The National Academy of Sports Medicine

Current Concepts in Functional Anatomy

Focus on Function

Functional Fitness, Performance Enhancement,

Injury Prevention, Reconditioning, and
Rehabilitation develops optimum levels of
functional strength and neuromuscular
efficiency

Function

Integrated, multi-planar (sagittal, frontal,

transverse) movement that requires
acceleration (concentric force production),
deceleration (eccentric force reduction), and
stabilization (Isometrics)

Functional Strength

The ability of the neuro-musculo-skeletal

(NMS) system to perform dynamic eccentric,
isometric, and concentric contractions upon
demand in a smooth coordinated fashion
during functional movements

Neuromuscular Efficiency

The ability of the NMS to allow agonists,

antagonists, synergists, stabilizers, and
neutralizers to work synergistically to produce
force, reduce force, and dynamically stabilize
the entire Kinetic Chain in all three planes of
motion
The ability of the NMS to produce the right
amount of force, at the right joint, at the right
time to allow for movement efficiency

Focus on Function

Traditional fitness, performance enhancement,

reconditioning, and rehab and does not
emphasize the development of functional
strength or neuromuscular efficiency
Primary emphasis is on force production in the
sagittal plane
Most injuries occur during force reduction in the
transverse plane
Does a traditional isolated approach really solve our
problems?

Muscle Function

How do muscles work during dynamic

functional movements???
If we know what muscles do during functional
movements, it becomes much easier to design
functional exercises programs

Muscle Function

Key muscles have the ability to dominate in

one plane of motion
However, all muscles work in all planes of motion
to allow optimal neuromuscular efficiency

Muscle function is a highly complex, integrated

neurophysiological event that is controlled by
the Central Nervous System

Muscle Function

The CNS directs pre-programmed patterns of

movement (Motor Programs) that can be
modified in countless ways to react
appropriately to the external environment

Gravity
Ground Reaction Forces
Momentum
External Load

Muscle Function

The CNS is designed to optimize the selection

of muscle synergies and not individual muscle
contractions

Current Concepts in Functional Anatomy

Two distinct yet interdependent muscle

systems
Stabilization System (Stabilizers)
Local Stabilizers
Global Stabilizers

Movement System (Mobilizers)

Global Mobilizers

Understanding Muscle Function

Stabilization Group
Local Stabilizers
Muscles

Multifidus
Transverse Abdominus
Transversospinalis
Deep Neck Flexors

Function

Neuromuscular control (Proprioception)

Continuous activity (contractions) throughout movement
Independent of direction of movement
Stabilization (Isometric) contraction (minimal length change)
Controls neutral positions

Understanding Muscle Function

Stabilization Group
Global Stabilizers
Muscles

Internal Oblique
Quadratus Lumborum
Gluteus Medius
Gluteus Maximus
Rotator Cuff
Scapular Stabilizers

Function
Generates force to control ROM
Low load eccentric deceleration
Non-continuous contraction (activity)
Activity is direction dependent

Understanding Muscle Function

Movement Group
Global Mobilizers
Muscles

Gastrocnemius
Hamstring
Quadriceps
Adductors
External Oblique
Rectus Abdominus
Erector Spinae
Latissimus Dorsi

Function

Force production/torque production (Concentric)

Concentric acceleration (Primarily saggital plane)
Non-continuous (Phasic) contraction
Direction dependent

Results of Muscle Imbalances?

Stabilizers
Delayed recruitment
Reacts to pain and
pathology with inhibition
Loss of joint
stabilizations
Leads to synergistic
dominance

Mobilizers
Become overactive
Reacts to pain and
pathology with spasm
Develops myofascial
adhesions which alter
(Length-Tension, and
Joint Arthrokinematics)

Force-couple Relationships

Muscles work synergistically to reduce force,

dynamically stabilize and concentrically
produce force in all three planes of motion
The CNS is designed to optimize the selection
of muscle synergies

Lateral Sub-system
Muscles Involved

Gluteus Medius
Tensor Fascia Latae
Adductor Complex
Quadratus Lumborum

Function
Frontal plane stability

Posterior-Oblique Sub-system
Muscles Involved
Latissimus Dorsi
Thoracolumbar Fascia
Gluteus Maximus

Function
Transverse plane
stabilization

Anterior-Oblique Sub-system
Muscles Involved
Internal Oblique and Hip
Adductor Complex
External Oblique and
Hip External Rotators

Function
Transverse plane
stabilization

Deep Longitudinal Sub-system

Muscles Involved

Erector Spinae
Thoracolumbar Fascia
Gluteus Maximus
Biceps Femoris
Peroneals

Function
Force transmission
longitudinally from the
ground to the trunk

Result of Kinetic Chain Dysfunction

Reciprocal Inhibition
Synergistic Dominance
Arthrokinetic Inhibition
Relative Flexibility
Pattern Overload

Reciprocal (altered) Inhibition

Increased neural drive
or decreased
extensibility of an
agonist will decrease
the neural drive to its
functional antagonist
Leads to synergistic
dominance

Synergistic Dominance
The neuromuscular
phenomenon that
occurs when synergists
and stabilizers
compensate for prime
movers during
functional movement
patterns

Arthrokinetic Inhibition
The process of
inhibition that occurs
from lack of proper
joint arthrokinematics

Relative Flexibility
The Kinetic Chain will
take the path of least
resistance
The body will always find
motion, but is it coming
from the right joint, at
the right time?

Pattern Overload
Repetitive recruitment
of the same muscle
fibers, in the same
range and plane of
motion and at the same
speed creates tissue
overload and eventually
injury

Summary
Muscles function with one another to synergistically reduce
force, stabilize forces and produce force.
Efficient movement is achieved through a fragile balance of
normal muscle length, and recruitment patterns to utilize the
right muscle, at the right joint, producing the right amount of
force, in the right plane of motion, at the right speed of
motion.
Inability for the human movement system to perform efficient
tasks through all planes of motion produces compensation,
altered joint and muscle function, increased tissue and joint
stress, and increases injury risk.

The National Academy of Sports Medicine

Thank you

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