Client: "Whenever I work out my back tension immediately goes away, my mood lifts, and I instantly have a lot more energy."
Me: "That's amazing!"
Client: "What's amazing is that I don't do it more often."
My client's quote doesn't need any elaboration, but don't you think he's describing one of the most interesting things about being human? We're able to forget what felt really incredible, completely life-changing, in only a matter of days. And if we skip this life-changing behavior for a few days or a week, it can seem next to impossible to start again.
It's serious, but also sort of...funny. We tend to our loved ones and keep frantic schedules, but we can't remember how good we felt a few days ago.
Many scientists suspect that most of what we do is habit---that we're on automatic pilot much more than we know. We could put a value judgment on our inability to get off the couch--we could call ourselves "lazy" or "pathetic"--but I think we should do that only if it helps :). Alternatively, we could keep it simple: our inability to get off the couch is a habit we know we want to change.
So let's be gentle with ourselves---being gentle is not the same as being passive. Exercise is fuel, and we're a quart low. For some of us, a little exercise is all we're needing.
Or, put differently, an object in motion stays in motion; an object at rest, rests. So all we have to do is START the movement. Whatever that movement is. It's just one step. Then we can take the next. Eventually, we'll be in front of the gym or the park or the playground, or our living room with the one empty corner. Then we'll be inside. And, at least for a short time, we'll remember.
The diaphragmatic breath could be called the "diaphragmatic and pelvic floor" breath---both moving together to make space for the expanding lungs.Read More
The research we have about the body feels a lot like the Mughal gardens. It's a massive amount of meticulous work that nevertheless constantly points to how much we don't know, how much we have yet to tame, and how much we may never.Read More
If you can't tell your massage therapist you're hurting, who can you tell?Read More
When you first experience P-DTR, it may remind you a little of acupuncture (without the needles). You may often feel as if you're being treated like an iPhone....Read More
Osteoarthritis, the wearing away of cartilage in a joint capsule, nearly always involves some kind of misalignment or compression of the joint. It's often assumed that cartilage can't regenerate, but science is beginning to tell us otherwise.Read More
Many of us, when we think about our bodies, have these simple categories we lock ourselves into, such as
Healthy Eater/Bad Eater
...and all of them reflect whether we deserve Praise/Blame. I think the Praise/Blame cycle pulls us out of and away from our bodies. It turns us into either the successful taskmaster or the bad student---either of which is a hard relationship to have with a body you have to live in all the time.
I like to think massage can help unlock the body from the Praise/Blame cycle. Massage can remind the body of itself, which can help bring it back from these strict categories---to whatever we were before these categories started loading themselves up on our heads. For a moment, or longer, we don't have to be good or bad, we can be flesh and bone, a whole sensitive person settling, restoring, and remembering.
Yesterday I wore some old warm work boots I hadn't worn in a long time. I had hurriedly put them on on the way to a chilly event. I go barefoot most of the day, and I've been doing some balance exercises that have probably made my feet a little wider (a stronger foot is sometimes a wider foot).
The boots were, for the first time, horribly tight. They pushed my toes together on either side, immobilizing them. Many shoes do this, of course, but I wasn't used to it any more. Not to exaggerate, but it was sort of as if someone had tied up 10 of my limbs.
As I stomped around with my bound up toes, I thought about how it's not a noble act to go barefoot, or to bypass pointy shoes for wide ones. In my case it's as selfish as anything. I love having movable toes. I love every single one of the joints in my toes and I want their freedom. I like to think of all the joints in my feet and toes doing their jobs, sharing the load, so that nobody has to work extra hard and get worn out. It could even be a kind of greed---I'm greedy about range of motion. I want all the range of motion my toes can have.
I still own some pointy-toed shoes, and I know I may some day again smush up my toes for a random occasion. But for now, my toes are free, and I love them more for what they went through last night. Size 8 work boots free to a narrow foot.
When you wake, wake up gently, reminding yourself that the U.S. was not built in a day. When you’re ready, roll to your side and, like a bill slowly being ushered into law, gradually come to sitting.
When a serious athlete gets injured doing a simple new exercise, it can feel baffling. It seems impossible that a body that can do so much is overwhelmed by something so small.
I think some school coaches are trying to make up for all the movement kids don't get in the rest of their lives. These coaches mean very, very well...Read More
One of my clients gave me an awesome metaphor for the "neural edge".
