Shoulder Stabilziation for Striking: are you Focusing on the Right Muscles?

When considering upper body striking, martial artists tend to focus on the pectoral, triceps and deltoid muscle groups, and the glenohumeral (GH) joint, which is the most obvious shoulder joint. The GH joint consists of the humerus and the glenoid fossa of the scapula (the “socket” of the shoulder blade). Since this joint is essentially like a ball resting on a shallow dish, and not a deep socket like the hip joint, ligaments and the attached muscles provide most of the stability. There are also three other joints in the shoulder complex that play important roles in maintaining stability for the GH joint, with the scapulothoracic being most prone to abuse in combative training. This joint is formed by the fibrous connection of the scapula to the posterior torso wall, which allows the scapula to glide and rotate as the GH joint requires.

The serratus  anterior and the trapezius provide the ability to adduct (pull close to the ribcage), retract, depress, and upwardly or downwardly rotate the scapulae.  They maintain alignment of the glenoid fossa  with the head of the humerus.  A strong, reasonably flexible rotator cuff group is important, but the trapezius needs to be able to provide rotation and stabilization so that the GH joint stays centered and the rotator cuff isn’t impinged. The trapezius and serratus need to work synergistically with the GH joint movers. Striking in general requires the same coupling of scapular and humeral actions that has been reported for other overhand actions  (Kibler, et. al., 2007) such as the tennis serve.

Specificity of Conditioning in Fight Activities: Basic Concepts & Application

Specificity of training is the basis on which all modern physical training rests. Briefly, to produce a desired physiological adaptation, a training program must place sufficient stress on the physiological systems in question (Willmore & Costill, 2004). In training environments this is commonly referred to as Specific Adaptations to Imposed Demands (SAID).  Adaptations to training are limited to the physiological system overloaded by the program. This includes neuromotor, morphological, hormonal and metabolic elements. Fighting activities (encompassing both combat sports and fighting/self protection scenarios) present a unique programming challenge, requiring a range of adaptations to all systems.

Basic Thoracic Spine Injury Prevention for Fighting Arts & Combat Sports

The actions of fighting arts (including combatives and self-defense systems) and combat sports place regular high stresses on the spinal column. I’ve previously mentioned the anterior-posterior compressive and shear forces that affect the lumbar spine, but not the transverse rotational (torsional) and lateral compressive forces that actions like punching, kicking, throwing and falling places on the thoracic spine. Basic fighting postures, such as a standing guard or striking can encourage thoracic kyphosis and lateral asymmetry.  Left unchecked, torso actions can become plagued by dominant muscular patterns of imbalance to one side or the other, as a result of a favored limb or ingrained movement compensations due to faulty stabilization or movement system activity. Over time these muscular imbalances  can lead to vertebral facet degradation and arthritis, disk herniations and ruptures, nerve entrapment and bone spurs (typically in the direction of excessive muscular tension), all of which translate to reduced performance.

Curvature of a healthy spinal column. Note the lateral symmetry.

A Brief Discussion on the Relativity of Skills

Ed. Note: while the examples used in the piece below relate to punching and recreational/athletic MA training, the concepts can easily be applied to all other fighting skills and situations in which they might be used.

How many ways are there to skin a cat? Or in this case, throw a punch? Among both novice and experts (and “experts”), it can seem as if there is a “right” way to perform a fighting skill, yet variations are to be found from style to style,  from individual to individual, and even from moment to moment within the same encounter. The Q & A below came out of a discussion with martial artist and CSCS Daniel Ramos (fellow ATSU Human Movement Science alum).

More for the Core: Are Sit-ups Helping Your Lower Back, or Hurting?

