Bi-later-ability

Thank you all for your comments following last week’s post. It’s lovely to hear everyone’s reactions to what I’ve written and reminds me of the importance of this ongoing research and thinking around my teaching. So this week’s inspiration came from my new-found hobby of swing dancing. It’s a step up from ironing, and somehow continues from last week’s post, which you can read here.

Swing is a social dance. You dance with a partner, either loosely facing or side by side. One person in the couple is the ‘lead’ and the other is the ‘follow’. This description is all highly simplistic I know, because you watch professionals dancing and they’re literally all over the place. But at a very basic level, your footwork and facings essentially mirror that of your partner.

Bare with me.

Following the usual set-up of the beginners class I go to, last night we first learnt a basic step, and then built on that into different variations. The lead dancer started by stepping back on the left leg, the ‘follow’ stepped back on the right. The pattern soon set in till it felt almost unconscious, which we only realised several variations into the class when we suddenly all found ourselves on the ‘wrong’ side of our partners. Having to do the basic step on the other leg before we could get back to ‘home’ felt like picking up a knife in the wrong hand. Panic!

What we experienced was the surprise of having internalised a movement pattern.

Repetition has long been the main way of learning dance steps. We talk about ‘getting it into the body’ or ‘feeling it in the body’ so that it becomes imprinted to such a degree that it can be performed unconsciously. This is the result of neuro-muscular patterning, the particular organisation and co-ordination of parts needed to carry out the movement. The rate of encoding will depend on how practiced our neuro-muscular system is at adapting to the demands of this new circuitry and what other library of sequencing the body already has to draw on. If the basic scaffolding (an understanding of centre, full access to the peripheral joints and an ability to sequence from one to the other) is available, then building the sequence will take less time. Perhaps for those without a basic scaffolding, more basic patterns will need to be laid down first before the full co-ordination can be accomplished. Once a pattern is imprinted into the body, it then becomes the ‘easy’, most available option, which in turn makes us more likely to select it, leading to further re-enforcement etc.

OK so perhaps you have no interest in learning social dancing, although I highly recommend it, but this little unpicking of learning seems relevant to how we create movement biases just through living. As I struggled to get my left leg to start the rock step back, I was reminded of this remark by Liz Koch:

Unlike a machine, we are not symmetrical but bilateral – Liz Koch

We are literally composed of two different and complimentary parts that work together around a single central core. However, somehow, through conscious or unconscious learning, we have all internalised movement patterns that have led to more or less use of one side over another. Of course I’m not suggesting that we all become ambidextrous. We will always have a dominant hand / leg. However I wonder how much we tend to lean onto these dominant sides. Remember that the body will always default to the easiest, most available pattern which, whilst over-developing activity on one side, will equally reduce access on the other side. Injury, for example, can lock us into a pattern that is aimed to protect the injured part in the short term, but causes more imbalances in the long term. Learned non-use leads to functional asymmetry. The result is a metaphorical limp in the neuro-muscular system with various compensation patterns, stresses and strains on the joints that lead to pain and injury.

Perhaps the roles of ‘lead’ and ‘follow’ might equally apply to two sides of our body? If so, the key to reducing this functional asymmetry is to somehow land up on the other side, to trick the body into stepping out of ‘home’ and remaining bi-laterally able.

The way towards bi-later-ability (my own word, not a technical term) is the ABC of better movement:

  • Increase Awareness: notice your habits.
  • Shake Things Up: walk around the park in the other direction, put your mat down on the other side of the room, start on the opposite leg, go to a different class (because teachers also tend to default into patterns of exercises and teaching techniques that come easiest to them), change the interlace of your fingers.
  • Listen to Feedback: Go to a class where a teacher can see what you’re doing and help bring your awareness to patterns that you are not aware of.

Be creative, let me know what other small habit shifts you’ve thought of.

 

 

Form Follows Function

Last night I decided to tackle the pile of washing that’s built up over the weekend. I always find it so interesting ironing out clothes. It’s not just a simple matter of removing the creases, which is easy enough. Have you noticed how getting the side seams to meet is so crazily difficult? I have to adjust all my tops several times before I can fold them symmetrically.

I’ve had a scoliosis since I was a teenager. It’s called an idiopathic scoliosis, assumed to have no real cause. It just popped up out of the blue. It’s a sideways (lateral) bending of the spine. A trained eye can see my curvature, but most people wouldn’t notice, since the curve is quite small. The main giveaway is that the Right side of my back is more indented than the Left, and the Left side of my back is quite tough. It basically feels as though I have more meat on one side than on the other.

One of the key features of a scoliosis is that as well as bending sideways, the spine rotates. It’s like the trunk of a tree bending and spiralling upwards. The interesting thing about ironing clothes, is that I can see that exact rotation in them. My whole pelvis twists around so that the Left hip sits further forward than the Right. Sure enough all my tops are slightly twisted in this way. I have to make a specific effort to untwist them so that I can fold them neatly.

My clothes, when new, are easily folded. There are no twists. They fold ‘naturally’ along the seams. The ‘bones’ of the t-shirts, ie: the seams and stitching that holds it in shape starts off being more or less symmetrical. But with wear it takes on my shape. What I’m looking at is the imprint of my own movement in my clothes. Movement that is both unconscious and repetitive so as to gradually pull the fibres of my clothes into a twist. When I iron them out and straighten them, they return to neutral.

