June 2015 Psoas

Psoas

The Psoas muscle is one of the most important muscles in our body, as far as I am concerned. Once again, the "P" is silent, so that is pretty cool too.  This deep hip flexor muscle is often blamed for lower back pain when it is tight or chronically contracted.  Most health care practitioners and fitness professionals are focused on stretching or releasing tight Psoas muscles. The Psoas is responsible for many bodily movements, so it is much more important to be sure that the Psoas muscles are active and functioning properly on both sides of the body. We'll discuss this in more detail and how you can be sure your Psoas muscles are working their best for your body. 

Where is the Psoas muscle located?

The Psoas muscle has a deep portion, which attaches on the transverse process of the lumbar vertebrae (L1-5). The superficial portion spans from the side of the body of the lowest thoracic vertebra (T12), the top 4 lumbar vertebrae (L1-4), and some of the intervertebral discs. The Psoas muscle runs down through the pelvis and inserts onto the lesser trochanter of the femur, located on the inside, or medial aspect, of the the upper part of the thigh bone. The Psoas shares this part of its attachment with the Iliacus muscle, which covers the front of the iliac bone of the pelvis. Together, they are referred to as the "Iliopsoas." A large group of nerves, known as the lumbar plexus, travels near the Psoas. This area of the body is also known as the "Solar Plexus" and is an energy center of the body. 

What functions do the Psoas muscles provide?

The main function of the Psoas muscle is hip flexion, which refers to bringing the femur bone toward the front side of the trunk of the body. This motion occurs each time we lift our leg and swing it forward when we walk. The Psoas muscles can work together as trunk flexors, bringing our trunk forward toward our thighs, like when doing a sit-up exercise. The right Psoas is involved in bending the lower spine to the right, and the left side bends the spine to the left. The Psoas is also involved in rotating the trunk to the same side and to the opposite side. There is activity in the Psoas muscles during hip External or Lateral Rotation, and some would argue that there is muscle activity also during hip Internal or Medial Rotation. 

How can I feel my Psoas muscles working properly?

One way to feel your Psoas is to lie on your back with your legs straight out. Slide your right leg out to the side about a foot and a half. Keeping your knee straight, turn your leg out from your hip joint, then lift your leg up to a 45 degree angle with the floor. Feel the Psoas muscle deep inside the abdomen and at the inside of the upper part of the thigh contracting. Hold that position for a few seconds, then bring your leg back down to the ground. Did you feel it? Try it on the other side and see if you notice any differences between your 2 sides. Is one side easier to lift, or does one side feel heavier? Do you notice any pain in your groin, thigh, or lower back?

What symptoms may I feel if my Psoas is not functioning properly?

If you have weakness with the above exercise or you feel pain in the front of the hip or in the lower back, your Psoas may not be working properly. When you are in a seated position for a long period of time and you stand up, you may feel some Psoas tightness in the front of the pelvis and it may be difficult to fully extend your spine to stand up straight for a minute.  Another common symptom of Psoas dysfunction is groin pain. You may also notice a sideways curve in your spine or a sideways lean if the Psoas is weak on one side and tight on the other. If you have any difficulty with these activities or are curious about any asymmetries you may notice, be sure to contact your Muscle Activation Techniques Certified Specialist to assist you in achieving your goals. 

What are some common exercises that can be done to target and strengthen the Psoas muscle?

Once you are certain that your Psoas muscles are active and ready for exercises, you can perform some of the following activities: Walking, Biking, Elliptical trainer, Rowing machine, Knee to Chest Marches while lying on your back, Hip Flexion/Marches (knee toward chest) while standing, or lying down with legs propped up on Exercise Ball, Abdominal  Crunches, Planks, Mountain Climbers, Downward Facing Dog, Forward Fold, just to name a few. 

Here's to your happy, healthy Psoas muscles!!

May 2015 Pterygoid

PTERYGOID

I love any name with a silent "P," and that includes "Pterygoid."  This jaw muscle and I go way back. In my early years of practice as a Physical Therapist, I worked at a clinic specializing in Temporal Mandibular Joint (TMJ) Dysfunction, commonly known as "jaw pain."  Since this muscle is involved with opening and closing the jaw, it can really cause problems when it does not function properly. 