A topic that comes up frequently on the FSRI blog is “core training,” particularly as it relates to moderating the lower back/spinal stress  that training in all fighting arts creates. I dialogue quite a bit with people from various fighting arts circles, and often someone will respond to a core-related topic with  “I do x reps of sit-ups everyday.” Ostensibly this seems like a good way to train the core musculature, however it neglects many important elements of the core’s movement and stabilization systems at the favor of the most visible aspect, the rectus abdominis (the “6-pack” that people are unfortunately obsessed with). Due to their positioning in the spinal column and the muscular attachments of several muscles, notably the psoas,  the lumbar vertebrae end up being exposed to kinematic demands and kinetic forces that are greater than one might think. Full sit-ups actually increase these forces, since hip flexion is required along with the desired rectus abdominis action, which places a combined compressive and shearing force on the lumbar vertebrae of the lower back:

Clinicians often recommend abdominal exercises as both a prophylactic and a treatment for low back pain…However, sit-up type exercises, even when performed with the knees in flexion, generate compressive loads on the lumbar spine well over 3000 N (ed: 675 lbs. force) . According to one clinical report, the use of sit-up type exercises appears to have actually contributed to low back pain development among a group of 29 exercisers. Partial crunches have been advocated as providing strong abdominal muscle challenge, with minimal spinal compression (Hall, 2007).

The action of a full sit-up creates several surprisingly high forces: compression on the anterior (front) facets, tension on the posterior (rear) facets and shear at the medial rotation point of the lumbar spine, particularly the lower vertebrae.

If the goal is to correct the stresses that training and conditioning place on our lower backs by strengthening the rest of the core, it should be clear that full sit-ups are not a good choice, and that the RA muscle is not the best target for “core training.” Don’t forget the image of the core as a tall tower with guy wires stabilizing it in all directions. The other core movers and stabilizers also need proper conditioning Although the RA is visible and easy to target, standard sit-ups and targeting it exclusively may actually increase the stress load to the lumbar spine, worsening existing muscular imbalances, performance deficits  and increasing the risk of low back pain/chronic injuries.

The solution is to leave full sit ups out of your conditioning routines. Take a look at Bob’s Back Brief article for some suggestions and links to video demonstrations of many core exercises which can add balance and increased performance- as well as decreased stress on the lumbar spine- to your conditioning.

Feel free to contact one of us for consultation and more ideas.

References:

Hall, S.J. (2007). Basic Biomechanics (5th ed.) (p.305). New York, NY: McGraw-Hill.

Knee Osteoarthritis in the Fighting Arts and Combat Sports

Among athletes, knee injury is a predisposing factor towards the development of knee osteoarthritis (OA). (Molloy & Molloy, 2011). Other joints may be at risk for overuse injuries and OA, but it is the knees in particular that seem to occupy a special place in the realm of chronic injuries.  Recognizing the risks of an activity allows for the development of injury-prevention programs specific to it’s demands and conditions. Although many martial artists don’t identify themselves as athletes, the demands of training are inherently athletic and the effects of training on the body are no different from those of athletic training.

Fighting arts and sports pose inherent risks to joint health, particularly acute or chronic injuries associated with the knees. A case by case analysis of the training activities and priorities of the various combat sports and so-called martial arts  would be necessary to discuss the risk of a certain format or style, but several mechanisms of injury are common to many:

• rapid and asymmetrical loading and unloading of joints during throws, tackles, sweeps, etc.
• bounding, cutting and darting movements, often under external load or force
• impact trauma from falls, kicks, sweeps
• compressive, shearing, tension and torsional trauma from joint manipulations

Spinal Overuse Injuries in the Fighting Arts: Risk Factors and Prevention Strategies

The modern understanding of “the core” and the need to properly condition it has become well known among athletic and active people, including martial artists (yes, the importance of the hips has been belabored for centuries, but the modern anatomically based concept is not necessarily the same thing). The core refers to the muscles, connective tissues and bones of the torso, yet to many it’s just the rectus abdominis (the “6-pack’).  However, the core can be more accurately thought of as the support, stabilization and movement system for the spinal column. This stack of 33 vertebrae (24 moving and 9 fixed) is connected by many ligaments and muscles, which provide oppositional tension akin to the guy wires on a tall tower.