I think that when I examined the twist in my clothes I realised that I was seeing a mirror of my form. But this was not the original form of the clothes. I ‘have’ a scoliosis, but my clothes do not. The form that you ultimately inhabit comes out of the repeated movement habits that you carry out and most of this is unconscious. The real problem isn’t the distortion that you “have” it’s your lack of awareness around this distortion. As Katy Bowman writes:

Having someone tell you that your frustrating, inconvenient, or painful condition is natural and that surgery or difficult (and barely effective) spot treatments are your only options is both disempowering and possibly untrue. So much of our physical experience is created by how we choose to live – it’s not the result of some unavoidable genetic fate. You can learn… how to use your body in a way that allows it to function better, the way it’s supposed to. – Katy Bowman

Now, most adjustments to boney alignment are quite complex. Hereditary elements do play a role. But more and more I’m tending to feel that the way we organise ourselves (unconsciously) plays a very key part in the degree of deviation that results. The more we bring ourselves back to neutral the less likely we are to have a large deviation in the first place. This, in turn, will reduce the strains that result from the adjustment on the rest of the body.

The good news is that once we develop awareness around our movement we can begin to make decisions about how we move that will have an “ironing out” effect on those distortions. How we organise ourselves depends on us.

You are how you move.

Where Pilates Goes Wrong…

I know that I spend a lot of time reminding people not just to obsess about the area that is injured, painful or out of alignment. The general thrust of my writing and talking about the body is to always look at the system as a whole. A key model for understanding this holistic approach is through the Anatomy Trains identified by Thomas Myers. Fascia, the connective tissue that wraps around each cell, each bundle of cells, each muscle, the tissue that interconnects muscle, to tendon, to bone, to viscera. Fascia, I have thought, is the reason the whole body is a whole system. But what if I’m slightly wrong?

As so many of my clients and classes wind down for the end of term, I have more time to think of my own body and training. I went for a run on Monday which absolutely shattered my lower calf muscles (the soleus area). No matter how much I stretched them out, they still felt tight. Walking down stairs was actually painful. Thursday comes and I was determined to get myself out for another run. I hoped that the movement would help to release them. It didn’t and I had to give up after 10 minutes just because the tension was getting silly.

Now, I’ve always struggled with super tight calve muscles. I tell everyone that I inherited them from my Dad, which is true! I swear I have my Dad’s legs! (How many times have I heard that from a client…?) But I also know, because I am a Pilates teacher, that this kind of overuse is a signal that the mechanics of my running are slightly dysfunctional. Something I am doing is leading to this over use. It’s probably wrapped up with my knees being hyper-extended and the position of my weight over my legs when I’m running. It’s symmetrical (both sides are equally tight), which is some good news. It’s probably something to do with the switchover between the soleus and gastrocnemius muscles during the take off and landing phases, (as my teacher Dominique Jansen has said in the past). Or maybe it’s just the shoes, or the fact that I haven’t run for some time.

My brain went into over-drive trying to work it out.

Later in the day I hobbled down to Triyoga to do a Feldenkrais class. We spent the whole lesson working on the shoulder girdle. The whole 1.5hours lying on our backs just doing movements around the shoulders and integrating this into spiralling the back.

I walked out of the class with no calve pain…

[Pause for effect]

This is why I keep on going on about Feldenkrais. But what I realised is that what happened yesterday was not just related to fascia. Feldenkrais talks to the nervous system and invites an overall more functional organisation of the whole body. So yes, we worked on the shoulders, but the whole body was adjusting in the meantime, and something else let go. Not only is the calve pain gone, but my scoliosis is less significant today.

The discovery has been both exciting and worrying. I realised that even though I actively attempt to address the body and person as a whole, Pilates does, unfortunately, still have a tendency to reduce pain to a specific area and to try to treat it. We look for logical connections: the neck and lower back, the neck and gluts, the hip and knee, the foot and lower back, the wrist and the shoulder etc. What we sometimes get wrong is that the system’s natural ability to self organise is so finely tuned to the balance of every part, that even our extensive body knowledge and eye for detail cannot always see the whole. Pilates goes wrong when teachers assume they know better.

Now excuse me whilst I go and have an existential crises.

 

DR 2

So in my last post I talked about the cause of a DR as the increased pressure against the abdominal wall from the inside out. Pregnancy is one example of why this might happen, however I am seeing, with considerable frequency, the same pattern happening in men. It seems clear that the main cause of the DR is posture. There are contributing genetic factors too, like hyper-mobility, which will make someone more prone to it. There are also occasions where a single event, like a sudden sneeze, coughing or lifting something heavy can bring about a hernia. However the chances are in both cases that the occurrence can be greatly reduced by maintaining appropriate tone in the abdominal wall and ensuring that you do not place too much pressure on it during habitual movement.

In my last post I identified four key areas that need to be addressed:

  1. Centering – asymmetry (unilateral imbalances) reduces the functionality of the Rectus Abdominis muscle. Before loading the abdominal wall you need to find centre.
  2. Releasing the shoulders – restrictions in shoulder movement leads to rib cage displacement. It may seem strange, but ensuring you have full ROM in the shoulder will reduce pressure on the abdominal wall.
  3. Release the rib cage – The ribs need to soften down. I drew a nice picture of this in my last post.
  4. Release the Hip Flexors – When the ribs are displaced, it makes it very hard to connect through the centre of the body, so when these clients do things like abdominal crunches with their legs in the air, they often tighten up in the Hip Flexors. This brings the pelvis into a forward tilt, also in my picture.

