Rotation is one of the most important motions that humans have in their repertoire of locomotion. After stabilisation of the neck, chest and pelvis is achieved at the age of 4-5 months, a baby develops the ability to rotate from supine to prone and back and then progress to four-point, quadrapedal and then verticalisation before the monumental task of gait is achieved.
So if rotation is one of the first components of movement and locomotion that we establish, it would also appear to be one of the first movements that we tend to lose as we develop dysfunctional or habitual movement.
Why does this happen? Or A question that I am often posed by my clients. How did I get to be like this? I would offer the following scenarios:
- Too much exercise- focus on sagittal plane or backwards and forwards motion.
- Too little exercise – stuck at a desk-sofa, inability to breathe, lack of movement.
For the committed exerciser a lack of rotation or the lack of reprogramming of rotation is often key. The neck and thoracic spine were built for rotation. Squats, deadlifts, pull ups, benching, Olympic lifting and other exercises do little to improve rotation. Even if a good trainer implements some great rotational exercisers such as wood-chops, cable push or pulls with rotation, med-ball tosses and the like, the action of creating an optimal rotation pattern is hard to achieve without some form of neuro-biomechanical re-programming. In short:
MORE DOES NOT MEAN BETTER
Understanding how good rotation (and frontal plane or side to side mechanics) looks like and how to reprogram it, should be considered by those wanting to improve mechanics or to move away from sources out of pain but of course a lack of rotation is not the only cause of pain and or altered mechanics. Regional interdependence is a concept that suggests that poor movement and pain in one area may be the product of another seemingly unrelated area.
So what’s good?
As always depending on your slant opinions can vary. I tend to use mechanical analysis such as SFMA (Selective Functional Movement Analysis), combined with some other biomechanical considerations such as, DNS, gait and to change the clients patterns I use techniques such as Neuro Kinetic Therapy and Proprioceptive Deep Tendon Release or PDTR for efficient results.
Here’s a quick way to analyse rotation.
The standing position observes a ground up view of rotation. In short it helps to breakdown issues related to mobility or stability. What you are looking for is approximately 45-50 degrees of rotation at the hip and pelvis and 90 degrees of rotation of the upper body. It should be compared with the other side
Completing the test seated with the feet on the ground allows for an assessment of rotation of the upper body minus involvement of the lower body to determine interactions. In short an approximate rotation of 50 degrees either side is ideal. Unilateral differences should be compared as part of the treatment strategy.
Is it a mobility or stability issue? An old vid blog can you up to date on this concept.
The rolling pattern is a great leveller for the athlete and non athlete alike. The concept is to assess the ability to roll using only upper body or lower body, analysing segmental movement and in most cases many people cannot adequately roll.
In fact the compensation strategies can reveal much about how an individuals brain has elected to move with compensatory mechanisms. Correcting these can be achieved with NKT and PDTR in the space of a few minutes in some cases.
Rolling patterns represent one of the first forms of locomotion in the neonate and initial rolling patterns starts at the age of 4-5 months.
Rolling assessment allows for the identification of muscles/structures that may contribute to poor rotation in gait, day – day and sporting activities.
Comparing upper to lower body and prone to supine can determine deficits that can be rectified in both pain and optimisation of movement.
- Upper body prone to supine left to right
- Upper body supine to prone left to right
- Lower body prone to supine left to right
- Lower body supine to prone left to right
When we lose efficient rotation in everyday activities such as walking and running, structures that may not be able to rotate efficiently may be forced into compensatory movement. For instance, the lumbar spine which has minimal degrees of rotation when compared to the thoracic spine can often be the source of pain
Integrating rotation into your exercise and injury prevention routine should be as important as your warm up itself. If you feel that you can’t rotate that well then get in contact with someone who can assess and change your rotation.
You can find out more in my breathing pattern and core workshop coming up soon called The Foundational Five about how to change core function.
- Cook, G. et al. Selective Functional Movement Assessment. Course Manual
- Kobesova, A., Kolar, P., Developmental kinesiology: Three levels of motor control in the assessment and treatment of the motor system, Journal of Bodywork & Movement Therapies (2013),
- Weinstock, D. Neuro Kinetic Therapy.
- Cook, G. Gill, L. Hoogenbam, Voight M. Using Rolling to Develop Neuromuscular Control and Coordination of the Core and Extremities of Athletes. N Am J Sports Phys Ther. May 2009; 4(2): 70–82.
Restoration of metabolic process- lowering the adrenal load.
Sugar, fat and other mal-aligned factors.
