What If We (Don’t Really) Know What Our Body Needs?
One of my friends recommended a great book which I have been listening to when I am walking Chana or pulling weeds. It is called “Talking to Strangers” by Malcolm Gladwell.
The book chronicles some amazing stories of times when people misjudged others to devastating effect. CIA agents who were unable to tell that their colleagues were double agents. The British Prime Minister who met with Adolf Hitler prior to World War II and evaluated him to be not interested in starting a war in Europe. Even judges who are less successful than computer programs at judging who will re-offend.
The stories remind me of that great movie Moneyball that came out over a decade ago. In the movie, the down on their luck Oakland A’s baseball team explores a winning strategy that demonstrates statistical data to be better able to predict a player’s performance than a coach’s subjective evaluation.
Over and over I am aware of how our subjective evaluations- of situations, of other people- is extremely limited by our own biases and perceptions.
And of course, how can I not see the connections to these cases and to my field of movement?
Over the course of the 16+ years I have worked as a physical therapist, I have heard- almost weekly the phrase “I know what my body needs” from patients. And yet, I continue to see these same clients and patients making judgement around movement that is wholly unsafe.
Time and time again, my own body is unable to feel when and where it is the most challenged.
My body tends to perceive familiarity of movement as “ease” and novel experiences are processed differently.
In the clinic I practice at, I continue to see patient after patient who is doing more in their daily life than they are strong enough for. But the familiarity of these daily activities is so alluring and so comfortable- it is near impossible for us to identify clearly the activities we are doing that are truly too challenging for us.
I realize a huge part of the problem is that it is very tough for us to feel, in the moment, when we are doing something that is too hard for us.
At the very least, we hope that our body will create pain to let us know that something is wrong with our movement decision while we are doing it to prevent injury. But this simply isn’t always the case.
Pain is subjective and complex, and each of us has different relationships with our pain systems.
Recently, I had a close family member who had no pain despite having a massive kidney stone. She was misdiagnosed and her case mismanaged due in part to biases by her providers and her lack of pain.
I also have clients who have moderate or even severe discomfort performing movements well below the level of challenge they expose their bodies to outside of the clinic.
If we really don’t know our body that well, what can we do to protect ourselves during our movement? How do we reconcile this somatic disconnection?
First, we accept that, in part, we really don't know what we need to create better health outcomes through our movement. Second, we practice curiosity and openness in identifying our beliefs and biases around our movement choices.
There are two strategies that I have found to be most transformational and impactful in my own relationship with movement and with my ability to more clearly feel cues my body is giving me (including fatigue and strength limitations). I have also witnessed the power of these practices in people I work with- BUT- I have very few clients and patients who actually practice both of these with regularity.
Strategy 1: Daily Body Scan
The more I practice and read about the effects of diaphragmatic breathing and mindfulness meditation, the more convinced I am that the body scan is a healing method that can deeply nourish our nervous systems as well as our somatic awareness. It has transformed the field of pain management and has helped people with anxiety live more full and balanced lives.
My favorite free body scan from Jon Kabat Zinn can be found here, and if you would really like to commit to a new level of personal practice I highly recommend the 8 week Mindfulness Based Stress Reduction (MBSR) course, that is centered on body scan practice. University of Massachusetts is the leader in offering these courses (you can find their online class here), but most large universities will offer a program for you.
Strategy 2: Embrace Movement Science (progress exercise thoughtfully and linearly)
Movement science has come such a long way in the past 20 years since I stared Physical Therapy school. We now have normative data of muscle strength for many muscle groups based on age. We also know what strength/ activation is required for common activities (cycling, walking, running) to ensue safely.
When I was treating youth athletes back in 2010-2013, I began to notice the disparity between what athletes were being asked to do by coaches and trainers in their off season, and where their strength levels were at.
I devised a progression that helped me test their level of participation functionally, and using this step wise approach to strength helped me advance greatly in my success rate of helping athletes get back to their sport and maintain safety during play.
We can all learn this progression and use it to our benefit to help solve movement questions- it is super straight forward.
Just recently, in March of 2023, I was at a course with a leader in biomechanics, and he showed a quick slide about exercise progression. It was the exact same progression I had come up with in 2010. Here is how to engage to maintain safety and integrity- the list starts with the easiest activity and ends with the toughest:
1) Non weight bearing (NWB) isometrics
2) NWB active motion
3) WB isometric (bilateral)
4) WB active (bilateral)
5) WB isometric (unilateral/ asymmetric)
6) WB active (unilateral/ asymmetric)
7) Plyometric or add weights (bilateral)
8) Plyometric or add weights (unilateral/ asymmetric)
Recall, isometric means non-moving muscle contraction. Unilateral means single limb.
Plyometric indicates a flight phase (acceleration and speed) such as a jumping lunge or hop.
In our next post, let’s go through an example of this progression with the lower body, and continue to explore strength leading up to our Muscle Magic workshop in June.
Until next time happy and clear sensing!
White board from our Practical Strength Foundations workout May 24, 2023