The following sequence is not a complete fix. It’s a starting point to address the main points mentioned above:

  1. Centering: start off by doing a low level centering exercise. My favorite is to lie down with pelvis raised onto one of those disc shaped wobble cushions, but a simple cushion does the trick too. You need to make sure that your ribs are not poking up to the ceiling so soften the rib cage and raise your head onto another cushion if needed. Start with pelvic rocks, then small clocks, rolling an imaginary marble around the pelvis. You can then draw one knee in and hold it with your hand and do a few knee stirs. Repeat on the other side. Then hold one knee in towards you to allow the other hip to open up. Change sides.
  2. Lateral Breathing: staying on the cushion but with both feet on the floor begin to breath into the sides of the ribs. As you exhale, allow the arms to lift up infront of you whilst you soften your ribs down. Then try to take one arm overhead, without displacing the rib cage. Keep softening the ribs down as the arm goes overhead. Repeat a few times to each side and then try this with both arms. Drop the ribs! Drop the ribs! Drop the ribs!
  3. You can now begin doing some low level abdominal work. Place your hands onto your belly, so that with each out breath you sink your belly away from your hands. Try drawing one knee in towards you at a time without swinging around on the cushion or collapsing your lower back into the floor. Then try to do the step up where you lift one leg, hold for an in breath and lift the second leg up to join it on the next out breath. Then reverse. Always breathing out when you either lift or lower the leg.
  4. Leg slides: With the pelvis still on the cushion and feet on the ground, you slide one leg down along the floor. As you do this try sinking the belly back towards the spine, breathing out all the way, and watch that the lower back doesn’t arch especially towards the end range of the knee extension. Hold the leg out there for an in-breath, and then press the heel into the floor, engage the muscles around the sits bones and drag the leg back in to the starting position. Repeat 3-4 times to each side, alternating legs.
  5. Bridge: press your heels into the floor as you raise the pelvis off the cushion. You want to think of lifting the pelvis from the muscles around the sits bones, keeping the ribs soft and opening the front of the hips. Remove the cushion from under the pelvis, and then roll the spine down to the floor bone by bone, focusing on releasing through the mid back. You can then repeat the bridge without the cushion a few times.
  6. Lunging HF stretch. Ok this one is just obvious, but don’t forget to avoid hanging into your lower back. As you lunge forwards you think of lifting out of the pelvis, keeping the ribs soft.

I’ve been busy writing this whilst suffering from a nasty cold, which means that I’ve had time to create a quick video of all of this (minus the lunge). It’s just a quick picture so that you know what to do when you’re on your own. Please excuse the red eyes and sore nose 🙂

Diastasis Recti

As some of you know, I’ve recently become intrigued by the number of men I come across with some degree of Diastasis Recti. A DR is a split in the abdominal wall, which we commonly come across amongst pregnant and post-natal women.

DR is accepted/ expected as a normal result of pregnancy. As the baby grows, the abdominal wall splits to make room for the growing bump. Post-natal Pilates focuses on re-knitting the abdominal wall by gradually increasing loads to tone the abdominals whilst encouraging the abdominal wall to sink downwards and inwards. It’s a tricky balance. If you load too much, the abdominal wall is pushed outwards, further exacerbating the problem. If you load too little the client finds it very hard to ‘feel’ anything in the abdominals and other muscle groups like the Hip Flexors begin to take over.

The good thing is that when you work with a post-natal woman, they know that their abdominal wall is vulnerable. So they don’t go for broke on big abdominal exercises. They (often) listen to my instruction to reduce loading if they’re in a big class, or engage with the issue rather than trying to ignore it. Men with a DR, on the other hand, have not just given birth. They don’t feel vulnerable, in fact many of them appear to be quite strong. They often show up in my classes because their physio recommended Pilates for their lower back pain…small wonder. Many of them simply don’t accept that the abnormal bulge in their abdominal wall is a problem at all. The literature out there backs this up, calling it harmless. But a split in the fascial sheets of the abdominal wall is not functional. Try telling a buff looking man that he needs to do post-natal Pilates….

Enter Katy Bowman.

Katy Bowman is a bio-mechanist. She looks at movement in terms of forces placed on the bones, joints, soft-tissue and even the cells. Her philosophy is to develop nutritious movement habits, varying the loads and directions of pull on the body so that we develop a varied movement diet, leading to all-round wellbeing. She’s a massive fan of the squat and hanging from trees, for example, movements that our sedentary culture has made very easy to forgo.

In her most recent publication Diastasis Recti, Bowman insists that DR is a whole body problem. She identifies that all occurrences of DR result from too much pressure on the abdominal wall. Whether this is because of a growing baby in your belly, or if, like a friend of mine, you just picked up something too heavy and literally ‘bust your guts’. From a bio-mechanical point of view, the cause is the same: too much pressure on the abdominal wall from the inside outwards, and though the onset may be sudden, the fault lines have slowly been creeping up:

 Slow sustained loads in a certain direction can deform tissues in a manner from which they cannot recover. Mechanical creep is the tendency of a material to deform slowly under a constant stress. The failure of a tissue in this case is called a creep failure. A diastasis recti or hernia is the result of creep failures.” Katy Bowman.

