Prepair2Perform (P2P) Assess, Align and Optimize Biomechanics Chad Benson MSc, PTS Author

VYPER

HYPERSPHERE

HYPERVOLT

The sitting disease and automation are killing our nervous systems, proprioception, function, metabolism, and mobility. Today more than ever, clients walk in the training door deactivated. Even those who work out regularly spend most of their day in low nervous system activation. In this seminar, you will learn how to assess ROM & Myoneural strength, as well as how to apply corrective movement therapies in order to:

1. Optimize movement via active range of motion 2. Optimize strength, power, footspeed & quickness 3. Optimize recovery between workouts 4. Individualize training programs

What is Vibration Therapy. It is a form of vibratory or percussive motion applied via an outside source. This motion can be applied via

Whole Body Vibration Muscle Specific Vibration

1. WBV (whole body vibration): is a general non-specific technique, traditionally applied by standing or planking (hands on a broad base)

2. MSV (muscle specific vibration). Is applied to specific body-parts via smaller portable devices with varying amounts / surface area.

a. VYPER – Frequency (level 1-3) are in alignment w WBV research

b. HYPERSPHERE – Frequency (level 1-3) are in alignment w WBV

research

3. Percussion therapy can be altered via a. Amplitude of shift, b. Frequency of shift & c. Direction of shift

4. How is Percussion different from TENS & Muscle Stimulation?

Vibration is mechanical stimulation, TENS is Transcutaneous electrical

nerve stimulation is the use of electric current produced by a device to

stimulate the nerves for therapeutic purposes. Muscle Stim is Electrical

muscle stimulation leading to muscle contraction via impulses

Benefits of Muscle Stimulation & Vibration: vibration therapy causes muscles to repeatedly eccentrically and concentrically contract resulting in nervous system activation, possible injury prevention & performance enhancement. The unused deactivated portion of the nervous systems loses the ability to generate force and restricts movement to protect itself from instability & excessive force. To better understand the benefits of activation and warm-up, the potential physiologic mechanisms must be reviewed. 1. Improved mobility & active ROM: to understand how vibration improves

ROM, we need to understand the difference between active & passive ROM.

a. Active range of motion is when a joint is moved through its range with

the person moving the joint him or herself.

b. Passive range of motion is when something or someone helps or

creates the movement. More importantly, it’s essential we assess ROM

& identify neurological “dead zones”.

The traditional way to perform release in at home or in a gym is foam rolling or

SMR (self myofascial release). Recent evidence has indicated myofascial

compression alone does not break or “release” fibrotic material commonly found

even at the most superficial muscular layers.

It likely leads to improved GLIDE

between the myofascial layers

IINTERFACES ARE ESSENTIALLY THE

FASCIAL PLANES BETWEEN LAYERS

LACK OF GLIDING IS THE ENEMY

CAUSED BY DEHYDRATION, REPETITIVE

STRESS, INCORRECT FIRING/LOADING

SEQUENCES, JOINT FUNCTION REVERSAL,

SLEEP PATTERNS

HYALURONIC ACID LAYER MEMBRANE

DISTORTION LEADS TO DIRECT FASCIA

CONTACT AND ADHESION

SMR / Foam Rolling is unlikely to create myofascial release:

IT TAKES APPROXIMATELY

2000LBS OF FORCE PER /INCH TO

MECHANICALLY DISTORT FASCIA…

ROBERT SCHLEIP [Cite your source here.]

2. Improved circulation & muscle thermogenesis:

https://drive.google.com/file/d/0B37decpR5tu3OS1qWTZQTHRxejA/view

3. Improved proprioception, muscle co-contraction & joint stability: one the

major reasons for increased ROM with vibration, is increased joint stability.

