Stalking the Wild Psoas

[txmarinemom]

But is there any therapeutic reason to stretch muscle?

Sorry, Sharon: I didn't even notice the link I posted contained a bookmark that didn't pick up where I thought it did.

The section "What Happens When You Stretch" gives an overview of what happens (therapeutically) during a stretch:

The stretching of a muscle fiber begins with the sarcomere (see section Muscle Composition), the basic unit of contraction in the muscle fiber. As the sarcomere contracts, the area of overlap between the thick and thin myofilaments increases. As it stretches, this area of overlap decreases, allowing the muscle fiber to elongate. Once the muscle fiber is at its maximum resting length (all the sarcomeres are fully stretched), additional stretching places force on the surrounding connective tissue (see section Connective Tissue). As the tension increases, the collagen fibers in the connective tissue align themselves along the same line of force as the tension. Hence when you stretch, the muscle fiber is pulled out to its full length sarcomere by sarcomere, and then the connective tissue takes up the remaining slack. When this occurs, it helps to realign any disorganized fibers in the direction of the tension. This realignment is what helps to rehabilitate scarred tissue back to health.

Personally, I can't imagine I've made it this far in life playing sports - and with scoliosis - without some scarring/adhesions in muscle/fascia. Remember, every bundle of muscle - and every bundle of bundles - is wrapped in fascia. If the muscle becomes short, the fascia is right there ... stuck to it.

Stretching is definitely a daily part of my life (as is regular deep tissue/sports massage), and I can tell a BIG difference when I don't. I lost some flexibility about a year after surgery (laziness), and had all kinds of weird aches and pains until I got busy on it again.

As far as specific examples of therapeutic reasons to stretch, I think I mentioned in the Rolfing thread a week or so ago about pain between the shoulder blades (in the rhomboids) that is actually caused by tight pectoralis muscles. That dorsal pain can specifically be effected by stretching the anterior of the body.

Also, the detrimental effects of taut hamstrings, is a good example applicable to post-op scoliosis patients.

Regards,
Pam

[skevimc]

[COLOR="Navy"]The info in this website (out of Australia) includes a simple stretching exercise. I'll be adding this exercise to my routine - will report back ;-)

It's a decent stretch but they describe it wrong. You don't lie prone (face down). It's supine (face up).

The psoas can torque your spine to the right or left, pull it forward and twist the pelvis into various distortions. Frequently one psoas will shorten and pull the spine and/or pelvis to our dominant side. The distortions of the spine and pelvis can also show up as a short or long leg. This all results in scoliosis, kyphosis, lordosis, trigger points, and spasms in back muscles trying to resist the pulling of the psoas.

It can also pull the spine downward, compressing the facet joints and the intervertebral discs of the lumbar spine. The pressure can cause the discs to degenerate, becoming thinner and less flexible. This degeneration makes the discs more susceptible to bulging or tearing, especially with twisting and bending movements. http://www.bowen.asn.au/bowen-therap...and-back-pain/

This is an excellent candidate hypothesis for why torso rotation can be harmful to discs in people including those with scoliosis. I wonder if this is what Schroth claims.

I question the amount of rotational torque the psoas actually exerts. It seems more likely that it stabilizes during rotation as opposed to actually rotating.

If Schroth therapists use this rationale to advise against rotation, then they might as well advise against forward and lateral bending as the psoas is probably a primary mover for these movements.

Trunk rotations can certainly damage discs. So can forward/back bends and lateral bends and axial force (compression). Rotational injuries rank third in low back injuries behind forward/back flexion and lateral bending. However, most injuries happen as a result of combined movements, e.g. extension plus rotation. But as I recall, rotation alone puts significantly less force on the disc compared to other motions.

Major point being... a bad disc is a bad disc. ANY movement will place it at risk for damage.

I would tend to think there could be some merit in that (especially with older spines which have had time to develop secondary problems). Leads me to question how the MedX effects the psoas compared to other rotational exercise. Maybe Kevin can comment. Good thought Sharon.

Aside from actually doing a study, it's all speculative. It would be a good study though. A bit difficult, but it is possible to measure the relative contribution of a muscle during a given task. There's a really cool MRI technique you can use to get this information.