Saturated fat is bad for you, so they said but it clearly wasn’t. Now it’s sugars turn. Sugar causes diabetes, cancer and many other modern conditions, if you are to believe many of the memes on social media. Well no, it doesn’t. Cancer for example is usually created from a specific defect to the respiratory apparatus of the cell. In English that means part of the cell that utilises oxygen. Sugar or Sucrose whose primary constituents are both Fructose and Glucose are readily available carbohydrates and the brain/central nervous system require plenty. Have you ever noticed that brain fog creep in when on that low carb diet? The reason? Restricted carbohydrates equals reduced cognitive process’s. Yes we can generate glucose via oxidation of fat, in the form of ketosis and you can also break down protein to generate glucose too, but these methods are less than efficient forms of energy generation and long-term utilisation of these systems is not ideal.
Sugar produces energy and when processed with oxygen is much more efficient than glycolysis or energy production without oxygen (anaerobic). In those who have damaged metabolism, there is a reliance on the production of energy in this manner, lactic acid is often produced even at rest. Therefore trying to exercise at intense levels poses a problem for those with both adrenal and metabolic issues.
Give the body what it needs? Got cravings? You know those ones where you are dying for some food, starchy carbohydrates, a sugary drink? There are no demons at work here, just a simple case of biology, carbohydrates are a primary fuel source for the body. Want to avoid coming crashing down? Avoid having 3 big meals a day and maintain blood sugar levels by eating frequently. Some do better than others but allowing 4-6 meals a day and noting how you feel is a step in the right direction. Maintaining a body temperature of 37 degrees and a pulse rate of 70-85 beats per minute is ideal. This has been well documented in the work of thyroid researcher Broda Barnes and the work of Ray Peat PhD.
Eating readily available carbohydrates such as ripe digestible fruits, protein and saturated fats (in the right amounts) such as coconut oil help to maintain blood sugar levels throughout the day without the resultant elevations in cortisol, which affect adrenal regulation issues.
Stressful situations often warrant the use of supplements such as Vitamins A, B6, C, magnesium and potassium. In particular sugary foods, which should include fruit, maple syrup and honey are ideal choices to diminish the stress response (even table sugar could play a therapeutic role in lowering stress).
Salt is also a powerful anti-stress compound. During stress sodium is often passed more rapidly from the body. Sodium spares magnesium. If you drink too much water the level of sodium excretion increases, which further decreases available magnesium. The research on lowering salt intake is inconclusive but what is known, is that when a low sodium state exists, aldosterone, a hormone that is used to regulate both salt and blood pressure elevates in response. It would come as no surprise that in a low adrenal state, feeling dizzy when moving from seated to standing exits due to poor blood pressure regulation. Craving salt is a mechanism to improve such a situation.
The current mind set regarding exercise and wellbeing is
Increased exercise + Low carb and raw foods = Health
And in the short term, markers suggest that this could be favourable. So how do you tell if this working for you long term? The monitoring of both pulse and body temperature give a great insight into optimal biological function. Here are some of the symptoms, which combine both compromised cortisol and thyroid function.
- Cold hands, feet and nose
- Energy crashes
- Poor wound healing
- Poor sleep
- Constipation or alternation between constipation and diarrheoa
- Weight gain
- Skin issues
- Low libido
Intense exercise + low carb/raw food diets= compromised metabolism.
Historically in many, changing both the way you eat and completing more exercise may have worked previously, but as you push the markers of exercising more and eating less or certainly eating foods that do not support your activities. You may see many of those symptoms above start to creep into your daily life. There’s no doubt that eating well and exercising are productive pursuits for optimal body function. However for many the lines are blurred as to what actually is a healthy diet. Consumption of large amounts of grains, margarine and low fat foods were being touted as healthy a decade or two earlier, now look at the research condemning that approach. The following information seems to be heading a similar route.
For the health conscious exerciser today a diet high in raw green vegetables, green juices, seeds nuts, fish oils, low carb, low starch seems to be the zeitgeist but is it that healthy? From a biological perspective the answer would be no. Eating these foods over a long period of time not only increases the stress response but may actually damage how our body’s cells actually function. Increasing available energy from easily digestible foods helps to assimilate energy for production. In contrast foods such as many raw green vegetables, nuts, seeds and vegetable oils, not only irritate the bowel, sit and accumulate bacteria damaging the intestinal lining, but also provide less than optimal nutrition, which will lower metabolic rate.
