The Rectus Abdominis and Abdominal Obliques are cornerstone muscles in musculoskeletal (MSK) medicine. These muscles are instrumental in activities ranging from athletic performance to everyday movements, serving critical functions like spinal flexion and trunk rotation. Their importance is further magnified in injury prevention, particularly in safeguarding the lower back.
The central aim of this article is to introduce and detail Motion Specific Release (MSR) techniques as they apply to the Rectus Abdominis and Obliques. These MSR procedures are designed to release restrictions in these crucial abdominal muscles, thus enhancing both athletic performance and injury reduction. As secondary objectives, the article will offer a concise yet comprehensive guide to the anatomy and biomechanics of these muscles, followed by recommendations for effective mobility and strengthening exercises.
Article Index
Introduction
Motion Specific Release
Exercises
Conclusion & References
Anatomy and Biomechanics
Rectus Abdominis
The Rectus Abdominis is crucial for spinal flexion and core stability. It's also significant in sports requiring strong core engagement and is a focus in managing lower back pain.
General Function: Spinal flexion, forced expiration.
Origin: Pubic symphysis and pubic crest.
Insertion: Xiphoid process and 5th to 7th costal cartilages.
Innervation: Thoracoabdominal nerves (T6-T12).
Clinical Significance: Essential in sports requiring powerful trunk flexion and lower back pain management.
Visual Cues of Dysfunction:
Anterior pelvic tilt or a swayback posture.
Difficulty in maintaining a stable core during tasks that involve lifting or bending.
Obliques (Internal and External)
The Obliques contribute to trunk rotation, lateral flexion, and are vital for rotational power in various sports. They also play a role in lumbar stability and are targeted for treating rotational imbalances.
General Function: Trunk rotation, lateral flexion, forced expiration.
Origin:
External: 5th to 12th ribs.
Internal: Thoracolumbar fascia, iliac crest, lateral half of the inguinal ligament.
Insertion:
External: Linea alba, pubic tubercle, anterior half of iliac crest.
Internal: 10th to 12th ribs, linea alba, pecten pubis via conjoint tendon.
Innervation: Thoracoabdominal nerves and first lumbar nerves.
Clinical Significance: Important in sports requiring rotational power and balance; targeted in treatment of low back pain and rotational imbalances.
Visual Cues of Dysfunction:
Altered gait, such as a wobble or drift to one side while walking.
Challenges in tasks requiring trunk rotation or lateral bending.
Rectus Abdominus MSR Release Procedures
Step-by-step Instructions
These procedures are demonstrated in the following video.
Positioning: Place the patient in a side-lying position, standing behind them for optimal access.
Initial Setup: Instruct the patient to bring their upper arm into full flexion and their leg into a full extension for anatomical alignment.
Consent: Before commencing, obtain explicit permission from the patient to access the treatment area.
Technique: Utilize an open, flat hand to initiate treatment at the lower end of the Rectus Abdominis. Apply superior traction to engage the fascial connections.
Synchronization: Progress methodically up to the xiphoid process, then reverse your hand motion to apply inferior traction.
Pressure: Use graded force as you traverse the length of the muscle, taking into account any muscular restrictions or fascial adhesions.
Focus Area: When encountering an area of restriction, slow your pace and concentrate the traction until a release is palpable.
Fiber Orientation: Bear in mind that the Rectus Abdominis muscle fibers run vertically, requiring an up-and-down directional focus for optimal release.
Concluding Steps: Instruct the patient to lie on the opposite side and repeat the procedure for comprehensive treatment.
MSR Demonstration Video
In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) procedures for releasing the Rectus Abdominis and Abdominal Oblique muscles.
Best Practices
Diaphragmatic Connections: There are very strong connections from the Rectus Abdominus to the diaphragm. You may need to use MSR diaphragmatic release protocols if significant restrictions are noted.
Kinetic Chains: Always consider the effects of a larger kinetic chain on the primary structures.
Hand Tension: The practitioner should keep their hands relaxed. Otherwise, the patient may tense up, leading to incomplete release.
