How to Wreak Havoc In Our Bodies!

Your 🔑 To Becoming THE Ultimate MSK Problem-Solver For Your Clients ...

Every time I see this movement applied as either an exercise, stretch or clinical test (e.g. The Thomas Test), I shudder because I know the utter havoc it is wreaking in the body!

This havoc extends across our entire body; including (but certainly not limited to) our lower body muscles, our pelvis, our pelvis muscles (extensors, flexors, adductors, abductors and rotators), our hips, our SIJs, our erector spinae muscles, our thorax, our shoulders and our neck.

That’s pretty much our entire musculoskeletal system screwed up through one common exercise!

Grasping how and why this havoc occurs is your 🔑 to becoming THE ultimate musculoskeletal problem-solver for your clients.

However, a significant change in thinking is required, switching your clinical decision-making from what you SEE and FEEL, to understanding how key body systems are FUNCTIONING TOGETHER (or not, as is more likely the case!).

My Mentor and I have found, over about 20 years (across 000’s of clients) that if we get ALL of the above musculoskeletal systems FUNCTIONING CORRECTLY, TOGETHER, IN HARMONY, we SOLVE the vast majority of long-standing, frustrating and extremely painful issues our clients come to us to solve for them. 

But this is NOT the way we are all taught to problem-solve 😢

We cannot SEE how (for example) muscles are functioning, OR HOW our Pelvis / Hips / SIJs or our Thorax are functioning together.

However, movements such as “knee(s) to chest”, are wreaking utter havoc on the FUNCTION of every one of these (and many other) systems and structures throughout the body.

Let me briefly explore each of these systems and structures in turn.

Our Lower Body Muscles

Our lower body muscle function is governed to a very large extent by how our pelvis is functioning, hence why understanding pelvis function is so vital in all musculoskeletal problem-solving.

So I will jump straight onto The Pelvis, Hips and SIJs.

Our Pelvis, Hips and SIJs

Understanding how our pelvis, hips and SIJs are functioning (or not) delivers HUGE indications as to how several other body systems will be functioning, not least our lower body muscles attached to or associated with our pelvis (~40 muscles!).

And it’s not merely down the body that our pelvis governs, it’s up the body as well.

Our pelvis sits in a unique location in our body; right in the middle. 

Our pelvis “hosts” the two most heavily loaded joints in the human body; our hips (the #1 most loaded joint) and our Sacro Illiac Joints (SIJs) (the #2 most loaded joint).

As I present in my Pelvis Masterclass, our pelvis has 2 major functions; Movement (gait) and Load Management. 

A free taster video from my Pelvis Masterclass is available to watch here.

And, something that most therapists do not realise is that our Pelvis function needs to be assessed separately on the LEFT and the RIGHT. We cannot consider the pelvis as a single bowl when it comes to pelvis function.

Key questions to ask about any knee-to-chest movement, exercise or stretch are therefore:

(1) How exactly is a knee(s) to chest movement impacting somebody's pelvis function (gait and load management) on the left and the right?

(2) How exactly is a knee(s) to chest movement impacting lower body muscle FUNCTION on the left and the right?

All we are doing is indiscriminately rotating our entire pelvis without any regard for whether it is functioning correctly on the left and the right, and indiscriminately elongating a shed load of muscles (e.g. glutes and hamstrings) without any regard to whether they should be elongated like this.

There is no way that any knee-to-chest movement, exercise or stretch can help PELVIS, HIP or SIJ FUNCTION (Gait and Load Management) or LOWER BODY MUSCLE FUNCTION. 

IT IS WREAKING HAVOC! 

Our Erector Spinae Muscles 

The 2 most important muscles impacting Pelvis Function and Thorax Function are longissimus and iliocostalis (Macintosh Bogduk 1991).

Longissimus and Iliocostalis are attached to multiple points on our sacrum and Illia, thus:

A key question is therefore:

How is any knee-to-chest movement, exercise or stretch going to impact longissimus and iliocostalis at the SIJ and the Illia?

Our SIJs and Illia are intimately related to our gait and our load management functions SO longissimus and iliocostalis are also intimately related to our gait and our load management functions.

Without understanding how a client’s pelvis is functioning (gait and load through their hips and SIJs), we shouldn’t be going ANYWHERE NEAR longissimus or iliocostalis!

And this includes performing any kind of mid- to lower-back massage, as we are flying blind on the impact we are having on pelvis function when massaging these complex muscles.

When I sustained my sporting lower back injury 30+ years ago, on advice I had regular back massages. I couldn't understand why such massages made my back pain worse - now I do!

All we are doing when performing any knee-to-chest movement, exercise or stretch is indiscriminately elongating longissimus and iliocostalis without any regard to the impact this will have on the Pelvis OR the Thorax.

IT WILL CREATE HAVOC on BOTH Pelvis (including Hip and SIJ) Function AND ALSO Thorax Function.

Which brings us neatly to The Thorax.

The Thorax

Longissimus and Iliocostalis are also intimately related to Thorax Function (Macintosh Bogduk 1991).

They attach at every level of our thoracic spine (T1 to T12).

What we find is that different degrees of misbehaviour in longissimus and iliocostalis will impact different levels of our thorax, on the LEFT and on the RIGHT, separately. 

And each level of our thorax moves (and needs to be assessed) as a discrete entity (much like our sacrum, SIJs and hips in our pelvis).

Here I cite just a few of the issues generated through movement issues at various levels in our Thorax: (there are many more than this!)

• Lower Back Pain

• Hip Dysfunction (e.g. loss of load management leading to femoro-acetabular or cam and pincer impingement)

• SIJ Dysfunction (and therefore gait)

• Diaphragm Dysfunction (i.e. breathing)

• Shoulder Dysfunction

• Neck Issues

• Blood and Body Chemistry (Oxygenation, Body Acidity)

• Gut Issues

• Vascular Conditions (e.g. Restless Legs)

• Hiatus Hernia

All we are doing when we perform any kind of knee(s)-to-chest movement, exercise or stretch is indiscriminately tugging unknown elements of our thorax, via longissimus and iliocostalis, without any regard to the impact.

So next time you consider performing any knee-to-chest movement, exercise or stretch, consider the above list of issues.

At this juncture, I have to highlight that this includes performing The (modified) Thomas Test!

Summary

I have only explored the tip of the iceberg here. 

But in summary, any movement, exercise or stretch that impacts our pelvis, hips, SIJs, back muscles AND our thorax needs to be performed in the full knowledge of how all of these integrated systems are FUNCTIONING, TOGETHER.

NO movement, exercise or stretch impacts all of these systems in a greater way than performing a unilateral or bilateral knee-to-chest.

Understanding this is your 🔑 to becoming THE ultimate musculoskeletal problem-solver for your clients.

I know that what I have said here will challenge many therapists.

But please do not confine your thinking here to just knee-to-chest, I merely used this movement as a catalyst to introduce a desperately needed, fundamental shift in problem-solving THINKING.

The scope and impact of what I have raised here are extremely wide and very relevant to a high percentage of common, frustrating and extremely painful issues clients present with.

For those special therapists who would like to understand more, ping me a message on Facebook or Instagram to arrange a FREE chat. 

I Promise No Selling And No Obligation. And I Guarantee You Will Learn Something New!

Please also pop over to my FREE Learning & Development Page where you will find lots of free resources, including short videos on topics I have touched on here ➜ https://learning.theintegratedfitpro.com/resources.

With gratitude

Simon @ The Integrated Fitpro®