Sharon, I'm not sure I'm fully understanding your question, but I'm going to answer what I think you're asking. Correct me if I missed the mark ...

You're right that (normal) ligaments stretch only minimally (a good thing since we want them to hold our joints together). When they do overstretch, I'm sure you know hypermobility is indicated.

Tendons stretch considerably more as they join muscle to bone.

I don't think stretching is irrelevant: Muscles do contract and relax, but they can also lengthen in response to stretching.

Here's one of the clearest explanations I've ever seen ...

Regards,
Pam

That's a pretty good link with some good basic information on it.

The stretching debate is as vibrant as ever. Does it help? Does it hurt? Is it completely benign? For sure, stretching affects the muscle fibers. There is a hypertrophy model in animals using a prolonged stretch (holding a joint/muscle in a casted stretch for several days) that induces muscle growth. It basically acts as an anabolic stimulus, much like weight training. As well, it can also make the muscles physically longer, although this effect is much smaller. But this is chronic loading.

I like the 're-organizing' concept of short term stretching. I'm at a loss of what the literature says about that specifically though.

[Pooka1]

I question the amount of rotational torque the psoas actually exerts. It seems more likely that it stabilizes during rotation as opposed to actually rotating.

Which muscles are involved in rotation?

Major point being... a bad disc is a bad disc. ANY movement will place it at risk for damage.

Is that an argument against PT for scoliosis? Don't the discs show damage first and then the vertebrae show damage? If so then any scoliosis curve assumes disc damage, yes?

[txmarinemom]

Hey, skevimc ... glad you came to the party.

There is a hypertrophy model in animals using a prolonged stretch (holding a joint/muscle in a casted stretch for several days) that induces muscle growth. It basically acts as an anabolic stimulus, much like weight training. As well, it can also make the muscles physically longer, although this effect is much smaller. But this is chronic loading.

Would you be so kind to explain how lengthening/strengthening can both be achieved? I guess what confuses me most is there's not the expected recovery time I thought it took to build muscle.

(... and now I just have a bunch of questions for you - LOL)

Is the hypertrophy a result of muscle injury consistent with weight training?

Which effect is seen first?

If hypertrophy is not initially noted, is muscle force reduction (or atropy, for that matter) observed for any length of time in the post-loading period?

If muscle gain is not initially measurable, does it appear in a manner/timeframe consistent with normal weight training?

Did these animals have a special diet?

Thanks for bearing with me!

Regards,
Pam

[skevimc]

Which muscles are involved in rotation?

Prime movers are internal and external obliques. There is EMG activity in the pecs, lats and sometimes rhomboids I think. (I question how much those muscles are actually involved in rotation versus activation based on the rotation apparatus.

Paraspinal muscles are involved, but primarily as a stabilizer. That's indicated by the orientation of most of these, i.e. they run up and down the spine, thus when they contract they will extend or flex the spine. The multifidus, which many people say is heavily involved in rotation MIGHT contribute ~3% of the torque. Again, the orientation of the muscle does not allow it to have a huge rotational component.

Is that an argument against PT for scoliosis? Don't the discs show damage first and then the vertebrae show damage? If so then any scoliosis curve assumes disc damage, yes?

You'd like to think that wouldn't you!! (delivered in Vizzini's voice from Princess Bride)

In reality, it would be an argument against all movement if there were any type of injury... ever. The 'trick', as I see it, is that with proper strengthening/form/technique the body can move and function without creating further injury. And certainly, there is a limit to what exercise/PT could do.

I am not aware of the amount of disc damage per se to AIS discs, although I know about the deformation due to asymmetric growth. I don't know if an AIS wedged disc would be damaged or just misshapen.

[txmarinemom]

Is that an argument against PT for scoliosis? Don't the discs show damage first and then the vertebrae show damage? If so then any scoliosis curve assumes disc damage, yes?

Just my $.02, Sharon ... (which isn't much ;-)

Unless I've just missed too much of other conversations, I didn't hear that as an argument against PT for scoliosis or "not scoliosis".

