PER­FOR­MANCE

New Zealand Fitness - - IN THIS ISSUE -

Pat­tern over­load By Paul Chek

Pat­tern over­load is in­jury to soft tis­sues sec­ondary to be­ing locked into a par­tic­u­lar

pat­tern of move­ment or re­stricted in one or more planes of mo­tion while per­form­ing

a work or sports move­ment pat­tern.

Although pat­tern over­load is much more com­mon in an en­vi­ron­ment that re­stricts free­dom of mo­tion, such as ma­chine train­ing, I have treated nu­mer­ous cases of pat­tern over­load in work­ers and ath­letes that were un­re­stricted in their mo­tions.

Pat­tern over­load re­sults pri­mar­ily from: a) An in­abil­ity to prop­erly

load share. b) Be­ing iso­lated or re­stricted to a spe­cific mo­tion with loss of move­ment free­dom in one or more planes. c) Overuse of any given pat­tern of move­ment, re­gard­less of free­dom of joint mo­tion.

IN­ABIL­ITY TO PROP­ERLY LOAD SHARE

The hu­man body is very in­tel­li­gent and eco­nom­i­cal. To pro­tect it­self from un­wanted in­jury the body will nat­u­rally se­quence the re­cruit­ment of mus­cles in as to pro­vide op­ti­mal load shar­ing across as many mus­cles and joints as pos­si­ble. For ex­am­ple, when per­form­ing a bent-over row, the body will select the ap­pro­pri­ate mo­tor se­quence to di­vide the load among all the work­ing mus­cles, al­low­ing each work­ing mus­cle to make its max­i­mum con­tri­bu­tion when most fa­vor­able with re­gard to the biome­chan­ics and neu­rome­chan­ics of the mo­tion.

An ex­am­ple of faulty load shar­ing can be seen in those in­di­vid­u­als that have been taught to adduct their scapu­lae prior to ini­ti­at­ing the pull with the lats and other mus­cles. This faulty mo­tor se­quence dis­rupts load shar­ing by re­cruit­ing the scapu­lar ad­duc­tors first, short­en­ing them beyond the range of their op­ti­mal length / force re­la­tion­ships and leav­ing the scapu­lo­humeral mus­cu­la­ture to con­tinue the work. This of­ten leads to strain of the teres ma­jor, mi­nor and in­fraspina­tus mus­cles, or pat­tern over­load.

The ath­lete who reg­u­larly per­forms pulling ex­er­cises in the man­ner de­scribed above will likely have a short­en­ing of the scapu­lo­humeral mus­cu­la­ture, which even­tu­ally leads to faulty scapu­lotho­racic rhythm. The re­sult is scapu­lae that ro­tate pre­ma­turely dur­ing all pulling or ab­duc­tion move­ments. Over time, this re­sults in stretch weak­ness of the mid­dle and lower trapez­ius, and rhom­boid mus­cu­la­ture. In­di­vid­u­als with this type of dys­func­tion will present them­selves clin­i­cally as ex­pe­ri­enc­ing pain be­tween the shoul­der blades and of­ten demon­strate re­duced range of mo­tion in shoul­der ab­duc­tion, in­ter­nal ro­ta­tion and shoul­der flex­ion.?

ISO­LA­TION OF MOVE­MENT BY RE­STRICT­ING 3D FREE­DOM

If you filmed any­one, even the most elite ath­lete, for 1,000 reps of the bench press, he or she would never per­form the ex­act move­ment twice in a row. This is one of the body’s meth­ods of pro­tect­ing mus­cles, ten­dons, lig­a­ments and all work­ing soft tis­sues from over­load. As one set of mus­cle fibers or mo­tor unit fa­tigues, the body changes re­cruit­ment slightly to favour another fiber bun­dle, which re­sults in slight al­ter­ation of bar path. This slight al­ter­ation of move­ment path­way will also serve to pro­tect ten­don fibers and all other work­ing tis­sues.

As you may know, the Smith ma­chine is an Olympic bar mounted on guide rails, which lim­its move­ment of the bar to one plane. The lifter us­ing the Smith ma­chine will be un­able to ef­fec­tively al­ter bar path, in­creas­ing the po­ten­tial for wear and tear of the ex­act same tis­sues each rep. In other words, pre­dis­pos­ing them to pat­tern over­load! If you watch care­fully as a lifter be­gins to fa­tigue while per­form­ing any Smith ma­chine lift or ma­chine lift of any type where the re­sis­tance is guided, you will see the lifter at­tempt­ing to al­ter the po­si­tion of the prox­i­mal mo­tion seg­ments. An ex­am­ple is the body squirm­ing around on the bench under the fixed bar. This is not only an un­nat­u­ral move­ment for the body, it also puts un­wanted torque on prox­i­mal joints, such as the shoul­der and the neck, in­creas­ing the chances of in­jury.

