Janda Approach

http://www.jandaapproach.com/about/

Muscle Imbalance, patterns, predictabel;
gluteus maximus - pelvic instability
ankle instability low back pain

http://www.jandaapproach.com/the-janda-approach/philosophy/

Structural vs Functional opproach

In musculoskeletal medicine, there are two main schools of thought, that is, a structural or functional approach. In the structural approach, the pathology of specific static structures is emphasized; this is the typical orthopaedic approach that emphasizes diagnosis based on localized evaluation and special tests (X-Ray, MRI, CT Scan, etc). On the other hand, the functional approach recognizes the function of all processes and systems within the body, rather than focusing on a single site of pathology. While the structural approach is necessary and valuable for acute injury or exacerbation, the functional approach is preferable when addressing chronic musculoskeletal pain.

A noxious stimulus is "an actually or potentially tissue damaging event.

Nociception (synonym: nocioception or nociperception) is defined as "the neural processes of encoding and processing noxious stimuli."^[1] It is the afferent activity produced in the peripheral and central nervous system by stimuli that have the potential to damage tissue

The Sensorimotor System

In chronic pain, special diagnostic tests of localized areas (for example, low back radiographs) are often normal, although the patient complains of pain. The site of pain is often not the cause of the pain. Recent evidence by supports the fact that chronic pain is centrally-mediated (Staud et al. 2001). Similarly, research on the efficacy of different modes of exercise management of chronic pain has shown a central effect of exercise in decreasing chronic low back pain (Mannion et al. 1999). This research supports the basis of Janda’s approach: the interdependence of the musculoskeletal and central nervous system. Janda states that these two anatomical systems cannot be separated functionally. Therefore, the term “sensorimotor” system is used to define the functional system of human movement. In addition, changes within one part of the system will be reflected by compensations or adaptations elsewhere within the system because of the body’s attempt at homeostasis (Panjabi, 1992).

Tonic and Phasic Muscle Systems

Janda identified two groups of muscles based on their phylogenetic development (Janda, 1987). Functionally, muscles can be classified as “tonic” or “phasic”. The tonic system consists of the “flexors”, and is phylogenetically older and dominant. These muscles are involved in repetitive or rhythmic activity (Umphred, 2001), and are activated in flexor synergies. The phasic system consists of the “extensors”, and emerges shortly after birth. These muscles work eccentrically against the force of gravity and emerge in extensor synergies (Umphred, 2001).

Tonic Muscles Prone to Tightness or Shortness	Phasic MusclesProne to Weakness or Inhibition
Gastroc-SoleusTibialis Posterior Hip Adductors Hamstrings Rectus Femoris Iliopsoas Tensor Fascia Lata Piriformis Thoraco-lumbar extensors Quadratus Lumborum Pectoralis Major Upper Trapezius Levator Scapulae Scalenes Sternocleidomastoid Upper limb flexors	Peroneus Longus, BrevisTibialis Anterior Vastus Medialis, Lateralis Gluteus Maximus, Medius, Minimus Rectus Abdominus Serratus Anterior Rhomboids Lower Trapezius Deep neck flexors Upper limb extensors

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 sensorimotor system
Knee effusion