It kind of sounded to me like "You're as likely to cause disc protrusion drying your hair as you are working out" (and I use that specific example because the damn blowdryer got mine 90% of the time when I was pre-op).

I'm curious: On what basis did you form the assumption disc damage is a given with scoliosis? Same with vertebral damage.

Although my vertebrae were certainly not in alignment, they *were* structurally sound (as far as individually). Since they are no longer "individual", I'll refrain from speculation on their current state.

My discs only began to protrude after a severe whiplash in '96. Although they did tend to protrude more often as the years went on, it seems normal to me previously protruded discs would be prone to ~subsequent~ protrusion ... especially in a segment of my spine that was compromised by the compensatory curve.

I (knock on my wooden head) haven't had a single disc-related pain since fusion - and I haven't altered my activities. The only thing altered was my compensatory curve.

*addendum: ... which makes me believe my discs aren't truly damaged ...

Regards,
Pam

[skevimc]

Hey, skevimc ... glad you came to the party.



Would you be so kind to explain how lengthening/strengthening can both be achieved? I guess what confuses me most is there's not the expected recovery time I thought it took to build muscle.

(... and now I just have a bunch of questions for you - LOL)

Is the hypertrophy a result of muscle injury consistent with weight training?

Which effect is seen first?

If hypertrophy is not initially noted, is muscle force reduction (or atropy, for that matter) observed for any length of time in the post-loading period?

If muscle gain is not initially measurable, does it appear in a manner/timeframe consistent with normal weight training?

Did these animals have a special diet?

Thanks for bearing with me!

Regards,
Pam

I'll try to address the other questions as well, but for now I'll say that the mechanical stretch of muscle (also seen with weight lifting) releases hormone called Insulin-like Growth Factor (IGF) (produced in the liver). There is a special 'muscle' version of it, that is synthesized, released and utilized by the muscle called Mechano-Growth Factor (MGF). IGF and MGF act along the same hypertrophic pathway (PI3K/Akt/mTOR). The end result of this pathway is protein synthesis, aka muscle growth.

It's definitely confusing. There are a handful of things like this that when scientists discover this stuff we're like WTF!!! That doesn't make sense. This method of hypertrophy isn't really viable in humans because I'm pretty sure the antagonistic muscles become atrophied, e.g. if you casted your arm in extension and stretched your bicep, after two weeks like that, your bicep would be larger but your tricep would be much smaller. (not to mention your elbow joint would be more than a bit stiff.)

The lengthening is only by a few sarcomeres added in sequence. It's not really significant to the overall muscle length.

[Pooka1]

You'd like to think that wouldn't you!! (delivered in Vizzini's voice from Princess Bride)

That would require that I have a horse in that race or a dog in that fight. I have neither. I am plodding along, trying to follow the logic wherever it goes. I have been forced to become interested in scoliosis because of my twin daughters. So I am. Of course is very difficult for a bunny with no relevant training in this field to follow the logic at times. Hence my incessant questions.

And certainly, there is a limit to what exercise/PT could do.

Not convinced everyone accepts there is a limit.

I am not aware of the amount of disc damage per se to AIS discs, although I know about the deformation due to asymmetric growth. I don't know if an AIS wedged disc would be damaged or just misshapen.

Good question. I think we need a disc expert.

[Pooka1]

Just my $.02, Sharon ... (which isn't much ;-)

Unless I've just missed too much of other conversations, I didn't hear that as an argument against PT for scoliosis or "not scoliosis".

It kind of sounded to me like "You're as likely to cause disc protrusion drying your hair as you are working out" (and I use that specific example because the damn blowdryer got mine 90% of the time when I was pre-op).

Yes I think you are right that he meant it that way. I am just trying to see where that idea can be taken though.

I'm curious: On what basis did you form the assumption disc damage is a given with scoliosis? Same with vertebral damage.

I thought that was known. Disc wedging precedes curving which precedes wedging (except perhaps in hysterical scoliosis cases with very long curves involving almost every vertebra). I am taking disc wedging to equal disc damage. Maybe that is wrong.

Also I am not clear on at what point wedging occurs. Is it inevitable above a certain Cobb angle? I assume my kids have some wedging given their Cobb angles but maybe that is wrong.

