MOTOR CONTROL IS AN INTERACTIVE PROCESS that allows the body to initiate activity to react to perturbations and other outside forces in a coordinated manner.
Normal global reactive motor control is complicated when you consider the vast amount of interactive and competing neuronal transmissions that are involved. However, in the simple example of evoking a patellar reflex, we can see that a stimulus, in this case a reflex hammer, places a rapid stretch on the muscle spindle fibers of the quadriceps. This sudden rapid stretch results in an afferent nerve transmission to the spinal cord and brain. There is a resulting efferent message that, traveling through an intermediate interneuron, inhibits contractions of the hamstring muscle, while another efferent transmission evokes a rapid contraction of the quadriceps.
This simple reflex arch is replicated in more complex patterns throughout the body.
Manipulation Activation of Core Stabilization
A few recent studies have documented that the protective mechanisms of some core muscles, particularly the multifidus and the transverse abdominis, are enhanced by high-velocity low-amplitude manipulations. While gaps remain in the science, it appears that the adjustment (i.e., HVLA manipulation) activates the multifidus by way of stimulating the muscle spindle fibers of the small muscles of the spine. Pickar has demonstrated that manipulation stimulates the proprioceptive mechanism by exciting both muscle spindle fibers and golgi tendon organs. Another study showed the effect the speed of the manipulation has on the muscle spindle response; the faster the manipulative impulse, the greater the muscle spindle response.
Fritz found that the multifidus muscles retained increased recruitment one week following treatment. This indicates that the response was not simply a myotatic (stretch) reflex, but could be something more analogous to hitting the reset button on a computer.
Chiropractic manipulation can enhance core stabilization, and particular exercises will also improve core stabilization. However, the synergistic effect of combining manipulation and exercise is preferred to either intervention alone. Core stabilization is a complex multifactorial system of sensory– motor control. It involves passive, active and reactive components. As our understanding of the science of these mechanisms evolves, we will need to continually adapt our treatment programs and referral patterns to maximize our patients’ outcomes.
This article is more technical than what I usually post. That said, it’s very exciting as it discusses how blending spinal manipulation with rehabilitative exercise improves low back stability. This is what I do on a daily basis in my practice. If you’re looking for treatment for your back pain that blends manual therapy and exercise. Call to make an appointment today. Take advantage of my expertise as Northeast Wisconsin’s only chiropractor who’s board-certified in rehabilitation.