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Gym Confusion

I was recently asked for some advice on a gym exercise by a young rugby player.  He had been at the gym and had been shown an exercise that concentrated on working his inner biceps.

Why?  Why would anyone want to work their inner bicep? and what is it anyway?

The bicep does have two heads (bi – two, cep – head).  They are usually called long and short but arguably one is more medial (closer to the centre line) and hence you could call them inner and outer, I suppose.

We will gloss over the naming and why someone would want to do this because there is a more important point coming up.

The exercises are below.  They consist of holding a bar bell in either a narrow, normal or wide grip and then performing a bicep curl.

I have tried this and I can confirm that the wide grip version does feel like it is doing something to the inside of your arm.  But what?

The elbow joint is a hinge joint.  It is designed to hinge in such a way that your hand comes up to your shoulder.  The ulna bone of the forearm has a large hook like structure at the end of it called the olecranon.  This is the point of the elbow and it fits snuggly on the end of thelbowe humerus.  The whole structure is surrounded by many ligaments that stablise the joint.  It is not designed to have any sideways motion.

Try it yourself.  Put your forearm out at 90 degrees and move your hand away or towards your body.  What you will find is that the movement is actually happening at your shoulder joint.  If you take your arm out to the side and then flex your elbow, your hand still comes up to your shoulder – your whole arm has rotated at the shoulder joint.

If we go back to the exercises – the narrow hold one, the humerus rotates in so that when you bring your hands up they are still fairly near your shoulder joint.  The normal spaced grip brings your hands up to your shoulders.

The wide spread grip is another matter.  If you were doing this with dumb bells then it wouldn’t be a problem.  The whole arm would have rotated outwards and when you do the bicep curl the hand would still come up to the shoulder joint.  But this is a barbell!  The hands are fixed in a position wider than the shoulders.  When you do a bicep curl in this position you are forcing the joint, trying to bring the hand up to some distance to the side of the shoulder joint.

It doesn’t like it. It hurts.  You feel tension in all the structures you are trying to pull out of their normal position.  Yes you can feel it up the inside of your bicep, but you aren’t working it – you are torturing it.

If you want to do this exercise (I guess its a bicep curls that also works on your shoulder area and your rotator cuff – if that is important to you) then please do it with dumb bells.

If you have any other strange exercises that need explaining please let me know.

 

All in a spin

You sometimes get asked some funny questions when you are an anatomist, an exercise professional and a trainee massage therapist.  They usually start with ‘I’ve got this pain here…’ and I love the opportunity to do a bit of detective work and try and identify the issues although I always start my answers with ‘I’m not a medic or a physio but…’

This week’s was a new one.

A friend had developed a pain in the back of their knee after a spin class. We did the usual hamstring test, that was fine. Test the calves, they were fine.  I asked them to point exactly to where it was hurting and then put on those x ray specs that have been honed through years of dissection and text book study.  Then you get that sinking feeling when they point to an area where you cant think of what is below the skin.  Its a fossa; a gap full of fat, blood vessels etc.  Your mind cant help moving towards the fascia and the concept that everything can affect everything else.

Then is struck me – what exactly had they done?  Could they rotate their tibia against resistance?  No they couldn’t.

They had not adjusted the saddle on their spin bike and had spent an hour in a class repeatedly going from full locked out extension of the knee to bent.  What muscle is that going to exhaust?

Our good friend popliteus.  Its only role in life is to unlock the knee.  When you full straighten your leg your femur actually rotates medially and locks into place.  To unlock it you need to rotate it laterally a little bit to start with.  If you spend a long time doing this then its going to start aching.

Its usually bought on by a direct blow to the knee or repeated use, a common running injury.  It would appear that it can be a spinning injury too.  Take the time and adjust your saddle.

The Devil is in the detail

I have just returned from a conference down in London where I was lucky headenough to take part in a wax modelling session where we produced a model of a face.  This started from the skull and built up each individual muscle.  Some of the muscles you can’t see in the picture and obviously you wouldn’t be able to see any of them once a skin layer was applied but their existence beneath the surface makes the face what it is.

It is this attention to detail which often defines a line between artists.  If you know what is under the surface then the contours of the skin become natural.  It is the driving force behind all of the art and anatomy courses that are run.

