By: Justin Price
Research into recreation habits around the globe have shown that walking is rated as the most popular form of physical activity on the planet. Yet many people experience discomfort and pain during the movement. Consequently, individuals may choose to find an alternative form of getting around, such as driving a car (for errands within walking distance), or continuing to walk despite the pain. Thereby, as movements become more imbalanced and compensatory, more pain and dysfunction is created. Either way, people that experience pain when walking are ultimately prevented from leading a fit and fully functional lifestyle.
Moving in All Three Planes
People have the ability to move in three planes of motion - sagittal, frontal and transverse. The sagittal plane is the plane of motion when the body or parts of the body move either in front or behind. For example, flexing the spine forward is a movement performed in the sagittal plane. Similarly, lifting both arms over head in line with the ears into shoulder flexion is a movement performed in the sagittal plane. When walking, legs swing forward in an alternate pattern and each arm swings forward in time with the opposite leg. Therefore, walking occurs predominantly in the sagittal plane.
The frontal plane of motion involves movements in a lateral direction, or movements that go from side to side. For example, when arms are raised out to the sides, this movement is performed predominantly in the frontal plane. Moreover, bending the spine to the side would also be a movement in the frontal plane. Although walking occurs primarily in the sagittal plane, some frontal plane movement is involved. For example, when one arm swings forward in time with the opposite leg, it also comes slightly across the body into the frontal plane.
Walking also involves movement in the transverse plane, which is defined as movements of rotation (e.g., when the torso twists or hips rotate). For example, when the arms cross the body in the frontal plane as described above, each also rotates slightly inward into the transverse plane.
When examining the action more closely, it is evident that walking is performed mostly in the sagittal plane. However, there are also components of each body motion that occur in the frontal and transverse planes.
Weakness in the Lateral Chain
A common reason pain and discomfort is experienced when walking is because individuals are not strong enough to stabilize the body in the frontal plane when it moves forward in the sagittal plane. For example, if the body is not able to correctly engage the lateral chain to prevent hips from shifting to the side (a frontal plane motion), then a person effectively falls off balance to the sides. If this happens every time a person steps forward, then the gait pattern starts to become a side shifting or waddling of the hips in the frontal plane rather than a stabilized forward movement in the sagittal plane. Hence, the root cause of pain for many people is a weakness in the lateral chain (i.e., portions of the legs, hips and spine).
Step Up to Assess Lateral Chain
A very simple assessment follows to assess whether or not an individual or client is shifting too much to the side when walking. Simply place a chair in front of a mirror. Stand behind the chair and look into the mirror. Align center of the head with a vertical line on the wall, so that the line is viewable in the mirror behind the head. Now step up with the left foot, and put the sole of the foot on the chair (see Picture 1). Look in the mirror and note how much the body has shifted to the right. Now put both feet on the ground again, and step up placing the right sole of the foot on the chair. Evaluate how much the body shifted to the left.
Most people will find that the body shifts more to one side than the other when trying to lift the opposite leg up to the chair. For example, if the body shifted more to the left when raising the right leg (as in the picture above), then the body likely lacks strength to stabilize the left hip and leg complex as the right leg is lifted while walking. This inability to stabilize the left lateral chain means that the weight shifts left causing a frontal plane deviation. This frontal plane deviation will affect the ability to swingthe right leg forwardand through in the sagittal plane.
Compensations Patterns throughout the Lateral Chain
When the hips shift to one side, the body's center of balance is also thrown off to one side. In order to keep the vestibular system (inner ear) level, the spine must shift laterally in the other direction to keep the head balanced over the body's center of gravity. As the popular song states, "The thigh bone is connected to the back bone." Of course, in between the thigh bone and the back bone are the hips. So, needless to say, when the hips shift laterally into the frontal plane (as observed in the step up assessment), the spine also shifts laterally since it is connected to the hips.
The most common compensation pattern for a lateral hip shift is for the spine to bend the opposite way to keep the body balanced. When the step up assessment is performed, it may be noticeable that when the right leg is lifted, the body has to shift more to the left side in order to be able to get the right leg up. If this happened, then the spine probably bent to the right (see Picture 2), thereby moving the entire body into the frontal plane. These compensatory movements affect all the muscles on the sides of the legs, hips and spine (the lateral chain).
Strengthening the Lateral Chain with the BOSU® Balance Trainer
You can use the BOSU® Balance Trainer (BT) to strengthen the lateral chain and help maintain stabilization. Not only can individuals move more efficiently when walking, but when performing any movement that requires a weight transfer from one leg to the other (e.g., running, playing tennis, lunging, golfing, etc.). The dynamic surface of the BT, combined with its cushioning ability to absorb shock, enables a weight transfer from side to side over the BT. This side to side motion helps apply incremental load to the muscles that stabilize, mobilize and strengthen the frontal plane (i.e., the lateral chain). As the lateral chain becomes stronger, balance to the side will no longer be lost when moving because stabilizing capability has increased. Increasing the strength of the lateral chain will ultimately help the body move in the sagittal and transverse planes with more ease. An individual will not always have to recover from moving too far from one side or the other. Eradicating these compensation patterns will help eliminate pain and improve function when walking or performing any weight bearing activities performed while on the feet.
Below are several exercises to use personally or with an individual or client to help strengthen and stabilize the lateral chain.
This exercise helps strengthen muscles on the sides of the hips, or abductors, while decelerating and stabilizing frontal plane motion. The abductors first work to decelerate when reaching the BT, and then to stabilize while pushing back off the BT.
Stand on one leg and squat back while reaching the other leg to tap the top of the BT. Try to keep the hip of the standing leg over the weight bearing foot (i.e., do not let it shift towards the BT too much). Gently push off the BT to help return to a stable, one leg standing position.
Side to Side Jumps
This exercise uses the dynamic motion of transferring weight quickly under the increased load of jumping to apply maximum force to the lateral chain. The hips must stabilize from moving too far to one side while landing so that an individual can change direction and jump back to the other side.
Jump over the BT from side to side as the leg closest to the BT pushes up and over to the opposite side. Bend at the hips, knees and ankles to ensure the load on all muscles in the lower body.
Reverse Lunge to Step Up
This is an exercise performed predominantly in the sagittal plane, similar to walking and running. However, having one foot on the unstable surface of theBT will cause any side to side deviations to become evident as balance is lost on one side or the other. Therefore, this is an all-around great assessment tool and strengthening exercise.
Stand with one foot in the middle of the dome on the BT and lunge backwards with other leg. Reach forward with opposite arm (just like an individual would when walking or running). Push up with both the front and back leg to return to a single leg stance position. Lunge backwards and return to starting position for a desired number of repetitions.
About the Author:
Justin Price is co-owner of The BioMechanics, a private training facility located in San Diego, CA, that specializes in providing exercise alternatives for sufferers of chronic pain. He is also the co-creator of The BioMechanics Method which is a method for pain reduction that combines structural assessment, movement analysis, corrective exercise and life coaching that teaches trainers how to help clients alleviate chronic pain and improve their function. He was named International Personal Trainer of the Year in 2006 by the worlds' leading organization of health and fitness professionals, IDEA Health and Fitness Association, and has helped thousands of people around the world overcome pain and injury through his methods. For more information about Justin or The BioMechanics Method, visit http://www.thebiomechanicsmethod.com/.
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