Inspired by a diagnosis of high blood pressure at her annual check-up, she recently started exercising. She had never thought much about her body, and hadn't exercised in many years.
"I had this idea when I started that it was like cleaning out this house that hadn't been cleaned for a very long time. You wouldn't go in and start dusting wildly, because the dust would fly everywhere and you would be coughing the whole time."
She's not a senior citizen, but she started with the senior classes at the gym, and found them to be a very good workout.
She started walking regularly, but when she decided to try to run, she began by running for a minute at a time. To learn the power of a minute of something you haven't done in many years, try twiddling your thumbs for a minute.
Too easy? Try the action in the video below.
(Technical troubles, video coming soon! It's of someone doing a very simple but unusual manual task for one minute.)
Those blips, when the fingers and palms start to tire and lose their coordination, are signs of crossing what manual therapists think of as your "neural edge" for that movement. It's when the nervous system starts to show fatigue. The man in the video has strength and motor control for other movements. But for that particular one, he's starting to fatigue. When asked what started to go wrong, he said he could feel his forearms straining to accomplish the task. The neural edge is when other muscles start to pick up the slack to make the action happen. It's when you start to lose form. It's sometimes when accidents and injuries occur.
My client reckoned that she didn't need to push her neural edge to achieve her goals.
Exercise was just part of her overall plan. She also changed her diet, took meditation classes, and started to get massage to help her feel more in touch with her body. She said, "I've never had much body awareness, but I figure if I just study and practice, it's something I can learn."
But I can't help but think she's underestimating her body awareness. Her blood pressure is back to normal and she has lost 20 lbs., by cleaning and polishing step by step.
Last summer a client had a fall that caused pain and guarding in one hip. He was diagnosed with sclerosis in the hip and a probable labral tear. He got high level massage and physical therapy with limited success. With the sclerosis as bad as it was, he was told that pain may be inevitable (although he had sclerosis in both hips, he had pain only in one). An MRI was suggested if it didn't heal on its own. If there was a tear, surgery might be an option. Over the next year the pain and restricted range of motion did not significantly decrease.
This July and August, we did two sessions of P-DTR (Proprioceptive--Deep Tendon Reflex) on his hip. From them he got 80% improvement---I wish all cases went this swiftly. But he could now put his ankle on his knee to tie his shoe, and he could sit cross-legged, but there was still a little restriction and pain when he turned his leg out.
This last Thursday night, he came in for pain in the neck. The work we had done on his hip had held, and we agreed to work on it another time. P-DTR plus massage brought his neck pain from "10" to "0", and as a happy side effect, a relationship we found between his neck and his chest muscles also increased range of motion in both shoulders. I also noticed some tension in his back and addressed it with P-DTR.
When he woke up the next morning, he automatically checked the range of motion in his hip, as he'd been doing every morning for a year. It flopped out to the side with no pain! He said he was so excited he jumped out of bed.
Why did working on his back or neck release his hip? Here's one possible explanation, P-DTR style. P-DTR divides sources of dysfunction into "hardware" problems and "software" problems. Hardware problems in this case might include sclerosis, especially if the sclerosis was restricting range of motion, or a recent, acute labral tear (sudden tears probably cause more pain than gradual wear and tear over time). The client may have had a tear at the time of injury that caused initial pain and guarding, but while the tear healed, the pattern of pain and guarding remained.
Software problems are problems involving the body's receptors. For example, a trauma might put stress on the receptors of a particular muscle. The body seems to call on receptors in related muscles to compensate for that stress. (This is very similar to the theory behind Neurokinetic Therapy, which many people take as preparation for P-DTR.) The older or more serious the problem, the more receptors seem to be affected. This can create a long chain of stressed receptors.
Any one part of the body could be at the top and/or bottom of a number of different chains. The important thing is to find the top links in each chain. My client may have had a receptor chain from the neck or the back to the hip (these chains aren't always in a series). If so, there are different ways we could have found this chain directly. But testing all the muscles in a chain takes time, and sometimes, for speed, we'll test only the ones at the top. When you address these with the P-DTR protocol, the rest of the chain disappears.
But the body can also be very communicative: The tension my client felt in his neck, and the tension I noticed in his back, may both have been clues the body was giving about an essential remaining relationship.
Again, hardware matters. The sclerosis in this client's hips is a road sign we want to heed. He may wish to monitor it with further therapy and follow-up x-rays. But we have to remember that many people have labral tears and sclerosis with no pain. Had a labral tear shown up on this client's MRI, it might have been a red herring.