Precautions
Manual therapy on the rectus abdominis requires careful consideration of underlying medical conditions, the patient's history, and current symptoms.
Precautions include avoiding therapy on inflamed or ruptured tissues, contraindicated medical conditions, and post-surgical cases without clearance.
Proper assessment, consent, and technique are crucial to minimize risks.
Rectus Abdominis Functional Kinetic Chains
Understanding kinetic chains is essential for MSK practitioners, offering a nuanced framework for precise diagnosis, effective treatment, and targeted rehabilitation through techniques like MSR. The framework includes:
Direct Myofascial Connections
Synergists
Stabilizers
Antagonists
Direct Myofascial Connections
These fibrous networks allow force to be transmitted across muscles, linking them in a continuous chain. A disruption in these connections can lead to impaired force transmission, affecting overall biomechanical efficiency.
Linea Alba: A fibrous structure that separates the left and right side of the Rectus Abdominis.
The aponeurosis of the External Obliques: Facilitates force transmission.
Pubic Symphysis: The inferior attachment site.
Xiphoid Process and Costal Cartilages: The superior attachment sites.
Diaphragm: Sharing the same fascial plane, influencing respiration.
Inguinal Ligament: Supporting the lower abdomen and influencing pelvic positioning.
Thoracolumbar Fascia: Shared posterior fascial plane with the erector spinae and quadratus lumborum.
Synergists:
These muscles work together to facilitate specific movements, serving as the action's active agents. Synergistic dysfunction often leads to compensatory patterns, affecting the muscle group's overall performance.
Obliques (External and Internal)
Transversus Abdominis
Psoas Minor
Quadratus Lumborum
Stabilizers:
These muscles provide the foundational support during movement, ensuring efficiency and safety. Weak or inhibited stabilizers can compromise joint integrity, making movements less efficient and more prone to injury.
Lumbar Erector Spinae
Pelvic Floor Muscles
Multifidus
Thoracic Erector Spinae
Antagonists:
Working in opposition to the action, antagonists are essential for both concentric and eccentric muscle contractions. If dysfunctional, antagonists can decrease strength and create muscle imbalances, impacting the range of motion and potentially leading to injury.
Erector Spinae
Quadratus Lumborum
Iliopsoas
Abdominal Oblique MSR Release Procedures
Step-by-step Instructions
These procedures are demonstrated in the following video.
Positioning: Have the patient lie on their side while you stand behind them to ensure optimal treatment angles.
Consent: Secure the patient's permission before accessing the treatment area to maintain professionalism and ethical boundaries.
Technique: Employ an open, flat hand to take inferior traction along the muscle fibers. Adapt your hand orientation based on the specific oblique being treated: internal or external.
Fiber Orientation: Understand the unique fiber directions—internal oblique fibers run "upward and medially," while external oblique fibers run "downward and medially." Tailor your technique accordingly.
Individual Variability: Acknowledge that patient-specific factors like posture and overall musculoskeletal health can influence the specific angle and approach.
Synchronization: Instruct the patient to return their upper arm to flexion and abduction for enhanced anatomical alignment.
Advanced Technique: Introduce circumduction movements to generate shear stress. This assists in breaking down myofascial restrictions and improves tissue mobility.
Focus Area: If you encounter a particularly restrictive area, slow down and spend adequate time applying concentrated force until you feel a release.
MSR Demonstration Video
In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) procedures for the Rectus Abdominis and Abdominal Oblique muscles. Note the MSR release for the abdominal obliques starts at 01:49.
Best Practices
Time Factor: Take your time with these procedures. The process of releasing myofascial restrictions cannot be rushed.
Circumduction Benefits: Employing circumduction in your MSR procedures offers neurophysiological advantages such as modulating nociceptive signals and fostering muscle relaxation. Furthermore, it has the added benefit of system-wide therapeutic intervention, aligning well with MSR's comprehensive treatment philosophy.
Kinetic Chains: Always consider the effects of a larger kinetic chain on the primary structures.
Precautions
Manual therapy on the rectus abdominis requires careful consideration of underlying medical conditions, the patient's history, and current symptoms.