Moving is important, no doubt, but exercising to within an inch of total fatigue can be detrimental, especially so when dealing with issues related to both adrenal and metabolic based issues. Finding the right type of exercise and even stepping back and focusing on exercise that doesn’t produce high levels of lactic acid, causes hyperventilation and the loss of carbon dioxide should be considered in the short term. The goal of improving metabolic function, restoring deep sleep and raising energy should always predominate over the loss of body fat reduction. It’s a tricky issue to get your head around for some, but when you start to feel great again. You’ll understand why.
On Dubai Today this morning, Keith Littlewood, our regular health, fitness and well-being expert from Scandinavian Health and Performance in Dubai joins us to take your questions.
Here is the first part of my article, which published in the May 2014, Womens Health and Fitness Magazine.
Adrenal fatigue or reductionist thinking?
Often, being given a distinct diagnoses that can relate to modern living can make sense to us, a modern condition that makes sense of the hectic lifestyle and the symptoms that we have been experiencing. Over the last decade there has been much literature on a so called ‘Adrenal fatigue’, whose symptoms are wide reaching from fatigue, digestive dysfunction, weight and sleep issues.
Walther Canon and Hans Seyle, probably the most prominent scientists to study and interpret the mechanics behind, adrenaline, cortisol and the stress response, showed that when rats were exposed to high levels of stress, they developed issues such as ulcers, intestinal bleeding and then finally death. The common suggested auto immune diseases that are becoming more prevalent, such as intestinal hyper-permeability or leaky gut can therefore be interpreted as symptoms of chronic stressors.
The premise of adrenal fatigue works something along these lines.
- You are exposed to stress
- You produce stress hormones (Alarm phase)
- Your body returns to normal
- You become stressed again on a regular basis
- You enter the adaptation phase
- You constantly maintain the stress response through permanent exposure
- The adrenal glands become exhausted
- Suggestion that you have adrenal fatigue or exhaustion phase
There are many problems with this interpretation and deduction of adrenal fatigue, and how many practitioners treat this reductionist diagnosis. If your adrenals were truly fatigued, you may not actually be with us anymore and ultimately be dead. Cortisol which is produced by the adrenal glands, is the primary hormone that directs immune function, inflammation and is involved in virtually all aspects of body function. Certainly the terms hypocortisolemia, too little cortisol and hyper, too much cortisol make sense, and that is what a typical adrenal stress test tells us. Are we producing too much or not enough cortisol , on that particular day, based around a suggested norm?
Cortisol does go up and down, and probably outside of suggested arbitrary norms especially if you experience or engage in the following:
- Excessive physiological or structural stress, intense exercise without adequate rest.
- Psychological stress
- Diet or fail to eat enough calories, eating too much may also contribute over time
- Eat a so called healthy diet based upon current guidelines
- Fail to get adequate sleep.
- Chronic exposure to environmental pollutants
The longer one stays in a state of chronic stress the more compromised all aspects of body function become. This can ultimately result in hormone, immune and metabolic systems dysfunction.
The positives from treating the aspects of adrenal fatigue are a compliance of those suffering from the suggested condition, to address aspects of why they have got to this current state of affairs. Overworking, too much or too little exercise, not enough sleep and psychological stress recognition can be aspects that can be changed with great effect.
To create effective change, should we not consider other aspects of function that would treat the root cause, rather than plaster over the symptom? Lets take a look at the cross over between symptoms of both adrenal and thyroid dysfunction, which have roots in energy and digestion. You may start to notice that there are many symptoms that you may experience a mixture of both and to highlight adrenal fatigue alone is problematic. The thyroid gland supports energetic process’s and when this becomes compromised we call on the adrenal glands to act in a supporting role. Addressing energy, metabolism and digestion, should be the target of any lifestyle or therapeutic interventions.
|Adrenal symptoms||Thyroid symptoms|
Low blood pressure
Sweats a lot
Need to wear sunglasses
Weight gain or loss
|Difficult to lose or gain weight
Feel cold hands and feet
However treating adrenal fatigue in isolation with adaptogenic herbs, restriction of sugar and other stimulants as is often the case, may be unwarranted and most importantly ineffective in resolving these issues. Treating any system in isolation is reductionist and often gives you at best, reductionist results. The complex interaction of the Hypothalamus-Pituitary-Adrenal-Thyroid-Gonadal axis is a system that helps our body manage many global aspects of our body’s function and therefore addressing adrenal balance leaves a gaping hole in your treatment strategy. Consider that the adrenals and in particular cortisol production can be a slave to the your environment, nutrition, exercise and other lifestyle choices. Take stock, address what may be affecting your stress hormone production, If these factors can be changed do so. Stress is a double-edged sword. We need a certain amount of stress to improve our physiological function. Constant exposure to stress decreases our biological state.
