I apologize for my tardiness in getting out another newsletter on my website. It has been difficult to keep up with my New Years resolution of writing an article once a month because I am also writing manuals for my on-line courses teaching Myomemory Advantage Transformation (M.A.T.).
Before getting into M.A.T.’S Spiral neuromyofascial pattern, let me summarize again what M.A.T. is. It is an integrated, general systems, and functional approach to evaluating human posture and movement developed by me from over forty years of a clinical physical therapy practice treating acute and chronic musculoskeletal pain and over twenty years of participating in the winter sport of nordic ski jumping.
In retrospect, I now find it truly paradoxical that I practice in a profession that evaluates the effects of gravity and ground reaction force (GRF) on the human body and trained and practiced in a sport that was foremost competing against gravity and GRF. These experiences have given me a different perspective on how our bodies’ function against these vertical forces of our environment every day.
The perspective from ski jumping comes from traveling at times as fast as 70 mph down an in-run on a jump while in a crouched position with my arms at my side.
Then launching my body into the air at take off and using the air pressure under my skis, to begin the flight. If everything went as planned, I would land again on my feet with my total body reacting to GRF in total elation.
The previous pictures are of jumpers in the modern era. Again I jumped during the 1970’s and 1980’s internationally for the U.S. Nordic Ski Team. The postcard below is of me while jumping at Lake Placid, N.Y. in 1979. I did not compete at the 1980 Winter Olympic Games, but was a forerunner. However, I did compete in the 1976 Winter Olympics in Innsbruck, Austria placing 30th on the large hill.
From my escapades in nordic ski jumping over twenty years, I learned foremost that vision plays a primary role in creating human skeletal balance and equilibrium. How else could a ski jumper balance himself/herself on a pair of skis flying through the air?
In addition, I learned a lot about musculoskeletal injuries and pain from my own unfortunate mishaps and falls resulting in surgeries to my L knee and both shoulders. I too have experienced and continue to experience the resultant musculoskeletal pain caused by dysfunction of my body’s skeletal, fascial, and neuromuscular systems.
It is with my experiences in nordic ski jumping coupled with my education and experiences in various physical therapy clinics that I developed M.A.T. An integrated and general systems approach that can be viewed under the aegis of both science and art. That is because M.A.T. is the attempt by me to better understand and describe the world around us. Overtime, history has proven that one of the most primitive needs of the human race is to understand the world in which we live, and to share that understanding.
Both artists and a scientists throughout human history strived to see the world in new ways and to communicate their vision by creating new theories, concepts, and technologies. When they were successful, the rest of humanity suddenly saw the world differently and our truth became fundamentally changed. It is my hope that M.A.T.can achieve this goal as well.
M.A.T. is a labor of art in a scientific, medical world with its four neuromyofascial patterns and related concepts being ahead of its absolute details because I continue to acquire more knowledge and wisdom in regards to human posture and movement with each client I treat.
Although M.A.T.’S foundational theory that human posture and movement is the sum total output of the brain and nervous system from the sensory input provided by the body’s visual, vestibular, and proprioceptive systems in creating static and dynamic skeletal balance and equilibrium against the vertical forces of gravity and GRF is absolute, some of M.A.T.’S initial concepts are not and changed with what I learned in the clinic. I guess that is the art of M.A.T., so please be patient.
M.A.T.is not a mechanistic view of the body’s anatomy and physiology even though in the past, this type of perspective has been useful in our study of human posture and movement. But unfortunately, this perspective of the body’s posture and movement did not humanize the experience nor understand the relationship to what you feel inside your body.
It is truly my hope and belief that this relational view of the human body presented in M.A.T.will in some way connect this mechanistic view of the body most of us are aware of with the living experience and memory of being in a body which grows, transforms, matures, and most importantly learns from the experiences of life.
I am neither a researcher nor am I a scholar with credentials. My only hope is that my unique experiences in the athletic and medical worlds are useful in providing some new insights and ideas to such people and that M.A.T. becomes a motivating force to create a “paradigm” shift in how we view the human body as an integrated totality.
As I revealed in my last two newsletters, M.A.T.’S side linear and diagonal neuromyofascial patterns involve descending reflexes from the body’s vestibular system in response to gravity which include its otoliths and semi-circular canals. The spiral pattern, however, involves ascending reflexes and the body’s mechanoreceptors and proprioceptors in response to ground reaction force (GRF).
The pinnacle of all human, functional movement is our vertical, upright walking and whereas the side linear and diagonal neuromyofascial patterns were involved with the “stance phase”of your gait, M.A.T.’S spiral neuromyofascial pattern involves the “swing phase” of your gait.
The “stance phase” begins when your foot first touches the ground and ends when that same foot leaves the ground making up approximately 60% of your gait cycle during which one leg and foot are bearing most or all of the bodyweight.
The “swing phase”of your gait occupies only 40% of your gait cycle, during which one foot is not touching the walking surface and the bodyweight is borne by the other leg and foot.
Keep in mind though that in a complete two-step cycle, both feet are in contact with the floor at the same time about 25% of the time. This part of the cycle is called the “double-support phase.” In addition, remember both the stance phase and the swing phase of your gait cycle represents a combination of open and closed kinetic chain activities of your skeletal structure I mentioned in previous newsletters.
