Dr. Spina, thanks so much for taking time out of your schedule to answer a few questions. Before we get into the good stuff–your mobility and manual therapy systems–can you give us a little of your background?
Sure thing (although I always hate this question).
I studied Kinesiology at McMaster University in Hamilton, Ontario, Canada. I later graduated with summa cum laude and clinic honors from the Canadian Memorial Chiropractic College as a Doctor of Chiropractic and subsequently completed the two-year post-graduate fellowship in sports sciences. During my time studying Chiropractic, I became the first pre-graduate student to tutor in the cadaver laboratory in the department of Human Anatomy, a position that continued throughout my post-graduate fellowship program.
Stemming from my passion of studying and teaching anatomy, in 2006 I created Functional Anatomic Palpation Systems (F.A.P.)™ which is a systematic approach to soft tissue assessment and palpation. Following the success of F.A.P. seminars, I later created a follow up system of soft tissue release and rehabilitation called Functional Range Release (F.R.)® technique which is now being utilized by manual practitioners around the world including the medical staffs of various professional sports organizations. I then combined the scientific knowledge gained during my studies with my 29 years of martial arts training in various disciplines to create the third installment of my curriculum, Functional Range Conditioning (FRC)™, which is a system of mobility conditioning and joint strengthening.
Aside from my work teaching seminars, I also own a sports centre in Toronto, Ontario where I practice and train clients. I am a published researcher, and I have authored chapters in various sports medicine textbooks.
1) Wow, definitely an extensive background–makes you the perfect candidate to answer my next question.
There’s a lot of buzz here in the states about mobility, stability and corrective exercise. In your opinion, where does the typical view of mobility and stability training fall short?
I believe it is a matter of nomenclature, which may seem trivial at first, but it is the basis on which systems are formed.
By my definition, mobility and stability are intimately related. Mobility, which is often confused with “flexibility,” can be defined simply as the ability to move or to be moved freely and easily. Another way to think of it is the ability to actively achieve range of motion. Flexibility by contrast is the ability to passively achieve range of motion. It is therefore possible to be very flexible, however have limited mobility. The former implies that you can passively achieve a particular range, while the latter implies neurological control of a particular range as it is being actively attained.
Let’s take this a step further by examining the role of the above concepts in movement creation and control.
Active ranges of motion occur as a direct result of nervous system activity and thus, at least by the current most plausible theory (the Motor Program/Engram theory) the movement was in some way pre-planned by a central processor (the mind) and executed by the peripheral connections (the brain and nervous system). This plan has within it specific instructions needed to successfully complete the task as, once again theoretically, it is assumed that it was previously encoded. Logically, one would not make a plan with tasks that they are not able to accomplish. Similarly the mind would work within its functional limits/abilities when composing details such as speed, amplitude, angle, etc, of a certain movement. In addition to specific instructions, the nervous system also has the ability, to a certain extent, to alter/correct the plan, using efficient short “circuit loops,” to deal with unforeseen circumstances, and/or sudden plan alterations stemming from some incoming afferent information.
The actual creation of the plan is a complicated and controversial topic. We can say however that it is likely that the limits/abilities utilized in its creation are determined by movement histories that have previously been attempted, and have offered valuable afferent feedback. The execution of the active movement is more clearly understood and is known to be under the guidance, control, and protection of the nervous system (note that the control, and protective elements can be thought of as the “stability”). This is why, when considering the several thousand/millions of movement plans executed per day, we very rarely hear of cases where joints are dislocated, or even subluxated, strictly due to active motion. When it does occur, it is either as a result of execution/plan errors (e.g. Pivoting/change of direction injuries), or stemming the application of an external passive influence, or force, which exceeds the joints ability to correct (ie. “stability”) for the resultant load.
Using the above analogy, mobility can be thought of as the “functional limits of active movement,” while “the movement” itself can be thought of as the original plan. On the contrary, the flexibility of the joint refers only to the ability to passively achieve a particular range. This is under less control of the nervous system, however its limit still governed by it (as it sets the stretch reflex threshold).
Also using the above analogy, we can see how mobility, and stability are thoroughly linked. Mobility represents the physical limits of motion, while stability ensures that those limits are maintained.
Getting back to your original question (finally), where some current systems fall short in my opinion is twofold. First, is in the definition of their actual goal, “mobility” (as opposed to flexibility). Second, in that they did not account for all of the available scientific evidence in the creation of the system. These two factors lead to actual training methodology that is inefficient, and often ultimately ineffective when compared to the goal.
A quick example is the prevalent promotion of stretching with resistance bands, or the use of foam rollers. Neither can logically be concluded to improve mobility as neither trains the nervous system to control ranges of motion or movement.
2) Motor control plus improved tissue extensibility equals improved movement–at least that’s what I gathered from your answer. Sounds a lot like your movement system Functional Range Conditioning (FRC)™. Can you tell everyone a little bit about your Functional Range Conditioning (FRC)™ system and how it differs?
