Fighting the Battle of Creep – Dr. Matthew DiLallo D.C.

 

Fighting the Battle of Creep.

What is Creep?
Creep is defined as the progressive deformation of a structure under constant load (1). This concept applies to both the structures that support our house, but also the structures that support our human body.  Due to the viscoelastic properties of the tissues in our body, it will help to think of creep in terms of a rubber band.  If you repeatedly or consistently pull, stretch, or hold the rubber band in ways that stress it (cause it to turn white), it will begin to lose its ability to hold its original shape. The rubber band has more laxity and in some cases even breaks. This concept applies to the soft tissues of your body.  For example, if you sit for the majority of the day working at a computer or driving a car you are subjecting your body to prolonged periods of spinal flexion, which is correlated to a host of negative effects. The consistent loading of the spine in flexion causes creep deformation to occur in the supporting musculature and passive ligamentous structures of the spine. When the ligaments are stimulated repetitively with constant load (in this case a flexion load), hysteresis (energy lost as heat during tissue loading and unloading) develops and the ligament length limits increase with each cycle (7). Thus, the repetitive use of the same force produces greater and greater ligamentous deformation or creep.

What are the complications associated with creep?
One of the effects of creep is the deactivation of your reflexive spinal stabilization system (2).  Simply put, you lose the ability to stabilize your spine.  The spinal stabilization system consists of muscle and tendon reflexes that coordinate the activation of muscles in your trunk. It activates muscles as needed in order to limit spinal movement thereby preventing excessive loading.  This deactivation of your spinal stabilization system due to creep can cause back pain and puts you at an increased risk for injury (2).

The human body is an extremely adaptive organism. It will start to adapt to the specific positions that you expose it to. This further complicates the battle against creep.  We can use the sitting example once again, in the sitting position, your hip flexors (psoas, iliacus, and rectus femoris) are in a shortened state. As creep sets in, your body adapts to having shortened hip flexors so that you become more efficient at sitting. This becomes an issue as we stop sitting and begin to move. Not only has creep turned off your ability to stabilize your spine, but now your hip flexors, which have adapted to stay chronically short, are tugging and pulling at your pelvis and lumbar spine. This causes mechanical compression of the articulations of your spine and can lead to back pain (1).  The shortened hip flexors also limit your ability to reach full hip extension, which is essential for moving. You body being the adaptive organism it is will find a way to let you move forward, but at the expense of compromising other structures of the body. When challenged, the brain will choose quantity of movement over quality of movement.  The inability to achieve full hip extension during movement causes your leg to externally rotate (turn out) placing a valgus force (pointing in) on your knee. The external rotation of your leg also translates down to your ankle which follows suit and is subject to external rotation forces (toes pointing out).  This causes your ankle to never reach its full range of motion and your body realizes this and you loose that range of motion. So to put it simply, creep does not only affect the spine, the effects of creep are felt all throughout the body.

What weapons can we use to fight the battle of creep?

The best weapon we have to fight the battle of creep is movement.  As said by Grey Cook “First move well, then move often.”  If at all possible we should avoid long periods of time sitting or being in a static position.  One solution would be to invest in a standing desk at work, but if that is not an option there are a few other things you can do.  Set a timer to remind you to get up and take a walk around the office or simply just to change your position. You can use a lacrosse ball or tennis ball and use it to mobilize different areas of your body while you work.  I suggest trying to accumulate about 10-15 minutes of mobility work per day. It doesn’t have to be done all at one time; you can break it up over the course of the day and works best if you focus on only one or two areas.  Research suggests that you should work on mobilizing an area for at least 45 seconds to produce significant changes in tissue length (9).  I prefer to use the term mobilize instead of stretch, the reason for this is best said by Dr. Kelly Starrett:  “Stretching only focuses on lengthening short and tight muscles. Mobilization, on the other hand, is a movement-based integrated full-body approach that addresses all the elements that limit movement and performance including short and tight muscles, soft tissue restriction, joint capsule restriction, motor control problems, joint range of motion dysfunction, and neural dynamic issues. In short, mobilization is a tool to globally address movement and performance problems.”  If you want the best bang for your buck you would be wise to incorporate the use of a JumpStretch band into your mobilization routine. Using a JumpStretch band for mobilizations helps to improve optimal joint centration that has been disrupted by the creep that has occurred over the course of your day and life.  Joint centration means that the articular surfaces of each joint have maximum contact with each other. This allows for ideal loading and the best biomechanical advantage at each joint. For examples of specific stretches to help combat the battle of creep please check out Performance and Wellness Chiropractic’s YouTube channel.