There are 2 divisions of the Pterygoid muscle, the internal or medial fibers, and the external or lateral fibers of the Pterygoid. The Internal/Medial pterygoid has 2 heads, one deep and one superficial. The deep head inserts onto the side of the sphenoid bone, which sits behind our eyes. The superficial head originates from the palatine bone on the roof of our mouth and the maxillary tuberosity which is a bump behind the top back teeth. Both of these heads insert onto the inside angle of the jaw bone, or mandible. The medial pterygoid works to close the jaw and move the jaw from side to side for chewing. 

The External/Lateral Pterygoid originates from the great wing of the sphenoid bone and pterygoid plate, and inserts on the condyloid process of the mandible, which is the part of the jaw bone that rests inside the joint, beneath a disc made of cartilage, and serves as the hinge point or axis for opening and closing the jaw. When the external/lateral pterygoid contracts, it works to open the jaw, protrude it forward, and move it side to side, along with the internal/medial pterygoid. 

What signs or symptoms result from problems with Pterygoid? Headaches, facial pain, ringing in the ear, or ear pain are some common symptoms people experience when their pterygoids are not working properly. Clicking in the joint is common when the disc is sliding inefficiently within the joint space. If the disc gets dislocated, the jaw can get stuck open or closed. The Temporal Mandibular Joint (TMJ) gets swollen from the improper mechanics of the muscles around the area, which adds to the discomfort. People who clench their teeth or grind them at night often have trouble with their pterygoids, and may also have imbalances in some of the other jaw muscles. Chewing, talking, and even kissing can become very difficult for people with TMJ Dysfunction. None of that is very fun, as you can imagine!! 

What causes problems with the Pterygoid? Muscular imbalances throughout the head, spine and pelvis can contribute to postural alignment imbalances that affect the position of the head and jaw bones, and put added stress on the pterygoids. People often injure their jaw in car accidents, or with a direct blow to the jaw or face. Some people have stress, tension, and unresolved anger issues and clench their teeth habitually. This puts a lot of stress on the joints and can worsen the symptoms noted above. 

How can we feel the Pterygoid working properly? You will feel a subtle muscle contracting inside the jaw joint as you open and then close your teeth gently. You can really feel the pterygoids inside the jaw joint as you move your jaw back and forth from side to side, gently.  You can place your fingertips on the outside of the jaw joint just in front of your ears and feel the disc slide along with the lower jaw bone. Notice if you feel one side or the other move forward more quickly or if you feel the disc popping as you move. A normal jaw will open to between 40-50 mm of opening if all goes well. 

Here's hoping your Pterygoids are doing well and keeping your mouths and heads happy as you enjoy yummy, nourishing foods and laugh and socialize with your family and friends!

April 2015 Piriformis

Piriformis

Advice on finding, feeling, and freeing up the Piriformis muscle for its full potential

Good Old Piriformis.  Even if you don't know much about muscles, most people have heard of this one. Any one who has had trouble with this muscle knows right where this guy is located!! This small but very important "pear-shaped" muscle is one of 6 deep hip rotators, located underneath the buttock muscle, gluteus maximus, on the back of each hip. Piriformis attaches to the front of the sacrum then extends deep through the back of the hip to attach onto the top of the hip bone, on the "greater trochanter" of the femur. This muscle runs right over the Sciatic nerve, which is the huge nerve that runs throughout the back of the leg, allowing us to feel and move all the muscles on the back of the leg.  

"What exactly does the Piriformis muscle do for our bodies," you ask? Well, a lot! The Piriformis muscles help to keep our sacrum stable and in a balanced position. When the hip is extended, this muscle is a hip "external rotator," meaning it rotates the hip and leg outward.  Think about the motion required to cross your leg and place your ankle on your opposite knee...thanks Piriformis! The Piriformis also works to abduct the hip, or move the leg out to the side, when the hip is flexed. This motion is important during walking to maintain our balance and help us shift weight to the other side of the body so we don't fall. What I think is particularly fascinating about this muscle, is that as we "flex" the hip up to bring our thigh toward our chest, the function of Piriformis reverses to be a hip "internal rotator." Think of the motion involved at the hip as you put your shoe on or take it off with one hand while standing.  Now, I'd say those are some pretty important functions!

