Gordon Zink, DO was the originator of the term Common Compensatory Pattern. He used the term to describe commonly found patterns of dysfunction in the body (neuromyofascial-skeletal unit) as a whole. Several other physicians, before and since, including Vladimir Janda, have also described recurring patterns of dysfunction found in their patient populations.

Dr. Zink, however, is considered to be “the first to provide a written, understandable, and clinically useful explanation for treatment, with a method of diagnosing and manipulative methods of treating the fascial patterns of the body.”  Janda’s research had provided a practical structural formula for classifying predictable muscle imbalance patterns primarily focused on sagittal plane deviations.  This structural integration model helped therapists understand how common tonic and phasic muscular adaptations caused paired antagonistic muscle groups to develop specific anterior/posterior preferences.  Zink’s work focused more on side-to-side rotational/side bending asymmetries located in the frontal and transverse planes.

Zink’s studies indicated that healthy adults normally present with a balanced symmetrical pattern of fascial strain predictably located throughout the body. His findings concluded that most people who considered themselves healthy presented with alternating patterns of rotational preference at the key crossover junctions.   He noted that zone-to-zone alternating patterns typically began with a left fascial rotational preference at the cervicocranial junction, followed by a right fascial bias at the cervicthoracic, a left at the thoracolumbar, and a right at the lumbosacral transitional junction.

When testing rotation from the cervicocranial to the lumbosacral regions, Zink discovered that approximately 80 percent of subjects who considered themselves healthy had rotational patterns of left/right/left/right, while the other 20 percent had a fascial preference for the sequence of right/left/right/left.  He labeled the group presenting with L/R/L/R as possessing a ‘common compensatory pattern’ and the opposite group and the opposite patterned R/L/R/L as demonstrating an  ‘uncommon compensatory pattern’.

Zink reasoned that, optimally, there should be equal fascial rotational motion to both left and right sides in all these referenced zones with, no bias present, Zink assigned this significant minority of subjects presenting with equal fascial bias in all four zones the title of ‘ideal’.  Conversely, those whose patterns did not follow the back and forth compensatory pattern in all zones were labeled ‘uncompensated’.  He discovered that the uncompensated individuals who neither fell into the ideal or compensated categories were slower to recover from illness, suffered more pain, and were more susceptible to venous and lymphatic congestion.

Spinal Engine Theory

Serge Gracovetsky, Ph.D.                                  

Serge Gracovetsky graduated from the nuclear physics program at the Swiss Federal Institute of Technology in 1968, and he earned his doctorate in electrical engineering from the University of British Columbia in 1970. Gracovetsky went on to become a tenured faculty member at Concordia University in Montreal where he taught for 27 years in the department of computer science and software engineering.

In the course of his career, Gracovetsky has studied subjects ranging from the injury process experienced by military jet pilots during emergency ejection to the reasoning process of physicians in making a diagnosis for low back pain.  He has founded and directed four companies devoted to developing technology to measure spinal function, based on the concept of the spine as the primary engine driving the pelvis during gait.

Gracovetsky is well known for his pioneering research on spine biomechanics and the Spinal Engine theory.  He currently serves on the scientific advisory board for the European Rolfing Association.

The human species evolved to avoid carrying unnecessary muscular masses that do not directly contribute to locomotion.  This development occurred from cleverly exploiting the Earth’s gravitational field and a few laws of physics, such as the conservation of angular momentum.

The law of conservation of angular momentum essentially describes a mechanism to transfer the action of one muscle to a distant part of the body.  The motion of one limb generates an angular momentum that must be canceled by the displacement of another limb so that the sum of the angular momentum of all the parts of the entire body remains zeroed at all times.

This law has numerous consequences for human locomotion.  Consider the motion of the pelvis during gait.  Suppose that the pelvic motion is due to application of forces produced by the legs.  Conservation of angular momentum implies that a counter-torque must be applied to the ground by the legs. This is done in some circumstances, such as skiing, when the foot forces the ski to turn in deep snow.  However, activities such as walking on tiptoes or running on ice do not transfer any torque to the ground. In other words, since little or no torque is applied by the legs to the ground, then little or no torque can be applied by the legs to the pelvis.