This is most commonly seen amongst the mobility joints. Below is a great

illustration of the joints and therefore motions that are most likely to improve

via this mechanism. But how do we know that this is the mechanism we need

to work on???? This is the cool part: if you have identified a dead zone, then

stability / antagonist strength training is more important than flexibility / ROM

training 😊. In the links below, I have provided an example of active vs

passive ROM for 2 of the mobility joints (shoulder & hip) illustrated below:

4. Improved posture: the combination of low intensity (level 1) vibration is the

stimulation of postural / tonic / stabilizer muscle chains. When there is a shift

in the length of a muscle (i.e. posterior shoulder muscles become weak when

upper back kyphosis exist).

a. Initially, the tonic muscles work harder to reestablish joint alignment

b. Over time this battle leads to fatigue and a weakening of the tonic

muscles in that region.

c. Those muscles are hard to activate w traditional training methods.

Specialized low threshold training and NS activation work in

combination to correct postural distortion

5. Improved bone density: vibration and vibration platforms lead to G-force like

ground reaction forces that transmit through the joints that are in direct

contact with the platforms. Methods like standing, compressing between the

hands, squeezing between the knees are all create transmission of bone

density stimulation ground reaction forces on the vibratory

6. Improved force & power: when the nervous system is upregulated and not

being inhibited via instability / pain, the body is permitted to move more

aggressively. Therefore it can develop a greater portion of its available

strength and power.

a. Preconditioning exercise performed with WBV at 50 Hz seems to enhance on-ice

sprint performance in ice-hockey players.

b. 60s of WBV with partial squat enhanced the performance score on the

QFT (Dot drill)

7. Increased pain threshold: one of the major benefits is a temporary alteration

in the pain mediated nervous system inhibition. Through up regulation of

muscle & joint mechanoreceptor firing, the brain perceives that the joint &

affected tissue are functioning properly. The mistake, thinking the issue has

been removed. Pain signals are designed to protect us, but in combination

with good movement management & corrective programming, we can

permanently change posture, joint stability, tissue health and therefore

mechanoception.

Scope of Practice & Contraindications of Percussion & Vibration

Scope of Practice: falls into the scope of practice of your current certifications.

In general, the application of vibration should applied to healthy individuals, not

currently not suffering any form of acute muscular (i.e. injury) or chronic joint

pain.

Contrainidications (according to Theragun):

1. Vibration should not be applied over contused (bruised) soft tissue,

thrombus (blood clot), or the site of phlebitis or varicose vein,

because of the danger of additional thrombus development or the

precipitation of an embolus.

2. Do not apply vibration around the lips of children, even for

desensitization of the lips. Likewise, vibration should not be

applied to the S2, S3, or S4 sensory dermatomes of infants or

children with immature gastrointestinal systems.

3. The vibration of phalangeal (finger) joints will almost certainly

cause them to spontaneously swell (become edematous),

sometimes to a gross extreme. Edema may become so extreme

that pitting edema may become evident in both the phalanges and

in the metacarpal portions of the hand.

4. If vibration is used in combination with electrical stimulation for

the treatment of extrafusal muscle spasm, trigger point formation

referred pain, or to facilitate the lengthening of a muscle, apply it

after electrical stimulation.

5. My addition to this is not on pregnant women T7 to sacrum.

6. Not on genitalia and not above your head or above Adam's

apple/or C5 area of the neck. Not on or near a pace Maker.

Mobility Assessments (ROM + Stability = Mobility):

The 1st step in reactivating the nervous system is assessing the individuals ROM

and stability. Assessment is essential to safely and effectively individualizing a

client’s training experience.

Peripheral Myoneural Strength (Stability) & ROM Testing: healthy or

functionally specific ROM and muscle strength in muscles surrounding the ankle,

knee, hip, scapula, elbow and wrist are extremely important when performing any

functional performance task or exercise.

1. Keep your assessment simple and quick.

2. Combine constant observation with your baseline assessment, P2P

prescriptions can be modified as movement compensations change.