*This was originally posted March 23 to my Facebook page. I just resumed taking P-DTR, which I first started taking with Scott, and the conversations I had with him are fresh in my mind.
Scott Marion was an extraordinary person and personal trainer in Menlo Park, California. I took two classes in Proprioceptive-Deep Tendon Reflex (P-DTR) with him (we were both students), and we spent about 6 days together, total. But some of the info and stories he shared with me I think of every day. Last week*, very unexpectedly, Scott died of a heart attack in his sleep. I have no idea how old he was---he looked like, well, like someone a little older than me who looked a little younger than me, if that makes any sense. But there’s no doubt his death was a terrible fluke.
Scott was one of those personal trainers who shines a spotlight on just how smart, hardworking, and investigative the best in the business---the best in any business---can be. He devoted himself to classes, and he was constantly reading up to help his clients. Once, when I was talking about a set of very odd symptoms that no doctor had been able to figure out, his eyebrows immediately furrowed, and I could see his mind whirring. He hesitated a moment, tilted his head, and said, “Do you like to read research?” When he got home that night he emailed me five separate, extremely relevant research articles.
Scott did not look like the stereotype of the personal trainer, with muscles that had clearly been buffed and polished in the gym. He was lean and wiry, with a scientist’s hunch. He huddled over a topic as if peering into a microscope. He said he had learned he needed to take an entire course before feeling like he could effectively apply it. (P-DTR at that time was a series of eight 2- and 3-day classes, and I know he had also taken Z-Health, Neurokinetic Therapy (NKT), NOI, Dynamic Neuromuscular Stabilization (DNS), Rocktape, and Muscle Balance and Function Development (MBF). As he wrote me, “The reason I need the whole thing is to understand how it relates to everything else that I already know.” So, if he liked the idea of a course, he committed to the entire course. It can be tempting to take courses piecemeal and feel like you're getting a nugget here and there. To commit to the whole course up front demonstrated, well, commitment---to the course creator's hard work, and to the level of complexity behind the best techniques.
Scott and I talked about how we care almost too much about our clients; and how our clients probably have no idea; and how that’s probably for the best. At the same time, one of the funniest things Scott said (he was very funny) was, “When my clients come they really just want to work out, they don’t really want me to do all this additional stuff with them, but I don’t care.” Unless you knew him this might sound aggressive, but he was just determined: This is what my education tells me you need, and I want to help you very much. His popularity spoke to his success.
This is the shortlist---we talked about pain theory, traditional Chinese meridians, intersections he saw between the two. He talked about a concept, I believe from Z-health, called the “Threat Bucket”: this is based on the idea that pain is the body’s response to perceived threat, and that threat is compound---any reduction in threat (emotional, physical, chemical, etc.) could in theory reduce a pain. I have shared this idea with my clients often--it’s a compelling way of helping people understand all the things that go into the brain’s ‘decision’ to send out pain signals. I think the concept was essential to his process, and I guess I’m sharing it now because it is just one example of how he was looking at the whole person to figure out how to help them.
Our community is stunned to have lost Scott. He will be deeply missed---even by people who knew him as briefly as I did.
(Thank you to Z-Health for posting these photos on Scott's Facebook page. )
I think this is one of the most important subjects I could write about. For if my algorithms and complex calculations are correct, it affects, like, half of you.
People who have problems "going #2" often blame themselves: they're too anxious, they don't eat enough fiber, they don't move enough, they don't drink enough water.
Of course all these things affect colon health---and, well, health. But all across the world people aren't having to go through this checklist each day. That's because the problem is often a basic muscle imbalance, exacerbated by sitting in chairs and the good-luck-with-that shape of Western toilets.
Now, all across the movement world (almost), the leading movers and manual therapists (the ones I like) want you to deep squat if your body allows it (keep reading). Gray Cook, Ido Portal, Katy Bowman etc etc all say this is an ergonomic position that helps maintain full function of the hips, knees, ankles and core.