The consequence is unavoidable:  Since the pelvis cannot be driven from below, it must be driven from above.  Somehow, the spine generates the necessary forces to drive the pelvis.  The need to explain how the spine generates this force was the reason developing the spinal engine theory.

You may be interested to know that in 1977, two years before she passed away, Dr. Ida P. Rolf had a book published that was entitled Rolfing: Reestablishing the Natural Alignment and Structural Integration of the Human Body for Vitality and Well-Being.  In this text, in the chapter entitled Your Psoas, Rolf writes: “Sturdy balanced walking (in which the leg is flexed through activation of the psoas, not the rectus femoris) thus involves the entire body at its core level.  In such walking, each step is initiated at the twelfth dorsal vertebra, not in the legs; the legs move subsequently.  Let us be clear about this: the legs do not originate movement in the walk of a balanced body; the legs support and follow.  Movement is initiated in the trunk and transmitted to the legs through the medium of the psoas.”
Back to Gracovetsky’s research:

Locomotion is generally perceived as being the function of the legs, where the trunk is considered to be carried along in a more or less passive way. This popular hypothesis has been accepted with little substantiation. In light of the numerous observations contradicting this view, an alternative hypothesis has been proposed in which the spine and its surrounding tissues comprise the basic engine of locomotion. This theory is consistent with available experimental data which suggest that the motion of the spine precedes that of the legs. Indeed, the variations in the power delivered to the pelvis by the spine are strikingly similar to, but slightly ahead of, the variation in power at the hip.

If you are not yet familiar with the joint-by-joint theory, be prepared to take a quantum leap in thought process.

One beauty of the FMS is that it allows the screener to distinguish between issues of stability and those of mobility, in relation to joint function.  Visualize the body as a stack of joints where each joint or series of joints has a specific function and is prone to predictable levels of dysfunction.  As a result, each joint will have particular training needs.

The list below looks at the body on a joint-by-joint basis from the bottom up:

Joint                                      Primary Need

Foot                                      Stability

Ankle                                   Mobility (sagittal)

Knee                                     Stability

Hip                                       Mobility (multi-planar)

Lumbar Spine                    Stability

Thoracic Spine                   Mobility

Scapula                                Stability

Gleno-humeral                   Mobility

Cervical C7-C3                     Stability

Cervical C2, C1                    Mobility

The first thing to notice is the joints alternate between mobility and stability as we move up the body.

Over the past 30-years, we have progressed from the approach of training by body part to a more intelligent approach of training by movement pattern.  In fact, the phrase ‘movements, not muscles’ has almost become an overused one, and frankly, that’s progress.  Most good coaches and trainers have given up on the old ‘chest-shoulders-triceps’ method and moved to the push-pull, hip-extend, knee-extend programs.

Still, the movement-not-muscles philosophy should have gone a step further.  Injuries relate closely to proper joint function, or more appropriately, to joint dysfunction.   Problems at one joint usually show up as pain in the joint above or below.

The primary illustration is in the lower back.  It’s clear that we need core stability, and it’s also obvious that many people suffer from back pain.  The intriguing part lies in the new theory of the cause: loss of hip mobility.

Loss of function in the joint below…in the case of the lumbar spine…seems to affect the joint or joints above.  In other words if the hips can’t move, the lumbar spine will.  The problem is the hips are designed for mobility, and the lumbar spine for stability.  When the intended mobile joint becomes immobile, the stable joint is forced to move as compensation, becoming less stable and subsequently painful.

The process is simple:

• Lose ankle mobility, get knee pain
• Lose hip mobility, get low back pain
• Lose thoracic mobility, get neck and shoulder pain, or low back pain

Now take this idea a step further:

What is the primary loss with an injury or lack of use?  Ankles lose mobility, knees lose stability, hips lose mobility.

The hip is a bit of an exception in that the hip can be both immobile and unstable, resulting in knee pain from instability (a weak hip will allow internal rotation and adduction of the femur) or back pain from immobility.

Weakness of the hip in either flexion or extension causes compensatory action at the lumbar spine, while weakness in abduction, or, more accurately prevention of adduction causes stress at the knee.

