Drawing In Again
Here are some comments on the drawing in maneuver from two people that I really respect. Frankly as a coach I see no value for this, but it seems to have taken on a life of its own. I think it would be just as valuable to put a hockey puck between the cheeks of your buttocks. I think even Forest Gump would figure this out pretty quickly. Last night I was watching the scene in “The Karate Kid” where Mr. Miagi is putting it all together. Not once did Daniel have to cognitively think about what he was doing. Wax on or wax off cued the action. I feel that the same is true with drawing in, you can’t think about it. The action of bracing will recruit the muscles that must be recruited in the order they must be recruited to insure quality movement. ( My Comments VG)
People I know who teach the "drawing in method" of activating the TA and multifidus in fact have a difficult time getting the muscles to contract with this method. An instructor for the North American Institute of Orthopedic Manual Therapy uses diagnostic ultrasound while a person is lying supine to see if they are in fact contracting these muscles. He found that PT's and Pilates instructors who were sure they were activating these muscles were actually not contracting them based on this imaging method. They were able to contract these muscle gps using the ultrasound for feedback.
I don't necessarily agree with this method unless the mechanical problem has been diagnosed and/or addressed. Is the inability to rotate being obstructed at the vertebral motion segment, or soft tissue fibrosis. Either of these scenarios causes pain due to mechanical deformation but they are managed differently. Another possibility would be inflammatory pain but this never lasts more than 20 days unless it is continually aggravated. Until you have a thorough mechanical exam it would be a leap to say you have an "instability" causing pain.
According to Nick Bogduk, MD spinal researcher and anatomist, the multifidus generates as much force as a baby's fart. Hardly enough force by itself to stabilize normal to high level activity.
Noel M. Tenoso PT, OCS
Advance Sports & Spine Therapy (503)582-1073
As for the "drawing in" technique- For most intents and purposes, it's a waste of time. Again, something is shutting the TA off. However, I'm wondering if there are exceptions to the rule. Let's say you have a person in they're 50's that has an arthritic ankle from an old fracture in they're younger days. That proprioceptive feed through the knees, hips, SI joint, is disrupted. Would one then choose to do some isolation stuff for the TA? Or, here's another scenario. You have an obese athlete or client. Now you have abdominaltosis pulling the TA forward, mechanically shutting it off. Would drawing in be appropriate then?
Joe Pryzulta. ATC & C.S.C.S.
posted by Vern Gambetta @ 2/25/2006 11:47:00 AM
2 comments
2 Comments:
A quote from Mel Siff on the topic:
" is the role of transversus abdominis
(TVA) as supremely important as some individuals have been suggesting? After
all, the body is extremely efficient at recruiting different systems and
processes if one of the important systems involved in a given action is
injured, ill-adapted, fatigued or otherwise compromised in its ability to
offer its optimal contribution. Not only does this happen in the muscular
system, but MRIs show that this plasticity of function even happens in the
brain.
Those who work clinically often will notice how many patients with physical
differences or dysfunctions "compensate" by using different muscles or
patterns to carry out a given task without any apparent ill-effects.
So much has been written recently about how essential transversus abdominis
is to trunk stabilisation and mobility, but has anyone ever undertaken
studies to show that people who may not be able to activate it very
effectively may compensate very effectively by using other patterns of muscle
activation and use? Is there really any convincing proof that "less than
optimal" TVA activation definitely results in significantly less efficient
and more dangerous trunk action in all daily activities?
Studies of actions other than trunk stability have shown that the same
muscles do not necessarily become involved or become involved to the same
extent or in the same pattern in different people or in the same person at
different times (e.g., there was an article in the Scientific American within
the last 2 years which used fMRI - functional MRI to demonstrate this). If
this happens with other movements, why should actions involving TVA be any
different? Is there any genuine proof, other than the current conjecture,
that TVA contributions to trunk action is not as predictable and
deterministic as is being claimed by some therapists? Does it really matter
all that much if it sometimes does not contribute as it "should" during human
movement and its decrease in function is compensated for by other muscle
actions?"
I am not a rehabilitation professional, so I am not speaking about how TVA activiation training may or may not affect "trunk" stabilization.
From a conditioning perspective it just makes no sense to me at all. Teach people to move and they will have a super strong TVA by "accident". Teach people to "draw in" and they will be really good at drawing in.
I think teaching folks to move is a better option...
Will
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