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This article is an excerpt from a handout used in our Healing Arts Seminiars and Bodyworks Program.
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Abdominal Laxity, Ptosis and Low Back Pain - A Common Source of Problems for Many Martial Artists, By Anthony Sell
A condition that is often misunderstood and attributed to other causes is that of Abdominal Laxity, which commonly leads to Ptosis.
In short, Ptosis is a term which refers to a condition where the muscles and connective tissues in the abdominal wall, due to stress, atrophy, injury or exhaustion, go lax, causing the viscera (internal organs including the intestines) to drop lower in the abdomen. This is often signified by a protruding belly, low back pain, problems with digestion and constipation, low energy levels, and other postural indicators.
Section Diagrams of the Different Types of Abdominal Walls
A. Normal abdominal wall with toned muscles
B. Normal abdominal wall with toned muscles and excess subcutaneous fat
C. Abdominal wall with Ptosis because of lack of muscle tone
D. Abdominal wall with Ptosis accompanied by excess subcutaneous fat
There
is a relationship between the tension of the muscles in the abdominal wall
and those of the back. In general, the balance of tensions in the body will
determine the posture. Under repetitive conditions however, sometimes it
is the postural conditions that affect the muscular balance between these
muscle groups.
This happens most often in people who are largely inactive, those who are seated behind a desk or in front of a computer day in and day out, and those whose posture erodes when they sit fixated, playing video games or watching the television. Manual laborers can also develop this condition if a portion of their daily activities includes twisting to one direction, or activities where they are hunched over a work area, due to scrutiny or expediency. Essentially any postural habit which allows the spine to round, the lower back to slouch, or the torso to twist in only one direction, without exercises and stretches to compensate and balance the muscle tension in the abdomen, can lead to this condition.
Good posture has to do with good habits, and if one has a tendency to slouch, in particular with a curvature in the lower back, the abdominal wall will begin over time to lose its tone, which will create a condition where the guts begin to drop lower in the abdomen. As this process continues, the muscles in the back begin to compensate, increasing in tension in order to hold the body together, and before long, there is a serious imbalance.
Student should be aware of their posture at all times. A big part of being a Martial Artist lies in knowing what your body is doing at any given moment. There is a Kinesthetic Awareness that is developed which allows a Martial Artist to know when they are leaning, slouching, standing contraposto, etc. A useful exercise is for students to examine their posture in the mirror and note any assymetries. A good way to begin examining posture is to make an initial examination when first in front of the mirror, then to take a deep breath, stretching the arms palm together above the head, letting them fall naturally to the sides. This will demonstrate how the body tends to lie at rest.
Postural
assymetries can give valuable clues to the state of balance in the body,
as the body tends to compensate for daily stresses. Attention should focus
on the line of the shoulders and the hips, the tilt of the neck, the length
of the arms, the orientation of the feet. Each of these can indicate a twist
or slouch in the spine. In profile, students should examine the pelvic tilt,
the amount of curvature in the spine at the thoracic and lumbar areas.
Another way to look for this condition is through the use of diagnostic muscle testing. One muscle test that we use to determine whether or not this condition is present consists of checking the athlete's ability to keep their knees together in a prone position. The Athlete reclines on their back, with their hands behind their head, feet flat and knees bent, pressed together. The Tester will sit at their knees, taking a knee in each palm, attempt to pull the knees apart from one another while telling the Athlete to hold them together.
A properly functioning body will possess the ability to lock the knees, in particular in this position. If the condition is not present, the Athlete should be very strong. The tester will notice immediately whether the Athlete is weak in this area, as they will separate with little difficulty, and the expression may change on the face of the Athlete as they struggle to hold the posture against the fatigue of improperly aligned muscles.
The treatment for this condition is very easy to learn and safe to perform. The technique we use has four steps to it. As with most muscle balancing methods, it is a subtle technique that places the body in a position which allows it to regain proper posture and and alignement. (We will detail the directions for this technique in a future article)
Diagram Showing the Action of the Abdominal Muscles and the Container system of the Viscera
1. Rectus Abdominus
2. External Oblique of the Abdomen
3. Internal Oblique of the Abdomen
4. Transverse Abdominal
In quadrupeds the abdominal muscles passively support the viscera like a
sling and play a relatively limited role in locomotion.
In the human in the biped state the abdominal muscles are considrably reinforced to connect and strengthen the pelbis with the torso in the vertical position, to prevent the latter from tilting excessively during walking or running. They have become powerful containing muscles actively wrapping the viscera.
As with most therapeutic massage, the condition may easily return if the recipient does not change the postural condition that led to it, and/or take steps to strengthen and maintain the newly regained balance and alignement. Specific forms of exercise are extremely important for maintaining muscle balance throughout the body, which is why weightlifting is so important. In addition to the corrective alignment and massage treatments for this condition, there are specific exercises that should be incorporated to strengthen this area. These include exercises which strengthen the lower abdominals, inner and outer obliques, as these muscle groups are principle to good posture. Stiffness in the back will be alleviated by working the erector spinae and related muscles through the use of hyperextensions, as well as working and stretching the hamstrings which tend to tighten to compensate for supporting the torso when the guts have dropped.
In addition to these steps, there are also certain exercises that should be avoided until the condition improves and becomes balanced and stable, as they can exacerbate the condition if the Athlete is not careful. Any abdominal exercise which focusses on the use of the hip flexors, particularly those which incorporate the use of resistance, such as decline bench sit-ups, boxer-leg raises, straight leg raises, etc., should be avoided until the condition is stable. Further, any floor-based abdominal exercise should incorporate a rounding of the lower back and avoid working with an arched back for any reason, as this will make matters worse.
If the condition has been present for some time, certain types of kicking can also complicate matters, as the abdominals will not be supporting the torso during the complex actions of the kicks, while the hamstrings and other hip flexors, such as the psoas major and illiacus will be overtaxed. This can lead to debilitating lower back pain. Kicking in fact can often be the cause of this condition, as the muscles in the lower abdomen, lower spine and hips are worked at an intense level, often to the point of fatigue and exhaustion.
The stresses involved in kicking Thai Pads and the demands of delivering Savate kicks from many angles can overtax these areas, causing abdominal laxity. Many kickers do not take steps to prepare and maintain their abdominal strength for these stresses, and many more do not allow themselves a gradual enough progression to develop good stability for kicking over time. Further, many kickers do not supplement their Martial arts training with lower body workouts in the gym to compensate for the muscular imbalances they create as they favor one lead over another, one technique over others. Over training is also prime culprit, as Martial Artists are renown for their tendency to not get enough quality rest and recovery between intense workouts.
If you have problems in this area, consider your training/resting habits and examine your support work. If you are lacking in support strength training, don't be surprised if you begin to have problems. Be assured, however that if you are aware of your body, conditions will present themselves, often subtly, which if taken care of in a timely fashion, are not too difficult to correct.