourself and others and assisting you on using the neurology that God gave you. 

  1. http://www.worldneurologyonline.com/article/arthur-simons-tonic-neck-reflexes-hemiplegic-persons/#sthash.6QS3Eat3.dpuf 
  2. Simons A (1923) Kopfhaltung and Muskeltonus. Ges.Z. Neurol.Psychiatr. 80: 499-549.
  3. Walshe FMR (1923) On certain or postural reflexes in hemiplegia, with special reference to the so-called “associated movements.” Brain 46: 1-37. 
  4. Janet M. Howle . Symmetrical Tonic Neck Reflex in Neuro-developmental Treatment Approach: Theoretical Foundations and Principles of Clinical Practice.   NeuroDevelopmental Treatment, 2002  p 341 ISBN 0972461507, 9780972461504
  5. Bruijn SM1, Massaad F, Maclellan MJ, Van Gestel L, Ivanenko YP, Duysens J. Are effects of the symmetric and asymmetric tonic neck reflexes still visible in healthy adults?Neurosci Lett. 2013 Nov 27;556:89-92. doi: 10.1016/j.neulet.2013.10.028. Epub 2013 Oct 21.

Subtle clues often provide the answers.

We like yoga as much as anyone else. We saw this picture on the latest cover and couldn’t resist making a few comments on this pose.

Yoga has many benefits. Our understanding is that in addition to the cognitive and spiritual effects of yoga, is that it helps to build your core.

 At first look you may say that this woman has a few issues:

  • she has a right pelvic shift and a left body lean
  • She has slight head rotation to the right and a slight left head tilt
  • you may have noticed that she appears to have more tone in the musculature on the right side of her face than on the left.   Just look at the nasolabial fold as well as the corner of her mouth any area of wrinkling underneath her left orbit.
  •  You may have also noticed the subtle flexion and lack of external rotation of the right hip.

 You may go on and think that she has a week right gluteus medius as well as an overactive quadratus lumborum on the left-hand side which may be causing the pelvic shift. The head tilt may be in compensation for the right side gluteus medius weakness and the subtle rotation may be an attempt to engage a tonic neck response. ( a tonic neck response is  ipsilateral extension of the upper and lower extremity to the side of head rotation with contralateral flexion of the same counterparts.

 You may have also noticed that the toes of the right foot are not dorsiflexed and that her hair appears to be flowing on the right side, and this is not the case at all, but rather she is either standing on a sloped surface or on the downward phase of a jump. According to the magazine it is the latter.  If you caught this at first then congratulations: you are sharper than most. If not remember to always look for subtle clues.

 Like Sir Topham Hat says in Thomas the Train: “  You didn’t get the whole story. What really happened is what really matters.

So why the mild facial ptosis on the left side? She could have had an old Bells palsy, or other form of facial paresis. Note that mostly the lower portions of the (left) face are affected (ie, below the eye). We remember that the upper portions of the face receive bilateral innervation but lower portions of the face unilateral innervation, from the contra lateral facial motor nucleus; this is why it could be a mild upper motor neuron lesion (micro infact, lack of cortical afferent input) and not an lower motor neuron lesion (like Bells Palsy). Why is this germane? Or is it not?

Stand in front of a mirror. Jump up in the air trying to assume the same pose as this woman does and what do you see.  Make sure that you jump up from both legs and then bring one leg over and your hands in front of you in the “praying position”. You may want to have a friend take a snapshot of you performing this. You will notice that you have contralateral head rotation,  a pelvic hike on the side opposite the leg that’s extended and a head tilt to the side that is flexed.  You are attempting to stabilize your core as you’re going up and coming down.

What we are witnessing is a normal neurological phenomena.  This gal merely seems to have some limited external rotation of her left hip. Now perform the same maneuver again but this time don’t externally rotate your leg as far as this woman does and what do you see. You should’ve seen an increase in the aforementioned body postures.

Subtle clues are often the key. Keep your eyes and ears open. 

The Gait Guys. Helping the subtle to become everyday for you, with each and every post.