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Thread: Not willing to give in to ''silly bullshit'', or arrogance?

  1. #11
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    Quote Originally Posted by Mark Rippetoe View Post

    If it's primary function is isometric, how is rehab optimized by including isolation concentric/eccentric movement? IOW, why is this -- "if such a tissue will only be optimally rehabbed by including concentric and/or eccentric contractions?" -- your assumption?
    It's an assumption that some physios make. The mantra is often: work it isometrically, then when it's ready, incorporate concentric and eccentric work. The assumption of course, may be completely off base, but it is a possible mechanism through which systemic, functional loading of a joint may not provide optimal rehab.


    Quote Originally Posted by John Petrizzo View Post
    The concentric function of the supraspinatus is to assist the deltoid through the first few degrees of abduction. The role of the rotator cuff muscles during the far majority of "functional" activities is to work together isometrically to stabilize the glenohumeral joint while the many larger, stronger muscles (pecs, lats, deltoids, teres major, biceps, triceps, etc.) that operate the joint create movement much like they do during the press so your example is not a great one.
    But one could argue that rehabbing a tissue requires types of contractions that aren't necessarily the type that are used during functional movements. For example, if it turns out that, regardless of a tissue's primary function (e.g. isometric stabilization in the case of supraspinatus), concentric contraction is also needed for optimal rehab, then an optimal rehab program would incorporate both presses and humeral abduction.

    I'm not making this argument: I'm in fact completely ignorant about mechanisms of healing as it relates to types of contraction. But it is a coherent and, on the face of it, plausible argument. If anything, it would be nice to give an answer to any would be physios who made this argument (other than: well, its primary function is isometric stabilization, therefore concentric and eccentric work will not provide any additional benefit).

  2. #12
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    I mean to say that, if somehow, after a neck injury, your neck muscles become so atrophied that you can't even hold your head up, then I would think that isolation neck exercises would be appropriate. This is a rather specific situation though and it's the only one I can think of.

  3. #13
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    Quote Originally Posted by JudoATunez View Post
    They have a short range of motion, or no range of motion at all (leg adduction, single leg balance exercises), involve little muscle mass, and cannot be loaded properly, and therefore cannot drive physiological adaptation. However, these exercises give you the subjective sense of accomplishment, as you're ''working'' to not lose your balance, or you feel the ''burn'' in a speciic region of the body, so many people associate this things with effectiveness.
    I rehabbed a bad MCL tear with a LP program of squats from a low weight. I was back to "normal" in about 6 weeks and back to PR range in 3 months. With a slight tear, you will be back soon.

  4. #14
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    Quote Originally Posted by spacediver View Post
    It's an assumption that some physios make. The mantra is often: work it isometrically, then when it's ready, incorporate concentric and eccentric work. The assumption of course, may be completely off base, but it is a possible mechanism through which systemic, functional loading of a joint may not provide optimal rehab.
    That's a brand-new mantra. But you have not described a mechanism. You have made an assertion.


    But one could argue that rehabbing a tissue requires types of contractions that aren't necessarily the type that are used during functional movements. For example, if it turns out that, regardless of a tissue's primary function (e.g. isometric stabilization in the case of supraspinatus), concentric contraction is also needed for optimal rehab, then an optimal rehab program would incorporate both presses and humeral abduction.
    If it turns out that the moon is made of a high grade of cheese, then we'll have a reason to go back. If.

    I'm not making this argument: I'm in fact completely ignorant about mechanisms of healing as it relates to types of contraction. But it is a coherent and, on the face of it, plausible argument. If anything, it would be nice to give an answer to any would be physios who made this argument (other than: well, its primary function is isometric stabilization, therefore concentric and eccentric work will not provide any additional benefit).
    You are not making any argument at all. You are merely making a statement that such an argument may exist, without describing the mechanism by which it might make sense. Much practical experience shows that progressively loading an injury in the tissue's normal anatomical function forces it to progressively return to its normal anatomical function. You are merely postulating that this might not be the case without explaining why. It matters not one solitary fuck what "physios" say or do, since their methods are not usually any more effective that the same amount of time spent in a good quality drinking establishment.

    Quote Originally Posted by BigA View Post
    I mean to say that, if somehow, after a neck injury, your neck muscles become so atrophied that you can't even hold your head up, then I would think that isolation neck exercises would be appropriate. This is a rather specific situation though and it's the only one I can think of.
    Perhaps it would serve better to think of a situation that might actually occur.

  5. #15
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    Coach, I am ignorant on ths topic, but according to what has already been covered, that in the event of an injury, these ''exercises'' (bands, bosu, etc.) can't force the system t return to pre-injury levels because they don't match the neuromuscular requirements of many of our general movements patterns, and they can't be loaded to drive an increase in strength, because that is what determines if the tissue will heal back or not (in the event of injury, tissue becomes weaker or is lost, so rehab should fulfill the role of developing strength in the affected area). Am I missing something else?

  6. #16
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    Think about the scarring process that will take place in the absence of anatomically normal movement as the injured tissue heals.

  7. #17
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    The muscle belly tissue will not ''re-arrange'' itself back to normal shape in the absence of functional movement pattern?

  8. #18
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    It makes a scar, that will serve as the site of a new tear.

  9. #19
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    I see. If the tissue is not rehabed correctly, scar tissue will replace the damaged tissue, in a process called fibrosis. This new tissue is of less fucntional quality than the normal tissue, and therefore, it leaves structures more prone to injury

  10. #20
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