THIS WEEK AT NEWMOVES, I HAVE BEEN READING ABOUT NEUROLOGY AND BEHAVIOUR. THIS HAS HAPPENED ACCIDENTALLY.
My original intention was to learn more about Fascia, the connective tissue that surrounds muscles, bones and organs. In discovering research that shows that the force needed to “break up” adhesions of fascia would probably also necessitate the breaking of bones1, I came across neurological explanations as to what is actually going on when we foam roll or engage in myofascial “release”. Without going into too much detail, it appears that we a) don’t know enough about fascia to ascribe it importance in the treating of pain and b) there are other more pertinent factors to focus on when dealing with pain.
Pain management usually comes in the form of trying to “fix” or “correct” structural “imbalances”. I have put all these words in quote marks, as I do not believe these terms to be useful in describing the human body. They arise from a view in which, symmetry is proclaimed to be the optimum and the most natural state of the human body. I disagree. Everybody is different. And this arises due to a combination of genetic and environmental factors.
No one was born balanced and from a very young age, our environments necessitate a need to be imbalanced. We have a preferred hand to write with, a preferred foot to kick a football with, even a preferred direction to turn to. Derek Zoolander for a very long time could only turn right. I digress.
That said, there are numerous people who thrive in “imbalanced” bodies. My favourite example is that of Usain Bolt. He has a scoliosis (an off centre curving of the spine). Yet he is the fastest man ever to have lived. In addition, there are a number of studies that refute the idea that our structures account for pain in our bodies. For example, a 2008 review of 50 studies found that there were no associations between measures of spinal curves and low back pain. Anterior pelvic tilts do not lead to low back pain2.
So it seems that I cannot definitively state what pain is what the causes are. My understanding has led me to realize that more focus should be placed on the neurological aspects rather than the structural aspects of pain.
I have also been reading a book called “The Power of Habit: Why We Do What We Do in Life and Business”. What I have learned, is that behaviour can be learned and internalized, without conscious effort to do so. An amazing example discussed in this book, is that of Eugene Pauly.
Eugene was a retired Aerospace technician, who lost his memory. Scientists studied him as he exhibited patterned behaviour, yet was unable to recall why or how. Experiments with Eugene showed that it was possible to learn habits unconsciously3.
This actually got me thinking about a client of mine who has a painful hip.
He changed his footwear a year ago, based on promises of improved health and walking. What these shoes inevitably did was changed the way he walked. This accorded with the view that behaviors can be learned and internalized without conscious effort. His body found a new way to execute the task of walking in new shoes. My client then stopped wearing the shoes and noticed the pain in his hip. I have no idea, but could this change in his environment (shoes that made him walk differently) have impacted his movement as we ascend the body on a bone by bone basis? It’s just a guess.
Being a specialist in movement, I observed my client move. I noticed that one of his hips had less range in left hip adduction than the other in the execution of a number of tasks. Could this have been a subconscious change in behavior or was it structural? If structural- this is not a key concern of mine. However, if he his not adducting his left hip due to a subconscious change in behavior due to wearing new shoes, it may be a cause of pain.
This has been a great starting point. I have created exercises for him to generate hip adduction in a number a variety of exercise related contexts. It may be a great way for my client to start feeling hip adduction and in turn, may help him to alleviate pain in his hip. The video in this post illustrates some of the exercises I created for him.
1. Christensen et al. “Spinal curves and health: a systematic critical review of the epidemiological literature dealing with associations between sagittal spinal curves and health.” Journal of Manipulative & Physiological Therapeutics. 2008.
2. Chaudhry et al. “Three-dimensional mathematical model for deformation of human fasciae in manual therapy.” Journal of the American Osteopathic Association. Volume 108, Number 8, p379-90. Aug 2008.
3. Duhigg C. “The Power of Habit: Why We Do What We Do In Life and Business” Random House Publishing. 2012