3. Assessment should be broken down from the whole into the parts:

a) Dynamic posture / during movement (not covered). For Ex FMS

b) Fascial line / kinectic chain movement efficiency

c) Individual movements, mobility & strength at eROM (end range of motion)

Lacks myoneural strength / stability at the eROM: a client’s functional

movement quality (i.e. performance) is dependent on muscle compliance and the

muscle's force capabilities at any given moment throughout their ROM. Muscle’s

without significant tissue restriction (scar tissue / fibrosis / trigger point) perform

well at mid-range of motion. If & When they hit functionally unused (due to

restriction / inactivity / limited ROM use ), they test as:

a) Weak (1 or 2)

b) Strong w major

compensation

c) Strong but lacks

endurance

Lacks ROM (see slides) when one muscle is not able to elongate to the degree

(i.e. comply) needed to produce the movement, compensations must occur to

produce that movement. Compensations tend to create inefficient movement and

(or) synergistic dominance of the smaller assistance muscles. Force couple of

imbalances (i.e. overactive antagonist & synergists), over time result in altered

motor recruitment coordination (i.e. synergistic dominance & overactive

stabilizers).

In order for movement to occur, the combination of strength / stability & flexibility / ROM must occur to safely support this movement. To better understand which is limiting the movement, both must be assessed. There are several easy ways to assess each.

Myoneural Strength Testing 101

• Muscle eccentric contractions are stronger than concentric.

• It is not a test of true strength, it’s a test of the Nervous System & it’s

current state.

• Muscles are tested & activated in their neurological “dead zone”,

typically in their eROM.

• This position is often weakened due to

1. tightness in the antagonist muscle or opposing motion /

movement.

2. Insufficient use of that ROM while performing in life sport or

fitness

Myoneural Strength Testing Observations

• Normal: turns-on / fires against the resistance

• Abnormal on / overactive: typically seen as spasm

• Abnormal on / overactive synergist: typically seen as a compensation

in a nearby joint.

• Abnormal off / underactive: seen as a failed muscle test

• Abnormal / Lacks endurance: typically seen as easy to fatigue w

continued contract resist cycles

Myoneural Testing: How To

1. If the muscle adapts / functions normally, the eROM will feel strong

(i.e. muscle resists well). If not, it “breaks” and gives way. This means

“something” is interrupting the sensorimotor signal.

2. Notes:

1. Use auditory, visual & tactile cues

2. Tests are performed in a specific plane & ROM to ensure that

the tests accurately isolate specific tissue.

3. Meet what the client gives & allow them .5 to 1sec to develop

tension, then overload by 10%

4. Retest if the client didn’t resist / understood the command

5. Give moderate adjacent joint stability but too much may create

a false negative & prevent compensations

6. Note any compensations & retest with instructions to control

the compensation

7. Tester begins in a biomechanically advantaged position.

3. Phase 1:The client is cued to create a strong concentric contraction…

“your line of drive is up, my line of drive is down…drive up strong,

hold, don’t let me move you”

4. Phase 2:When the eROM / shortened ROM is achieved, the tester

meets (i.e. hold) the client’s force and overloads it by approximately

10-15%.

ROM / Flexibility Testing 101: There are 2 two major types of

flexibility • Active: sometimes referred to as mobility, it refers to the ability of a person to

drive or create ROM without outside assistance from gravity, straps or an assistant. It requires a person to actively move their segment via muscular contraction via force couples (i.e. agonist, synergist and stabilizers).

• Passive: does not require active assistance on behalf of the participant. Gravity, straps & or an assistant cues the client to let all tension out of the movement before moving the segment into it’s eROM.

• eROM is a person’s end range of motion. It is best defined as the point when a client reaches an end position with a low level of restrictive tension (i.e. stretch reflex or pain).

Range of Motion Testing: 1. When performed by a skilled practitioner, passive ROM of motion testing can

help determine the difference between biomechanical (i.e. bone on bone & capsular restriction Vs muscular / fascial tension).

2. Determining an eROM via active ROM, is in my opinion requires less skill and is more effective for understanding the potential movement deficiencies.

The big 3 questions are: 1. Is a person’s movement deficiency (i.e. restricted or altered ROM in an

overhead squat the result of a 1. tissue extensibility or 2. muscular coordination issue.