So Diastasis Recti is NOT just a natural result of pregnancy. It is the result of abnormal amounts of force on the abdominal wall, of which pregnancy may be one cause.

The abdominal muscles support the lower back. Poor tone or weakness in the abdominal wall results in a gradual wear and tear on the discs and intervertebral joints in the lower back. It’s obvious that a tear in the abdominal structures makes them a lot less functional (read: weak), which is why they really need to be addressed. I think that when medical professionals say that DR’s are ‘harmless’ what they mean is that they are not cancerous growths. But a DR is not something to ignore.

It follows that if the cause is the pressure on the abdominal wall, then just fixating on the location of the DR itself, as we tend to do with post-natal women, is a very limited way of looking at it. That doesn’t mean that specific, targeted abdominal work is not necessary. On the contrary, we do need to work to restore correct functioning of the abdominal muscles, but it needs to done within a program that considers the pressures on the abdominal wall brought about by the organization of the body as a whole.

If I hold a picture Doc - 28 Mar 2017 - 21-56in my mind of clients who have a DR, the picture is roughly this. The rib cage is flailed, compressing the mid-back area and the pelvis is in a forward tilt. This appears to create more space out the front, making it the favoured posture for a pregnant woman. I think that men who adopt this posture (if they are not obese) do so because they may be trying to sit upright, but don’t have the mobility in their upper thoracic area or shoulders, and therefor hinge on the mid-back section. Once you displace the ribs in this way, it makes it very hard to feel a connection through the centre, so any abdominal work is likely to go into the Hip Flexors or lower back.

 

Bowman goes through a very comprehensive program of exercises to address every detail around this posture type, (and I highly recommend her book to clients, especially men, who have a DR). However, one of the key factors that makes DR quite difficult for a post-natal woman is: asymmetry, which I don’t think Bowman has addressed sufficiently in her book. Having one leg longer than the other, or some rotation in the pelvis, or a scoliosis all lead to a weakening of the abdominal wall. Lack of alignment causes weakness in the surrounding muscles. So addressing this is just as important. Once the body is aligned, the hip flexors are released and the ribs are dropped, we can then progress to more targeted abdominal work focusing on sinking the abdominal wall. The trajectory is therefor: align the pelvis, release the rib cage, open up the hip flexors and then integrate low level abdominal loads.

My next post will go into more detail on each of these. 🙂

 

The Hip – Foot Sling

I’ve been talking about the Spiral Line, or how collapsing into the Spiral Line causes a downward spiral. I hope that what’s coming across is the fact that you are not just a series of parts fixed together, and that a holistic, whole body approach is necessary to address injury or pain.

Today I’d like to look specifically at the Hip and it’s role in the Spiral Line.

The hip is involved in the Spiral Line at two major points: the outer side, by the ASIS, and the back and lower side, by the sits bones. These two points are directly related to the arches of the feet via the Spiral Line.

If you put your hands on your ‘hips’, you’ve most probably placed your hands on the pelvic crests (The Illia). If you trace your fingers to the front of these two bones, that’s the ASIS. This point is connected fascially to the inner arch of the foot. The Spiral Line runs from the ASIS down the outside of the leg (the ITB), then crosses forwards from below the knee across the front of the shin and down to the inner arch (via Tibialis Anterior).

doc-21-feb-2017-12-09-1Tibialis anterior hooks under in the inner arch of the foot where it meets the tendon of Peroneus Longus at the base of the first metatarsal. Peroneus Longus runs from this point towards the outer side of the foot and up the outer (lateral) side of the shin bones. The line then continues towards the back of the thigh up the hamstrings and towards the sits bones (ischial tuberosities).

As you can see from the diagram, the tendinous insertions in the foot create a stirrup around the arch of the foot. However the really interesting thing is that this continuous line connects the pelvic placement with the arches of the feet in a sling like structure.

This is super important!!!!!!!!!!!

doc-21-feb-2017-12-10If the arches are dropping inwards there is a fair chance that your knees are rotating inwards and that your pelvis is tilted forwards. If you’re rolling onto the outside of your feet, there’s a fair chance that your knees bow outwards and your pelvis is in a backward tilt (also known as tucking under).

Remember that these are simplifications and no body is 100% of one thing.There are millions of variations of the above. Sometimes one side of the line is tight on one leg and lax on the other leg. (I will talk about this later when I look at whole body movement and the spiral line.)

Since my series has been focusing on the “Downward Spiral”, I will give you a few tips on how to work with the first of these patterns, where the arches are dropped and the pelvis is in a forward tilt.

  1. Do not stretch the hamstrings!* I often come across people with this pattern who insist that their hamstrings are tight. Actually, if your pelvis is in a forward tilt, then your hamstrings are too long, ie: they are in a constantly lengthened position under load. If you stretch them any more then they will just tighten up against this. They are actually too weak and need to be strengthened to encourage the pelvis to come more towards a neutral alignment. I’m sorry to say that this is a really tricky thing to achieve because the Hip Flexors at the front of the hip are often tight and therefore stop people from being able to access the gluts and hamstrings in exercises that should target these areas. Unfortunately, what tends to happen is that people just arch their backs instead, which just causes more problems. So before you can tackle the hamstrings themselves you will need to:
  2. Lengthen the Hip Flexors. The kneeling lunge is probably the best option, however if your knees are dodgy you can lie on your back with your pelvis slightly raised on a cushion and hug one knee in towards you.
  3. Engage the sits bones. Now obviously the sits bones are bones and cannot contract, but this image, that you often hear me give in class, is a key one for the functional integration of the hamstrings and gluts in hip extension. When you ‘narrow the sits bones’ you engage the top attachments of the hamstrings and the lower fibres of the gluts. This anchors the lower end of the pelvis so that the front of the hip can let go. You need to find this connection first before going into hip extension exercises like the bridge. My favourite exercises for this are either footwork on the Reformer or the matwork version which is supine leg slides.
  4. Do the Bridge.

