Wartenberg Part 3: Relaxation training, centration and skeletal opposition: A conceptual model

Abstract

Some people are unable to relax even in a resting position. Undoubtedly, this interferes with manual therapy. Presumably, letting go requires a feeling of safety. If so, for those without neuromusculoskeletal pathology, all that may be needed is encouragement. But this must move beyond words; safety and comfort must be experienced somatically. Safety requires stability. In those unable to relax, stability is purchased through persistent and, sometimes, wide-ranging muscular co-activation. Skeletal opposition, a different stabilization strategy, permits more relaxation and is more efficient since it uses only bursts of muscular co-activation. To reach maximal efficiency of movement there must be trust in the safety of unstable equilibrium. Creating suitable conditions for this somatic learning is the subject of this paper. Introduced are two concepts useful in describing movement excellence; each with two sub-divisions. Skeletal opposition is discussed in two forms: centrifugal and centripetal. Secondly, centration strategies, either expansile or load-bearing, are discussed with examples. Described in earlier installments was Wartenberg's pendulum test (Wartenberg, R., 1952. Knee dropping test. This test, designed for diagnosing spasticity, can assess relaxation. Also presented were four other tests: abrupt relaxation test, supine head–ankle oscillation test, isometric tense-relax testing and ballistic perturbation testing, the last three recumbent. Four telltale signs of extraneous muscle effort were outlined, as were four signs of relaxation. Myofascial techniques, at three levels of scale, were illustrated. Torsional oscillation, scalable in application, was introduced as both test and treatment. Speculations regarding oscillation as therapy were presented. These include the simultaneous use of two asymmetric oscillations to reach deeper using reflection and refraction; force collimation using bridge points; standing waves and oscillatory still points. Some people are unable to relax even in a resting position. Undoubtedly, this interferes with manual therapy. Presumably, letting go requires a feeling of safety. If so, for those without neuromusculoskeletal pathology, all that may be needed is encouragement. But this must move beyond words; safety and comfort must be experienced somatically. Safety requires stability. In those unable to relax, stability is purchased through persistent and, sometimes, wide-ranging muscular co-activation. Skeletal opposition, a different stabilization strategy, permits more relaxation and is more efficient since it uses only bursts of muscular co-activation. To reach maximal efficiency of movement there must be trust in the safety of unstable equilibrium. Creating suitable conditions for this somatic learning is the subject of this paper. Introduced are two concepts useful in describing movement excellence; each with two sub-divisions. Skeletal opposition is discussed in two forms: centrifugal and centripetal. Secondly, centration strategies, either expansile or load-bearing, are discussed with examples. Described in earlier installments was Wartenberg's pendulum test (Wartenberg, R., 1952. Knee dropping test. This test, designed for diagnosing spasticity, can assess relaxation. Also presented were four other tests: abrupt relaxation test, supine head–ankle oscillation test, isometric tense-relax testing and ballistic perturbation testing, the last three recumbent. Four telltale signs of extraneous muscle effort were outlined, as were four signs of relaxation. Myofascial techniques, at three levels of scale, were illustrated. Torsional oscillation, scalable in application, was introduced as both test and treatment. Speculations regarding oscillation as therapy were presented. These include the simultaneous use of two asymmetric oscillations to reach deeper using reflection and refraction; force collimation using bridge points; standing waves and oscillatory still points.