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Director of Biomechanics and Sports Science
In Part 3, the discussion will continue with a focus on performance based concepts with respect to the avoidance of over-activation of the QL. Increased muscular tension of the QL poses the potential for a Pivot Blocking effect. One such example of a mechanism permitting increased muscular tension of the QL was discussed in the previous article with a brief description of Lower Cross Syndrome.
To review, using the reference, Management of Common Musculoskeletal Disorders, Fourth Edition, by Darlene Hertling BS, RPT and Randolph M. Kessler, MD, With Contributors (Lippincott Williams & Wilkins, A Wolters Kluwer Company), on page 150, Lower Cross Syndrome’s QL effect was described:
“An imbalance can also exist in the lateral lumbopelvic musculature. If weakness occurs in the gluteus medius (Fig 7-21) it can be compensated for by overactivity and tightness in the ipsilateral quadratus lumborum (Figs. 7-16B and 23-8) and tensor fascie latae (Fig 7-2).136”
The QL is a powerful participator in ipsilateral (same side) lateral flexion. Using the resource entitled, Illustrated Atlas of Musculoskeletal Anatomy, 2nd Edition, by Dr. Patrick Barron (Pine Island Publishers, Inc.) on page 63, the gluteus medius’ primary joint action is defined as “abduction of the femur” and “internal rotation of (the) femur” (via the anterior section of the muscle). Clinically, on page 63 of this same text, Dr. Barron states that a weak gluteus medius contributes to the following:
“Weakness or paralysis of this muscle will produce a pelvic tilt or drop on the contralateral side (Trendelenburg Sign).” Contralateral refers to the opposite side.
Therefore, for example, a weak gluteus medius on the right side may be associated with:
• A “tight” right QL.
• The “tight” right QL may produce a resultant elevated right side of the pelvic complex.
• As per the Trendelenberg Sign, the opposite side (left in this example) of the pelvic complex will be prone to drop or lower.
How does this information pertain to the golfer? The presentation of the pelvic complex of a right handed golfer in GBP, with a right weak gluteus medius muscle, (as part of a possible Lower Cross Syndrome) will demonstrate the “high side” (elevation or upward tilt) of the pelvic complex on the trailing side as opposed to the target side. This is the opposite of what would be desired and customarily required for golfer set-up at Impact Fix (The Golfing Machine, 8-2). This type of biomechanical pose arrangement may contribute to a Pivot Blocking effect.
Thus, the weakness of the gluteus medius muscle, such as seen in aspects of Lower Cross Syndrome, a common malady occurring in the general population (including golfers), produces a compensatory over-activation of the same side QL, which induces synergistic contributions from the same side internal and external oblique muscles, altering the alignments as well as functional operation of the Pivot.
The expectation must be present that muscle group imbalances due to functional capacity issues, personal history, unilateral activities of daily living and/or a lack of physical conditioning will produce static alterations to structural alignments and dynamic movement pattern aberrations in golfers with a similar rate of prevalence as that of the general population, or perhaps in greater proportion of prevalence. The nature of the unilateral redundancy aspects of the stroke motion as well as the challenges to the biomechanical stability of the structural system in comporting to the “address position", over and over again, can be a significant factor in contributing to various dysfunctional patterns of muscle group imbalance and joint stress issues.
Can dysfunctions such as Lower Cross Syndrome with associated QL “tightness” and gluteus medius weakness manifestations be counteracted for with the creation and implementation design of performance based alternatives that bolster Pivot based functions rather than “block” Pivot based functions?
The first approach must be to examine how abduction of the femur is incorporated into the Stroke Pattern:
• Abduction is an outward (lateralward) motion of the femur bone via the ball and socket hip joint in a frontal plane (frontal oblique plane relative to GBP) of motion. The femur is generally elevated laterally in a path that would move parallel to a square stance line.
• With the foot planted in a stable relationship as a unit of the base of support with the ground in GBP, the action of abduction produces a tandem response in the opposite ball and socket hip joint of adduction. This is a tandem based, dual, closed chain action.
• The combination of abduction and adduction produces a lowering of the pelvic complex on the abduction side and an elevation of the pelvic complex on the adduction side.
Thus, relative to this specific topic of discussion:
• In an open chain motion of the ball and socket hip joint, in Quiet Upright Standing (or in GBP), the side of engagement has a non-fixed (non-docked) foot with the ground.