It’s so difficult to describe these exercises in any detail. So ask me in class if you’re not sure about any of these.

*Generally speaking, if you notice that you have one area of your body that constantly feels tight, it’s a sign that it is being asked to do more than its fair share. A muscle that is constantly tight is essentially very weak. Stretching constantly is not a good idea. By looking at whole body alignment you can learn to achieve a more functional distribution of effort so that no one area ever feels constantly stiff. But that’s a point for another post altogether.

 

 

 

 

 

Piggy in the Middle

Do you remember that game where two people throw a ball to each other over the head of another player who is standing in between them? The ‘piggy in the middle’ has to run around like mad trying to intercept the pass, whilst the others play all sorts of tricks like ducking  or switching directions at the last moment. Yep, well, the piggy in the middle is a great metaphor for the knee.

When the ankle joint receives weight it is normally in contact with the ground. This restricts the movement possibilities within the ankle, providing a relatively stable base on which to stand (‘relatively’ being the operative word here). The hip joint is structurally stable being both deep inside the pelvis and reinforced by layers of strong tendons. In relative terms, the knee is in a much more precarious situation. In the downward spiral (my term, not a technical one), the knee has to accommodate the torsion created by deviations / restrictions above (in the hip) or below (in the foot) or both.

However, the knee is not designed to rotate! It’s a hinge joint. It is designed to allow us to flex in the lower limb. This decelerates the fall of the body, reducing the impact of the ground’s force when our weight is met by a hard surface. It should only move forwards (flex) or lengthen (extend – as opposed to hyper extend (that’s another story)). Restrictions around the ankle and hip force the knee into inward (knock knee) or outward (bow legs) rotation (- bow legs is not really a result of the Spiral Line collapsing, I’ll cover that on another post). Continuous torsion over time ultimately leads to injury. It’s the piggy in the middle, and all it can do is scream in pain.

doc-17-feb-2017-07-51-2

It is very rare that a knee injury is directly the result of poor functioning in the knee itself! (Dislocation and hyper extension are obviously an exception.) And yet the tendency is just to treat the knee with medications, massage and exercises that directly relate to the knee alone, instead of addressing the underlying cause of the torsion which may be in the ankle, the hip or both. No, I’m not saying you shouldn’t strengthen the VMO and release the ITB (if you have dodgy knees you’ll have come across these terms already). Unfortunately, we often only know about the pattern when the knee starts to create some noise, by which time damage within the knee itself has already taken root. So we then have a situation where we do need to treat the knee to relieve the pain. But the knee pain is a symptom of a wider pattern.

So how do we identify restrictions that may be putting a torsion strain on the knee before we get to that point of injury, and what can we do to reduce them? Here are some suggestions:

  1. When you next walk up a flight of stairs, look at how your knees move over your toes. Do your knees roll inwards or outwards? Both of these are a sign of some compensation. Try sending your knee directly forwards over your toes. It may feel strange, or effortful at first, but by gradually encouraging better alignment you start to unlock the poor pattern.
  2. Listen out for noise. It’s obvious enough, but constant cracking, popping and crunching in the knee is not a good sign. If it is on one side but not on the other (unilateral) then this could be a sign of whole body torsion (again, my term not a technical one), which is particularly common for people with a scoliosis or some other asymmetry (like a leg length discrepancy). Working to reduce the impact of this structural asymmetry on the soft tissue will help to reduce the constant pulling on the knee. You need to do a well rounded class that includes release and stabilisation for the pelvis and spine. Attacking the leg alone with a foam roller may just exacerbate the situation.
  3. Decompress the knee. If you are hearing clicking sounds in the knee and starting to experience pain you need to focus on decompressing the knee joint. The typical thing to do is to strengthen the VMO (the lowest fibres of the inner most quadriceps muscle) which helps to lift the knee cap, whilst releasing the ITB (the tough tissue on the outer side of the leg). You should also look to lengthen the hamstrings. (My next post will look at functional use of the hamstrings.) But you cannot ignore the lower leg. The muscles in the lower leg also tend to tighten up, especially the ones around the outer side (the peroneals), these are particularly hard to stretch, and are often by-passed in people with dropped arches. The Feldenkrais variations of calve stretching described in the video on my previous post will massively help to relieve this tension. Try to avoid really tough stretching. Work on creating glide between the layers of muscle instead.
  4. Strengthen the muscles around the hip. This will be covered on my next post.

Warning: Listen to your body. The aim is to move without pain and no blog can really tell you how to assess and correct your movement. Speak to a professional and get them to give you some feedback on your knee tracking. Just remember, the cause is not normally in the knee.

🙂

My next post will look at the hip – foot sling.

On Presence

Sometimes I think that the word ‘mindfulness’ is a little unhelpful. It conjures up an image of sitting quietly for hours everyday, silencing your thoughts and listening to your breath. Apart from the fact that this is not a realistic target for most people, I think it can give a very ‘brain centred’ image of the practice.