FRC™ is a system of mobility conditioning based in scientific principles and research. In its creation, every aspect of the training procedures utilized were formed on this foundation. Thus it teaches practitioners how to efficiently, and effectively improve articular mobility, which, as we have discussed, means that it builds articular stability in the process. Furthermore, in creating the system, we have also considered how best to build strength and load bearing capacity in the soft tissues simultaneously.
The system follows a general procedural “Flow Chart” that allows the certified practitioner to determine mobility goals, assess for aberrant joint mechanics, expand available ranges of motion, condition and prepare available ranges of motion for use (including improving stabilization), and finally how to begin to integrate the mobility into progressively complex movement patterns. All the while, they are keeping mindful of improving tissue quality and resilience.
Many systems of mobility development are presented as either ‘warm up,’ or ‘cool down’ procedures. Thus they are more of an “after thought.” Whereas FRC is a directed system of training that either stands alone, or is integrated into ones existing programming that realizes and emphasizes the importance of real mobility development.
3) That definitely makes sense–all training and rehab exists on a continuum, why completely separate the parts?
As a guy that works mostly with team sport athletes, most of the injuries my guys suffer are during change of direction or when muscles are placed under tension at end range. Does your Functional Range Conditioning system address either of these common injury causers?
It does address both of these causes of injury. Regarding injury during sudden changes of motion, this implies that there is a breakdown, or inability of the compensatory system (aka dynamic stabilization) to avoid tissue damage. This type of injury is more common with unfamiliar, or untrained movement demands. It is also common with demands occurring while tissues are in ‘dangerous,’ or vulnerable positions. As we discussed, the FRC system was designed to simultaneously build tissue strength through progressive adaptation as mobility is attained. It further focus’ on training the bodies articulations in positions where they are known to be weak. For example, a shoulder that is in a position of abduction and external rotation is inherently less stable and thus can result in anterior subluxation/dislocation under minimal strain. FRC training recognizes common angular weakness and specifically trains within these ranges improving load-bearing capacity. Such tissue adaptation reduces injury rate, and/or severity by providing a “passive” reserve safety net for when dynamic stabilization fails. Put simply, when stabilization (controlled by the nervous system) fails, the difference between an injury, and prevention of an injury, comes down to how well the tissues have been prepared to handle/absorb force. FRC improves force absorption capacity over multiple joint positions. As I always say, you will always regret not training the position that you got injured in.
Regarding tissues/muscles placed under end range tension, much of the FRC systems training methods are performed at the end range of articular motion. Thus, the soft tissues, and nervous systems of FRC trained athletes are well prepared to deal with end range stress.
Along the same lines, loading under eccentric conditions is actually the most common scenario leading to injuries. The FRC system also takes this into account implementing preventative training strategies for this mechanism as well.
4) “You will always regret not training the position that you got injured in.” That’s a profound and resonating statement, Dr. Spina, that hold’s true for every athlete that’s been sidelined by a soft-tissue or joint injury. My next question has more to do with the structures that we are affecting with training and manual therapy. I think there is a lot of confusion on the topic, and I’m sure you can clear it up.
There are quite a few mobility and manual therapy systems that do well to address the neuromuscular component of movement and rehab, but what about fascia? The fascial component is huge and it seems as though it’s often disregarded.
It is my opinion that the concentration on fascia as of late is actually equally as restrictive as a sole focus on the neuromuscular aspect. Fascia is but one tissue of the much broader ‘collection’ of tissues known as Connective Tissue. Other examples include bones, ligaments, tendons, capsules, cartilage, and blood vessels. As we thoroughly review at the FRC seminars, each of these sub-categories simply represents a tissue continuum whose boarders are difficult to delineate even with the help of a microscope. In other words, it is difficult, and unrealistic, to distinctly separate these tissue forms, as they are in fact continuous and simply represent changes in composition of identical elements. I will spare you the details here, it suffices to say that a complete system, be it mobility conditioning or manual therapy, must take this anatomical reality into account. All training activities, and manual treatment applications are affecting each and every tissue type simultaneously. We must thus account for all of them when creating a sound, complete system.
5) Ok–so let’s stick with that line of questioning. It seems that most trainers and therapist think about movement and rehab through a neuromuscular lens–for example by trying to correct for movement patterns. How do tissues traditionally thought of as ‘passive’ affect movement and function?
The very idea that there are ‘active’ vs. ‘passive’ tissues is one that has historically been propagated through scientific dogma. As with many topics, assumptions become inherent to the topics, which are then passed on unquestioned through the education system and literature. If one was to examine the work of an anatomist who had dissected a specimen, they should remain mindful that they are viewing that particular individuals representation of what they believe things ‘should’ look like; an artistic depiction so to speak. Take the Medial Collateral Ligament, or MCL, of the knee for example. In a living person, this structure does not exist in and of itself. Rather it simply represents a thickening of the medial joint capsule, which is it self completely continuous with any and all tissues surrounding the articulation. The demonstration of the “MCL” is only possible due to the use of a scalpel, and the anatomists resolve to demonstrate that particular structure.