Want to feel your Piriformis working? Lie on your stomach with your knee bent to a 90 degree angle. Slide your bent knee slightly away from your opposite thigh. Using the Piriformis muscle deep in the hip, allow your lower leg to come across to the back of the opposite leg while still maintaining the 90 degree angle. Feel the muscle contracting in the center of the buttock area? Pretty cool, huh? Another way to feel it is to lie on your back with your knee bent all the way up toward your chest.  With the knee bent and your lower leg parallel with the floor, rotate your hip inward so that your foot moves out to the side, away from your body. Now can you feel a muscle in the back of your hip working for you? That is your Piriformis, my friend.

What happens when Piriformis is not working correctly? This poor guy gets the blame when folks have tightness or pain in the center of the back of the hip, or when they feel weakness or pain extending down into their leg. These symptoms are also known as "Sciatica" symptoms. Some people's Sciatic nerve, or parts of it, pierces right through this muscle, so that can create some of the same symptoms.  One of my biggest pet peeves is when people are told that the Piriformis muscle should be "released," or stretched to the max, as is often recommended in traditional Physical Therapy sessions or group fitness classes. Maybe the Piriformis muscle just wants to be understood, not stretched!!! Sometimes Piriformis is crying out for help as it compensates and tightens up, when the other bigger, more efficient hip rotators are not performing at their full potential. Sometimes it is crying out as to say, "Dude, STOP sitting on your wallet!!!"  Other times, the Piriformis becomes compromised if the pelvis is not in an ideal position or alignment due to other muscles not functioning properly. It may just need a little reminder of how is is designed to work properly throughout its entire range of motion, followed by some re-education activities.  A whole body assessment must be performed to truly identify if the symptoms in the hip and leg are from an injury to the actual Piriformis muscle itself, or if the symptoms are simply your body's way of getting your attention to help a bigger issue.

Over the past 16 years of Physical Therapy practice, this muscle has been the recipient of many of my treatments. Ever since becoming a Muscle Activation Techniques (MAT) Certified Specialist in 2010, I have changed my approach to assess for weakness and then specifically re-activate and correct the imbalances in and around the Piriformis, which has taken my clients results to a whole new level. I have to say that it is a whole lot more fun for all of us than the old way I used to treat, using my elbow to dig out the tightness, followed by a stretch. For those of you who worked with me prior to 2010 for your Piriformis issues, I do apologize for any discomfort I may have caused you.  I promise to make it up to you should you choose to try some new and improved Muscle Activation Techniques treatments... :)   

March 2015 Longissimus

Longissimus

This month’s “Muscle of The Month” is one of my favorites. Maybe it is because we share a “middle child” connection that I am particularly fond of this muscle. This is a good thing, because as a "Greg Roskopf's  Muscle Activation Techniques (MAT) Certified Specialist, I find that Longissimus is not as efficient as it could be in MANY of my clients, so I work hard to get this muscle working properly.

Longissimus is one of the 3 muscles that make up the “Erector Spinae” Group. Located in the middle of the Erector Spinae group, between Spinalis and Iliocostalis, Longissimus is the longest of these 3 muscles on the back of the body, running along each side of the spine. This muscle begins in the lumbar (lower back) region, connecting to a thick connective tissue known as the Thoracolumbar Fascia.  The Longissimus has attachments onto each of the ribs and thoracic spine, and runs all the way up to the side of the neck (cervical spine) and into the base of the skull.  

You may be wondering: “What functions does the Longissimus provide for our bodies??”

The Erector Spinae muscles are all responsible for keeping our trunk and upper body upright against gravity while we are sitting and standing. When one side is not working as well, the other side of the body has to work overtime to keep us upright, and that gets tiring!  Since the Longissimus attaches to the Thoracolumbar Fascia in the lower back area, the tension it generates helps to keep this area stable. Many other muscles connect into this region as well, so all of them must be working efficiently to have the proper support and stability in our lower back and Sacro-iliac (SI) joints. Some of our abdominals attach into this same area of the back, so instability here can even affect the efficiency of the front of our abdomen!  The Longissimus muscle is involved in bending our spine and trunk to the side, rotating it to the same side, and extending it back (like for maintaining upright posture or performing a backbend). The Longissimus Cervicis (in our neck) causes us to bend our neck sideways to bring our ear toward our shoulder, turn our head to the same side, or look up toward the sky. The Longissimus Capitis (attached to our skull) also brings our head to the side on top of our neck, and helps us to lift our chin toward the sky as we look up. This long muscle does A LOT for our bodies!  