I have always been fascinated by the ecorche figures.  Those statues that show all of the musculature, the most famous being that of St Bartholomew holding his own skin.  I have always thought that the knowledge of the artists to produce such works must have been immense.

At Edinburgh College of Art there is a cast ‘Smugglerius’. smugAn ecorche in the ‘Dying Gaul’ pose.  Every muscle can be seen, it is a great study guide and I have always been impressed by it.

Until last week.

Last week I discovered that whilst it was produced by Agostino Carlini, he had the help of William Hunter and a large amount of plaster of Paris.

Smugglerius was produced ‘from life’ by posing the executed criminal James Langar and casting him.   The statue has always been referred to as Smugglerius but Joan Smith and Jeanne Cannizzo (Scotsman 30th January 2010) did an excellent piece of detective work which strongly suggests that the identity of the man is a thief, James Langar.  Even if the identity is wrong they did identify that William Hunter skinned an executed criminal and then Carlini cast him in plaster.

This raises all sorts of moral questions as to how the bodies of the dead are treated without their permission and we need to remember that it an object that ‘speaks of the time it was done.’

The fact that every muscle can be seen is maybe not so suprising now that I am aware of its history but it got me thinking about the artist’s need to represent things as they actually are.

I have another project bubbling in the background which has me looking at the other side of the coin from convicted criminals (don’t ask – its a long story which I hope will reach fruition in about 4 years time).  I’ve been looking at statues of thingslion that have legs or arms as well as wings.  It appears anatomy isn’t so important in this realm.

It has been pointed out to me (and to be fair I had realised it myself) that everything that has arms / legs and wings is actually mythical, be it dragons, Pegasus, the winged lions in St Mark’s Square or the numerous pictures of angels.

Whilst one area of art was so obsessed with the human body that they took casts from dead bodies, the other area of art was quite happy to just stick some wings on things saintwith no thought as to how they would actually work.

I have in the back of my mind a hankering to work out what a body of an angel with actual working wings would look like but I imagine it would be the sort of thing that would occupy nightmares rather than visions.

If it is not important that the wings are functional then why are they there?  Are they just a symbol that indicates the ability to fly?  Now days we are happy to accept that Iron Man can fly using technology maybe back in the day we needed an indication that flight was possible without it actually being powered by the body.  This doesn’t seem to hold true for Santa’s reindeer which we are quite happy to suggest fly around the world without the aid of wings.

It’s interesting as to where we are prepared to draw the line between things that need to be correct and places where it doesn’t matter.

 

Frauds, Imposters and Mind Tricks

FIM

My anatomy study goes in cycles.  During term time I am busy with the ATP programme and the Post Graduate Diploma, during the summer I can catch up on the other related courses that I am doing in the background.  I tread a path between the Western medical interpretation of anatomy and other subjects where the detail is not so great, some might say accurate.

This is how I find myself writing a piece for my sports massage course on releasing tension in the neck and upper back and having to relate to acupressure points LI4 and LI11.  At this point I need to reflect on how westernised my anatomy learning is.  I’m very much a ‘need to see it’ sort of person.  If I can see that that blood vessel connects those two points then I can accept it.  Once we get into meridians and invisible lines of energy flow I begin to get very sceptical and have problems retaining the ideas – fundamentally probably because I don’t believe them.

Now Eastern medicine has been around a lot longer than Western medicine and there must be something in it or it would have disappeared by now. I struggle with believing in something I cant see, which is essentially faith.  Did you cure me because of the pressure on the meridians or did you cure me because I believed you were going to?  Very hard to differentiate and I would love to see the scientific paper that distinguishes between the two.

However, I’ve produced a paper that explains how the neck tension is dissipated.  I’ve researched the concept and I can see in the learning objectives what it is that I am meant to be able to understand and I have produced a high merit level paper on it.  Does that make me a fraud?  As the teacher you would look at that paper and think ‘job done’. That student has taken on a complete understanding of how that works, but I haven’t. I am a complete imposter.

Or am I?

I know how it’s meant to work.  Is that fact that I don’t really believe it an issue?  is there a difference between superficial learning and just not really believing what you learn.  If I don’t believe it then have I not understood the argument put forward for it.  Is it just because I can’t see it that I struggle?