When I first came across the word in yoga 15 or so years ago, it seemed to me to be the opposite of mindlessness. Rather than moving without attention and awareness, moving mindfully is about consciously engaging in the movement, being present in the movement, ie: not switching off and thinking about your Tesco’s shop whilst doing a downward dog. The practice of mindfulness has been abstracted from this into a practice on its own. The goal is to be fully present as opposed to absently allowing the mind to drift into the past or future. It suggests a way of achieving the ‘Zen’ without the acrobatics, making it more accessible. But in a way this approach just propagates the dualistic mind-body split that we seem to be addicted to in our culture.

To be fair on the mindfulness practice, they do often use the body and breathing as an anchor to meditative practice. But I just find the static nature of the task to be quite painful. Don’t we spend enough time sitting?!

When I first started teaching I struggled with how much to expect clients to listen and follow my directions. I guess that, because Pilates involves lying on your back for a while (or at least to begin with), it can seem like an opportunity to switch off. Sometimes people show up for a class and spend most of it trying to sleep. (Of course I don’t mind that: if they are really that tired then they absolutely should sleep.) Then there are people who just want their bodies to be taught whilst their minds drift off. Funny ha? But surprisingly common too. They treat their bodies a bit like they treat their cars: they’ve no idea how they work, they just need them to function. When they don’t work, they rock up at the mechanic and ask for it to be fixed. This split of mind and body is a deeply ingrained attitude that the fitness industry has tended to reinforce. I’m sorry to break it to you, but there is no dream set of exercises that will fix your knee pain, give you back that flat stomach or make you lose that weight. The reason for this is that we are genetically pre-disposed to economise, to cut corners, to cheat. Mindless movement is just giving license to all your bad habits which are usually the reason for your pain in the first place. The only way to achieve pain free movement and a healthy weight is to wake up and be present in your movement, which is why concentration is one of the principles of Pilates.

Now I also know some people who use exercise as an opportunity to switch off and genuinely believe that this “dream time” does them good. Well, there is a reason that mindfulness has become so popular and that’s because the evidence suggests that being ‘present’ is key to our general sense of happiness. I recently came across this article by Maria Popova where she quotes Alan Watts writing in 1951! I don’t think I’ve heard the argument for presence articulated so well:

What keeps us from happiness… is our inability to fully inhabit the present… our primary mode of relinquishing presence is by leaving the body and retreating into the mind — that ever-calculating, self-evaluating, seething cauldron of thoughts, predictions, anxieties, judgments, and incessant meta-experiences about experience itself.

I speak here simply from the point of view of a movement teacher, from my own experience of different exercise forms, and from my own battles with silencing the endless chatter in my head. This is what I think: if you are mindfully engaged in your movement practice, not only do you move better and achieve more, but you will also be happier.

Here are a few suggestions for being more present in your movement:

  1. Join a class – Being in a class gives you some kind of anchor (the teacher’s instruction, verbal cues and hands on correction) that keeps you mindfully engaged in what you are doing. In this state you are more likely to work effectively because you cannot switch off and slip into the easier habits that you have unconsciously learned in order to minimise effort. The good news is that by listening in, staying in tune as it were, you are not only going to gain more physically, you will also be practicing mindfulness.
  2. Choose classes and teachers who will support your mindful practice – So this one is a bit of a tricky one because there are a few teachers who, to my mind, have forgotten the point of the practice. I’ve experienced and witnessed many teachers taking clients through a practice whilst chatting away nineteen to the dozen about their kids schools, what they did on the weekend and the state of their garden, intermingled with “now sink your belly and wrap the backs of the legs together…”. I know I sometimes joke about how I take my Pilates very seriously, but I’m sorry there is a balance and too often it’s being tipped away from mindfulness. By it’s very nature, the equipment studio and private sessions are a more relaxed, informal environment than the matwork class, so it’s natural (and right) that teachers develop a relationship with clients. My philosophy on this is to allow the client to lead this. It may be that they really need to get something off their chest, or they’re lonely and I’m the first person they’ve spoken to that day. But after giving some space for this, I try to gently encourage them back to the practice. Luckily for me, this is what I’m good at, teaching. I’m terrible at small talk. But if you have a teacher who keeps drifting into chatter, I suggest closing your eyes and focusing on your breathing. You could also ask a question about what you’re doing. It takes some discipline, but if you stop engaging with the conversation, they’ll soon get the message. It’s your class after all!
  3. Change something – If you always go to the same class, run the same route, do the same sequence of swimming strokes, then mix it up. Not only is this better for your body, but it requires a different attention.
  4. Practice Awareness through Movement – So you know how much I constantly go on about Feldenkrais? Trust me it is pure genius. The deepest way to learn about your own movement is by listening to your body. Yes Pilates is good for you, but Feldenkrais is like the abc of moving. You could join a class (check out the Feldenkrais Guild Website) or, for the time poor, you can access free classes online. The Feldenkrais Guild website has a number of short audio classes on their resource page. If you do a short session before you go off for your run or swim, you’ll tap into something different.

Let me know what you think and how you get on!

 

 

The Key to a Healthy Lower Back is in the Gluts

Lower back pain is one of the most common complaints that I deal with in my work as a Pilates teacher. In fact it is one of the main reasons most people take up Pilates in the first place (myself included!) And yet whilst the issue is so common, and can be extremely debilitating in the worst cases, it amazes me how little it is understood.