“How do we isolate this muscle to feel it contract?” Well, I thought you’d never ask! To isolate the lumbar and thoracic sections of the Longissimus, lie on your back with your upper body bent to the side, now slide both of your legs over to that same side so your body is forming a C shape. Use the back muscles on the shortened side of the curve to push your legs further to that same side. Make sure you are using the muscles on the back of your body rather than on the side of your abdomen or trunk. For your neck, lie on your stomach with your head off of the edge of your bed. Lift your head all the way up and turn it all the way to one side. Tilt your chin up toward the ceiling to isolate the portion that attaches to your head. Be sure to breathe as you move into these positions and only go as far as you can without any discomfort. 

“How will I know if my Longissimus is not working correctly?” you may also be wondering.  If you feel limitations in your ability to perform the functions listed above or have tightness or discomfort while bending, turning or extending your spine, your Longissimus should be checked out. If you feel generalized pain in the lower back or SI joints, have chronic neck pain or headaches,  Longissimus could be a culprit.  

Once you have checked in with your personal MAT Specialist and are certain that all muscles are in good, solid working order, you can move on to more general strengthening exercises.  Some general exercises that will involve the Longissimus are Supermans, Bird/Dog, Roman Chair Back Extensions, and Dead Lifts.  Your body will thank you to keep your Longissimus muscles happy and strong!

February 2015 Transverse Abdominus

TRANSVERSE ABDOMINUS

Most of you already know I am a total NERD for muscles, but I LOVE this one!  This muscle is the deepest abdominal muscle in our body, underneath all the other core muscles, but it hardly gets any attention. Most everyone knows about the "Obliques” on our sides, and the one in front that makes the 6-pack, “Rectus Abdominus”, but “Transverse Abdominus” is the most important one, in my opinion, and some people aren’t aware that it exists!  Transverse Abdominus (TVA) is a ginormous muscle, spanning from the bottom of our spine (Lumbar vertebrae 5, 4, 3, 2 and 1) wrapping around (transversely) both of our sides, connecting to the top of our pelvis from back to front, running over the top of Rectus (like a kangaroo pouch) and then attaches to the middle connective tissue of our abdomen, known as the “linea alba”.  That's just the lower fibers!!  This dandy’s upper fibers extend up the entire front of the abdomen underneath Rectus, and ends it’s journey connecting into all the lower front ribs, near the bottom of our breastbone. Phew!!  Now that’s a dandy, am I right???

So, now that you know where it is…what does TVA do for you??  Well, tons of stuff, actually.  This muscle functions as an “internal girdle” for keeping our abdominal organs in place, helps to promote the important process of carrying and delivering a baby, and is used to remove the “junk” out from our digestive system through elimination.  On a more fun note, TVA is the main muscle that contracts during a belly laugh!  How about keeping our pelvis in a stable position? Well, we can thank the TVA for that one too. With a stable lower spine and pelvis, our arms have the proper neurological recruitment patterns for efficient upper body movements.  If that isn’t enough, there’s more!! By contracting the lower fibers of this guy, we can twist our pelvis and trunk/spine to the same side. By contracting the upper fibers, we can twist our ribcage and spine to the opposite side.   This muscle also helps us to bend our trunk to the side, as well as flex or bend it forward when we touch our toes, or do an abdominal “crunch.” This is one busy muscle!

How do we isolate this lovely muscle?  Some would say: “Pull your navel into your spine.”  That gets it somewhat, but to really isolate it more specifically, Muscle Activation Techniques (MAT) teaches 2 different ways, one for the lower fibers and one for the upper fibers.  Want to try? For the lower fibers, lie on your back with your left knee bent and foot resting on top of your right thigh. Feel the left abdominal area between your pelvic bone and bellybutton. Now lift the left side of your pelvis up and over toward the right side, as if trying to reach your left knee up and over to the corner of the room where the right wall meets the ceiling. Feel it? Now try that on the other side and compare what you feel each way. For the upper fibers, sit on the edge of a chair with your knees straight and feet flat on the floor. Turn your torso to the right as you feel the area contracting between your left ribs and the middle of your belly. Got it? Now reverse it, and again, compare the sensations you notice.

You may be wondering, “What would I notice in my body if the TVA is NOT working properly??”  Well, that is a very good question. Weakness in the TVA can lead to all sorts of issues including lower back pain/tightness, neck pain/tightness, radiating pain/weakness/numbness into the leg(s), inability to reach arms overhead, poor bladder or sexual control, decreased ability to assist a bowel movement, difficulty delivering a baby, poor digestion, and more. Ever experience any of these?