Your normal functional, human gait or your manner or style of walking is a product of the all the postural and movement patterns or neuronal patterns created by both descending and ascending reflexes generated by your nervous system that set the tone, the stiffness of the synergistic muscles for your limbs and trunk involved your gait in reaction to the vertical forces of gravity and GRF.
Your brain generated and organized these neuronal patterns reflexively below your consciousness from the “triad of sensory input” coming from your visual, vestibular, and proprioceptive systems regarding these vertical forces of your environment. These neuronal patterns of posture and movement generated by your brain are in a linear, diagonal, and spiral design that have a functional interplay or coordination during your gait.
In the mechanistic view of your gait, it visualizes your lower body as a set of conjoined pendulums. During each step you take, the swing leg functions like a simple pendulum, a device renowned for its efficiency, while your stance leg functions like an inverted pendulum.
In contrast to this mechanistic view which passes your body’s weight from leg to leg between each step of your gait, a “spiral” model involving your entire lower body functions as a single integrated, totality or mechanism. The cycling of your feet translates to rotation of your hips via a linked series of virtual hubs and axles (lower extremity kinetic chain) emulating the mechanisms of a wheel.
To produce forward motion under such a spiral model, the stance foot pushes laterally while the swing heel abducts, creating a force couple moment that drives the swing hip’s rotation around the midline of your body while positioning the swing foot for the next step. Your body’s center of gravity (COG) advances in a smooth, continuous motion while your legs cycle beneath it. Thus, M.A.T.’S spiral neuromyofascial pattern gets its name.
Don’t forget though that the design of your nervous system and its anatomy evolved to be upright in harmony with these vertical forces of the earth. Therefore, learning to work with these forces of the earth is foremost rather than struggling against them. To be human means to orient your structure vertically and is your most fundamental human orientation against these vertical forces.
In creating your posture and movement, gravity is the force of the Earth that drives all matter including you to its center while GRF can be defined as the reactive force of the earth pushing back against your skeletal structure. Therefore, gravity and GRF are in a constant interaction with your structure where gravity keeps you on the earth and GRF helps you push off the earth.
This impulse of GRF starting at the foot moves like a wave through your entire structure and body in three planes.
This way GRF both supports the body structure and initiates the movement of the contralateral arm and racquet to meet the ball like when playing tennis. It is the same whether you are walking, swinging a golf club, or lifting weights or other objects, GRF naturally lengthens, widens, and deepens the body in all three planes as it moves through a motion with the force of this energy (GRF) filling you up from its base in contact with the ground. Truly confirming the belief that “motion is life!”
Unfortunately however, that is not the scenario for most people I see in the clinic. The impulse of GRF for most will run into places within their soft tissues and structure that is being held up and gets stuck by their fascial holding patterns. That is, the tension of the fascia that acts like a wall blocking the transmission of forces through your structure and body. We all demonstrate a certain stasis of relationship involving gravity and GRF that are “holding patterns” which can impede vertical orientation and integration as well as the spiral model of your gait.
As with any holding pattern, this stasis results in diminished volume, stability, mobility, and health of your body’s soft tissues. However fortunately, these dysfunctional holding patterns of the fascia can gradually transform using M.A.T. and its exercises using the triad of sensory input allowing you to discover new possibilities with your posture and movement and help you reach your physical potential.
Recycling these natural forces of gravity and GRF gives your body a natural massage increasing the pumping of your blood and lymph. As your structure and body gives into gravity and GRF referred to as “pronation,” it allows the down-weighting of your structure and body receiving a gentle compression that folds the body’s soft tissues around the bones and gently compresses the joints. Gravity and GRF gives your body a natural lengthening of its soft tissues to increase joint space and stretch your soft tissues followed by “supination” allowing you to push off the earth.
This natural cycle of your body and structure moving in pronation and supination rehydrates and flushes your blood and lymph systems. That is why movement and especially walking is so vital to your health and well being.
In addition to turning your muscles on through the stretch reflex, GRF will also create rotational forces or torque forces on your extremities and their joints. Torque is defined as a rotational force around a vertical axis or the bones of your structure. In response to the torque forces created from GRF, the neuromuscular system will also try to control or dampen their effect on your structure and its joints.
You are probably more aware of the external forces effecting your body in your everyday life like GRF with every step you take, but in contrast, you are not usually aware of the internal forces inside the body like the torque forces created by your muscles in response to GRF.
However, there are many examples of torque forces in your body seen with your gait. The torque created at the hip joint helps rotate the leg in reaction to GRF and push off the ground. The torque created by the concurrent medial roll of your stance foot during gait and the lateral abduction of the swing foot is translated to the hips by a series of virtual axles and hubs operated by the bands of connective tissue and muscle that runs the length of your legs.
In your nervous system’s reaction to GRF, rotational or torque muscle forces are generated to effectively and efficiently accomplish and control the functional task of your gait. But also keep in mind, your muscles can also generate linear forces on your bones and joints by sliding the joints closer together or farther apart creating your joint stability and mobility. Therefore, your muscles act as both stabilizers and mobilizers.
Your experience of walking can be best described as a dynamic experience of your posture and movement involving both descending and ascending neuronal activity. Neuronal activity to and from your brain as well as up and down your spinal cord of the central nervous system (CNS) along with your peripheral nervous system (PNS), creating the subtle adjustments within M.A.T.’S four neuromyofascial patterns maintaining your skeletal balance and equilibrium.