2. Do we need more flexibility or stability?? 3. Once assessment has determined the movement issues, what can we do to

change the is

There are several ways to help determine whether it’s a Myoneural or Tissue related issue. Both techniques outlined below require an unloading of the nervous system & therefore the functional requirements. Both start by including the nervous system, then removing to see if ROM is improved.

a. If ROM is > it’s a strength / stability issue b. If ROM is = similar, it’s a ROM issue c. If ROM is > but not ideal, it’s likely both

1. A Dead Zone = the difference between active & passive ROM. i.e. if I lift my

arms overhead, this is active ROM. If a trainer can pull them further, then

passive ROM is greater than active. When this active passive difference exist,

it’s referred to as the neurological dead zone and is best illustrated via this

equation.

o Passive ROM – Active ROM = Dead Zone = Stability

Active paex

Passive

Dead Zone

Methods to inhibit overactive muscle. When a movement has restricted

extensibility, we can improve it, by removing the restriction. For the purposes of this course we will focus on inhibiting overactive muscle. The most common methods to inhibit overactive tissue are: 1. Stretching

• Agonist Stretching (2+ min static, PNF, stretch wave – not shown in this course)

2. Myofascial release (SMR) on the involved tissue / muscle. Typically, an acute bout of SMR of the quadriceps is an effective treatment to acutely enhance knee joint ROM without causing a deficit in quad muscle strength.

• (Post) SMR pin & hold: takes advantage of pressure sensors and signaling to & from the pain & movement centers of the brain

• (Pre) SMR pin & move Create glide amongst the moving & fascial surfaces of the skin, muscle, and fascial layers.

3. Vibratory alteration: using high frequencies for relatively long periods (45-90 sec) may cause a muscle to weaken temporarily. The overactive muscle becomes underactive, and permits the previously weak muscle to fire (i.e. myoneural upregulation)

Methods to activate & under overactive muscle: Below we examine best practice & training methods for nervous system activation. Whether the goal is athletic performance, body composition, aging gracefully or fascial fitness, progressive activation & client preparation is an essential component of an effective personal training experience. Increasing the activation of the Mechanoreceptors and Fast Twitch (FT) Muscle Fiber (some techniques not covered in this course)is an essential component of 1. protecting joints and 2. optimizing your client’s results. FT muscle fibers are bigger, react more quickly and more forcefully than slow twitch fibers. These muscle fibers help prevent injury in the gym and burn more calories than their slow twitch counterparts. Therefore, FT activation is an essential component of any training program. Several components listed below must be included into every client workout, and all of them within the weekly plan. Some of the key tools to muscle & workout activation include: 1. (PW) Vibration: creates easier depolarization & Co-contraction. It also

Reduces arterial stiffness and increases plasma Nitric Oxide concentration (i.e. blood flow -see benefits)

• The vibration elicits involuntary muscle stretch reflex = proprioception contractions leading to increased motor unit recruitment and synchronization of synergist muscles

• Vibration creates pressure & activation of vibratory receptors (Pacinian Corpuscles).

Spinal Peripheral Activation: stimulation to the peripheral nerves upregulates

signalling to up and down the nervous system

Application: slowly roll (i.e. 1 inch

/ sec speed) along the erector

spinae muscle group. Use light

pressure and at least 1inch of

separation from the spinal

column.

Appendage Peripheral Activation: Creating a closed chain btwn floor & or

another bodypart creates action reaction forces up the kinectic chain. This

works best on firm (but not hard surfaces.)

Application: perform movement while standing on, holding or trapping

vibratory device btwn bodyparts (i.e. knees, hand against chest)

MSV (muscle specific vibration)

Application: slowly roll (i.e. 1 inch / sec speed) along the belly & ideally line of

pull of the muscle.

Vibration at eROM:

Application: Use various stretch techniques to place muscle into weak but

required / optimal position. Directly apply vibration along the belly of the

muscle in a previously weak range.

2. Oscillatory Rolling / Massage: oscillation can stimulate an automatic nervous

trigger known as the myotatic stretch reflex. Quickly motioning in short

strokes stimulates the mechanoceptors in the muscle below.