Precautions include avoiding therapy on inflamed or ruptured tissues, contraindicated medical conditions, and post-surgical cases without clearance.
Proper assessment, consent, and technique are crucial to minimize risks.
Abdominal Oblique Functional Kinetic Chains
Understanding kinetic chains is essential for MSK practitioners, offering a nuanced framework for precise diagnosis, effective treatment, and targeted rehabilitation through techniques like MSR. The framework includes:
Direct Myofascial Connections
Synergists
Stabilizers
Antagonists
Direct Myofascial Connections
These fibrous networks allow force to be transmitted across muscles, linking them in a continuous chain. A disruption in these connections can lead to impaired force transmission, affecting overall biomechanical efficiency.
Rectus Abdominis: Shares fascial connections through the linea alba.
Transversus Abdominis: Interwoven through the same fascial sheet, contributing to intra-abdominal pressure.
Quadratus Lumborum: Connected via the thoracolumbar fascia, playing a role in lateral flexion and stabilization.
Psoas Major/Minor: Connections exist through the fascial network deep into the abdomen.
Lumbar Erector Spinae: Links via the thoracolumbar fascia, contributing to lumbar stabilization.
Pelvic Floor Muscles: Interconnected through fascia, aiding in pelvic stabilization.
Diaphragm: Fascial connections help coordinate breathing mechanics and core stability.
Thoracic Erector Spinae: Connects through fascial planes along the spine.
Latissimus Dorsi: Linked via the thoracolumbar fascia, involved in spinal and shoulder mechanics.
Serratus Anterior: Myofascial links contribute to scapulothoracic movement.
Intercostal Muscles: Direct fascial connections play a role in rib movement and stabilization.
Gluteal Muscles: Some fascial continuity exists through the pelvis.
Tensor Fascia Latae: Linked through the fascial network affecting the hip and lateral stabilization.
Adductor Group: Connects via fascial tension lines, affecting hip mechanics.
Hamstrings: Some deep fascial connections exist that affect pelvic tilt and lumbar stability.
Understanding these myofascial connections can offer deeper insights into dynamic movement patterns, stability, and how imbalances could contribute to dysfunction. This can be particularly useful when employing Motion Specific Release (MSR) procedures.
Synergists:
These muscles work together to facilitate specific movements, serving as the action's active agents. Synergistic dysfunction often leads to compensatory patterns, affecting the muscle group's overall performance.
Rectus Abdominis
Transversus Abdominis
Quadratus Lumborum
Latissimus Dorsi (when doing rotation)
Stabilizers:
These muscles provide the foundational support during movement, ensuring efficiency and safety. Weak or inhibited stabilizers can compromise joint integrity, making movements less efficient and more prone to injury.
Erector Spinae
Pelvic Floor Muscles
Multifidus
Transversus Abdominis
Antagonists:
Working in opposition to the action, antagonists are essential for both concentric and eccentric muscle contractions. If dysfunctional, antagonists can decrease strength and create muscle imbalances, impacting the range of motion and potentially leading to injury.
Opposite Obliques (during rotation)
Erector Spinae
Quadratus Lumborum
Mobility Exercises
Mobility is the cornerstone of effective muscular function, especially for muscles as central to movement and stability as the Rectus Abdominis and the Obliques. Proper mobility allows for an optimal range of motion and is often a preliminary step to more complex MSR techniques. Below, we delve into specific exercises for the Rectus Abdominis and Obliques, framed in both anatomical and biomechanical terms.
Rectus Abdominis Muscle Mobility
Cat-Cow
Anatomical and Biomechanical Considerations: This engages spinal flexors and extensors dynamically primes the Rectus Abdominis for greater ROM (Range of Motion).
Myofascial Release
Anatomical and Biomechanical Considerations: Foam rolling exerts mechanical pressure on the myofascial components, aiding in fascial slide and reducing muscle viscosity.
Scientific Rationale
Dynamic stretching and myofascial release improve fascial glide and reduce muscle hypertonicity, thereby improving both spinal and pelvic biomechanics.