Simply, your gait it is a dynamic dance between these four neuromyofascial patterns to generate structural stability and mobility. However unlike the side linear and diagonal patterns, M.A.T.’S spiral neuromyofascial pattern is facilitated primarily by proprioceptive sensory input and your nervous system’s reaction to GRF perceived by its mechanoreceptors.
These motor and sensory nerves along the spinal cord which came later in your neruodevelopment set the stiffness of the muscles for your extremities, spine, and trunk in response to GRF.
However, it is your brain that receives and interprets information from your body’s multiple inputs including the vestibular, visual, and proprioceptors that creates your gait. Proprioceptiion is an important neuromuscular sense also referred to as somatosensation.
The term somatosensation is an all encompassing term including its sub-categories of proprioception as well as mechanoreception, vibration, pressure, discriminatory touch, thermoreception (temperature), nociception (pain), and equilibrioception (balance). Mechanoreceptors send information into the CNS regarding your external environment such as with GRF whereas proprioceptors send information into the CNS regarding the internal environment of your body in response to GRF.
Two proprioceptors or sensory organs at the local level which are vital to the functioning of your neuromuscular system in response to gravity and GRF are the muscle spindle and golgi tendon organ (GTO) located in the muscle-tendon complex of every skeletal muscle.
The muscle spindle senses the change in length of a muscle as well as the speed of its lengthening, whereas the GTO senses the excessive tension of the muscle and inhibits muscle activation in order to decrease the tension on the muscle and tendon complex.
Both these local sensory receptors in the muscle-tendon complex inform the CNS and the brain as to the position and movement of your head, neck, trunk, and isolated extremities in space. A requirement for fine motor control and for creating the stability and mobility you need to perform the activities of your everyday function and especially your gait.
In fact, both these proprioceptors are responsible for regulating or setting the “muscle tone,” the stiffness of your neuromuscular system determining how you will respond to the vertical forces of gravity and GRF at the local level.
Muscle tone could be best described as the readiness of your soft tissue’s to respond appropriately to your environment of gravity and GRF no matter the activity as well as your behavioral needs.
Simply, the quality of your muscle engagement through the neuromuscular system that also affects the engagement of the global fascial web because of the myofascia and M.A.T.’s four neuromyofascial patterns permitting or inhibiting your posture and movement.
Although GTO’s, joint receptors, and other sensory systems contribute to proprioception mainly through descending reflexes and the vestibular system, the muscle spindles are considered the most important with M.A.T.’S spiral neuromyofascial pattern.
Muscle spindles are like a motor generating power and subsequent movement against GRF. That is because the muscle spindles indicate the degree to which the muscle needs to be activated to overcome a given resistance such as gravity and GRF.
In our every day function, the constant resistance that everybody’s structure has to overcome is gravity, but with movement GRF has to be overcome as well.
It is actually the stretch reflex of these muscle spindles reacting to GRF that facilitate muscles of the upper and lower extremity kinetic chain to generate enough power allowing us to move against this vertical and external force of our environment.
In fact, muscle spindles are the most readily found proprioceptive, local sense organ in skeletal muscles. Rough estimates have suggested approximately 50,000 muscle spindles are in the entire body.
The muscle spindle is actually a stretch receptor having its own motor supply consisting of several “intrafusal” muscle fibers whereas the individual, power producing fibers of the muscle are called the “extrafusal” fibers.
When a muscle spindle’s associated muscle is stretched, the spindle can cause two things to happen:
1) It may signal its associated muscle to contract in a protective role in order to prevent it from stretching too far and too quickly. The goal being to protect that isolated muscle.
The stimulation of such a reflexive muscle contraction is known as the the stretch or “myotonic, stretch reflex.” Remember the patellar reflex done with a reflex hammer at the doctors office? That is an example of the myotonic, stretch reflex.
2) It can cause inhibition of the opposing muscle or its antagonist to the muscle being stretched so as to prevent it from contracting and any further stretching which is referred to as “reciprocal inhibition.”
Ultimately, it is the muscle spindle that alerts the brain of nearby joints and the soft tissues that are in danger of being stretched too far. This is a very important concept in understanding the sense of body awareness also known as proprioception or kinesthetic awareness.
Because the muscle spindles indicate the degree to which a muscle must be activated in order to overcome a given resistance, as a load increases, the muscle is stretched to a greater degree. This process causes engagement of the muscle spindles for that muscle resulting in greater activation, facilitation of the host muscle. Skeletal muscles of the human body that perform precise movements will have many muscle spindles per unit of mass to help the exact and precise control of contractile activity. For example, the sub occipital muscles like the obliquus capitis superior and inferior of the M.A.T.’S spiral neuromyofascial pattern have approximately 36 spindles per gram of muscle tissue whereas, the much larger gluteus maximus of the spiral neuromyofascial pattern has less than 1 spindle per gram of tissue.
During the functional activity of walking, your gait, the muscle spindle is responsible for the “eccentric muscle loading” of the lower extremity kinetic chain in response to GRF followed by the “concentric muscle contraction” to generate the power to overcome the force of gravity at push off.
The muscle spindle and GTO at the local level as already mentioned actually reflexively sets the stiffness of the neuromuscular system, the muscle tone in preparation of your body’s response to the vertical forces of gravity and GRF.
Keep in mind though that there are many other proprioceptors such as in the ligaments of joints that affect the function of the neuromuscular system. For example, the ruffini endings monitor the direction and speed of joint capsular stretch sending their information back to the CNS to set the stiffness of your neuromuscular system. They are also present in the fibrous layer of the proximal joints while the pancinian corpuscles are more evident in the fibrous layer of the distal joints.
