Age Is Not A Diagnosis, 1

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.

You're a Natural

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.

The Deadlift is the Best Way to Lift Something Heavy

The word "deadlift" used to send me running. I thought lifting barbells was something you did to show off.  But a good deadlift is simply the best way to lift heavy things---and once you have the form down, you'll use it even for lifting lighter things.  Before you start talking about your knees, hips and ankles: I can think of very few of my clients who, for structural reasons, can't do a proper lift.  And when you start to feel yourself get it right, it feels fantastic, and it starts to change ALL your bending and lifting patterns. 

Watch the famous Gray Cook coach a deadlift below.  If you're already deadlifting, compare your deadlift to the one in the video; does it look the same?  If you haven't been deadlifting, it's best to get your deadlift assessed. You may need your deadlift regressed further than this guy. There are also different tricks you can do to help position the knees and ankles properly, which this video doesn't go into.  I can take a look at your deadlift.  For more specific personal training, please contact me for a referral. 

In the meantime, it's still worth watching the video to get an idea of how different this lift differs from the way many of us try to lift heavy things.  For example: 

The first thing you may notice in the video is that the back isn't perpendicular to the ground---a lot of us were trained to keep our backs perfectly perpendicular when we lift something.  

The second thing you notice is that you really have to get your bottom behind you---"the butt goes back" so that the spine stays in neutral (maintaining the natural lumbar curve).  Many of us aren't used to sticking our bottoms back, but it's the best position for the discs of your back.   

Finally, you'll see that he's put a stack under the bell so the lifter doesn't round his back. We can bet that guy was not using a stack till he came to that conference. But there's no shame in needing a stack!  When he learns how to lengthen his hamstrings he'll be able to remove the stack. (Hint, hamstrings are often tight because either they or something else is weak.  If they keep tightening up, get assessed so you can figure out why.)

All of these are components of the "hip hinge", a powerful way to protect the spine, and a subject for a future post.   

Move What You Can Move: Edgework for Pain

When you're having muscle discomfort or pain, Cory Blickenstaff's Edgework is a simple technique you can try on your own or with a therapist. Some of you may intuitively do a version of this, but using Edgework's systematic approach may be more effective.

I've selected some videos from youtube, but there are a few others on there, and Cory also has a blog: blog.forwardmotionpt.com (the blog is down right now but should be up soon).  

If you've heard of using "graded exposure" to movement to relieve pain, this is a simple, systematic kind of graded exposure. 

The only caveat is that if you're not sure the cause of your pain, be cautious and consider getting care.  And of course if it doesn't work, don't force it; it's just not the answer for you.  

This intro video focuses on the foot and ankle, and on the basic Edgework steps: Nudging, Scraping the Barrel, and Stacking the Deck.   

In his second intro video, Cory shows how you can progress this work by loading the foot and repeating the three concepts:

 * Nudging: Moving gently toward the edge of discomfort, then backing away from it. 

 * Scraping the Barrel: Going to the edge and then staying there, working the joint through whatever range of motion is possible without leaving or crossing the edge.  As the edge expands, you can expand the movement.  

* Stacking the Deck: Going to the edge, then adding a novel, pain-free movement.    

In all of these, he's weaving in some good science on pain.  For example, in "nudging" he's asking the body to answer the question, "How dangerous is this, really?"  Pain and muscle guarding are often the brain's response to a suspected threat.  But the brain sometimes overreacts, sending out pain signals and muscle bracing that continue after the threat is gone. If the body and breath stay calm, and you bring the muscle right to the verge of discomfort but not over it, you're gently helping the brain to see that nothing bad is about to happen.   

Note in the following video on low back pain how he couples the work with diaphragmatic breath to send a signal to the body to dial down the flight-or-fight response. 

And here's some for the knee: 

You can apply the concept to any part of the body, being gentle and never sustaining pain in any direction.  If you have any questions about where to start, contact me and I'll see if I can help you brainstorm.  Should you do this before getting care?  Once you have been cleared for fracture, break, or soft tissue damage you can try it. Ideally, you would do it in tandem with care, or follow it up with care, to help you figure out why you got the injury in the first place, or, if you have had the injury a while, to tease out related compensations.  Also be sure to evaluate all your movement habits (not just the obvious ones), to see whether there are simple things you can change at home.  If the discomfort doesn't go away, if it comes right back, or if it seems to move somewhere else---or if the area doesn't seem to be as functional or strong as it used to be---consider getting care.  

Compensation (Everybody's Doing It)

Many people can feel that their bodies have been compensating for a past injury or condition. Sometimes these compensations are themselves the cause of pain or weakness: for instance, you have a car accident, your body has no pain at all, but you seem to have a harder time lifting heavy objects.  Or, you have an ankle injury, it heals beautifully, but a few years later the opposite knee starts to twinge.  Over time rehab experts have developed guidelines about which body parts tend to compensate for ("pick up work for") other body parts.  With Neurokinetic Therapy™ we get even more specific, identifying exactly which parts of your unique body are involved in a compensation. The results can be surprising! Resetting these compensations can often be the key to healing a musculoskeletal injury. 

