Discussion in 'Strength & Conditioning Discussion' started by troublefunk, Sep 16, 2013.
Arthrogenic Muscle Inhibition
Pretty sure i got this to some degree after a knee injury.
Teh physio hooked me up to these electrode things on my vastus medialis (? the inside quad) which measure how much of an impulse is going through your muscle as you contract and extend through your ROM and shows where the signal totally drops off.
It's almost certain you did.
Here's the original meta-study, which references 116 other studies.
Arthrogenic Muscle Inhibition: A Limiting Factor in Joint Rehabilitation
You have to download the study as a pdf, but it's free.
In my opinion the single biggest factor in loss of physical function, performance, strength, ROM, and biggest single causal factor in breakdown, injury, inability to recover from injury. Mostly ignored by the medical, fitness, s & c communities.
Yeh it was causing other problems not related to the initial injury. The VM is the muscle which tracks the patellar through the knee so when that shut down it wasn't tracking straight, and that was causing pain.
He had me doing specific exercises to get over it. Basically just sitting in the leg press, going really slowly, trying to keep the electro meter stable through the full ROM. Over, and over, and over....
Interesting. Couple thoughts.
a) The focus on Vastus Medialis makes sense, its the first thing I would check for lateral patello-femoral pain, but it's overplayed. I've worked with lots of people with lateral PFP with VM inhibition, but lots without it. Inhibition in any knee muscle (or muscle that crosses the knee joint, 17 by my count) means the knee isn't functioning properly.
b) By far the best/fastest method for improving the contractile capabilities of inhibited muscles: test the specific muscle or muscle division (some muscles have multiple tests, Traps have 4, longissimus has 4), if inhibited palpate origin and insertion, retest the muscle. Reinforce with isometrics specific to muscle.
This sentence doesn't make sense.
Achieving/reestablishing proper neuromuscular activation is always a main target of rehab after injury/surgery. That's pretty established and common knowledge.
1) I think AMI is the single biggest factor in: physical dysfunction, pain, breakdown, injury, inability to recover from injury.
2) Really? So AMI is a common topic amongst Orthopedic Surgeons, PT's, AT's? Most that I ask about it have never heard of it, or can't discuss it intelligently.
What are these pretty established and common practices that correct AMI?
1) why/based on what facts do you think that?
2) neuromuscual inhibitions from joint injury/surgery (in this respect your body basically recognizes surgery as an injury) is on every relevant textbook. A major part of injury/surgery rehab is aimed towards establishing proper muscle activation and calibrating relevant proprioceptuve reflexes.. If whoever you asked about it has never heard of it then you need to associate yourself with less incompetent individuals.
I posted an incredibly interesting, detailed meta-study, that is relevant to every person in this forum. Did you read the study? Care to comment on it? It's 12 pages long, with 116 sources.
Rather than comment on the study, or AMI, you call me out on a typo (which with a little effort you could have figured out), and on a tangential comment I made in a follow up post.
What's your deal? Only you get to post science to this board? You have to be the "expert", or you start derailing the thread? Why not post on the topic rather than say, "Oh my, so silly, I already know all about muscle inhibition, so it's not really interesting to me." Grow the fuck up.
Before I respond to you again, why don't you respond to my question. What are these rehab techniques that are addressing AMI?
Easy there killer. You may want to holster those pistols. This is the interwebz, not an old western saloon.
I think if you simply went to some OS, PT, OT, etc... or whatever and asked if they heard of AMI I would wager they haven't. But if you explained to them what it was, you will quickly find out that neuromuscual inhibitions from an injury is pretty common knowledge and I believe, although I am no expert its addressed in physio quite extensively.
I am not an injury specialist but I have definitely heard of AMI, although never referred to it as AMI.
Where else do I get to eyeball strumpets, play a rigged game of poker, and take a headshot on someone without punishment? This hear interweb's the closest thing we've got to that there wild west on this side of the Mississip'. If ya ask me the only thing we're missing is a bottle of watered-down bourbon.