All of these proprioceptors respond to high velocity changes in joint position and acceleration and deceleration of the lower extremity kinetic chain of joints against GRF setting your muscle tone in response. In addition, the golgi-mazzoni corpuscles located along the inner surface of the joint capsule respond to the perpendicular compression and not the stretching to the joint capsule.
Finally there are the golgi ligament endings in both the intrinsic and extrinsic ligaments of a joint. They monitor the position of the bony segments that make up a joint.
No matter the proprioceptor named, it is the function of all these proprioceptors together whether located in the muscle tendon complex or ligaments of the joints, that play a role in setting the tone, the stiffness of the neuromuscular system at the local, isolated joint level in response to gravity and GRF.
Besides the eccentric loading of the lower extremity kinetic chain to GRF as just mentioned, another important kinetic chain link involved with your upright vertical gait is the side bending and rotation of your cervical, thoracic, and lumbosacral spine that encourages the cross-pattern, spiral gait pattern of humans.
Therefore, the muscular and fascial soft tissues affecting the hips and lower extremities must be balanced in length and tension to achieve this pinnacle of human movement, vertical upright walking, but just as vital is its central element permitting the coupled motion of the spine. As you trace the path of energy from heel strike in reaction to GRF, you can see how the spine conserves this energy it has been given from the ground gratis.
It seems reasonable to suggest that this pulse of energy from GRF and the lower extremity chain entering the body at the L5/SI interface is then distributed to all levels of the spine until none remains at the atlas/axis junction of the neck.
Compression forces created by GRF increase the torsional stiffness of spinal segments so that when the axially rotated spine receives this energy from heel-strike, the spine will be forced to de-rotate to prepare itself for the next gait cycle.
The efficient exchange of energy between heel strike and the pelvic and shoulder girdles is made possible by the oscillating nature of the human gait. However if the timing of gait is off due to compensation in the spine, pelvic girdle, hips, lower extremities and/or trunk, the energy is lost from GRF and the gait becomes less efficient.
As you can see, the timing in your nervous system’s reaction to GRF with your gait is critical for efficiency when walking or running, but rarely is timing discussed when treating musculoskeletal dysfunction and pain. Instead in our allopathic, medical system, joint pathology is still the focus and not what caused the joint pathology. From my experiences in nordic ski jumping, outstanding performances I witnessed came down as well to the timing of the skill.
When looking at spinal motion during gait, it consists of a three part system. The lumbar and thoracic spine work in tandem to counter-rotate the pelvic and shoulder girdles. This ensures the pelvis rotates while the angular momentum is balanced and no torque is transmitted to the ground.
The third component of this spinal engine is the cervical spine, which maintains an automatic de-rotation of the shoulder girdle motion to stabilize the head. This explains why the coupled motion of the cervical spine should be opposite of the lumbar spine.
When discussing the coupled motion of the spine during your gait, you have to keep in mind what I mentioned about the sacrotuberous ligament (STL) with M.A.T.’S side linear pattern. The STL is also involved with sacral rotation, pelvic torsion, and the lower back when it comes to your upright gait and other functional activities. In addition, the hamstring muscle, biceps femoris longus, part of M.A.T.’S spiral neuromyofascial pattern blends in with STL.
During human gait, the two innominate bones should take turns rotating forward and backward synchronously, while the entire pelvis rotates from right to left around a vertical axis. The shoulder girdle rotates in an opposite direction creating what is referred to as a cross patterned gait.
As the innominate bones of the pelvic girdle rotate anterior and posteriorly, the COG of your trunk changes over your hip joints. Your sacrum then rotates and side bends with a wobbly movement between the two innominate bones affecting the STL.
Movement of the sacrum is coupled to opposite sides and closely follows the induced rotation of the pelvis with each step. In an attempt to compensate for this unleveling of the sacral base, the lumbar spine will rotate and side bend opposite the sacrum.
During human infancy, motor movements are characterized by clumsy, inefficient homolateral motions. As you physically grew along with the maturity of your nervous system, mastering cross-patterned movement allowed your body’s systems to begin to work together in integration and synergy as one seamless team.
Before you were able to crawl as an infant, you moved mostly relying on the foundational reflexes of your vestibular system and these homolateral movements which involve only one side of your body such as the R hand and leg jutted forward simultaneously. Throughout this primitive neurodevelopmental stage, your R cerebral hemisphere controlled the R right side of your body and the L hemisphere controlled the L side. The resultant controlled movement pattern continued until you began to cross-crawl.
This new contralateral movement pattern involving M.A.T.’S spiral neuromyofascial pattern reorganized your CNS so all of the four neuromyofascial patterns begin to work together as a team in synergy to allow this cross-patterned motion. However, in some people you will observe that a smooth cross-patterned gait is not evident. Therefore, they are missing the strong neurological bridge through the corpus callosum connecting the two hemispheres of the brain achieved in cross-patterned motion. Instead, they rely on more of their descending reflexes and vestibular system and homolateral motion when walking.
However, in some people you will observe that a smooth cross-patterned gait is not evident. Therefore, they are missing the strong neurological bridge through the corpus callosum connecting the two hemispheres of the brain achieved in cross-patterned motion. Instead, they rely on more of their descending reflexes and vestibular system and homolateral motion when walking.