But while we tend to talk in negative terms about compensation (the word alone suggests something's missing), please remember that compensation is what the body does.  It's been doing it from when you were born, often prior to any injury or trauma, in response to the position of your joints, the shape of your body and the way you used it (possibly also the way you were carried, the kinds of shoes you wore, etc., etc.). This happens all over the world, in every culture, no matter its lifestyle. You could easily replace the word "compensate" with the word "adjust," or "calibrate."  

In order to accomplish a task with the tools at its disposal, the body adjusts and calibrates in very useful ways. Athletes are some of the best compensators, adjusting for and calibrating around pain and weakness as efficiently as they shimmy down a mountain or dodge a linebacker. We have the idea, based on research and clinical evidence, that there is an ideal way all muscles should work. That is a very useful construct---I use it in my practice every day---but there is no one, or no one I've heard of, whose entire body works that way. Each of us is a unique variation on the ideal.  

Below is a great description of how compensation works, from Douglas Nelson's book "The Mystery of Pain". But as you read it, please remember that every body's doing it: 

When you want to move, your brain considers the intended outcome and then figures out a way to accomplish the action. Knowing what the final goal of the movement is, the brain recruits every muscle and neural pathway available to accomplish the intended action in the most efficient manner. Every simple action, such as bending over to tie your shoes, requires a symphony of muscular action to take place. No single muscle is involved; multiple muscles must turn on and off at precise times to accomplish even the most basic actions. With such complexity, any disruption of the system can have vast consequences. When one muscle does not participate appropriately due to pain, or the memory of pain, other muscles must compensate by doing more. Over time, these overworked muscles may lose their sense of humor regarding their new job description. 

Changing the recruitment pattern of muscles is analogous to driving down a road and then finding that a fallen tree has blocked the route.  You still need to get where you are going, so an alternative route is employed. Unfortunately...these alternative routes aren't often very efficient. When the detour is removed (original pain), the brain still employs the inefficient detour. There is a redistribution of activity both within the muscle itself and also in the complex relationships between muscle groups.  This limitation of movement alters normal muscle function which then can potentially lead to more pain in the future. 

Dr. Paul Hodges has done some wonderful work with this subject (Hodges and Tucker 2011). His work has shown how pervasive these alterations are throughout the entirety of the muscular and nervous systems. By changing these muscle functions, we become less flexible in the broadest sense of the word. Our movement possibilities are limited, we become less efficient, and less adaptable in our nervous systems.

All true. But for all that (Gabi again), we're all compensators, and naturally artful at it. On top of which, many of us are or become, either through nature, nurture, or both, "excellent compensators". The body of an "excellent compensator" is especially good at figuring out what it needs to do to get the job done, even if that job is getting down a mountain at a record pace on a torn Achilles. Are this person's movement possibilities limited? Only compared to what he could do on an intact Achilles. Thus, someone may be born with or acquire scoliosis and be a great rock climber. Someone may start running marathons after losing a limb. Etc.

How to maximize your body's movement potential? Move your body in all the ways it can move, as far as you can move it.* Load and challenge your body with care. Study and apply good form. Aim for ease. Vary your movement practice and keep learning new moves, but return to the basics (walking, squatting, lifting). Your body will be adding and subtracting compensations along the way, adjusting and calibrating to history, use and position, just for you.  

*As far as you can actively move it. I haven't found value in stretching beyond your active range of motion. Or in mimicking Cirque de Soleil performers. A subject for another post....

Hearts It Is

One time on Valentine's Day I made a heart out of rocks in my garden. A client came in furious: "You have to take that out right now." At first I thought she was joking. "It's AWful," she said. Her jaw was set. Her eyes were hard. What could be more loaded than a heart?

Many massage therapists probably go through the following process with their logos: I could use an image of a body, but what age would it be, and what gender and what proportions? I work on people who use wheelchairs and people who have missing limbs; should the body be standing, and should it have all its limbs? I could use an image of bones, but that's just one part of a whole complex body. Many of us turn to other symbols we like, or interesting squiggles and abstractions. 

All bodywork starts with deep care---my care for your body and your care for yourself.  We may not get very far if either are missing, but we can do a lot with both. A lot of effective businesses aren't that way; a businesswoman could produce a great product and customer service because she loves money, not people. You can fake empathy, or hire people who have it. But it is really hard, I think, to be an effective therapist if you lack honest empathy.  Hence the heart of my logo.    

At the same time, if neither of us think of you as a machine, that will be a bit tricky too. You may be a very complex and unique machine, but some things are predictable and repeatable. We're looking for and at those things, hence the cogs and gears.  

It would be funny if I were a really mean person using this logo; I like that it holds me to a particular standard. Last week a client said, "I love your logo....it's so...perfect."  You can imagine how happy that made me. I thought, "I'm being who I want to be for her."  

Picking a logo is like picking a baby's name---opinions make things complicated. All I can do is hope to live up to the logo, and to help you in the way I would want to be helped: with good care and good reason.