Application: multidirectional shifting of tissue w a foam roller (no vibration

req’d)

3. Agonist Strengthening: also known as corrective exercise is designed to

slowly increase gamma & alpha motor recruitment (i.e. increased firing

frequency and motor unit recruitment). By strengthening a weak

movement pattern, you both inhibit overactive and activate underactive

muscles. Remember it’s the execution of an exercise, not the exercise

itself that creates activation and therefore joint alignment.

How to muscle activate via corrective exercise & movement: • Manage

• Posture / alignment

• ROM

• Speed of Motion (SOM)

• Complexity

• Load of Motion (LOM)

• Fatigue of Motion (FOM)

• Minimal shaking or spasm

• Use low threshold / slow twitch training methods before high

threshold (i.e. LOM & SOM)

• Do not go to the point of pain (i.e. pain free ROM)

• All Core Activation movements should progress from floor to the

specific actions required to function in life sport or workout.

Corrective Exercise Training Guidelines & Reminders

Motor Learning Process is a step-by-step process in which we can integrate vibratory and taping procedures to reinforce the learning process

End goal is to create permanent lasting functional movement free of dysfunction for our specific body

Biomechanics are as individual Create movement symmetry and therefore joint stability Level the pelvis (i.e. bridge, side plank, plank) Core neutral is the foundation from which strong movement is created.

Learn to ACTivate your local, global & movement core musculature Time your core bracing and forced exhalation with maximal force

requirement. This will help create spinal & pelvic stability. Take a 360’ / muscle balanced approach to training and preparation. Manage movement & the killers of function (speed, ROM, intensity,

complexity & volume) The optimal activation sequence is:

a. WBV (not shown) + SMR (pin & move) + MSV = 3-5 min each https://youtu.be/gIInxp70OJY

b. Core Activation / Active Isolated/ End Range of Motion = 5 min c. Dynamic Warm-up = 5 min https://youtu.be/LGrd2oNLFHk

Straight Leg Raise P2P Assessment: Active Passive ROM

Difference

Step 1. Assess active & passive Pelvic Stability & Hamstring ROM & determine

which ft is lowest. Give that side preferential treatment.

Step 2. If there is difference between active & passive ROM, apply vibration

Step 3. Reassess ROM. If no difference after Activation try an inhibitory SMR,

non-vibratory protocol (see previous table)

Step 1. Asses

Active: Pre MSV

Step 2. MSV Origin & Insertion Activation

Step 3. Reassess

No Active Passive ROM Difference: Use Pin & Move Protocol

Assess Pelvic

Stability &

Hamstring ROM

If no difference in

active & passive

ROM, apply non-

vibratory,

inhibitory SMR

1. Calves

2. Low

Hamstrings

SMR bottom & top

of long muscles

Each position is

held w subtle slow

movements,

typically assisted

by trainier

Reassess ROM

If no difference

after SMR, try the

stabilization /

activation protocol

Shoulder Abduction & Retraction Assessment

Step 1. Assess Shoulder Stability & Pec ROM

Step 2. If there is a difference in active & passive ROM, apply vibratory Activation

to the weak muscle / unstable joint

Step 3. Reassess ROM: If no difference after activation, try an inhibitory SMR,

non-vibratory protocol for pec major, minor & lats

o DZ = Low Trap & Rhomboid (MSV) o DZ = Plank + Side Plank + Back Hollow o No DZ = Mobilize Pecs & Lats (Ant Humerus)

Step 1.

Active: Pre MSV

Step 2.

Step 3. Active: Post MSV

Corrective Pin & Move

Step 1. Assess ROM

Step 2. No Active Passive

Difference

Step 3. Move along tissue at

parallel to line of pull of tissue

until sensitive or hard tissue is

found

Step 4. Melt into tissue at a 5-7

threshold & perform 2-3

diaphramatic breaths

Step 5. Perform programming 4-

6 slowly executed reps of the

listed movements

Step 6. Reassess ROM

Images: ©Trigger Point Therapy

Myofascial Lines Superficial Back

Line (SBL)

• Flexor digitorum

• Brevis

• Gastrocnemius

• Hamstrings

• Sacrotuberous

ligament

• Erector spinae

• Scalp fascia

Superficial Front Line

(SFL)