If you look at the spine in relation to the rest of the skeletal structure, you can see how the vertebrae of the lower back are relatively exposed. Whilst the sacrum is closed in by the pelvic bones and the thoracic vertebrae articulate with the rib cage, the lower back is not supported by any other structure. At the same time it bares the weight of the upper body and, being more mobile than the thoracic spine, tends to become the pivot point for a lot of spinal movement.

Excessive over-use of joints under load will bring about gradual wear and tear. In simple terms, this is what causes most back pain.

The traditional / standard prescription for lower back pain sufferers is: strengthen the ‘core’, by which most people mean ‘abdominals’. Of course there is some sense in this. If you strengthen the muscles in the lower abdominal area, then you create functional support for the joints of the lower back, reducing strain.

The key core muscle for lower back pain is the TVA. This wraps horizontally around the waist like a corset. Activating the TVA brings about a lengthening sensation through the whole spine. Up the back the spine is supported by a series of layers of muscles. These are relatively weak in the average person because so many of our daily activities tend to involve collapsing into a forward bending position.  A third component of the ‘core’ is the pelvic floor. Postural deviations tend to put more downward pressure on the floor of the pelvis which becomes weak and loses it’s buoyancy. So strengthening these three areas could go some way to reducing back pain.

However, the presence of pain in any joint is a signal that there are restrictions higher up or lower down the chain that are causing the over-use in the first place. What I’ve come to realise is that ineffective use of the musculature around the lower back is the result of poor integration with other parts of the body, and specifically, with the hip joints.

I’m going to give you two examples to illustrate this. These two postural tendencies are ones I know well. I have clients who present with both. I am simplifying by only considering forward / backward movement. Posture is three dimensional, so this clean side on view does not account for compensation patterns in other directions of movement. We’ll leave that out for the sake of this argument.

Doc - 17-03-2016, 10-37The first postural type that I come across in lower back pain is when the pelvis is in a slight backward tilt as illustrated in my sketch. We call this a ‘tucked under’ posture. This is an extremely common postural type and one that, funnily enough, Pilates can actually encourage! I have come across numerous lower back pain sufferers who actually adopt this position to relieve the pain. Actually they’re just de-stabilizing the lower back even more. When someone walks into a matwork class, one of the first preparatory exercises they are told to do is the pelvic tilt. I’ll hold my hand up here: this is exactly how I begin my classes! Someone with this tendency is likely to just press into their lower backs. The second preparatory movement is to take the spine into a bridge, where the cue ‘rolling the spine down bone by bone’ also encourages people to collapse into their lower backs further.

Doc - 17-03-2016

The second postural type is the anterior pelvic tilt. Here the hip flexors are tight, pulling the pelvis into a forward tilt. The lower back becomes shortened creating the exact opposite to the first postural type. Someone in this position may well benefit from the initial pelvic rocks, which will create some traction through the lower back area. However as soon as they begin moving into the bridge their lower backs begin to arch, amplifying the extension (shortening) of the lower back. Another very common problem in this postural type in particular is the loaded flexion exercises like the hundred, single leg stretch, double leg stretch. All of these will just go into the hip flexors making the situation a lot worse.

So whilst the long term effect of abdominal strengthening and traditional Pilates repertoire will be beneficial for the support of the lower back, in the short term they may simply play into the problem and make it a lot worse.  Rather than focusing solely on the ‘core’, both these postural types will benefit more from working on a common area of under-use: The Gluteals.

The buttocks are one of the most misunderstood areas of the body. Some people just think of the butt as something they wish was smaller (or bigger). Some people feel embarrassed about the thought that they have one and most people don’t realise that whilst it can be an area for fat storage, it is also the site of a major muscle group. Gluteus Maximus is the main hip extensor (ie: it opens the front of the hip) and Gluteus Medius and Minimus stabilise the hip (stopping us from falling over when we stand on one leg). When these muscles are under-used the deep hip rotators ( whose aim is primarily to rotate the thigh bone outwards) end up having to do a lot of the work. A lot of people have heard of a tight Piriformis, for example.

In the case of the first postural type described above, the hip remains in a chronically extended position where the deep hip rotators are literally tacking down the back of the pelvis towards the thighs. This tucked under position means that the gluts are unable to perform as an intermediary between the legs and the lower back, so people with this tendency are literally hanging their legs off their lower backs.

If the hip is not taken into extension enough, then it remains in a flexed position, (the second postural type described above). This leads to over-tight hip flexors and the increased lordosis (arch) of the lower back. As a result of the imbalance, the pelvis comes into a forward tilt making lower back articulation very difficult.

The key to a healthy lower back is to have tone and access to the gluts. This is not a question of mindlessly targeting the buttocks in repetitive exercises. It’s about ensuring that there is the right balance of movement around the hip to allow the gluts to fire up in the first place. Every body is different, and I don’t want to start suggesting exercises over blog posts. But perhaps the following points may help you make some adjustments that could help:

For people with a tendency to tuck under the key is: FOLD AT THE HIP! Stop sitting onto your lower back. When you sit down on a chair try to find your sits bones and sit right onto them. Almost imagine the tailbone pointing backwards which will bring the pelvis into a small forwDoc - 29-07-2016ard tilt, reducing the pull on the lower back. Often achieving this is difficult because the deep hip rotators are tight. So doing a seated glut stretch is a really useful way to create space in the hip joint which will allow the spine to lengthen upwards when sitting.