Remember, the “righting reflexes” (RR) are descending reflexes from the vestibular system and were developed at birth as part of the neurodevelopmental sequence and remain with you for your entire life in creating your skeletal balance and equilibrium. It is this group of reflexes that help your body to respond to a sudden loss of balance and assist integrated movements of the head and trunk. They also helped to take you as a maturing infant through the developmental milestones of head control, rolling, sitting, crawling, standing, and cross-patterned gait.
Clients who present with a homolateral gait pattern need cross-pattern and spiral neuromyofascial training to help strengthen whole-brain neuronal connections, but also good bodywork to correct compensatory muscle imbalance patterns that have formed over time.
You will often times see clients demonstrating homolateral remnants during their gait causing them to walk in a block-like fashion, with the shoulder and pelvis rotating as one unit. Something I saw a lot during this pandemic from too much sitting and their reliance for skeletal equilibrium and balance on their vestibular system.
You especially see this with M.A.T.’s side linear neuromyofascial imbalances where the head and neck will side bend to one side as the client weight bears on the opposite leg. This unbalanced position not only un-levels the eyes, but produces excessive energy expenditure, due to altered head over leg positioning. Unleveling of the eyes triggers head-righting reflexes that sets the stage for whole-body stress and neck pain.
However when you are more erect and upright during your gait, it establishes the ease of head rotation around a vertical axis, which serves to widen what you can see while moving. In early man, it was a necessity for survival to achieve this optimal head-on-neck positioning allowing for head and neck rotation in all directions limited only by the skeletal structure rather than impediment from protective muscle guarding.
A walking or gait pattern that does not land in a balance of forces such as seen with a homolateral gait causes compensation that can limit the movement at the cervical spine and especially at the atlas (C1) and axis (C2) where most of of our neck rotation occurs. It is a known fact that balance is greatly enhanced when the head is vertically integrated and aligned with the stance foot and eyes straight ahead.
This head and neck positioning allows for gravitational and GRF to transmit easily through the body. When the head is not vertically integrated and aligned, compensation throughout the musculoskeletal and fascial systems will occur.
Within the spiral pattern, the atlas like the sacrum is comparable to the keystone in an architectural arch of a building and is the central skeletal structure keeping the body in “ideal skeletal alignment” with the integrated body aligned over its ideal COG while standing. With poor alignment of the atlas, compensation throughout the structure occurs. The atlas is in effect the connecting link between the skull and spinal column and its alignment determines the correct position of the head on the spinal column in reaction to gravity and GRF just as with the dura mater mentioned in an earlier newsletter.
When the occiput of the cranium rests on a translated atlas in the frontal plane as mentioned in the side linear neuromyofascial pattern and a rotated atlas in the transverse plane as seen in the spiral neuromyofascial pattern, the so called “balance organ”, together with the cervical proprioceptors and eyes involving the vestibular-ocular reflexes (VOR) designed to keep alignment level with the horizon, will cause compensation throughout the skeletal structure.
With this misalignment of the atlas in the transverse plane, the axis (C2) too can be adversely affected causing compensation. The second cervical vertebra is considered by many as the most important of all the neck’s bony structures due to its dural membrane attachment and also because of the powerful myofascial structures anchoring it from above and below. The deep suboccipital muscles that bind C2 to the occiput and atlas work in harmony with other muscles to balance the head and neck especially during your gait.
In most of your daily activities like walking, stair climbing, and reaching, your dynamic skeletal balance and equilibrium requires a static foot placement on the ground that will create around your body’s COG controlled balance shifts involving your neuromuscular and fascial systems.
The two words inherently linked with skeletal balance and equilibrium no matter the task at hand again is stability and mobility. When you are stable and mobile, you are able to call on your neuromuscular system from an extensive variety of angles, positions, and motions to maintain your balance and equilibrium.
Again, mobility refers to the amount of range of motion of your isolated joints and integrated body you can use during any movement. Mobility is therefore limited by your flexibility. Stability on the other hand, is the ability to withstand dynamics and turbulence caused by changing your COG. Simply, stability is controlling your COG during movement.
It is the primary function of your neuromuscular system to control those shifts of your COG during your gait. The successful accomplishment of both static and dynamic balance and equilibrium is based on the interaction between gravity and GRF and the lower extremity “kinetic chain” during the stance and swing phase of your gait that facilitates the action of your muscular, articular, fascial, and neural systems.
A kinetic chain which is also sometimes called the “kinematic chain” is an engineering concept used to describe human movement. This concept is simply rigid, overlapping segments of your skeleton and especially the lower extremities connected via joints creating a system of movement so that movement at one joint will affect movement at another joint in a kinetic, skeletal link.
When walking, it is the vestibular system and its descending reflexes of M.A.T.’S side linear and diagonal patterns that is active during the stance phase and as mentioned and it is M.A.T.’S spiral pattern and its ascending reflexes that is active during the swing phase of your gait.
Therefore, your stance phase, swing phase, and overall the timing of your gait is greatly affected by the pronation and supination of the lower extremity chain including the lower leg, ankle, foot, hip, and pelvic girdle in reaction to GRF. Both are normal movements of the lower extremity kinetic chain and occur during the human gait cycle.