Poor psoas and illiacus strength or activation will cause patterns of lumbar flexion as a substitute for hip flexion.  Poor strength or low activation of the glutes will cause a compensatory extension pattern in the lumbar spine to replace the motion of hip extension.

This fuels a vicious cycle.  As the spine moves to compensate for the lack of strength and mobility of the hip, the hip loses more mobility.  Lack of strength at the hip leads to immobility, and immobility in turn leads to compensatory motion at the spine.  The end result is a kind of conundrum, a joint that needs both strength and mobility in multiple planes.

Excerped from, Advances in Functional Training, by Mike Boyle.

Earl Grayson “Gray” Cook

Gray Cook is a practicing Physical Therapist and Orthopedic Certified Specialist. He is also a Certified Strength and Conditioning Specialist and Kettlebell Instructor.  He is the founder of Functional Movement Systems, which promotes the concept of movement pattern screening and assessment.  His work and ideas are at the forefront of fitness, conditioning, injury prevention, and rehabilitation.

Professional Status

• Licensed Physical Therapist
• Board Certified Orthopedic Specialist
• Lecturer/Author/Instructor
• Certified Strength and Conditioning Specialist
• Level 1 Olympic Style Weight Lifting Coach
• Founder, Functional Movement Systems Expert/Consulting Facility
• Perform Better Advisory Board
• Titleist Rehabilitation and Conditioning Specialist
• Assistant Professor, Averett University
• Certified Kettlebell Instructor, RKC

Cook is an influential figure in both rehabilitation and exercise.  His career started with an undergraduate degree in Sports Medicine and Exercise Science, with minors in Athletic Training and Psychology.  His interest took him to the University of Miami where he studied Physical Therapy and furthered his strength and conditioning development.

Gray Cook is an influential figure in both rehabilitation and exercise.  His career started with an undergraduate degree in sports medicine and exercise science with minors in athletic training and psychology. His interest took him to the University of Miami where he studied physical therapy and furthered his strength and conditioning development.

It’s no accident that he became a certified strength coach and licensed physical therapist in the same year because his work has targeted fundamental errors in the way that exercise and rehabilitation have been practiced.

Gray has introduced a systems approach to understanding, training and rehabilitating movement.  A part of this approach is the Functional Movement Screen (FMS).   The FMS is a systematic method for observing movement patterns, which are then rated and ranked on a numerical scale that identifies significant movement limitations or asymmetries.

Professional evolution is often geared toward specialization but most highly specialized professions hit a plateau and adopt an approach that incorporate systems that protect the user against fundamental errors. This historical trend can be seen in aviation, medicine, and education.

Fitness and rehabilitation are approaching a critical tipping point where fundamental systems are necessary for improved outcomes. This is because our current knowledge and scientific advances have not reversed the downward turn in the health and fitness of our culture.  Fundamental systems minimize logistical errors that will improve communication between the many disciplines that exercise and rehabilitate the masses.

Cook contends that we must map movement patterns and consider movement as a behavior and not simply as clean mechanical data. We must also develop better understanding of how movement is learned, maintained and restored.

Cook’s work cuts to the core of problems like low back pain,  obesity,  and the general physical decline of a modern culture.  By revisiting the natural developmental principals that all infants employ as they learn to walk, run and climb, Gray forces us the rethink motor learning, corrective exercise and modern conditioning practices.

Michael Boyle is known internationally for his pioneering work in the field of Strength & Conditioning and is regarded as one of the top experts in the area for Sports Performance Training. He has made his mark on the industry over the past 30 years with an impressive following of professional athletes, from the US Women’s Olympic teams in Soccer and Ice Hockey to the Boston 

Bruins, Boston Breakers, New England Revolution, and most recently the Boston Red Sox. His client list over the years reads like a Who’s Who of athletic success in New England and across the country including legendary Boston names such as Nomar Garciaparra, Cam Neely, and Ray Bourque. 

In 2012, Michael was selected to become part of the Boston Red Sox coaching staff, acting as a strength and conditioning consultant for the team.

How it all began…

Mike got his start while studying to be an athletic trainer at Springfield College. While at Springfield, an interest for strength & conditioning sprouted, and Mike became a competitive powerlifter. Deciding to combine his two passions, Mike volunteered for three years at Boston University working primarily with the football team. This was the start of Mike’s over 25 year career at BU. Currently, Mike continues to train the BU ice hockey team, winners of the National Championship in 2009.