OVERUSE OF ANY PAT­TERN OF MOVE­MENT

The terms repet­i­tive stress in­jury (RSI) and cu­mu­la­tive trauma dis­or­der are com­monly used in a phys­i­cal ther­apy or med­i­cal prac­tice to de­scribe tis­sue break­down and in­jury due to repet­i­tive exposure to a par­tic­u­lar move­ment.

These in­juries are com­mon among ath­letes, mu­si­cians, work­ers who per­form data en­try and as­sem­bly line work­ers. Pat­tern over­load

de­scribes RSI in the ath­letic per­for­mance and con­di­tion­ing en­vi­ron­ment. It is a ma­jor source of in­jur y among am­a­teur and pro­fes­sional base­ball pitch­ers, quar­ter­backs, ten­nis play­ers, golfers, swim­mers and dis­tance run­ners.

When­ever some­one per­forms, con­di­tions and / or trains us­ing pre­dom­i­nantly one pat­tern of mo­tion, or has poor mo­tor skills in a given pat­tern of mo­tion, the risk of in­jury to the re­spec­tive work­ing tis­sues is el­e­vated.

To avoid pat­tern over­load in ath­letes per­form­ing repet­i­tive mo­tions, the con­di­tion­ing coach and / or ther­a­pist must be care­ful not to pre­scribe ex­er­cises that serve to load weak­ened tis­sues un­less there is spe­cific ther­a­peu­tic in­tent and sound ra­tio­nale for such train­ing.

For ex­am­ple, the in-sea­son ten­nis player com­ing to the gym to con­di­tion for ten­nis (a sport of high-speed lung­ing) may very well have a sig­nif­i­cant de­gree of break­down in the work­ing tis­sues from prac­tic­ing and com­pet­ing alone. Should that ath­lete choose to, or be di­rected to per­form high vol­ume or high-in­ten­sity lung­ing ex­er­cises in the gym, the chances of sus­tain­ing in­jury to the knee ex­ten­sor mech­a­nism and lig­a­ments, hamstrings or low back in­crease sig­nif­i­cantly. If the ath­lete has any de­gree of pain or in­flam­ma­tion in the joint, there is likely to be a cor­re­spond­ing deficit in sta­bil­ity.

Another un­der­ly­ing cause of pat­tern over­load is poor or non-ex­is­tent pe­ri­odiza­tion of any given train­ing and con­di­tion­ing pro­gramme.

In ad­di­tion to pe­ri­odiz­ing gen­eral stres­sors to the body, care must be taken when writ­ing pro­grammes to ex­e­cute ex­er­cises in the cor­rect or­der. Some gen­eral rules for or­ga­niz­ing ex­er­cises in a · pro­gramme are:

Ex­er­cises should al­ways progress from the most com­plex to least com­plex · move­ment pat­terns. Ex­er­cises should progress from those re­quir­ing the high­est level of move­ment skill to the least de­mand for · move­ment skill. Ex­er­cises should gen­er­ally progress from those re­quir­ing the least base of sup­port to those pro­vid­ing · the most base of sup­port. Ex­er­cises should progress from those re­quir­ing the great­est cog­ni­tive de­mand to the least cog­ni­tive de­mand.

The only ex­cep­tion to these guide­lines is when an elite ath­lete is be­ing trained by a pro­fes­sional coach trained in the sci­ence and prac­tice of strength and con­di­tion­ing.

CON­CLU­SION

Pat­tern over­load is a very com­mon, but fre­quently over­looked source of mus­cu­loskele­tal in­jury.

To re­duce chance of in­jury, care should be taken to pe­ri­odize the use of ma­chines and exposure ac­tiv­i­ties that re­quire chronic exposure to any spe­cific move­ment pat­tern.

The sta­bi­lizer sys­tem of the body should al­ways be cleared as suf­fi­cient to han­dle the rep­e­ti­tion and load­ing of any pat­tern of move­ment to be en­coun­tered.

Today, with the mas­sive in­crease in the num­ber of peo­ple work­ing in a seated po­si­tion and our overindul­gence with ma­chine train­ing, there is a tremen­dous lack of move­ment skill in the pop­u­la­tion at large.

This means that much more at­ten­tion to de­tail must be ap­plied to learn­ing, teach­ing and ex­e­cu­tion of seem­ingly com­mon free weight ex­er­cises and move­ment pat­terns.

Us­ing a tor­nado ball re­quires huge amounts of sta­bil­ity and very spe­cific in­di­vid­ual pro­gres­sion.

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