This brings me nicely around to my upcoming ATP year where I am studying neuroscience.  Look at the brain and it’s impossible to differentiate some of the things I’m being asked to learn about.  You can’t see them, you have to believe that they are there and there are some things we just don’t know about.

Will I struggle with being able to retain facts about things I can’t see?

 

 

Let’s spread the word

The e book version of The Lance Grows Rusty has been out for 23 days.  Kindle sales are trickling in and arrangements to produce the actual book are under way.

Now let’s spread the word and see how many institutes and research departments we can get it into.  

I’ve had feedback from people who have read it who say they enjoyed it and I’ve had a couple of people in Edinburgh attempt to name the people who inspired some aspects of some of the characters.

It’s made enough to buy a pot of restriction enzymes.  Please buy a copy and see if we can get enough to send a student to a U.K. conference.

Logic and the Language of Anatomy

commThe language of anatomy can be something that either entices students in to learn more or can act as a really barrier to their engagement. The vast majority of us are no longer taught Latin or Greek in school and so the terms that were maybe in everyday usage a few centuries ago are now archaic and their meaning lost to many. Yet if you know the meaning of these words the anatomical names suddenly make a lot more sense and you can even work out what things might be called.language

A recent publication ‘The secret language of anatomy’ looks at some of these phrases and a friend of mine, Kat Sanders, recently got to the final of fame lab talking about the same subject. If you haven’t heard of fame lab then you need to look at this years final. Not only do you get to hear Kat talking about anatomical language you also get to see the rapping epileptic who won it. Outstanding!

 

The important thing to get across to students is that if the effort is put in to learn the terminology then this can pay dividends.

Anatomy is tested by spot tests. Something I used to hate but now actually love and something that has to be experienced before you can understand just how terrifying they can be. You are placed in front of a specimen with a question or simply an arrow pointing to something and given 30 seconds to answer. A bell rings and you move onto the next one, and the next one and the next one. If you panic at the first one and don’t answer it in time and spend your next 30 seconds worrying about the fact you haven’t answered the first one then you are on a slippery slope to a very low score.

The answer is to keep calm, take your time to work out what you are looking at and then be precise. Last year I was taking one of these tests. It was on the limbs and I was studying the trunk so I wasn’t expecting to score well, I was taking it for the practice of taking spot tests (yes I do try and prepare that much). The bell went and I had infront of me an angiogram. Ok, it says it’s an angiogram so I am looking at blood vessel, probably arteries. I can see the outline of a leg in the x ray and I can see a big letter L in the corner, so I am looking at the blood supply of the left leg. The arrow is pointing to something infront of the bone of the leg so I am going to call it the anterior tibial artery of the left leg. With no knowledge, but an understanding of how anatomists name things I have just scored 2 points.

Some things aren’t so easy. I remember the epiploeic membrane. Could I remember that name? No. Ok, so why is it called epiploic? Pleo is Greek for to float upon. The epiploic membrane sits on top of the intestines like a great sea of mesentery. You can understand why it was named as that. They aren’t all so easy to understand but even some of the weirder ones stick in your mind. Saphenous is Greek for evident or obvious so that vein up the back of your leg is actually called the obvious vein, because you can’t really miss it.

conclaveI recently managed to apply this knowledge the other way. Whilst on holiday I read Robert Harris’ new book Conclave. (Very good book – you should read it.). As the title suggests this was about the election of a new pope and there were a lot of use of the word genuflect. I didn’t know what that meant. I did know that the blood vessels around the knee are called genicular arteries and veins so genu could well mean knee. Flec relates to flexion. Was genuflecting the practice of bending ones knee? The little bob that priests give infront of alters. Spot on!

Not only is it possible to apply knowledge of words to work out anatomy names, it’s possible to go the other way. Anatomy is everywhere.

 

Genuflect

Book Launch Day

Today is the day that ‘The Lance Grows Rusty’ is available to everybody.   All of the spearopt1profits are going to go back to medical research so please go ahead and buy a copy.

The story is a fictional tale inspired by my ten years in research labs prior to joining the University of Edinburgh.  If you have ever worked in research science then something in this book will resonate.  If you have ever worked with me then maybe a wry smile of remembrance will cross your lips as you read.

There are two options.  You can get a kindle version here.  (£1.70 of your £2.99 will go to medical research)

Or you can go to the just giving page  and donate at least £2.99 for a copy of the PDF. (95% of your donation will go to medical research).