Although my vertebrae were certainly not in alignment, they *were* structurally sound (as far as individually). Since they are no longer "individual", I'll refrain from speculation on their current state.

Okay so you made it up to ~50* without any wedging. Maybe my kids vertebrae were not wedged then.

My discs only began to protrude after a severe whiplash in '96. Although they did tend to protrude more often as the years went on, it seems normal to me previously protruded discs would be prone to ~subsequent~ protrusion ... especially in a segment of my spine that was compromised by the compensatory curve.

I (knock on my wooden head) haven't had a single disc-related pain since fusion - and I haven't altered my activities. The only thing altered was my compensatory curve.

Isn't there other disc damage besides protrusion? I was told I had a crushed disc but I wonder if that is an actual condition.

[txmarinemom]

Yes I think you are right that he meant it that way. I am just trying to see where that idea can be taken though.

We all know this train can derail at annnnny moment.

I thought that was known. Disc wedging precedes curving which precedes wedging (except perhaps in hysterical scoliosis cases with very long curves involving almost every vertebra). I am taking disc wedging to equal disc damage. Maybe that is wrong.

Also I am not clear on at what point wedging occurs. Is it inevitable above a certain Cobb angle? I assume my kids have some wedging given their Cobb angles but maybe that is wrong.

I'd really like to see the background on this. I'll sort of buy that discs can get "wedged" (although I don't agree that's the right word because they're somewhat malleable) when they're in a jam - i.e., a stack of misaligned vertebrae. However, I'm not convinced they retain that shape after correction due to the toothpaste-like consistency of the nucleus. The outer annular surface of the disc simply holds the "goo" in.

I'm going to completely pass on whether some Cobb angle dictates a disc is "stuck in a certain shape". Never heard that (nor have I ever been told that by any doctor ... ortho, PM, etc.).

Maybe if DDD is present - and the discs are dehydrated ... MAYBE. I don't know. It seems with age it would be more likely.

Isn't there other disc damage besides protrusion? I was told I had a crushed disc but I wonder if that is an actual condition.

My discs were merely (I can say "merely" *now ;-) protruding 3mm. If yours was "crushed" (I seem to recall they let you naturally fuse), it was herniated.

Quite simply ... your goo came out - where mine did not.

Pam

[Pooka1]

My discs were merely (I can saw "merely" *now ;-) protruding 3mm. If yours was "crushed" (I seem to recall they let you naturally fuse), it was herniated.

Quite simply ... your goo came out - where mine did not.

Pam

YES! I think that is what happened! My recollection of the radiograph is that there was no space in-between the two vertebrae and that they were expected to fuse on their own. I think that happened because I have had exactly zero pain after that (1991) until very recently.

In re wedging discs, I known I read that and was very surprised that discs could be wedged given they are bags of "goo" as you state. Maybe I misunderstood but I was very surprised.

[mamamax]

It's a decent stretch but they describe it wrong. You don't lie prone (face down). It's supine (face up).

Now that is funny! Guess someone should write them :-)

I question the amount of rotational torque the psoas actually exerts. It seems more likely that it stabilizes during rotation as opposed to actually rotating.

I'd be interested to know that too Kevin. Found this (but don't know how to read it):
http://www.thefreelibrary.com/Determ......-a020849089

Found this from some Kinesiology Lecture notes (University of Wyoming):

F. PSOAS INSUFFICIENCY:
When iliopsoas is tight the pelvis is rotated downward and lumbar lordosis in increased, displacing the pelvis anteriorly. This loads the hamstrings, causing the knees to bend. Quads become statically contracted calves hypertrophy and decrease in dorsi flexion is seen at the ankle. Increased dorsal kyphosis and tightening of erector spinae and thoracolumbar fascia and PLL. Decreases forward motion and hip joint and produces weak abdominal muscles.

[txmarinemom]

Found this (but don't know how to read it):
http://www.thefreelibrary.com/Determ......-a020849089

Found this from some Kinesiology Lecture notes (University of Wyoming):

F. PSOAS INSUFFICIENCY:
When iliopsoas is tight the pelvis is rotated downward and lumbar lordosis in increased, displacing the pelvis anteriorly. This loads the hamstrings, causing the knees to bend. Quads become statically contracted calves hypertrophy and decrease in dorsi flexion is seen at the ankle. Increased dorsal kyphosis and tightening of erector spinae and thoracolumbar fascia and PLL. Decreases forward motion and hip joint and produces weak abdominal muscles.