For people with a tendency to tilt the pelvis forward and arch the back, the key is to OPEN THE HIP. Most of us have tight hip flexors, so doing some Hip Flexor stretches like the kneeling lunge will help create some movement here. Once you’ve found a sense of opening the front of the hip, without letting the lower back, arch you can translate this into walking by leaving the back leg in contact with the floor for longer. This has the effect of lengthening your strides and though it may seem like it’s slowing you down initially, you’ll notice that you’re moving much faster in fact.

These are just a few points that you’ll already know if you’ve done any work with me. Next week I’ll talk a little more about how the tilt of the pelvis connects with and is affected by the feet.

 

Quality not Quantity

I think it’s time we all stopped talking about ‘eating less and exercising more’ as the key to weight loss. It is not. Restricting calorie intake and increasing exercise leads to an input / output mentality that ties many people into an obsessive cycle. Yes it works in the short term, but in the long term it is unsustainable and can bring about a very negative relationship to both food and exercise, which only re-enforces the negative spiral. As the biomechanist Katy Bowman says in ‘Move your DNA’:

There is great debate over the generalized calorie-in-vs.-calorie-out theory when it comes to weight loss. Despite this theory seeming like a no brainer, it isn’t. Metabolic science is hugely complex and there is much left out when we fill the “calorie-out” side of this coin with “exercise” and research whole-body metabolic activity questionnaires, pedometers, and other ‘easy-to-quantify’ but indirect and inaccurate measures of energetic expenditures.

As a teenager I was completely obsessed with my weight. I loved dance and spent most of my free time at the ballet school. I matured early and had pretty much the body I have now when I was 11 years old. Still, I dreamt of becoming a ballet dancer and thought I needed to be stick thin to achieve this. Unfortunately teachers at the ballet school actively encouraged me to lose weight. The way I did this was by skipping meals, going through whole days on no food and then, starving by the evening, eating dinner plus lots of bread to make up. Luckily this never really progressed into a serious eating condition, but so began my difficult relationship with food.

When I moved to London to train at a professional dance school things got a whole lot worse. I had no concept of how much to eat or what to eat, for that matter. Like most first time Londoners I gained 5kgs even though I was spending most of my day dancing! For the rest of my training and a few years after that my body clung persistently to those extra kgs. The worst thing of all was that I expended so much of my energy just wanting to be thinner that I missed out on what I was really there to do. After leaving college I did about 3 different part time jobs. I would be in the gym at 7am, workout for an hour and then go to professional class at 9am before heading to work till 8pm or 10pm. Everyday! Still, my body held on to those stubborn kgs. I was killing myself on the treadmill every day, and barely eating.

By this point my main work shifted to a gym, so now I was around fitness fanatics all day long. I was having to stand up at the reception desk for 8 hours at a stretch and realized that my back was aching. I was forced to see an osteopath who basically told me to go and do Pilates. I decided to do the Teacher Training instead. The course I did was matwork only and spread out over a whole year. I started to learn how to move again and finally had the tools to train myself. By the end of the year I had lost the excess weight and now rarely go over my happy weight. The best thing is that I was also stronger and more flexible than ever before too.

Yes I am going to say it: the difference was Pilates. Why? Because instead of focusing on quantity of “exercise” I was finally working on the quality of my movement. Quality is the key ingredient that is missing from the ‘eat less exercise more’ paradigm. It’s not what you do, it’s how you do it that counts. The reason for this is that our bodies are programmed to try to conserve energy. Technique, and the watchful eye of a teacher, is the only way to access the benefits of a movement without causing injury and strain elsewhere. When you work your muscles effectively, you gain strength without shortening and tightening up. This raises your basic metabolic rate. Now your whole body is using up more energy even at a resting state. The initial mindful investment of energy goes to work for you for the rest of the day, a bit like a financial investment. People earn money by doing work, exchanging their time and energy for money. But people become wealthy because they invest that earned money in assets that go to work for them. It’s the same story with weight loss. If you detach yourself from the direct relationship between input and output and focus on quality output and quality input, your body will do the self regulation so you can just get on with your life.

Since my epiphany I have been baffled by the crazy things people do in the name of getting into shape. No you do not need to starve yourself and run laps around your park every day. And for those who still think this is the way forwards you may be surprised to learn that being programmed towards efficiency, the more you do something the more efficient your body becomes at doing it, ie: the less calories you burn. This is how it’s possible to run a marathon and still have a potbelly.

Now to be clear, my situation, and that of many of my clients, is very different to that of people who are obese. Obesity brings with it further complications and may actually require an eat less and move more initiative to get the initial weight loss going. Pilates can help to get the spine and joints moving and reduce the strain that the additional weight puts on the body as a whole. (Every now and again I have to carry small weights around to my clients. It’s amazing how painful carrying 2kgs extra can be!!!) Luckily few of the people I work with are in this category. Most just want to lose a few kgs off stubborn areas and these are the people I’m talking to here.

My issues with eating lingered for several years until I started living with my ever-wiser older sister who literally taught me how to eat. If you’re stuck in the negative input-output trap, there is a way out: eat proper food, join a Pilates class, do a little cardio that you enjoy and get on with your life! Exercising more does not necessarily burn more calories. It’s quality not quantity that counts and yes, Pilates does help.