But even if deep squatting didn't do any of that, it would help you go #2. And go efficiently. There are many known reasons we want to be able to do that. Further, squatting may equally help with incontinence and a number of other conditions. I can't verify all the claims in the following list, and I really don't mean to scare you---we all know Westerners have been living to ripe old ages for hundreds of years with Western toilets. But because of the pelvic floor's role in not only waste elimination but also sex, childbirth, breathing and a healthy core. it's not hard to imagine that it affects much more than we usually give it credit for: http://naturesplatform.com/health_benefits.html
If you can deep squat or safely build up to it, sitting in a deep squat several times a day is one of the most effective ways to help the pelvic floor lengthen. It's also an ergonomic position for helping the waste to move out. Here's Katy Bowman's formula for developing the deep squat (read both of these):
Sometimes a physical or manual therapist with a movement background can improve your deep squat more quickly, so you may want to get help with it.
Some people may have a condition that prevents deep squatting. Do not try this if you've had a knee or hip replacement (manual therapists, if you've seen someone who was able to squat safely with a replacement, please let me know). It's also possible that your bone shape has developed in a way that prevents the deep squat. Don't worry. Read Katy's blogs above for suggestions, try some of the unloaded versions below, and get care for any pelvic floor muscle imbalance.
Also, though I don't know of them, there might be some conditions for which sitting is a more effective bathroom position than squatting. And finally, don't substitute this for medical advice, silly.
The yoga positions "Child's Pose", Supported Child's Pose, "Happy Baby", and "Knees to the Chest" are examples of simple "unloaded" (non-weight-bearing) positions that can help relax the pelvic floor. The Squatty Potty toilet stools mimic an unloaded squat: http://www.squattypotty.com/
When we talk about "the pelvic floor," please remember that we're talking about a bunch of muscles at once, muscles that affect both going #1 and #2. Problems going #1 may also be pelvic floor disorders and benefit from the same suggestions. Take a look at these images of the pelvic floor (male and female) so you can see how many muscles are involved from front to back. (Click each image to enlarge.)
If squatting alone doesn't help or isn't an option for you, positional or manual pelvic floor releases may help. (Like squatting, this can also help prevent or improve many other conditions, including incontinence, cystitis, and IBS.) Most people will only need external releases (these are uninvasive and can often be done by the client); some may also benefit from internal work with a physical therapist specifically trained in that work. I list some external releases below, but please remember that muscles anywhere on the body become tight for a reason. Usually, the muscle tension is the body's way of maintaining stability. Releasing muscles without knowing why they're holding on can sometimes create pain or dysfunction. (NKT therapists are particularly good at identifying when it's safe to release muscles, but there are many good therapies out there. Most of all, maintaining good form during a well-designed workout is one of the best things you can do to help muscles lengthen and strengthen at the same time.) If you would like to go ahead and try the releases on your own, just be cautious. If a muscle isn't releasing easily, if the muscle tension keeps coming back, or if something else starts hurting, please get assessed. Here are just some examples of external pelvic floor releases:
1) Here is a simple release that aims to target the whole pelvic floor:
2) Sometimes you need to work specific areas. One way of doing that is simply placing a tennis ball under the muscles of the pelvic floor, obviously not directly on openings, and melting in to release them. There are several other methods as well. See images above to locate the muscles of the pelvic floor.
If you can deep squat and want to try it safely in the bathroom, you could get one of these: http://www.naturesplatform.com/index.html. In addition, "Anglo Indian toilet seats" can be affixed to your toilet to allow people the option of deep squatting. (I don't yet know the best place to get shipping inside the U.S. but I'm sure it's available.)
If you would like to get assessed for pelvic floor dysfunction and your doctor has cleared you for more serious issues, pelvic floor physical therapy for this may be covered by your insurance. It may never occur to your doctor to refer to physical therapy for constipation, so talk to them about it. Pelvic floor physical therapists are trained to be extremely keen and sensitive to their clients and the hesitations people may have about getting care. Nevertheless, please don't hesitate to investigate your options carefully in advance, confirm proof of licensure, and ask as many questions as you want about the process,. You can search physical therapists in your area by specialty here: http://www.womenshealthapta.org/pt-locator/. (While some pelvic floor physical therapists specialize in women's issues, many work with both men and women.) Other modalities to look for include NKT Level 2, Restorative Breathing, or a Restorative Exercise therapist (these three are for external work only; anyone doing internal work should be properly licensed to do so). There are many other modalities out there. Before you schedule, ask your therapist if pelvic floor modalities (or learning how to deep squat, if that's your goal) are part of their work, and where they received their training. Do not hesitate to investigate them thoroughly. Your safety and comfort is essential when receiving this or any kind of bodywork.
The therapist had just "fixed" the client's overhead squat---a lifelong athlete, he was squatting better than he had in years.