Oblique Muscle Mobility
Medicine Ball
Anatomical and Biomechanical Considerations: The obliques function as the primary movers in lateral flexion, and the addition of weight provides eccentric control during the return phase.
Scientific Rationale
Lateral flexion and axial rotation exercises promote oblique mobility and facilitate spinal and pelvic alignment. This is crucial for functional movements such as walking, running, and other rotational activities.
Strengthening Exercises
Strength is integral to functional anatomy; it's not just about muscle size, but about the capability of muscle and tendon systems to produce force. This is particularly crucial in a biomechanical context, where muscle imbalances can significantly affect postural equilibrium and joint stability. Given the Rectus Abdominis and Obliques' role in core stability, strength training exercises are essential, especially when considering MSR techniques that can release restrictions and optimize function.
Rectus Abdominis Strengthening
Planks
Anatomical and Biomechanical Considerations: Isometric tension in the Rectus Abdominis maintains anterior-posterior spinal alignment, requiring co-contraction of stabilizing musculature like the pelvic floor and multifidus.
Bicycle Crunches
Anatomical and Biomechanical Considerations**: The dynamic nature of this exercise provides both concentric and eccentric phases for the Rectus Abdominis, enhancing muscular coordination and proprioception.
Scientific Rationale
Planks and Bicycle Crunches provide a balanced approach to strengthening, focusing on both isometric stability and dynamic movement, thus enhancing functional biomechanics.
Oblique Muscle Strengthening
Russian Twists
Anatomical and Biomechanical Considerations: This activates the obliques as primary rotators of the trunk, also requiring stabilization of the Rectus Abdominis and erector spinae.
Side Plank Dips
How to Perform: Assume a side plank position and lower your pelvis towards the ground before lifting it back up.
Anatomical and Biomechanical Considerations: This challenges the obliques in an isometric fashion and adds a lateral flexion and extension component, mimicking functional movement patterns.
Scientific Rationale
Both Russian Twists and Side Plank Dips are comprehensive exercises that engage the Obliques in their primary functions, thus aiding in rotational stability and lateral functional capacity.
Conclusion
In summary, the Rectus Abdominis and Obliques are not just workhorses of the musculoskeletal system, but also pivotal in safeguarding lumbar health and optimizing athletic performance. This article provides an in-depth look at the anatomy and biomechanics of these muscles, as well as actionable Motion Specific Release (MSR) techniques to enhance their function. By integrating MSR with targeted mobility and strengthening exercises, practitioners and patients alike can elevate their approach to core stability, muscular balance, and overall well-being.
DR. BRIAN ABELSON DC. - The Author
Dr. Abelson's approach in musculoskeletal health care reflects a deep commitment to evidence-based practices and continuous learning. In his work at Kinetic Health in Calgary, Alberta, he focuses on integrating the latest research with a compassionate understanding of each patient's unique needs. As the developer of the Motion Specific Release (MSR) Treatment Systems, he views his role as both a practitioner and an educator, dedicated to sharing knowledge and techniques that can benefit the wider healthcare community. His ongoing efforts in teaching and practice aim to contribute positively to the field of musculoskeletal health, with a constant emphasis on patient-centered care and the collective advancement of treatment methods.
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References
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Huijing, P. A., & Jaspers, R. T. (2005). Adaptation of muscle size and myofascial force transmission: a review and some new experimental results. Scandinavian journal of medicine & science in sports, 15(6), 349-380.
Vleeming, A., Schuenke, M. D., Danneels, L., & Willard, F. H. (2012). The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. Journal of Anatomy, 221(6), 625-632.
Clark, M. A., Lucett, S. C., & Sutton, B. G. (2012). NASM Essentials of Corrective Exercise Training. Lippincott Williams & Wilkins.
Lee, D. (2004). The Pelvic Girdle: An integration of clinical expertise and research. Churchill Livingstone.
Jull, G., & Moore, A. (2018). Grieve's Modern Musculoskeletal Physiotherapy. Elsevier Health Sciences.
Hodges, P. W., & Richardson, C. A. (1999). Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Archives of Physical Medicine and Rehabilitation, 80(9), 1005-1012.
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