Raising biological wholeness such as energy levels, cognition and increasing balance throughout the hormonal system can give much better results than focusing on the adrenals. Remember that the adrenals and ultimately cortisol production elevate in response to, what you eat, or fail to eat, the environment, psychological and physiological stress. All of these aspects are changeable. In the next article I suggest some strategies that can be used to improve energy and lower adrenal stress.
In the past few months I have had the pleasure of working with Amna Al Haddad. She is a motivated, strong woman with a goal of training for the 2016 Olympics in Rio. When I first met Amna she was a little disappointed with her progress and felt like she had hit a wall with her training.
Initially the goal was to tweak her energy levels by analysing her metabolic rate and modifying diet to get the optimal amount of energy, to improve performance. When people participate at high level sports they can often become very strong through compensatory mechanisms. Using bio-mechanical assessments and motor control evaluations such as SFMA and Neuro Kinetic Therapy, we were able to change the way that Amna’s nervous system communicated with the appropriate muscles and present some strategies that kept them optimal.
Understanding the difference between mobility versus stability issues is key.This ensures that movement remains great and injuries are reduced.
It’s been great to see Amna hit some new PB’s and stay motivated for her goals ahead. Really looking forward to see her excel over the next few years as it has been a pleasure working with someone so motivated to achieve their targets.
“Working with Keith in the past few months have been absolutely great. My performance, energy levels, and stability definitely increased after our treatment sessions. My muscles have been compensating a lot, often causing a lot of dysfunction and irritation that has affected my weightlifting and strength levels.Keith understands the human body in a different way than what I have seen before from a performance consultant; he can immediately show you how to activate a muscle and restore its strength, reduce pain, and more in just a few seconds! BUT..you have to do your homework to reinforce the new movement patterns.”
Amna Al Haddad, UAE national Olympic Weightlifter
If you haven’t yet met someone who has recommended you either some form of diet or a type of exercise, you are unique, in fact a real rarity, and somewhat lucky.
The fitness and wellness industry is awash with much dogma, often created by short term ideologies, that in long term may be harmful to ones health. A friend sent me a link to a simple yet effective graph from Keith Norris’s blog on chasing performance goals and their impact on health. This got me thinking about the fields that I work in and how much of the recommendations are riddled with dogma and lack critical thought processes.
There’s often a reason for this dogma existing and for many it is due to the anecdotal gains that can be experienced in the short term. Here are just a few reasons why:
- High carb to low carb
- Eating grains to not eating grains
- High meat eater to vegetarian
- Sedentary to high intensity exercise
- Modern SAD to Paleo
- Regular diet to juicing
There are plenty more and the point to be made is, some positive gains can be made in the short term, change to metabolic markers, restriction in excessive calories, weight loss and a variety of other markers. From the diagram above you can observe that whenever there is a change to the input of a system, change can occur and especially when there has been little variance in the past. As change occurs and an almost linear increase in perceived health markers also occur, a Zone of Optimisation and resultant dogma often ensue.
‘This really worked for me, and it will do for you, trust me!’
Is the problem for many people, those often short term gains, on the way up on your performance curve, may actually start falling sooner than you think.
For the performance exerciser, poor movement, compensation and ultimately pain will ensue.
For those to the new diet, great results could turn into stagnation, weight gain and a host of metabolic disturbances.
Is it working for you? Well do you:
- Have good digestion?
- Have deep restorative sleep?
- Balanced energy?
- Healthy libido?
- Balanced emotions
- Good stress response
If you don’t, you may just be coming down from that peak of physiological and biochemical gains. When might it happen, 1, 2 or even 5 years down the line perhaps? Hysteresis or a systems memory can be changed with ease if there exists, little underlying metabolic damage and a reduction of factors that increase resistance to repair that system. Supporting metabolic processes should be first and foremost.
Understanding that fitness is not always a healthy pursuit and paying attention to markers that increase vitality should be a goal, and be pursuant to any fitness goal.
Move, play, eat, digest and sleep well.
What’s your gut telling you: why your digestion holds the key to your health. IBS? Bloating? Far from being isolated digestive disorders, these are now being linked with everything from osteoporosis to depression. Keith Littlewood from Balanced Body Mind joins us to answer your questions about performance, digestion and much more.