Evidence Based Practice in the Fighting Arts: Appraisal and Suggestions

The practice of martial arts has come to be diverse in terms of the wide range of  arts and schools available and in terms of the population that is involved. Physical fitness and talent may only be required to a small degree, or they may be paramount to success. Students may be dedicated about conditioning, or they may be “weekend-warriors” whose primary physical activity is a class.  An instructor may be qualified in a technical realm but not be a good source of information in others, such as the nature of violence. The need for Evidence Based Practice (EBP) is just as high as in any other vigorous physical activity, yet appeals to tradition, history and authority and “experts” often lead students and practitioners to accept dubious information or ignore new information, which can have consequences on a number of levels. For this discussion, the practice of the various martial arts can be divided into two realms: non-competitive recreational (i.e., oriented at self defense, fitness, cultural pursuit, etc.) and competitive (amateur or professional competition). Most of this discussion will focus on the recreational realm.

What is EBP?

Briefly, evidence-based practice can be seen as a tool for:

• finding evidence to support decision making and for analyzing the quality of the available evidence
• distinguishing low quality sources of qualitative and quantitative information from high quality sources
• promoting critical thinking and synthesis of the literature
• recognizing that best evidence may change over time

Evidence-based practice is a key feature in modern medical education. In the above diagram of EBP components, it doesn’t take much effort to exchange “patient” for student and “clinical expertise” for instructional expertise

It’s also important to recognize what EBP is not:

• A cookbook approach to training and decision making
• Not based solely on hard evidence- empirical experience, intuition and active experimentation have a role. EBP considers personal experience, judgment, values, etc. alongside information from objective, quality sources.
• Not restricted to RCT’s and meta-analyses

Failures of EBP in the Fighting Arts

An extreme example of a lack of critical thinking and evidence-based practice can be found in  the cult of personality that has developed around Ueshiba Morihei, founder of the Japanese art of Aikido.

Basic Physical Training Concepts for Fighting Artists, pt. 2

Stagnation: Too Much of a Good (?) Thing

Martial arts are often marketed and practiced as if they are a finished product with set training and methods. The entrenchment of this idea varies from circle to circle, but it is quite common. It’s very appealing to both new students and long-term students alike. Predictability and stability are things that we tend to gravitate towards in our choices of recreational activities, as can be seen by the guy who goes to the gym and does the exact same workout every visit, or the  karate sensei who plans each class to be a further exposition on the basic techniques that the last year’s worth of classes were based on. Stagnation of training activities can take the form of:

1. repetition of specific skill-based activities: techniques or drills, especially elementary techniques
2. repetition of physical conditioning exercises past the point of useful adaptation

For new students the appeal of a set training format is very strong, as it minimizes the new material that they have to learn on a given night, which reduces anxieties and confusion in front of more experienced students. A handful of things can be learned, whether that be a drill, technique or conditioning exercise,  and then repeated reliably in each successive class. This is a comfortable routine, and if it is tied to claims of efficacy or magical thinking, the new student may place an inflated value on whatever he or she has done the most, regardless of ability.

For the long term student, stagnation may be appealing due to one of two factors:

Basic Physical Training Concepts for Fighting Arts Practitioners

If you’ve ever heard something like “we’ll do 500 punches/kicks to relax you- after your muscles are too tired to be involved, you’ll have pure technique” then you have heard some of the inaccurate training information that has plagued karate training for a while. It might make sense on the surface; relax those pesky prime movers and let my hips take over.

Right. In the meantime, the damage that this sort of thing will cause to your joints, tissues and functional movement patterns will probably end up counter balancing any development that you may make. If the example above were so, why don’t we see professional American-style football coaches making their players do biceps curls and pushups to failure right before working on precision passing technique? This topic can get into some sophisticated concepts and jargon pretty quickly, but suffice to say, quality of practice and movement is more important than quantity- and focusing on quantity can sharply reduce quality.

Linked Research Article: Injury and injury Rates in Muay Thai Kick Boxing

Follow the link to a British Journal of Sports Medicine article on rates of injury  occurrence within a group of 152 Muay Thai practitioners. The link will only take you to the abstract, to read the full article you’ll have to register, which is free. Not surprisingly, lower leg and head trauma lead the pack.

British Journal of Sports Medicine:  Injury and injury Rates in Muay Thai Kick Boxing