Moving is a Must: But Why?

One of the most common questions I am asked during treatment sessions as a physical therapist is “Why are we doing this?” Or “What is this doing for me?”

As the therapy provided at the Wellness Station is movement-based, it is important to understand why movement is so critical for our health, quality of life, and physical function. The movement lessons facilitated are typically targeted directly or indirectly at a biomechanical or neuromuscular issue. The specific movements may establish a refined sense of clarity and improved efficiency for someone experiencing difficulty with a daily activity, such as bending and lifting, going up or down stairs, reaching overhead, sitting for a prolonged time, and much, much more. While the rationale behind specific movement lessons may address specific individual factors (e.g. lack of muscular strength, excessive tension in certain areas, less than optimal form or alignment), sometimes overly focusing on the mechanics and the specific “benefits” of performing a movement can take away from the experience. When clients ask me those questions (e.g. “What is this doing for me?”), I often turn the question back around to them, and may ask something like “What are you feeling and sensing in your body as you do this movement? How might this relate to the issue in your daily life that you described?” For example, a lesson that involves torso side bending might make reaching overhead easier and possibly replace a prior inefficient overhead reaching movement that was a factor contributing to the discomfort. 

It might be helpful to understand a little about why we have a nervous system. While this is an extremely broad and complex topic that is the subject of many books, the nervous system can be simplified as the “control center” of ourselves as organisms. Control is necessary to achieve a preferred mode of function, and our nervous system can help correct and adapt when the preferred mode is not present (similar to the concept of homeostasis, or seeking balance). Our nervous systems allow us to react to and adjust to our environments in order to manipulate them.1 The structures of our nervous system look for order in the random, and create order when it is not present. As we move around and manipulate the outside world, our nervous system allows our muscles to move our bones, reacting to our environment to maintain order within our tissues. Our nervous systems likely evolved in the first place to allow us to move as the conditions of life required it, perhaps to move away from danger or incompatible conditions and towards resources and safety. In other words, we have a brain so we can move. Movement is a necessary condition for our life as a complex organism. If we can move more optimally, we can live more optimally.

As the modern world is an environment in which it is less of a short term requirement to move, many of us simply move less, or become sedentary. Our food? Delivered. Going somewhere? The car does it for us. Going up a level? Elevator. The cleverness of the human mind has contributed to extremely useful innovations in technology that can make our daily lives a whole lot easier, but these modern conveniences actually can rob us in the long term. If we were built to move but our environment no longer requires us to move as much, how do our bodies respond? Over the long term, not favorably! For this reason, we need to intentionally move our bodies, move for the sake of moving, and hopefully enjoy doing it!

Finding Joy

On a fundamental level, all of us can find joy in movement. Think about the sheer joy of babies, first discovering how to roll over, bring their foot into their mouth, pick up a toy, and stand up. Movement can be a richly rewarding experience. Rather than seeing exercise as a chore that we must do to strengthen certain muscles, improve fitness, etc., can we tap into the joy of movement? This enjoyment will serve as a motivating factor that will encourage us to move more often in a variety of ways, which will ultimately be more beneficial in our lives than trudging through exercises we find to be boring or uncomfortable. This might be dancing, Feldenkrais lessons, yoga, swimming, walking, lifting weights, or simply rolling around on the floor! Find something you enjoy, and do it very often.

Regulating Nervous System

As we learned, we move because we have a nervous system. Our nervous system allows us to move. Thereby, engaging in movement is an excellent way to regulate our nervous systems. Mindful movement helps us focus our attention on the present moment, increase the release of neurotransmitters and hormones that support our mood and mental health, and can help to downregulate excessive tension that we hold in our muscles. This regulation of the nervous system through movement can help bring us from a sympathetic state (fight or flight) to a more calm and pleasant parasympathetic state (rest and digest). This can positively impact our experience of pain, mental health, and the function of our organs.

