Thursday 23 February 2017

Three Dimensional Flexibility
What is the Evidence?

Posted by at 8:45 PM in

Three Dimensional Flexibility

All joints move in all three planes of motion and all muscles are lengthened in all three planes of motion during all tasks/movements of the human body.  This importance of the three planes of motion and especially of the transverse plane has been documented in the research as far back as 1948.¹  

The concept of kinetic chain linking was published in engineering  literature in the 1800s.²   The kinetic chain linking concept was applied to the muscular system in the 1950s.³

So if we move in all three planes, and indeed we do...doesn’t it only  make sense that we would need flexibility and strength ...we would need to train and rehab in all three planes as well? 

I am not sure what took us so long to get back to the importance of the transverse plane and of the kinetic chain but we are finally getting there.

More and more research is published every month to substantiate the importance of training and rehabilitating with the understanding of biomechanics and the importance of kinetic chain linkage. The research demonstrates the importance of the left ankle function in a right handed pitcher with elbow pain4; the importance of hip abductor and rotator strength in patello-femeral pain5 , the importance of utilizing joint position influence to modify or “tweak” both exercise and evaluation techniques6 and that alteration of joint position affects muscle length7.

As a physical therapist, most often the job is to assist the patient to rehab back to the very activity that got them to the office in the first place..whether that be back to their job, their sport, or just back to being able to walk with less risk of falling. It is imperative that as a PT , one understand how the links influence one another and how to utilize this knowledge-backed by the research to design safer and  more effective treatment and training programs.

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¹ A.S. Levens, M.S,C.E. Berkeley, Verne T. Inman, M.D. San Francisco and JA Blosser M.D. , Berkeley California. Transverse Rotation of the Segments of the Lower Extremity in Locomotion. October 1948

² Reuleaux, Frank. The Kinematics of Machinery . 1876

³ Von Baeyer, Hans 1933 International Orthopedic Conference and 1955. Kinesiology of the Human Body. 

4 Sciascia et al . The Pediatric Overhead Athlete: What is the Real Problem?

5 Willison JD, Ireland ML, Davis I . Core strength and Lower Extremity Alignment During Single Leg Squats. Med Sci Sports Exerc. 2006 May 38(5);945-52  and

5 Cliborne TL et al. RElationship Between Hip and Knee Strength and Knee Valgus During a Single Leg Squat. J Appl Biomech. 2006 Feb;22(1); 41-50

6 The Interaction of Trunk-Load and Trunk Position Adaptations on Knee Anterior Shear and Hamstring Muscle Force.  J Athle Train 2010

6  Evidence Based Treatment of Hip and Pelvic Injuries in Runners: PMR Clinical N Am 2005

7 Jung et al Effect of Medial Arch Support on Displacement of the Myotendinous Junction of the Gastroc During Standing Wall Stretching. JOSPT. 2009;39:867-874.