Please be aware that there is a 24 hour delay with the justgiving page and you need to give your permission for us to contact you otherwise they withhold your email address.

(If you have donated anonymously on that page and want a copy of the book then please get in touch telling us when and what you donated and we will send you a copy.)

Please spread this message as far and as wide as you can and let’s see how much we can raise.

Consider it like a fund raising raffle but you have already won a book to read in your coffee break.

What does it profit a man…

Publishing is not the way to make money, unless you have a block buster of course.

The Lance Grows Rusty is not likely to be that.  I found the manuscript as we moved house.  With a little bit of rewriting, I had a book that the proof readers seemed to enjoy and so I thought, why not publish it as an e book and put the profits back into medical research.

I would love there to be enough funds to send some deserving researcher off to a conference, maybe a summer studentship, a PhD stipend, but to be truthful if it made enough to purchase one pot of restriction enzymes I would be happy.

The manuscript was edited, proof read, converted into kindle format and put up for pre order.  It’s priced at £2.99.  Of that, only £1.70 goes into the donational account held at the University of Edinburgh (where I have already negotiated having complete control over where it goes).  There had to be a better way.

Two meetings with the excellent Kerry in Development and Alumni and we have an answer.  If you go to the just giving page  and donate at least £2.99 then you will be sent the PDF.  This can be opened as an i book and has a linked contents page so works pretty much like an e-book.  This way all of your £2.99 will go into the medical research fund.

if you want an actual book then get in touch because some are in production.

The official launch date is 1st August.

Lets see how much we can make.  Research scientists helping themselves.

The Lance Grows Rusty

The new book is ready for pre order on Amazon.spearopt1

Although a fictional tale it is inspired by the years in research labs (before I moved to the University of Edinburgh – that bit is important to say, apparently).

If you have ever worked in a research environment then something in this book will resonate with you.  If you have ever worked in research science in Edinburgh then it may spark a few memories and if you have ever worked in research science in Edinburgh with me then maybe a wee wry smile might cross your face.

All of the profits from the sale of the book are going to go back into medical research so please help me get the message out there.  Profits aren’t that great on Amazon so I need the message to get as far and as wide as possible.

If you know anyone who could help in any way then please get in touch.

Shape of things to come

I was recently asked about the shape of the spine.  Did I think the shape of the spine had changed?

Now this question was in relation to the evolution of Pilates so it should be caveated with ‘Did I think the shape of the spine had changed since the 1940’s?’  It was a question as to whether the original Pilates exercises developed by Joseph Pilates were still relevant today.

My gut reaction was there had been no change…because nothing changes that quick.  I’m sure that, if time travelled allowed, I was presented with the spines from someone from the 1950’s and someone from the 2010’s I would not be able to tell the difference.  I started to dig a bit more and found a lovely illustration by De Vinci of a spine from 1500’s.spine

You can see it has the same curves as the spine today.

When you understand where the curves come from then its obvious.  The spine in the chest and sacral area curves out towards the back in what is called a kyphotic curve.  This is the natural curve that we all have as we develop as a baby – the natural rounding of the back.

Once we are born we start to try and hold our head upright.  This develops the secondary curve at the neck, a lordosis, a curving towards the front of the body.  Its a lot easier to balance something if you can get the support under the weight of it and so the spine curves forwards to balance the head on top of the spine.

A little while later we start to stand.  We now need to balance the top half of the body on top of the legs and so we develop a secondary lordotic curve in the lower back so that we can stand.

If a person is bipedal (walking on two legs) and has their head is upright then they will have these same curves in their back.

But…

Joseph Pilates wasn’t doing exercises on dead bodies.  The shape of a spine might not have changed but what we do with it whilst we are alive has changed.

Again, if time travel allowed, if you showed me a person from the 1950’s and someone from 2010’s I would definitely be able to tell the difference.  The posture would be different and it’s the posture caused by those surrounding muscles that Pilates, and other exercise programmes, need to work with.

Are the exercises still relevant today? I would say so.  They might be more challenging today because we don’t have as ‘good’ a posture but should we modify exercises to accommodate the fact that we slouch?  Our basic underlying anatomy hasn’t changed.  We should still be striving for good form in our exercises.  Modifications to allow for poor posture are a slippery road to injuries, I suspect.