However with the spiral neuromyofascial pattern, it all starts with the foot and its spiral action. You don’t need perfect foot structure to walk comfortably, but it does require good functional movement in several key joints to lessen wear and tear and reduce damaging knee, hip, and low back compensations. Correcting these problems can be as simple as balancing the foot and allowing increase motion or decreasing motion in a single fixated area involving the talocalcaneal or subtalar joint during the stance phase of your gait.
Remember with the side linear neuromyofascial pattern when I quoted Dr. Phillip Greenman, “The subtalar joint is the body’s steering wheel and the most important joint you didn’t know you had.” Located just below the ankle, where the calcaneus (heel bone) and the talus (ankle bone) meet, it primarily does only two things, rolling in and rolling out in reaction to GRF.
Keep in mind that the talus is the only bone of the human, skeletal structure that does not have a muscle attached to it. It reacts to the inversion and eversion of the heel that reacts to GRF. But how the talus reacts to GRF during the stance phase of your gait sets up the reaction of M.A.T.’s spiral neuromyofascial pattern during the swing phase beginning at the feet.
It is the energy from heel strike impacting this motion of the subtalar joint that helps initiate the coupled motion of the spine as just mentioned. Upon heel strike, 80% of your body weight should be directly over your calcaneus producing a vertical force that is transmitted up through the lower extremity chain into the body at the L5/S1 interface.
The ankle pronates (roll in) and heel everts during the stance phase of your gait allowing for the absorption of your body weight in reaction to GRF. In supination (roll out) the heel inverts to push-off as the contralateral limb swings forward. This pronation and supination of the ankle sets up the reaction and the spiral of the foot during the swing phase of your gait.
With supination of the ankle, the muscles of the spiral pattern facilitated are the ipsilateral (same side) fibularis (peroneal) muscles including the longus, brevis, and tertius, biceps femoris longus, vastus lateralis, gluteus maximus, external oblique, and olbiquus capitis superior and contralateral (opposite side) rhomboid major, posterior deltoid, long and medial heads of the triceps, extensor/flexor carpi ulnaris, and extra-ocular muscles of the eyes.
Conversely with pronation of the ankle, the muscles of the spiral pattern facilitated are the ipsilateral posterior tibialis, semitendinosus, vastus medialis, tensor fascia latae (TFL), and obliquus capitis inferior and contralateral serratus anterior (lower portion), anterior deltoid, long and short head of biceps, extensor/flexor carpi radialis, and extra ocular muscles of the eyes.
As with all of M.A.T.’S neuromyofascial patterns the emphasis is on functional muscle imbalances and myomemory created over time by your postural and movement habits and behaviors.Vladimir Janda, a clinician, researcher, and educator from Prague, who was a pioneer in assessing and treating musculoskeletal pain stated, “muscle imbalance is an impaired relationship between muscles prone to facilitation and muscles prone to inhibition.”
I can’t emphasize enough that this condition seems to be a prerequisite for both acute and chronic musculoskeletal pain and the resulting habitual imbalance of muscle usage around a particular isolated joint and/or a kinematic chain of joints. This creates a situation where some of the muscles crossing a joint become weaker while some become stronger causing relative weakness, but not absolute weakness. Your neuromuscular system now becomes a relationship of antagonists rather than one of synergists as is its inherent design.
Your own muscles now counter act each other in order to create vertical balance, equilibrium, stability, and mobility of your structure without your weight habitually ever being transferred through the center of a joint’s axis and your body’s COG during activities of daily living. In short, it creates muscle imbalances resulting in musculoskeletal dysfunction that if not treated can cause inflammation, pain, and eventual degeneration of your joints.
The location of acute and chronic musculoskeletal pain and inflammation I see most with the spiral pattern involves the foot, knee, elbow, shoulder girdle, and upper neck.
Your feet have been developed and tested over millions of years. They are built for endurance and agility and form the foundation from which your body is aligned in reaction to GRF.
Because the spiral pattern involves ascending reflexes in reaction to this vertical force, I will begin with the foot and the muscle imbalance created between the fibularis muscles and the peroneal longus, brevis, and tertius and the posterior tibialis often referred to as the “strap muscles” of the lower leg.
The fibularis muscles also called the peroneus muscles or peroneals are a group of muscles in the lower leg comprised of the fibularis longus, brevis, and tertius. While all three muscles move the sole of the foot away from the midline of the body in eversion, the longus and brevis move and extend the foot downward in plantar flexion and the tertius pulls the foot upward toward the body in dorsiflexion.
The tibialis posterior muscle originates on the inner posterior border to the fibula laterally. It is also attached to the interosseous membrane medially, which attaches to the tibia.
The tendon of the tibialis posterior muscle descends behind the medial malleolus of the ankle and it terminates by dividing into a plantar, main, and recurrent components. The main portion inserts into the tuberosity of the navicular bone along the medial aspect of the foot while its smaller portion inserts into the plantar surface of the the medial cuneiform of the foot. The plantar portion inserts into the base of the second through fourth metatarsals, the intermediate and lateral cuneiforms, and the cuboid. Finally, the recurrent portion inserts into the sustenaculum tali of the calcaneus.
It contracts to produce inversion of the foot and assist in plantar flexion of the foot and ankle and has a major role in supporting the medial arch of the foot. Dysfunction of the posterior tibialis can lead to flat feet as well as a valgus deformity due to unopposed eversion when inversion is lost.