World renowned coach…

Mike brings a depth and breadth of knowledge that is unmatched in the industry, with 10 years of experience at the professional level and over 25 years at the collegiate level. Mike’s work has been featured in the media on HBO RealSports, ESPN, CNNSI, as well as in Sports Illustrated and USA today.  In both 2004 and 2005 Men’s Journal named Boyle one of the top 100 trainers in the United States. Mike places great value on continuing education and encourages his staff to always keep learning. His former assistants, students, former players, and interns are sprinkled across the collegiate and professional ranks with teams like the Miami Dolphins, San Jose Sharks, Atlanta Falcons, Buffalo Bills, Anaheim Ducks, and Boston Celtics.

Michael is an international lecturer, author of two books and multiple DVD’s on Strength & Conditioning, Weight Loss, and Reconditioning. Mike’s impact is now being felt globally through his website www.strengthcoach.com, the number one source of performance enhancement information on the internet, and through the translation of his book, Functional Training for Sports into Japanese, Chinese, and German.

In his role as an educational speaker, Mike has address thousands of coaches and trainers all over the World including:

• Netherlands Olympic Committee – Fall 2006
• German National Ice Hockey Federation – Spring 2007
• Major League Baseball Strength & Conditioning Coaches – 2009
• World Golf Fitness Summit – Spring 2007
• American Hockey Coaches Association – Spring 2009

Mike’s Top Selling Educational DVD Products Include: 

• A Joint by Joint Approach to Warm-up and Training
• Strength & Power for Sport
• Fat Loss Secrets
• Interval Training
• Power Development for Golf

                                                                                                        Fascial Fitness

                                                                                                      Form Walking 

Looking at individual muscles… their origins, insertions, and actions… is a great way to study anatomy… but,

if you want to understand movement you really need to understand muscles in their relationships to other muscles… and even more important, their relationship, to other connective tissue…

As Thomas Meyers has pointed out, our children will understand movement in a completely different way from the way we learned it.

Today, we can group muscles as Spring Systems (Dalton), Global Muscle Systems (Lee), Functional Lines (Meyers), and Chain Reactions (Janda).

Active Range of Motion Routine

Active Range of Motion (AROM) is the first component of the movement work in theCastleMethod.

The term ‘stretching’ is so often used, and there are so many different ways and reasons to stretch, that the term itself, while common, can often be misinterpreted as some particular activity one may be familiar with, but which may not even resemble the AROM rationale and activity I am referring to.

Pick up just about any book on stretching and what you will probably find is a list of all the muscles, their origins and insertions, and how to create a lengthening tension in each individual muscle.  Creating a list of every muscle, and how to stretch it, is a very linear, structural paradigm.  This type of approach also seems to imply that all muscles function in a similar manner, responding in a similar way to stress, and requiring a similar approach to their healthy maintenance.  This type of ‘reductionist’ approach lacks an understanding of the relationship between structure and function…  as if muscles exist and work individually, independent of other muscles or, the central nervous system.  Unfortunately, our neuromuscular system just doesn’t work this way.  The central nervous system (CNS) and the muscular system don’t exist and work independently of each other.  They work together.  This intertwining is the complexity we refer to as function.

In both my own athletic career, and in my manual therapy practice, I have found little value in the structural approach to stretching.  Honestly, I have found it to be both unsophisticated and ineffective in comparison to:

• Janda’s Functional Approach,
• Boyle and Cook’s Joint-by-Joint Approach
• Zink’s Common Compensatory Pattern
• Gracovetsky’s Spinal Engine Theory

These methods, approaches, and techniques, listed above, are the basis for the AROM component of theCastleMethod.

The primary rationale for AROM is to maintain and/or restore muscle balance. This is known as ‘normalizing’ peripheral structures.   To prevent painful movement, or restore pain-free movement, normal muscle tone surrounding joints is a primary requirement.