This practice provides a very mechanistic view of the human form. This muscle goes from bone ‘a’ to bone ‘b’ and thus when contracting, approximates ‘a to b.’ Further, this ligament attaches from location ‘c’ to location ‘d’ and thus protects the articulation against forces that separate ‘c and d.’ Stemming from this basis are systems of training and/or methods of treatments which fail to account for the continuity of form, and thus function. As Aristotle said, “the whole is greater than the sum of its parts.”
The author Jaap van der Wal puts forth a more realistic representation of anatomy. He describes that there are in fact no ‘passive’ tissue elements as all non-contractile tissues are influenced by the action of interconnected actively contractile tissues. Thus tension in passive elements are in a sense ‘tuned’ by the action of active ones. This explains how joint stabilization is maintained throughout a joints range of motion as opposed to only at specific angles as would be the case if passive tissues were truly passive.
Getting back to your original question, the traditional ‘passive’ elements play just as important a role in the development and execution of movement patterns, as well as the maintenance of articular stability as the active ones as they are inherently inseparable. You are correct in noting that many systems all but ignore the ‘passive’ system attempting to describe all things in terms of neuromuscular functioning. This faulty reasoning leads to the creation and utilization of systems that ignore the adaptive processes of such tissues and thus are incomplete and likely less effective.
I lecture extensively on this topic at my manual therapy seminars as well as at the Functional Range Conditioning seminar.
6) There’s no separating the neuromuscular component from the “passive” elements. Got it–when you think about the body holistically, it makes much more sense. Let’s continue with the holistic theme. Manual therapy and movement conditioning–how do these two modalities blend with loaded training?
In my system of manual therapy, Functional Range Release (F.R.)® technique, there is no separation between treatment and rehabilitation; and this system can be seen as continuous with the FRC training system. Loaded training procedures, which I term PAILs and RAILs (Progressive and Regressive Angular Isometric Loading) are utilized in conjunction with tissue release procedures. Both the application of external forces, such as those imparted with manual treatments, and the creation of internal forces stemming from tissue activation (such as isometric loading), both provide input/instruction to the cellular elements of the tissues accepting said loads/forces. As I commonly note, ‘force is the language of the cells.’ These imparted forces therefore provide us with an opportunity to “communicate” with the cells and influence their adaptive, and/or reparative processes. In my mind, manual therapy and movement conditioning are on the same continuum. Systems that treat them as separate are thus incomplete (in my opinion).
When treatment and training principles are complementary, with the underlying understanding that the ultimate goal is inducing beneficial tissue and neurological adaptations, one can create more efficient, and effective biomechanical functioning.
7) I couldn’t agree more–all the elements of rehab and training must align. Charlie Weingroff talks about this extensively when he explains the necessity for building a well-skilled, complimentary team. When building my team I look for practitioners that train and treat using solid systems. I think it’s a great time to learn more about yours. Tell us briefly what one can expect at an FRC™ certification seminar.
The Functional Range Conditioning certification seminars include both lecture and practical (training) components. The lecture components explain, in great detail, many of the concepts that we have introduced in this interview analyzing them at the gross tissue, cellular, and sub-cellular levels. FRC training principals are then explained in this context, and subsequently practiced by participants. As there is much more to the system than can be covered over the course of one weekend, those who are successful in passing the certification are given access to our members only website which provides a growing compendium of FRC exercises, as well as blog posts providing further explanations and new developments.
Successful participants also receive the designation of a “Functional Range Conditioning Mobility Specialist,” or FRCms (granted by Functional Anatomy Seminars) which includes participation in the “Find-a-provider” function of our website.
As there are various ‘movement’ based assessment and/or training seminars, I do want to note that the FRC system focus’ not on movement assessment and creation per se. Rather, it is focused on preparing the body for movement by ensuring adequate mobility with which movement can be created. This is summarized by my equation – MOBILITY α MOVEMENT POTENTIAL – where mobility is directly proportional to movement potential. The system is therefore completely compatible, and even complementary to the various other movement systems and paradigms.
If you are interested in learning more about the system, or registering for an upcoming certification please visit http://functionalanatomyseminars.com/functional-range-conditioning
Dr. Spina, thanks so much for taking time out of your schedule to answer my questions with such detail. I know I learned a great deal during this interview.
Readers, Dr. Spina is holding is first ever FRC™ certification seminar in the U.S. on October 5th and 6th at Ranfone Training Systems in Hamden, CT. To sign up, or learn more, click the link below.