About every day approximately 25,000 people in this country sprain an ankle. Ankle sprains occur with extreme inversion and eversion of the heel and when the foot twists, rolls or turns beyond its normal range of motion. When a ligament is stretched beyond its normal range a sprain occurs. There are lateral ligaments on the outside of ankle and the deltoid ligament on the inside of the ankle.
There are two types of ankle sprains involving the ankle and foot which include an eversion sprain when the foot rolls outward in eversion and tears the deltoid ligament. Conversely, an inversion sprain occurs when the foot is twisted upward and inward tearing the lateral ligaments.
Because the fibularis muscles evert the foot, bringing your weight toward the ball of big toe, the medial (deltoid) ligaments are sprained in an eversion sprain. Conversely, the tibialis posterior inverts the foot, bringing your weight toward the ball of the second through fourth metatarsals, the lateral ligaments are sprained in an inversion sprain.
Keep in mind though, the position of the heel in supination and pronation of the ankle established with M.A.T.’S side linear and diagonal patterns can also be the cause of ankle sprains and not just them muscle imbalance between the peroneals and tibialis posterior of M.A.T.’S spiral pattern.
The next set of muscles up the lower extremity kinetic chain involve the hamstrings which are one of the most misunderstood muscles in the body and the explanation of them shortening when you bend the knee or lengthening when you straighten the knee is a huge simplification. To simply see them as a sagittal plane beast in flexing the knee does a disservice to the power they hold in the others planes of position and motion of the body and especially involving the transverse plane and the spiral pattern.
The hamstring complex consists of four primary muscles that are for the most part are two joint muscles meaning they cross and operate at both the knee and hip. The hamstrings originate at or near the ischial tuberosity and then insert at various points along the tibia and fibula respectively. That is except for the biceps femoris brevis which is part of M.A.T.’s side linear pattern.
The biceps femoris longus and semitendinosus have attachments more to the outside and inside of the knee so are more involved with rotation while the semimembranosus dominates in the sagittal plane and M.A.T.’S superficial posterior linear neuromyofascial pattern which will be discussed in my next newsletter.
Eccentrically or lengthening in reaction to GRF, these hamstrings together decelerate both hip flexion and knee extension with either external or internal rotation. Concentrically or shortening, these muscles can extend the hip and flex the knee through acceleration, with necessary motions involving either external rotation or internal rotation depending on the muscle.
It has been pretty well documented and understood what the hamstrings’ role is in injury prevention and function at the hip. But what isn’t so often discussed is the powerful role the semimembranosus, biceps femoris longus and semitendinosus play at the knee during running and sprinting.
Research has shown that hamstring activity was at its highest just before and immediately after ground contact. What this tells us is that these hamstring muscles have to slow down extension in the swing leg and then be able to quickly turn around and reverse motion to help propel us forward at push-off.
Keep in mind too, the knee joint also implements internal and external rotation through flexion and extension. During your daily, functional activities, many muscles are used in tibial internal rotation, such as the popliteus muscle, semitendinosus, semimembranosus, sartorius, and gracilis and in external rotation such as the vastus lateralis and biceps femoris longus.
Especially involved in this rotation at the knee and the spiral neuromyofascial pattern is the sartorius and gracilis. The longest muscle in the human body is the sartorius. Its name is Latin and it is loosely translated to “the tailor’s muscle.” It crosses the medial aspect of the knee and inserts with the gracilis and semitendinosus (medial hamstring) as pat of the “pes anserinus” (goose foot) tendon, not the proximal, anterior, and medial tibia.
The sartorius is synergistic aiding the hamstrings with knee flexion and helps the iliopsoas flex the hip. It also assists the gluteus medius in abducting the hip and works with the piriformis to laterally rotate the hip. The question must then be, “What is its primary function?”
As the sartorius, gracilis, and semitendinosus, all muscles of M.A.T.’S spiral neuromyofascial pattern converge at the medial aspect of the knee with their tendons combining to form the pes anserine tendon. It appears that the pes anserine muscles are in place to allow the walking muscles of the hip including the sartorius, gracilis, and semitendinosus to act as stabilizers of the medial knee. Just like the IT band is in place to allow the walking muscles of the hip including the gluteus maximus and tensor fascia latae to act as lateral knee stabilizers.
The knee is the most unstable of joint of the lower extremity kinetic chain in reaction to GRF. It relies predominately on its ligaments, but they alone fall short in providing the stability given the amount of the weight bearing forces going through the joint, if not for the muscles just mentioned that assist in stabilizing it.
The most powerful of these stabilizers for the knee joint and the reason for the patella, are the quadriceps providing anterior knee stability. The knee consists of two major joints, tibiofemoral joint and the patellofemoral joint. We just saw how the pes anerine muscles help provide stability to the tibiofemoral joint. With the quadriceps, the patellofemoral joint is localized.
The patellofemoral joint (PF) is where the back of your patella (knee cap) and femur (thigh bone) meet at the front of your knee. It is involved in climbing, walking, on an incline, and several other knee knee movements. It is also the joint affected by a common injury referred to as “runner’s knee.”
The PF joint is a complex structure not only involving bones, but a network of muscle and connective tissues involving M.A.T.’S spiral neuromyofascial pattern. All of the bony surfaces inside the PF joint are covered with articular cartilage, which is slippery and helps the bones glide smoothly against each other when your knee bends or straightens.
The underside of you kneecap sits in a groove within your thigh bone called the patellofemoral groove. Within this groove, your knee cap mostly moves up and down, but it does have some side-to-side play and can tilt and rotate as well.