Janda’s Functional Approach

Dr. Vladimir Janda, known worldwide as the ‘Father of Rehabilitation’, was responsible for the ‘Classification of Muscle Imbalance’ patterns.  Through his research, he discovered that groups of muscles respond to stress in very predictable ways.  While there are multiple forms of stress that can affect our musculature, the primary stressor is gravity.  As humans, understanding the negative effect gravity can have, on our bodies, over time…and what we can do to minimize this effect, is essential to restoring and/or maintaining pain-free movement patterns.

Janda classified muscles into two groups.  One group he named ‘TONIC’ and the other group he named ‘PHASIC’.  When under stress, the tonic muscles were found to become shorter (and tighter), while the phasic muscles responded by getting weaker (and eventually, over-stretched).  The response of the tonic group is related to the term ‘facilitation’, and that of the phasic group to ‘inhibition’.

Muscles often work in pairs, called ‘antagonistic pairs’.  Antagonistic pairs of muscles create movement when one contracts and the other relaxes.  An example of an antagonistic pair is the biceps and triceps; the triceps relaxes while the biceps contracts to lift the arm.  Another example of an antagonistic pair working together is: the quadriceps and hamstrings in the leg.

Sherrington’s Law, also called Sherrington’s law of reciprocal inhibition, explains how a muscle will relax when its opposite muscle (e.g., biceps/triceps) is activated.  Sherrington’s Law (Sherrington, 1907) states, “A hypertonic antagonist muscle may be reflexively inhibiting their agonist.  Restoring normal muscle tone and/or length must first be addressed before attempting to strengthen a weakened or inhibited muscle.”  Muscles that have been reflexively inhibited (weakened) due to tight antagonists, often recover spontaneously after addressing the tightness.

The Castle Method utilizes Janda’s classification of muscle imbalance as the first step in ‘normalizing the periphery’.  In assessing functional lesions that are causing pain, we utilize a proven starting point regarding which muscles have most likely become short and tight, and which muscles will have responded by becoming weak and possibly overstretched.

Excerpted from:  (Page, Frank, Lardner.  Assessment and Treatment of Muscle Imbalance, The Janda Approach.  2010, Human Kinetics, Champagne IL.

*What is important to understand about AROM is that both short/tight and overstretched/weak muscles will elicit a similar, ‘tight’ sensation.  If you are basing a stretching routine on which muscles feel tight, you run the risk of stretching muscle groups that are already inhibited and weak.  Stretching these muscles may only increase the severity of the imbalance that may be causing the pain.  So, you can see why basing a stretching routine on which muscles feel tight might be the wrong approach.

The rationale for the AROM routine utilized in theCastleMethod has been developed in part from Janda’s Classification of Muscle Imbalance, known as the Upper and Lower Crossed Syndromes, and focuses primarily on the muscles and muscle groups that are known to always respond to stress by getting shorter and tighter.  There is no guesswork, or shotgun approach, to this process.

 Janda’s Classification:

Layer Syndrome (Stratification Syndrome)

Upper Crossed Syndrome (Proximal or Shoulder Crossed Syndrome)

• Short/Tight
  • Upper Trapezius
  • Levator Scapula
  • Pectoralis Minor
  • Shoulder Internal Rotators
    • Anterior Deltoid
    • Latissimus Dorsi
    • Teres Major
    • Pec Major
  • Sternocleidomastoid (SCM)
  • Suboccipitals
• Weak/Overstretched
  • Cervical Flexors
  • Rhomboids
  • Lower/Middle Trapezius (Lower stabilizers of the scapula)
  • Serratus Anterior
  • Shoulder External Rotators

Lower Crossed Syndrome (Distal or Pelvic Crossed Syndrome)

• Short/Tight
  • Thoracolumbar Extensors
  • Iliacus
  • Psoas
  • Rectus Femoris
  • Hamstrings
  • Gastroc/Soleus
  • Thigh Adductors
  • Tensor Fascia Lata (TFL)
  • Piriformis
• Weak/Overstretched
  • Deep Abdominals
  • Gluteus Medius
  • Gluteus Maximus
  • Lumbosacral Erector Spinae

MET emerged initially from osteopathic traditions and has shown to fit well with most all manual therapy disciplines.   These methods were integrated with  innovative manual medicine approaches as taught by the East European giants Vladimir Janda, MD, Karel Lewitt, MD, and Leon Chaitow, ND, DO,  who were collaborators with the osteopathic developers of MET.  Together, their bodies of work form a basis for a segment of my own manual therapy practice. Muscle Energy Techniques are a class of soft tissue manipulation methods that incorporate precisely directed and controlled, patient initiated, isometric and/or isotonic muscle contractions, designed to improve musculoskeletal function and reduce pain.