Maxene ...

The iliopsoas is comprised of at least 2 muscles (iliacus and psoas major). Sometimes the group includes psoas minor - but only about 40% of the population have that muscle. (funny, huh?)

Both the iliacus and psoas major attach (at the insertion) to the lesser trochanter of the femur (posterior). Because their origins are the iliac fossa and the bodies/traverse processes of the lumbar vertebrae, respectively, when they're tight, they tuck the pelvis under.

Tucked pelvis = flattened lordosis.

Tucked pelvis = hamstrings pulled taut.

Quads are working like crazy to keep you balanced, and because you're now leaning slightly backward (try walking with your pelvis tucked under), your ankles aren't bent as much as they should be.

Increase in dorsal kyphosis is also just compensation in your upper body trying to keep you from falling back the direction you came.

Erector spinae are stabilizers, as Kevin said, and they're stressed by the posture - trying like crazy to compensate. Sure, they'll be tight. Thoracolumbar fascia is just connective tissue - and yeah ... if you're all contorted, it's confused too. Ditto with the posterior longitudinal ligament (PLL ... runs behind the spine).

Hope this helps.

Pam

[dailystrength]

Some more info on the Psoas. I wouldn't postulate that the psoas is causative in scoliosis but I'm beginning to find enough information about it to speculate that it may at least be biomechanicaly influential in progression. Don't know really - just a speculation. The info in this website (out of Australia) includes a simple stretching exercise. I'll be adding this exercise to my routine - will report back ;-)

The psoas can torque your spine to the right or left, pull it forward and twist the pelvis into various distortions. Frequently one psoas will shorten and pull the spine and/or pelvis to our dominant side. The distortions of the spine and pelvis can also show up as a short or long leg. This all results in scoliosis, kyphosis, lordosis, trigger points, and spasms in back muscles trying to resist the pulling of the psoas.

It can also pull the spine downward, compressing the facet joints and the intervertebral discs of the lumbar spine. The pressure can cause the discs to degenerate, becoming thinner and less flexible. This degeneration makes the discs more susceptible to bulging or tearing, especially with twisting and bending movements. http://www.bowen.asn.au/bowen-therap...and-back-pain/

Thanks for all that interesting research! Whee, another avenue to explore. On Liz's website she mentions Peter Levine's work on healing trauma -- interesting also. I have wondered at times if muscle tension may play a role... we should be paid for all this research, huh?

As for right now, I'm pretty tired and will get a massage or am considering chiropractic treatment/massage (cheaper with insurance co-pay) this weekend. Hard to find balance between exercise and rest sometimes... wear myself out, get sick, rest, repeat

[green m&m]

I don't know if this has been posted -- I tried reading through all the posts but my brain is refusing to corporate with me thanks to working so late...

Anyway, I'm sure many of you know, the psoas muscle is where the filet mignon/tenderloin(mmm...:9) comes from. The psoas group is non-weight bearing in quadrupeds.

In bipeds, the psoas muscle is weight bearing.. probably not tasty.

Just had to post that, after taking a pig butuering class, all I think when I hear psoas muscle is tenderloin.

To go off on the theory that psoas muscle could contribute to causing scoliosis, I am inclined to think that's a small possibility. For me personally, my psoas major is bulkier on the concave side of my lumbar curve. So for me, this might not apply to everyone, it seems my muscles 'adapted' to my curving spine. I'm guessing the years of being overstretched bulked the muscles up while the years of being 'squished' caused muscle mass to decrease. The muscle group that has the most noticeable difference for me is sacrospinalis. The convex side compared the convex side is so bulky and beefy... that might be in my favor and could even be slowing down progression.

I'd imagine, if concave side was the beefy side, the curve could progress faster due to all the strong muscle work pulling on the curve. This theory makes sense in my head, but maybe only in my currently fuzzy head