Saturday, March 27, 2010

Pain, Habits, and Our Favorite Exercises

Which would you prefer- to stand or walk in a way that hurts or doesn't hurt?  How about doing an exercise where you're clumsy or weak, or one you can do really well?  Finally, would you rather do a tedious chore while you think about something else, or one that requires constant mental focus?

For most of us the answers are avoid pain, do what we do best, and ignore tedium.  When it comes to improving our bodies though, more work and deliberate action are needed.

Injury and Pain
Avoiding pain is called antalgia.  Specifically this means adopting a gait(walk) or posture(how we stand or sit) that reduces or eliminates a particular pain.  For example, if the bottom of a foot hurts we take very short steps with that leg and put as little weight on it as possible.

The pain is an important signal from our body that something is wrong, and may mean that you should consult with a doctor(and remember, massage therapists and personal trainers usually aren't MDs.)  When there is trauma to the body, such as closing a garage door on your foot or dropping a kettlebell on your knee, as this therapist has done, it is important to let the injury heal and to consider medical attention.

While the injury is healing, antalgia will discourage you from stressing the damaged tissue.  It is hardly necessary to mention how powerful the reflex to avoid pain can be.  Here's the problem:  Avoiding pain can be so reflexive and constant that an entire new method of moving(ie antalgic gait) or standing(ie antalgic posture) becomes habitual and unconscious.  The body's urge to avoid pain can be so strong that even after the injury has healed the new dysfunctional habit remains.  Most insidiously, the new habit can actually feel "normal."

To the Gym
If you're really good at the bench press, you haven't been paying attention to this blog!  (Sorry, that was humor.)  OK, so if you're really good at the bench press, but lousy at deadlifts, that indicates that the deadlift and other posterior chain exercises are where you should focus.  Instead of continuing to develop what is already strong, for fitness and health everyone should be focusing on where they're weak.  Even for sports where particular actions are dominant, balanced strength is important. Sure, we have more fun doing our favorite exercises, but it's the difficult ones that bring improvement.  Do both!

Next, when we lift a weight, do we use exactly the same amount of force with both hands or legs?  Not likely, although doing so is an important goal.  Either the load is lifted a bit off center if it is a bilateral exercise, or one side lifts less or with worse form if it is a unilateral exercise.  Perhaps the handle on one side of the chest press machine is pushed harder, or your body tilts more while doing dumbbell curls with one hand than the other.  This is where I mention the importance of awareness when exercising, and scold again not to use most machines because they conceal imbalances(some machines don't though, and rehabbing an injury is where they may be valuable.)

Exercises that are done often, maybe for years, become grooved into our neuromuscular system so they feel natural, and we enjoy the feeling of competence from performing an act we think we do well.  And if we can pick up 50 pounds our usual way, but only 40 pounds in similar but "abnormal" feeling way, there is a strong tendency prefer the way where more weight gets lifted

Back to antalgia for a moment.  When there is an injury, what do you suppose happens to the muscles that would normally act on the injured site?  They do less work to avoid causing it to hurt, and for a muscle, doing less work means getting weaker.  To paraphrase, "The weak get weaker and the strong get stronger."  Some movements and exercises get easier, some get harder.

Two Plus Two Equals Three
Putting these tendencies together, we get "compensation."  An injury leads to pain, which leads to faulty movement, which leads to weakness, which leads to compensating with another part of the body.  Sometimes by favoring a different limb, sometimes by using synergists(muscles which would normally assist the movement) instead of agonists(the stronger primary muscle for the movement.)

The sequence works the other direction too- An area of weakness, a reliance on synergists, or loading a joint in a dysfunctional way can lead to further injury, and the cycle continues.

What to Do
First, to repeat myself, consider consulting with a doctor.  Next, rehabilitating injuries is the realm of physical therapists, so treatment from a PT may be needed depending on the severity of the problem and your commitment to overcoming it.

If there isn't an acute problem or very apparent dysfunction with your body, working with a personal trainer, yoga instructor, or other movement and posture specialist will be helpful in finding and correcting these problems.  A massage therapist or other bodyworker skilled in orthopedics can be very valuable in finding and loosening tight areas, and promoting proper healing after the acute stage of injury.

Finally, exercise and move fully aware of your body.  Look, with the eyes and with internal senses, for asymmetry in movement and strength.  Think about your workout and notice if you are doing the same old exercises or challenging yourself with new ones.  Make sure that you work your body equally front and back, pulling and pushing, left side and right side.  (Note that to overcome existing imbalances, more work in one area may be needed.)  Choose exercises that reveal and require good form, skip those that conceal bad form, and don't cheat.

The result will be more and functional strength, better mobility, and less chance of further injury.  Best of all, a better appreciation and enjoyment of using our bodies.

Thursday, March 4, 2010

The Anatomy Trains Myofascial Approach and Functional Fitness

A great book for bodyworkers I just finished reading is Anatomy Trains by Thomas Myers.  Myers, who originally studied under pioneer bodyworker Ida Rolf of Rolfing fame, explains how the body is comprised of an interconnected system of myofascia.  Myofascia means the combination of muscle(myo) and connective tissue(fascia).  The exciting theme is to consider and treat the body in terms of myofascial lines which include various individual muscles and cross various joints.  It turns out that under the skin, there isn't such a distinct and separate collection of components as traditional anatomy teaches.

For example, the rhombodieus connects from the upper spine to the medial border of the scapula(that's the edge of the shoulder blade nearest the spine).  On another page of the anatomy book would be listed the serratus anterior, a muscle connecting to the same part of the scapula, wrapping underneath it and attaching to the ribs on the side of the body.  Examining the two at once, a single structure is seen- a muscle which starts at the upper spine and sweeps down to the lateral ribcage, with the edge of the scapula attached across the middle.  The two are antagonists, pulling in opposition, but the tissues are physically interconnected and functionally working together to position the scapula.

Where this gets really interesting is comparing the concept of continuous "trains" of muscles and fascia to the concepts of Functional Fitness.

Functional Fitness, or Functional Strength, is the idea of training the body in ways that are usable outside the gym in sports and everyday life.  One of the main precepts of Functional Fitness is to exercise the entire body in multiple directions simultaneously.  This is contrary to many common exercises and especially exercise machines.  Many exercises are designed to isolate individual muscles and to specifically not use the rest of the body.  This is fine for a competitive bodybuilder concerned only with appearance, but not very useful and potentially harmful for everyone else.

Anatomy Trains and similar myofascial techniques teach us not to isolate muscles in bodywork, just as Functional Fitness teaches us not to isolate muscles in our workouts.  It's how we're built.

I have some bananas ripening for banana walnut cookies I'll make soon.  Clients coming to my Los Altos office Friday and for a few days after will get one with their massage.  To put cookies into perspective, read this article from The New York Times: In Obesity Epidemic, What’s One Cookie?  Apparently considering one food item in isolation is less important than looking at the entire diet.