If you want to know about your own body – talk to the experts.
Recent conversations I had with my physiotherapist. Insights that I think most people could benefit from.
I guess I am lucky, in that I found a good physiotherapist who really knows his stuff and goes to great lengths to explain things. I have been seeing him recently about a couple of niggling issues that really needed sorting out. I have known him for a number of years and he has always been straight talking and direct and he knows that if he gives me the necessary exercises I will do them – unlike some of his patients who think that they don’t have to put the work in.
He told me two stories about his experiences, both were connected and they rang bells with me straight away, partly because of the issue he was treating me for and partly because I had been chewing on this particular bone for a long time.
The conversation started about how back trouble is often misdiagnosed and that the root of the problem is in the relationship between the back and the core muscles.
He had been working with a male gymnast who was pretty much in his prime. The guy was in great condition, as you would expect; incredibly strong, body like an anatomical diagram and super flexible. The physio had treated him before for minor muscle issues, ankle, quads etc, but this time he came in with a back problem. Initially the physio was puzzled, how could this be? Theoretically the guy had all the attributes and, in his own discipline, he knew what he was doing – but here was the crux of the issue…
The physio figured out that the load-bearing aspects of what he was demanding of his body were being picked up by the major muscles in and around the back, but internal deeper structural muscles were not getting a look-in, so while one part got stronger, the other (hidden) part was getting weaker. These were the core muscles, the ones you can’t see and can’t engage with in a direct, obvious and observable way. In a way, something had to give, injury was inevitable.
Once the physio had figured that out, he was able to prescribe a whole raft of core exercises, subtle but effective, and, the gymnast being a disciplined sort of guy, engaged fully with the exercises and was able to recover.
He told another story, linked to the above.
The school gym class.
At one time in his career the physio was heavily involved in the treating of children. At one point he was dealing with a referred patient, a child with coordination issues, somewhere in the zone of dyspraxia. As a result of this he was liaising with the child’s junior school. The school invited him in to observe their daily early morning gym class. It wasn’t a gym class as such, these children were very young; the teacher, who wasn’t a gym specialist had set up a series of ‘stations’ and equipment in the school hall, all very play-based. A few of the stations were balance-based, while others were more dynamic or strength-orientated, a real variety. The physio said that the teacher had done a good job, but after observing the class something stood out for him…
He took the teacher aside and explained that because the children were given free choice as to which exercises and stations they would do, they seemed to deliberately avoid certain activities, they steered away from the things they found difficult or what they thought were pointless, at least in their eyes.
They spoke to the children during subsequent observations. One young boy seemed to go for the strength-based exercises, so the teacher asked him to try the balance beam, the boy was a little dismissive at first, but then it became apparent that he had terrible balance and really struggled with it. Consciously or subconsciously the boy’s body wisdom was directing him towards the things he was naturally good at, and away from the things he found difficult. From the physio’s point of view, these weaknesses should really be addressed.
At the same gym lesson the teacher was really proud of the coordination one child was showing in the act of twirling a hoop around his left ankle which had a string and a ball attached, he skilfully skipped over the circling string and ball and kept this going for quite a while. Initially the physio was impressed, but then asked the child to try the same thing on his right leg; the result was that the child couldn’t do it – he’d specialised the skill to only the one leg.
Naturally the physio was able to advise the teacher on how to meaningfully restore the balance and at the same time create more enjoyment for the children.
How this applied to me.
The physio told me these stories because he was addressing these same issues in my treatment. Earlier I had told him I was puzzled because he had directed me towards similar core work he’d prescribed for the gymnast. I felt at that time that my normal training regime and what I had been working for years in my Wado karate discipline had built up a solid and dependable core; I said this to him and he agreed, but…
He said that my movement had become over-specialised, with dependency on specific muscles and actions that directed the pressure away from other more contributory and subtle muscle groups. The result was that what I was relying on was liable to suffer from overwork with no back-up plan, certainly no back-up structure to spread the load in a smarter way. Then, when one injury occurred, however minor, the load was unconsciously switched to another part of the structure that was not used to picking up that level of work, thus compounding the problem.
The antidote was a weird set of exercises, that perhaps felt like nothing meaningful was happening, that was until the symptoms started to ease off – and this came about remarkably quickly. I must say, I was impressed with his astute observations. I suppose that’s what you get with all those years of experience behind you.
Way back in April of last year I posted a blog item called, ‘Has movement culture got anything to offer martial artists?’
One section of that was titled, ‘Listen to the wisdom of your own body’, I think I would revise that blog post now, or at least add a disclaimer. I think I was ‘listening to the wisdom’ of my body but failing to apply a little more granular thinking and actually interrogating that wisdom properly. This same ‘wisdom’ was causing the boy in the junior school gym class to avoid the balance beam, or the other student to only do the trick on their left leg.
In researching that blog post and reading around the subject, I watched a huge number of videos and interviews with movement culture guru Ido Portal, and in one of those videos a basketball player was talking about this very same issue of specialised movement that can take you down the road to injury.
The more I thought about it the more I realised that the answer was staring me in the face all the time; these are the main observations:
· Specific to movement; watch yourself all the time. Observe the smallest things; how you get out of a chair, how you choose to get dressed or change your clothes.
· Observe what you actively avoid doing. Look for any specific biases. You can extend this to observing how other people move, or what their posture is telling you, use that as a cautionary lesson.
· Don’t be too quick to dismiss other disciplines or ideas just because they don’t fit with your personal philosophies. Look toward things like yoga, Pilates or even the Alexander Technique, be curious and keep an open mind.
· Just because and exercise is boring it doesn’t mean it has no value.
· Re. Physios; if you can afford it don’t begrudge the fee you pay for expert advice. After all, you wouldn’t think twice about paying a £200 repair bill to fix your car, what price would you be prepared to pay to fix your body (and possibly make you pain-free)?
Image credit; ‘Leonardo da Vinci Anatomical drawings’, published by Liber.