Julie Wiebe’s Diaphragm/Pelvic Floor Piston for Adult Populations Online – Part 3
In the previous blog posts I have tried to shed some light on Julie Wiebe’s course entitled Piston Science for Adult Populations. Blog 1 and Blog 2 have looked at the importance of incorporating the diaphragm as the primary driver for the rest of the core, in addition to understanding how posture can affect the ability to recruit optimally through the core musculature including the diaphragm, transversus abdominus, multifidus and of course the pelvic floor.
Creating a lasting postural change can be difficult, so it is important that we know how to sustain gains.
Once the thorax and lumbo-pelvic positioning has been optimized for core function the question that remains is, how do we maintain it?
Having a well-coordinated core system (well-functioning piston) will not in itself maintain those postural gains. Some attention must be paid to those global muscles required to create a longstanding postural adjustment.
If my clinical experience in utilizing Wiebe’s system is any indication, your patients will initially feel uncomfortable with trying to maintain this new postural position, despite seeing an immediate change in how their core functions. Like any strength changes, it will take work and dedication achieved through sound education derived from Wiebe’s work, reinforced by exploring which muscles are being ‘over-worked and under-paid’ and which muscles are doing very little to contribute to postural support.
Now is the time to explore Wiebe’s introduction to the Postural Synergists. The Postural Synergists are specific groups of global muscles which function together to improve dynamic postural performance. These muscular groups reconnect the anticipatory (core) and reactive (postural synergist) muscular systems.
Wiebe reviews all of the postural synergists in her course, proving examples of how a deficiency in a certain muscle group can be applicable in various postural dysfunctions.
Let’s look at an example of the importance of recognizing these factors in posture and performance. I will use the posterior oblique synergist including the gluteus maximus, contralateral lattisimus dorsi and the intervening thoracodorsal fascia in this example. If we see a patient with a pelvic organ prolapse with a compensatory posture of a posterior pelvic tilt and thoracic kyphosis we know the diaphragm and therefore the core is not functionally optimally, but we can also ascertain that neither would the gluteus maximus and latissimus dorsi based on the action we expect out of these individual muscles. The latissimus dorsi functions to retract and depress the scapula (essentially lifting the chest), whilst the gluteus maximus helps to enhance a neutral pelvis and aid in hip extension. A deficiency in this postural synergist group using the example mentioned, will re-enforce chronic poor posture and under-utilization of the core.
Therefore, it is essential that once we have established a baseline for coordinating proper core function through posture, that we enhance that posture using a progressive strengthening program targeted to each individual’s needs.
Wiebe breaks down these synergists, but also provides a systematic approach to exercise progressions. This approach to pelvic dysfunction intervention continues to re-inforce the philosophy of practice that we must look at each individual from a whole-body approach, moving beyond just the borders of the pelvis.
Pelvic Floor Physiotherapy for individuals with concerns with prolapse, urinary incontinence, or a multitude of pain disorders need to be viewed orthopedically in this fashion. Our job is so much more than Kegel exercises.
Julie Wiebe and Pelvic Health Solutions have joined together to offer 20% off Piston Science Bundles A and B, Sports Medicine Bundles A and B, and Piston Science Module One. Click here to receive a 20% discount on any of these courses and use code NewYear20. Offer is valid until 02/28/2018.
Written by Michelle Vanderpol