When you contract your quadriceps including the rectus femoris, vastus intermedius, vastus medialis, and vastus lateralis along your anterior thigh, they pull on the quadriceps tendon that attaches to your kneecap making your knee straighten. However, two of the quadricep muscles keep your kneecap in the femoral groove during this motion, the vastus medialis obliquus and the vastus lateralis, which are located on the inside and outside of your anterior thigh.
When you walk up and downhill, go up and downstairs, kneel, squat, or get up from seated position, your patellofemoral joint is involved. It usually works well, but like the rest of your body, it undergoes wear and tear mainly because of a muscle imbalance affecting how the PF joint moves.
Another muscle imbalance of M.A.T.’S spiral neuromyofascial pattern and your gait that I see in the clinic is with the rhomboid major and serratus anterior. Both muscles are involved in the cross-patterned gait involving contralateral limb movements.
Both these muscles surround and encase the shoulder blades. However the rhomboid major has a particularly difficult job. They are responsible for your shoulder blades’ connection to the spine even though the trapezius of M.A.T.’s side linear and levator scapulae of M.A.T.’S diagonal patterns also do this. The rhomboid major connects from the inner edge of the shoulder blade to the spine.
The serratus anterior originates from the first eight or nine ribs and runs behind the shoulder blade to connect along the same inner edge of the shoulder blade as the rhomboids. Both these muscles stabilize the shoulder blade on the rib cage, but work in opposition to each other as the rhomboids pull your shoulder blades towards the spine and serratus anterior pulls the shoulder blades toward the front of the chest. In the spiral neuromyofascial pattern, they are synergistic with the external oblique, an abdominal muscle that rotates the rib cage.
The spiral pattern and cross patterned gait can also affect the elbow that involves the muscles in the anterior compartment of your forearm and especially the superficial layer including the flexor carpi radialis and ulnaris.
The action of the flexor carpi radialis causes flexion of the wrist and abduction or radial deviation while the ulnaris causes flexion of the wrist and adduction or ulnar deviation.
Muscle in the posterior compartment of the forearm are commonly known as extensor muscles. Three of its superficial muscles includes the extensor carpi radialis longus and brevis and the extensor carpi ulnaris. The extensor carpi radialis extends and causes radial deviation at the wrist while extensor carpi ulnaris extends and causes ulnar deviation at the wrist.
With an imbalance of the flexor and extensor carpi radialis muscles, lateral epicondylitis or “tennis elbow” can occur which is an inflammation of these tendons. Medial epicondylitis or “golfer’s elbow” can occur with an imbalance of flexor carpi ulnaris and extensor carpi ulnaris.
Finally, it brings us to the cervical spine and more specifically the upper cervical spine involving the atlas (C1) and axis (C2). Remember the atlas connects your skull to your spine and with support of the axis just below, gives your head its range of motion especially with rotation which was vital with early man’s survival. Misalignments of the atlas and axis can also cause misalignment of your entire structure.
That is because the atlas is the keystone of the human musculoskeletal system which is a complex functional system. You will also find the name “Atlas” in Greek mythology, a man who was forced to carry the weight of the vault of heaven for all eternity on his shoulders for punishment.
Like the mythological figure, Atlas, the first cervical vertebra was named because it supports the weight of the entire head (average human head weights 11 lbs). When your atlas is misaligned, proprioceptive and interactive communication between your brain and the rest of your body is disrupted, resulting in a neurological deficit and compensation to the vertical forces of gravity and GRF.
Although to the layman, the atlas may appear to be a small and insignificant vertebra and although it could be argued that the body has many others as equally important, in reality the first cervical vertebra is comparable to to the keystone in an architectural arch where without it, everything collapses. The atlas is in fact the connecting link between the skull and spinal column much like the dura mater mentioned in regards to the body’s craniosacral system.
The misalignment of the first vertebra directly or indirectly causes negative repercussions on all systems of the body including the skeletal, muscular, nervous, cardio-circulatory, lymphatic, and fascial systems.
When your skull rests on an unlevel or rotated atlas, the so called “balance organ,” together with the cervical proprioceptors and the eyes involving the vestibular-ocular reflexes (VOR) are facilitated to maintain the alignment with the horizon. As a result, the ligaments and muscles of the sub occipital are under constant tension, in an effort to compensate for the misalignment of the head. The rest of the spine and body compensates accordingly to maintain “homeostasis.”
With misalignment in rotation of the atlas, the alignment of the axis (C2) may be adversely affected with the other vertebrae below adapting accordingly.
The tone of the muscles affecting the position and motion of the atlas and axis in the spiral neuromyofascial pattern are the obliquus capitis superior and obliquus capitis inferior. When a muscle imbalance occurs between these two muscles, literally the perception of your environment involving the vertical forces of gravity and GRF changes with compensation noticed throughout your musculoskeletal system.
Well, there you have it, M.A.T.’S spiral neuromyofascial pattern. In closing, if you remember, the first two patterns of my newsletters, the side linear and diagonal patterns, directly involved your vestibular system and your nervous system’s reaction to gravity, whereas the spiral pattern involves your mechanoreceptors and proprioceptors in reaction to GRF. My next newsletter will cover the fourth and final of M.A.T.’S neuromyofascial patterns, the deep and superifical anterior/posterior linear neuromyofascial patterns. Until then, be well.
Terry