Learning To Learn

Engaging in new movements is an excellent way to learn. Participating in Feldenkrais lessons is essentially learning about learning! It can be an eye-opening experience to become aware of how we react to new challenges. When we are attempting to learn something physical, are we able to maintain an open mind? An ability to be kind and patient with ourselves? Or do we have more of a tendency to push, strain, over-effort, or give up? Practicing “learning” movements can help expand our brains, which can be helpful whenever we have to learn something new whether that be a new movement, a musical instrument, a language, or something we encounter at our jobs or in school.

Nourishing Tissues

The tissues of our body are deeply dependent on movement in order to be healthy. Our joints require frequent movement in order to circulate lubricating fluid (synovium) to keep healthy, gliding surfaces with minimal friction. Our bones require weight-bearing movement in order to maintain their density. Our muscles require challenges in order to get stronger instead of weaker. Almost all tissues in our body require blood flow in order to receive oxygen and other nutrients to stay alive, healthy, and comfortable. Movement fills our muscles with fresh blood, and cardiovascular activity helps to circulate blood with more gusto throughout our entire systems. 

There are many, many reasons to move your body. It might be helpful and more rewarding to consider movement as a gift or a privilege that we get to do. Moving away from the “how is this helping me” mindset and tapping into appreciation of the miracles of movement may motivate us to move more, allow us to feel more human, and keep us healthy and mobile as we age.

References:

Feldenkrais Moshé. (1981). The Elusive Obvious. Meta Publications.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

The Carpenter or the Gardener: Which One Are You with Your Body?

One’s participation in physical therapy can certainly reflect either more of a gardener or a carpenter mindset. Many clients come to us who have clearly been to physical therapy in which they were influenced by the carpenter mindset, which may have negatively impacted their experience.

According to Alison Gopnik, parents fall into one of the two categories: gardeners or carpenters. Put simply, a carpenter is one who thinks their child can be molded, whereas a gardener provides a protected space for their child to explore. The psychology and philosophy professor described these two styles of parenting in regards to raising children in her book, The Gardener and the Carpenter. This book is worth a read, but if you are more of a listener, her podcast on the Ezra Klein show is great to listen to on a walk or car ride.

In addition to illustrating the two styles of parenting, Gopnik describes how and why it may get more difficult for us adults to learn as we age. The process of aging itself is not the primary reason it becomes more difficult to learn, but more so our tendencies towards being a “carpenter” rather than a “gardener”, which is propagated by our culture’s celebration of efficiency and hard work over play and exploration.1

In regards to parenting, a carpenter is one who thinks their child can be molded into a particular kind of person. Want them to be a successful doctor or lawyer? Have them spend more hours studying. Why spend time playing on the playground if time could be spent practicing crucial life skills that they will need as an adult? The tendency of a carpenter is to put more effort into everything if you want better results. The irony of the situation is that play is pretty much the most important thing a child can do to ensure they will be successful as an adult. The time spent playing and exploring is absolutely crucial for a child’s rapidly developing brain, as play allows us to learn how to respond to unexpected situations, create, imagine, work well with others, and problem solve. Motor skills are developed by exploring movement in a variety of stimulating situations and environments, which simply cannot be taught in a classroom. For gardener parents, this goes without saying. Those with the gardening style are not concerned with controlling their children and who they will become, but rather providing safe spaces and experiences to allow their children to explore. This style facilitates a dynamic and nurturing environment in which a child is intrinsically motivated to learn, explore, create, and connect.

How does this apply to us adults? Many of us lose our child-like minds as we go through life, seek fewer new experiences, and develop habitual ways of being. We are less likely to question the status quo, spend less time engaging in “play”, and may find it more difficult to learn new ways of being and thinking. Although this is partly because of the pruning that the brain does as we emerge into adulthood (inhibitory control develops which impacts decision making and decreases impulsive behavior)2, it is likely more related to cultural influences. This shift that occurs can be tied back to childhood, as the traditional educational systems tend to fit the “carpenter” model. As we go through childhood into adolescence, we are encouraged to forget about play. We are taught that we must fit into a specific mold measured by standardized tests, and more effort will make us more successful adults.