• Extensor

digitorum—

longus and brevis

• Tibialis anterior

• Patellar tendon

• Quadriceps

(including the

rectus femoris)

• Rectus

abdominis

• Sternalis

• Sternocleidomast

oid

Lateral Line (LL)

• Peroneus longus

and brevis

• Anterior ligament of

the fibular head

• IT band, TFL, glute

max

• Lateral abdominal

• External and

internal intercostals

• Splenius capitis

and

sternocleidomastoi

Front & Back Arm Lines

Stock Imagary: © istockphoto.com

Medical images © Fitness Professionals

Fascial Integration: Assessment Superficial Back Line (SBL) Assess (ROM) Toe Touch & Straight Leg Raise

Assess (My) Glute Max Sagittal

P2P (Sp) PLantar Fascia

P2P Hamstrings

(V) TLF / Low Back Si2Si Knee Drops

(Sp / V) Rec Femoris

Link: https://youtu.be/Rndv7Rh92G4 Link: https://youtu.be/kgadNRE2_Yg

Movement: Chin Tucks (M)

Movement: MR Prone Cobra (S)

Movement: Down Dog (M) Movement: Assisted Bridge (S)

Notes:

Fascial Integration: Superficial Front Line (SFL) Assess (ROM) Modified Thomas Test

Assess (My) Rectus Femoris

P2P (Sp / V) Tibialis Anterior

NB* See Rec Fem in SBL

P2P (V) High Quad Pin & Move

(V) TFL

(Sp) 2 way Hip Extension

Link: https://youtu.be/xH-3bfrZYw4

Link: https://youtu.be/ua3PnM8wx2E

Movement: Prone Cobra (M)

Movement: Assisted Bridge (S)

Notes:

Fascial Integration: Lateral Line Assess (ROM) Kneeling Side Bend

(My) Glute Med (posterior fibers)

P2P (Sp) QL’s

P2P (Sp / V) Adductors

(V) IT Band / Lateral Thigh

Link: https://youtu.be/X1utzRrkk3Y Link: https://youtu.be/GD_jVt847RQ

Movement: 10 & 2 Child’s Pose Side Bend (M)

Movement: Hinging Kneeling Side Plank (S)

Notes:

Exercise Library / Protocol Exercise Library / Protocol Upper Pin & Move

• Lats + Sweeps & Back Scratch

• QL + Side Bends

• Psoas + Back Ext + Leg Ext

• Traps / Neck + 3D (no vibration)

Lower Pin & Move

• Plantar Fascia Roll & Twist

• IT / Lat Thigh + Ham Curl

• Piriformis + Hip Flexion + Clam

• Quad + Ham Curl

REFERENCES Pamukoff DN, Ryan ED, Blackburn JT. The acute effects of local muscle vibration frequency on peak torque, rate of torque development, and EMG activity. J Electromyogr Kinesiol 24: 888–894, 2014. The acute effects of local muscle vibration frequency on peak torque, rate of torque development, and EMG activity.

Whole Body and Local Muscle Vibration Reduce Artificially Induced Quadriceps Arthrogenic Inhibition Pamukoff, D. et al. (2016). Whole-Body and Local Muscle Vibration Immediately Improve Quadriceps Function in Individuals With Anterior Cruciate Ligament Reconstruction, Physical Medicine & Rehabilitation, Volume 97, Issue 7, Pages 1121–1129. Acute Effect of Whole-Body Vibration Warm-up on Footspeed Quickness Donahue, Ryan B.; Vingren, Jakob L.; Duplanty, Anthony A.; More Journal of Strength & Conditioning Research. 30(8):2286-2291, August 2016.

Contact Information:

Chad Benson 778-999-8586 Arctraining71@gmail.com Instagram @prepair2perform

Gareth Bryson 604-798-0100 Gbryson@ufcgyms.ca Instagram @primalfreak

Product Information: Bands – Loops – Tubing: https://www.360conditioning.com/fitness-conditioning/training-and-toning/resistance-bands-en.html Hyperice: https://www.360conditioning.com/fitness-conditioning/shop-by-brand/hyperice.html