www.efeld.com
The art, practice and science of Feldenkrais®
Director: Robert J. Burgess BEd, PT, PhD, Feldenkrais Practitioner

Advanced Motor Control Therapy for Low Back Pain

Evaluation, Treatment and the Science of Motor Control


North Country Hospital Saturday-Sunday Oct 7-8th 2023

View My Motor Control videos here: Motor Control Videos

View My Lumbar Stability video here: Lumbar Stability

View My Core Stabilization critique videos here: Core Stabilization: Flawed, Failed and Dangerous

For all inquiries please email me at robert@efeld.com.

Advanced Motor Control Therapy (AMC Therapy) has been developed by Dr. Burgess from over 40 years as a PT and 30 years exploring the Feldenkrais Method in PT. AMC Therapy is the result of this experience and learning particularly for the treatment of low back pain.

AMC Therapy re-introduces purposeful skeletal spinal action schemas back into motor control therapy for low back pain rather than solely a focus to muscles. AMC Therapy utilizes both modes of motor learning and control.

The class begins with Core Stabilization and Motor Control Exercise exercises and then advances from muscle recruitment to spinal skeletal schemas for motor control.

Instantly, this class will increase your success with exercises for low back pain. The switching back and forth between muscle recruitment and engaging skeletal segments is powerful and immediate.

More difficult to learn but very potent are the hands on techniques- Mobilizations for Motor Control.

You will learn:
-the major mechanical characteristics of CLBP
-exercises for pelvic and lumbar power and mobility
-hands on techniques- Mobilizations for Motor Control
-skeletal differentiation and training of spinal motor schemas.

Leg-Trunk Coordination

Raising the head and leg simultaneously, activates the pelvis and lower lumbar spine. The pelvis and lumbar spine are the base and prime mover of this action but become stiffened and less effective in low back pain. L4-5 and L5-S1 becomes more defined and differentiated in your awareness. Slow, small repetitions and slower and smaller repetitions drives greater differentiation. Moving to better sense L5-S1 and more defined sensing to move with more skill. Proprioceptive learning through skeletal sensing and moving.

 

1. Introduction

Motor Control theories of Equilibrium Point Hypothesis (EPH), Active Inference (AI) and Optimal Motor Control Theory (OMC) will be presented. These are the current motor control theories. AMC Therapy takes full advantage of the modifiable motor schemas for spinal function- the brain models the internal skeletal configuration of movement.

The impact of Core Stabilization and a muscle approach to treatment for LBP has over shadowed research in the fields of spinal sagittal aligment and motor control (the motor cortex may well be a sensory cortex with an ouptput of proprioceptive predictions rather than muscle recruiment).

Recently, researchers have demonstrated that LBP is not an unstable spine as has been the popular belief, but LBP is actually a stiff spine.

Stiffness is Un-Differentiated Action© - if you can't feel it and differentiate it, then you can't and don't utilize it. We find ways to rediscover awareness and control of yoru anatomy. A loss of low lumbar lordosis and an increase in upper lordosis by excessive co-contraction drives a flat, undifferentiated and stiff back. The very low spinal levels are the stiffest and the most difficult to determine mobility.

AMC therapy offers methods to determine and affect L4-S1 mobility.

You will learn for yourself from your own body and exploring movement.

Participants will have an opportunity to enhance and extend the Motor Control theory and practice (originally Core Stabilization Theory) and instantly obtain improved results by switching from the Muscle Model to the Skeletal Model for control of spinal action. This process is reversible allowing both theories and practice.

2. Course Content

The Trunk as a Kinematic Chain from the Pelvis, to Thorax to Head and the Length of Spine. Local, adjacent, at a distance and global exercises and mobilizations drives a new motor control.

Pelvic Tilt. Which way do you tilt- anterior or posterior?

Leg-Trunk Coordination©, Arm-Trunk Coordination©- body segments working together.
The Hip Abduction Trilogy©. Empowering the Pelvis and Leg.
Body Segments or Muscles or Joints? Switching modes. What do Brains do?

Lumbo-Sacral Kyphosis: What we can learn from Isthmic Spondylolisthesis (IS) Research. IS sporned a major breakthrough in understanding sagittal alignment in all spinal conditions. It especially realised low lumbar kyphosis as a major factorin spinal disorders.
Pelvic floor- weak or over active? Strengthening or Skill Training and Stretching?

Passive Straight Leg Raise as a measure of Lumbar Mobility and Rigidity. The pelvis and lumbar spine are involved in PSLR.

Comparative vertebrate functional anatomy for understanding the human spine in action. For example: The Snake is all vertebrae and ribs just like our thorax. The thorax is designed to move. However, the Turtle's bony plates are also ribs!- evolution flattened the ribs. The turtle's spine is fused to the undersurface and obvisouly rigid. According to Gracovetski, we are lizards standing up on two legs. Trunk Side Bending and Human Locomotion- spinal lengthening is a critical component of normal gait and human function. Old Dogs wag the tail alone on a rigid body. The Young Dog tails wags with the entire spine.

Immobility creates Instability. A review of literature on Spinal Instability. Does it exist?
The Kinematics of Lumbar DDD. Sagittal Alignment & Mobility of DDD. Natural History of the Spinal Sagittal Alignment.

Mobilizations for Motor Control©.
Lumbo-sacral mobilizations for flexion, side bend and traction motor control. Stretching the Pelvic Floor.

3. Course Schedule

Registration 8am.
8.30-9.30am. Transversus abdominis recruitment, pelvic tilt, trunk flexion in supine and leg-trunk coordination. Differentiating spinal segments. The Hip Abduction Triology. Movement lesson and exercises.

9.30-11am. Lumbar Geometry, Sagittal Alignment and Kinematics of Trunk Flexion and Extension. Spinal basics of posture and mobility for Normal spine, CLBP, DDD, Isthmic and Degenerative Spondylolisthesis. PSLR- six signs and their significance. Lecture and labs.

11-12. Lumbo-Sacral mobilizations- flexion and side bending. Hands on practice.

1-2.30pm. Trunk rotation- the role of the pelvis and thorax. Differentiating spinal segments. Movement lesson and exercises.

2.30-3.30pm. Mobilizing the Thorax. On side and prone. Hands on and exercises.

3.30-4.30pm. Lumbo-Sacral mobilizations in prone. Weight bearing, side bending, rotation and traction. Local, adjacent, at a distance and global mobilizations.

The course allows 14 hours CEU's.