He happened to be facing a yellow wall.
Then the therapist had him face a blue wall---his squat was even better. Amazing! 20% better! His body must be getting used to the new squat!
Then the therapist had him face a green wall.
His squat plummeted. He lost all his gains.
He turned back to blue. No problems.
The client stared at the therapist.
"You played football, right?" said the therapist, as if it were the most normal thing in the world.
Every major injury the client had had was on the bright green field.
Hearing this might be alarming. "You mean I can never look at a tree again?" But why wouldn't that good or bad feeling you have when you look at certain colors be, like any feeling, deep and physiological, with sometimes very specific roots? In the class that followed, everyone had color preferences; colors that made them feel better, colors that made them feel worse or perform a given task less effectively.
Neurodevelopment expert Lois Laynee's explanation for this is that the limbic system wants to feel safe, and it will do whatever it can to feel safe. The limbic system doesn't have a lot of common sense; it errs on the side of caution. It records things that make it feel unsafe so that you will wisely avoid them again. In doing so, it may include in its record things that aren't actually dangerous---say, green. Building resilience in ourselves means in some ways restoring those broken links, not just in our conscious mind, but in the unconscious physiology of the brain and body.
When I was in college I discovered I did not like looking at dark blue, gray or black. Blue especially made me sad. On one hand, I was happy with myself for identifying this; on the other, I felt like a freak, having to cross out an entire color from my line of vision. Later on, I was in a situation where I had to live in a house that was decorated entirely in blue. (When I described it to my friend, she said, "That's God, laughing at you.") Having some happy all blue memories was probably good---I don't have quite the same affliction any more.
As soon as you read about the football player and the squat, you may wonder how many other things can trigger unconscious stress or weakness without us ever knowing how or why. Why some people hate dogs, or getting health care, or one city over another.... We can try to understand, and it may be best, for our own sakes, if we try to heal (we often don't need to understand in order to heal, but that's another story). But at the point at which we come up against mysteries, let's be gentle with ourselves. Our limbic systems, these primal brains and bodies of ours, are doing things we only know the half of.
(And yes, while you're at it, maybe wear your favorite color. It could just put "dressing for success" in a whole new light.)
A client came in distressed because she had gone to a new doctor with a very specific and unusual symptom and was told it was "age". The client suddenly saw a future in which all her health conditions are attributed to age.
There were a lot of things this doctor did that were perfunctory; their attempt to write her problem off as age was probably symptomatic of their practice. And this may NEVER happen to you. But having a doctor call your problem "age" can be startling, and can render anyone briefly speechless.
Age may be a factor, but it is not the diagnosis. Your doctor needs to articulate what exactly they suspect is happening.
If you've waited months for that appointment and are concerned about your condition, you may not be able to afford the time to get in with a new doc. So if the symptom is in only one region, ask why that area seems "older than the others" or why age is doing something to you that it's not doing to your other friends. This goes also for the "age-related changes" you get on an MRI. If they can't articulate it or you don't like their answer, please ask to be referred out. Age is just one dimension. You deserve someone who understands your body in all its dimensions.
Sometimes people self-diagnose their condition as "age" when what they really mean is "time". A 20-something marathon runner who gets an injury at mile 21 doesn't think, "Oy, I'm so much older than I was when I started this thing." If you've been pain-free for years and suddenly have pain, if a pain you could live with suddenly becomes too much to bear, or if your body used to recover quickly from nagging pains but starts to send out a steady alarm, you may have just reached the point in your marathon where your body is calling for rehab and changing form or lifestyle.
If someone ever put in your head the notion that you're uncoordinated, tell them to, er, shove off.
Sometimes clients, when I ask them to move a certain way, will grow nervous and apologetic and explain that they're uncoordinated.
Inevitably I find these clients able to execute the movement perfectly.
We're naturals. As babies, we learn to roll, crawl, stand, and walk, then reach and carry and hug and run and duck and throw and whistle and grin, and then somewhere along the way something or someone tells us---some of us----that we don't have IT---the ability to move.
Of course there are differences in our innate and learned abilities. But you couldn't walk, drive, cook, or clean without a profound level of coordination. It's that profound level of ability that we tap into to help you learn a new movement.
Learning and practicing new movements may be helpful for brain health, so please don't shy away from the enormous capacity you have for doing this---and most of all, please don't be so hard on yourself. You're a natural.