• In such an open chain activity, when the same side gluteus medius muscle is engaged, the joint action of abduction may produce an associated elevation of the same side pelvic complex innominate bone when the range of motion of abduction moves beyond a limited initial arc of motion.
• In the open chain activity, it is not uncommon for assistance to be provided by the same side QL in an effort to support or compensate for any limitation in hip ball and socket joint range of motion and/ or insufficient muscle concentric contraction properties of the aforementioned participating abductors such as the gluteus medius.
• In a closed chain motion of the ball and socket hip joint, in Quiet Upright Standing (or in GBP), the side of engagement has a fixed (docked) foot with the ground.
• In such a closed chain activity, when the same side gluteus medius muscle is engaged, the joint action of abduction produces an associated lowering of the same side pelvic complex innominate bone as the motion is coupled with a tandem, nearly compulsory, adduction of the opposing ball and socket hip joint.
The open chain and closed chain actions create biomechanical mechanisms promoting opposite pelvic complex spatial pose alignments!
The open chain motion of the lower extremity of abduction in the above example may produce a more vibrant same side (ipsilateral) QL synergistic "compensatory" response to help elevate or raise the associated ipsilateral innominate bone to provide an ample synergistic assistance to the open chain abduction joint action of the involved same side lower extremity. The closed chain motion engages the ground with pressure and friction, producing a cooperative, tandem, coupled, co-joint action of the opposite ball and socket hip joint creating a different pelvic complex spatial pose alignment.
Therefore, in reference to this aforementioned example:
• If a golfer without Lower Cross Syndrome, utilized a common but counterproductive approach which incorporated direct lateral flexion of the lumbar spine to form a secondary spinal tilt, this action would vibrantly engage the ipsilateral QL.
• This will recruit the associated ipsilateral internal and external oblique muscles creating a potential Pivot Blocking effect.
• Overtime, there is the risk for the development of muscle imbalance which may alter pelvic complex spatial orientation which may lead to the development of a Lower Cross Syndrome.
• A golfer with Lower Cross Syndrome, forming GBP, forming a secondary spinal tilt, with a common but counterproductive direct attempt at lateral flexion of the trailing side lumbar spine, may default to the unconscious elevation of the trailing side innominate bone due to an already “tightened” QL, further recruiting the synergistic same side internal and external oblique muscles creating a potential Pivot Blocking effect. (Please note: The trailing side QL may have been subjected to the development of evolving into a “tight” QL, in association with a Lower Cross Syndrome, through the “wear and tear” effect of the unilateral redundant “routine” associated with the constant and persistent formation of the “address set up”, over an extended period of time, in the counterproductive manner just described.)
• In either of the above examples, once the QL is engaged, the "exhibited" lateral flexion is the biomechanical by-product of a coupling effect which includes rotation of the vertebrae to the opposite side (please refer to Part 1 of this article series for more information about this biomechanical coupling effect).
• In either example, in GBP, this would yield an “open” alignment of the golfer's torso region relative to the stance line. This would further affect the stroke pattern and curb the ability to employ a 10-12-A, Standard Pivot. The resultant default Pivot would now be prone to be a 10-12-C, Delayed Pivot.
The combination of the above would greatly impact the performance based functions of a golfer and likely contribute to faulty execution with the risk for the production of compensations and snares contributing to the increased probability for ball flight control issues.
Therefore, the formation of GBP can create a secondary spinal tilt with two common methodologies:
• Primary lateral flexion of the trailing spinal column only.
• Tandem abduction of the trailing side ball and socket hip joint with adduction of the target side ball and socket hip joint.
Of the two methodologies, the latter procedure of forming a secondary spinal tilt where the trailing side of the pelvic complex is lowered and not raised, would result in a more optimal GBP set up, vibrantly engaging the trailing side gluteus medius muscle, and reduce the “tightening” of the ipsilateral QL thereby decreasing the risk of a Pivot Blocking effect as well as the risk of an unintended “opening” of the torso’s alignment toward the target rather than a “square” alignment.
Hence, the main point of focus in this article centers around the methodology and manner by which a golfer forms GBP. In addition, there are two alternatives to forming the secondary spinal angle at GBP as well as two alternatives to conduct Axis Tilt during the commencement of Start Down. In either instance of GBP set- up or during the Start Down period, the tandem ball and socket hip joint motions and joint actions by which the procedures are conducted will be superior to using a primary lateral flexion of the lumbar spine procedure.
Part 4 will continue the discussion.
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