We want to be sure that both sets of fibers on each side of the body are working throughout their full range of motion before we do strengthening exercises, just like any other muscle in the body.  Once we are certain that TVA is working and you can feel the precise areas being isolated, you can perform many different strengthening exercises to target this area. Planks, abdominal curls (“crunches”), torso twists, windmills, burpees, mountain climbers, pelvic tilts, and knee to chest marches, to name a few.

As a Muscle Activation Techniques (MAT) Certified Specialist, I can precisely check your TVA muscles and make sure that they are performing their jobs efficiently. Who knows, maybe we can have a belly laugh or two in the process, to help them along! : )

January 2015 Upper Trapezius

Upper Trapezius

Have you ever felt tightness in your upper shoulders or into your neck? How about a headache at the back of your head, or up the side of your head into your temple? If you answered “Yes”, it is likely that your Upper Trapezius muscle was involved. I will share with you how this muscle works, as well as the easiest and most effective ways to take care of this muscle.  Knowing how your body works can help you to keep your body working well.

Where is Upper Trapezius located?

The Trapezius muscles are appropriately named since each side looks like a trapezoid. The right and left sides together form a diamond shape from the back of the head, out to each of the scapulae, and down to the middle of the back.  The Trapezius muscle consists of 3 sections on each side, the upper, middle, and lower fibers.  This article focuses on the highest portion, known as the Upper Trapezius.

What does Upper Trapezius do for me?

We use our Upper Trapezius to raise our shoulders up to our ears, or “shrug” them.  In addition to supporting the weight of our arms at our side, the Upper Trapezius rotates the shoulder blade upward as we reach forward and overhead.  The Upper Trapezius connects to the base of our skull, and we use it to look up and extend our neck. The left side of the Upper Trapezius rotates our head to the right when it contracts, and vice versa.

Why does my Upper Trapezius get injured or sore?

Overdoing any of the above motions or lifting too heavy a weight may cause this muscle to become strained. Also, cradling a telephone between your ear and shoulder for long periods of time may cause this muscle to become shortened, then tight or painful.

What can I do to keep my Upper Trapezius working well?

As you sit or stand comfortably, try the following activities to feel your Upper Trapezius working on each side of your body. Remember to stay within a pain-free motion.  You can perform each of these a few times to get the circulation moving and feel your muscles working.

1. Raise your shoulders up toward your ears. Relax them down.

2. Look up to the right and bring the left ear toward your left shoulder. Reverse.

3. Keep your elbows straight and raise your arms straight in front of you.

4. Keep your elbows straight and raise your arms out at an angle in front of you.

5. Keep your elbows straight and raise your arms out to the side.

Did you feel your Upper Trapezius muscles working? Great!

How can I strengthen my Upper Trapezius muscles?

If you want a little more strenuous exercise for these muscles, try “Shoulder Shrugs” while holding a weight in each hand. Some other strengthening exercises commonly performed that involve the Upper Trapezius are the “Clean and Jerk”, where a weight is lifted from the floor to the shoulder, then raised straight up overhead. You can also perform “Upright Rows” where you raise a bar, kettlebell or weight in front of your chest as you bend your elbows out to the sides. “Dead lifts” also work your Upper Trapezius as they support the weight of your arms and any extra weight you are lifting in front of you.

As you can see, Upper Trapezius is a very important muscle and has some functions we rely on many times throughout every day.  It is important to make sure your Upper Trapezius is working at it’s best.  

Latissimus Dorsi

Latissimus Dorsi is one of my favorite muscles! The Latin name “Latis” means broad, and “Dorsi” comes from the Latin word dorsum, which means back. This huge muscle connects the arm to the lower back. When Latissimus contracts, it pulls your arm toward your side, allows you to reach behind you, it helps your trunk, ribcage and spine rotate and bend to that side, AND it helps you use your arms to push up from a chair. Wow, that is one very busy and important muscle!! You have likely used the “Lat Pull Down” machine at the gym to build strength and tone up this area. You can also work the Lats by doing Rows, Planks (on your side), pullups, bridges, dead-lifts, and all sorts of exercises with an Exercise Ball. If you have questions about whether any of these exercises are right for you, or if you want to be sure your Lats are working properly, I’d love to help you!