https://www.youtube.com/channel/UCXOy765JS6r36vRBeYJzlFg/videos

Dr. Matthew DiLallo DC, MA, CSCS

Office Phone: 561-402-4701

 

 

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References:
1. McGill SM, Brown S. Creep response of the lumbar spine to prolonged full flexion.Clin Biomech. 1992;7:43-46.
2. Sanchez-Zuriaga D, Adams MA, Dolan P. Is Activation of the Back Muscles Impaired by Creep or Muscle Fatigue? Spine. 2010;35(5):517–525.
3. Yamashita T, Minaki Y, Oota I, et al. Mechanosensitive afferent units in the lumbar intervertebral disc and adjacent muscle. Spine. 1993;18:2252-6.
4. Roberts S, Eisenstein SM, Menage J, et al. Mechanoreceptors in intervertebral discs. Morphology, distribution, and neuropeptides. Spine. 1995;20:2645–51.
5. Rhalmi S, Yahia LH, Newman N, et al. Immunohistochemical study of nerves in lumbar spine ligaments. Spine. 1993;18:264-7.
6. Christensen, K. Plastic deformation and long-term support. Dynamic Chiropractic. December 15, 1999 (17).
7. Twomey L, Taylor J. Flexion creep deformation and hysteresis in the lumbar vertebral column.Spine. 1982 Mar-Apr; 7(2):116-22.
8. Solomonow, M. Ligaments: A source of musculoskeletal disorders. Anatomy, physiology, pathophysiology review. Journal of Bodywork and Movement Therapies 2009 (13):136-154.
9. http://www.strengthandconditioningresearch.com/2013/11/18/stretching
10. Yahia L, Rhalmi S, Newman N, et al. Sensory innervation of human thoracolumbar fascia. An immunohistochemical study. Acta Orthop Scand.1992;63:195-7.

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Posted by Dr. Matthew DiLallo

Dr. Matthew DiLallo DC, MA, CSCS Dr. DiLallo is a Chiropractic Physician, and a graduate of Palmer College of Chiropractic (FL campus). While attending Palmer, Dr. DiLallo served as the Vice President of the Sports Council Club where he worked with local athletic event organizers to minimize injuries to participants with pre and/or post event treatment. Dr. DiLallo had the opportunity to provide treatment to the athletes competing in Crossfit SouthEast Regionals and RAGNAR Relay from Miami, Fl to Key West, Fl. Dr. DiLallo received his Bachelors Degree in Physiology from the University of Colorado where he also was the 4 year starting punter for the Buffaloes Football team. He then attended the University of South Florida where he obtained his Masters Degree in Exercise Science. During his time at USF he completed an internship with the Strength & Conditioning Department where he worked primarily with the USF Football, Baseball, and Track and Field teams. Prior to entering Palmer College of Chiropractic, Dr. DiLallo worked as a Strength & Conditioning Coach for the Pittsburgh Pirates. Along with being a Chiropractic Physician, Dr. DiLallo is currently a Certified Strength and Conditioning Specialist (CSCS), Full Body Active Release Technique (ART) Certified, Graston Therapy Certified and RockTape Functional Movement Taping (FMT) certified. Dr. DiLallo currently owns and operates Performance and Wellness Chiropractic located in Palm Beach Gardens and is a Punting Coach and the overseeing Chiropractic Physician for 4th Down Solutions.

Website: http://performanceandwellnesschiropractic.com

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