My experience with many Doctors, PT's, AT's is they have a very general understanding that there is a thing called "muscle inhibition", and that it plays a role post-injury/surgery. But most don't actually understand what it is, can't define it or explain it. And the only interventions that I have been exposed to are which are effective at addressing AMI are not used by PT's and unknown to OS's.
I have been to many Orthopedic Surgeons and PT's over the years for myself, wife, and kids. Never, not once, was "muscle inhibition" mentions. The OS's and PT's all talk about "stretch and strengthen".
Most of my clients have been to OS and PT before coming to me. Some have had injury, some not. Some have had surgery some not. I always ask, "Did your OS or PT talk to you about muscle inhibition". Never, not once. Oh and BTW, if as Miaou states, "Achieving/reestablishing proper neuromuscular activation is always a main target of rehab after injury/surgery. That's pretty established and common knowledge.", then why are my clients coming to me AFTER PT with their primary problem being AMI?
I understand that most texts on the subject discuss AMI, but if Doctors, PT's, and AT's are not discussing it with their patients, and not using methods that correct AMI, then how exactly am I wrong that AMI is "Mostly ignored by the medical, fitness, s & c communities." That's my original quote that miaou objected to. Again, what are the widely used PT rehab methods that address AMI?
I don't see what reason you have to be upset.
I didn't call you out on any typos. I commented that muscular inhibitions from injury is a well-known fact, it is addressed in rehab/prehab and that the particular statement you made (that "AMI is the single biggest factor in: physical dysfunction, pain, breakdown, injury, inability to recover from injury") doesn't make any sense because in my opinion it seems random, unquantifiable and unprovable (so AMI is a bigger factor than, say, connective tissue damage, like cartilage damage or intravertebral disc damage? how could you even quantify that?).
In my first post I wrote: "Achieving/reestablishing proper neuromuscular activation is always a main target of rehab after injury/surgery. That's pretty established and common knowledge."
To which you replied: "What are these pretty established and common practices that correct AMI?"
The reason I didn't respond to your question was that I didn't mention there being any "pretty established and common practices that correct AMI" in my post to begin with, and I dislike people putting words in my mouth.
Ways to improve activation include electrical muscle stimulation (for the initial stages of rehab after surgery/serious injury), use of biofeedback techniques, isometric contractions, limited ROM isolation exercises (like TKEs for VMO), full ROM isolation/single-joint exercises, proprioception training, compound exercises and explosive exercises. The target is first to increase the amount of muscle activation (thus the isometric and isolation exercises) of the inhibited muscle, then the goal is to achieve good activation in the context of compound motor patters and also to achieve timely activation (the right muscles need to be firing at the right ratios but also at the right times). Activation exercises (usually isometrics and single-joint exercises) are also commonly used during warmup of athletes that have diagnosed inhibitions without having suffered any injuries.
Also, find somebody to give you hug, mang.
I posted a great study, about an incredibly important subject that most other posters likely don't know much about.
Apparently you don't like when others post relevant science. So rather than stay on the topic of AMI you disagree with my editorial statement: "Mostly ignored by the medical, fitness, s & c communities." I respond to you and you come back with:
"If whoever you asked about it has never heard of it then you need to associate yourself with less incompetent individuals."
Why be a douchebag? The funny thing is, with the exception of isometrics, the methods you describe for improving AMI don't work very well. And there's the problem, you like to think you have it all dialed in, but you don't. There are some great methods for adressing AMI: Clinical Kinesiology, Advanced Muscle Integration Technique, Muscle Activation Techniques, but guess what? They are mostly ignored by the medical community. Imagine that.
Right. It's ok when someone knows more that you on a topic. Just don't be such a priss about it.
Holy fuck, this guy lacks reading comprehension and is awfully defensive.
In before everyone is riding each others ****'s and defending our own or yada yada.
Separate names with a comma.