The combination of tightness and weakness observed in muscle imbalance modifies body segment alignment and alters the equilibrium point of a joint.  Typically, the equivalent resting tone of the agonist and antagonistic muscles permits the joint to take up a position where the joint surfaces are evenly loaded and the inert tissues of the joint are not overly stressed.  However, if the muscles on one side of the joint are facilitated and the opposing muscles inhibited, the result will be misalignment towards the tight muscles.  Such alignment changes create weight bearing stresses on joint surfaces, and result also in shortened soft tissues (muscles) chronically contracting over time.

As put forward by Chaitow, the function of any articulation (joint) of the body, which can be moved by voluntary muscle action, either directly or indirectly, can be influenced by muscle energy procedures.   A basic tenant of the muscle energy modality is that muscles cause and/or maintain both non-painful (early) and painful (later) somatic dysfunctions.

Two major aspects of MET are their ability to relax an overactive muscle and their ability to enhance stretch of a shortened muscle, or its associated fascia when connective tissue or viscoelastic changes have occurred.  Muscle energy techniques can be used to lengthen a shortened, contractured or spastic muscle; to strengthen a physiologically weakened muscle or group of muscles; to reduce localized edema, to relieve passive congestion, and to mobilize an articulation with restricted mobility.

There currently exist at least nine different MET protocols that are characterized by:  type of contraction and physiological mechanism utilized, chronic or acute setting, and stretch or no stretch.  The particular choice of MET will be based on:  indications, contraction starting point, modus operandi (agonist or antagonist), force of contraction, duration of contraction, action following contraction, and number of repetitions.

The protocol I describe and demonstrate for correcting rotational malalignment of the hip is based on a method that effectively reverses the action of the origin and insertion of the contracting muscles.  This technique results in the exertion of a rotational force that is exactly opposite that of the rotational malalignment we are attempting to correct. (see MET links)

METs for Correcting Rotational Malalignment of the Hip

The demonstrated techniques are self-care techniques given to the clients following a corrective treatment session, and are intended as a form of ‘home exercise’ or ‘home work’.

Most manual practitioners will agree that muscle energy techniques are among the most valuable tools that any manual clinician can have in his or her tool box. Why?

1) METs have a wide application.

• Crosses all interdisciplinary boundries.
• Can be applied to muscle hypertonicity and muscle tightness.
• Equally effective when applied to joint dysfunction and joint capsule adhesions.
• Effective for any type of client from high-level athlete on down.

2) METs can be applied in a gentle manner, but still

• Provides effective correction of dysfunction. Especially muscle hypertonicity and joint dysfunction.
• Method of joint manipulation that is well tolerated by the apprehensive patient.
• MET has been shown to be equally effective as thrust techniques.

3) METs actively involve the patient in the process.

• Empowers the patient to perform self-care/treatment.
• Self-care techniques transfer responsibility to the patient.
• The patient is an active participant not a passive recipient of treatment.
• Dovetails with other active release techniques.

4) METs are effective.

• Clinically based research indicates patients benefit to a greater degree than when these methods are not

Techniques

• Isometric Contraction- using reciprocal inhibition (in an acute setting, without stretching)
• Isometric Contraction- using post-isometric relaxation (in an acute setting, without stretching)
• Isometric Contraction- using reciprocal inhibition (in a chronic setting, with stretching)
• Isokinetic (combined isotonic and isometric contractions)
• Isotonic Concentric (for toning or rehabilitation)
• Isotonic Eccentric Contraction (performed slowly, for strengthening weak postural muscles and preparing their agonists for stretching)
• Isotonic Eccentric Contraction (isolytic, for reduction of fibrotic change, to introduce controlled microtrauma)

Excerpted from:  (Chaitow, Leon.  Muscle Energy Techniques, Advanced Soft Tissue Techniques. Elsevier Limited, 1999, 2006.)