When it comes to a physical injury or mobility issue, the carpenter mindset can impede our healing. We may become limited in our ability to explore our bodies in a healthy, nurturing way, for our carpenter tendencies might lead us to believe that we have to be strict, rigid, and “correct” with the way we engage with ourselves. 

Let’s consider the example of the supine pelvic clock, a foundational movement of the human body that anyone who has been a client at the Wellness Station is likely familiar with. It is done in a lying down position with knees bent, with the idea of an imaginary clock underneath the pelvis (12 would point towards the head, 6 towards the feet). This type of movement is also commonly prescribed in traditional physical therapy, although typically referred to as a pelvic tilt. The manner in which it is taught might be more reflective of the carpenter mindset, which can detract from the experience.

Consider the following hypothetical conversation between a “carpenter” physical therapist and a client:

Carpenter

Client: How do I do this movement?

Therapist: Tilt your pelvis to flatten your low back against the ground. 

Client: What is this doing for me? 

Therapist: You are finding the correct position for your back- this will protect your spine and strengthen your core. 

Client: What is the correct way to breathe?

Therapist: Breathe out as you flatten your low back, breathe in as you go the other way. 

Client: How many should I do? 

Therapist: Perform three sets of 10 repetitions of this exercise.

Now, same questions but the gardener therapist: 

Gardener

Client: How do I do this movement?

Therapist: Begin to rock your pelvis towards 12 o clock by pressing through your feet and allowing the space between your low back and the ground to decrease. Now, move your pelvis in the opposite direction, towards 6 o clock, allowing the space under your low back to increase.

Notice which parts of you begin to make more contact with the ground, and which parts might lift away.

What sensations are associated with going towards 12? How about going towards 6? Which body parts do you feel are moving? What can you do to bring more ease and comfort into this movement pattern? What variations of this movement pattern can you explore? 

Client: What is this doing for me? 

Therapist: This is a foundational movement of the human body that is providing an opportunity for learning to occur. We can use it to calm the nervous system, improve awareness and ease of movement, and gently stimulate areas of your body that may be contributing to your pain patterns. 

Client: What is the correct way to breathe?

Therapist: Rather than believing there is a correct and an incorrect way to breathe, recognize that life is dynamic and our bodies will naturally breathe for us in ways that will depend on the situation. Begin to become aware of how your breath is responding to the movement. Is there a feeling of synchrony between breath and movement?

 Client: How many should I do? 

Therapist: Take your time exploring this movement, and rest often. There are no specific number of sets and reps that I will prescribe. It is up to you to listen and respond to what your body is asking for. Once you do not feel like being attentive to this movement anymore, it is time to explore something else.

It may be clear that the actual movement is not as important as the context and the manner in which it is performed. Embracing a child-like mind and a “gardener” attitude in relation to the body is the recipe for healing and graceful aging. Our bodies have the tools they need to heal, but we must provide the right environment in order for them to heal. Healing requires an environment that is nurturing, compassionate, and dynamic, the same kind of environment we hope to provide for our children. Throughout your experience in therapy and beyond, consider moving away from the rigidity of a carpenter mindset, and begin to consider how you can become a gardener for the sake of your healing journey. 

References: 

1.https://www.npr.org/sections/goatsandsoda/2018/05/28/614386847/what-kind-of-parent-are-you-carpenter-or-gardener 

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721973/ 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Wellness Station for Athletes: Hit or Miss?

We have been asked before whether our approach here at the Wellness Station is suitable for athletes. Regardless of age and sport, the care provided at Wellness Station can be extremely beneficial, as we are able to offer care that typically isn’t found in traditional physical therapy practices. Most athletes, particularly in high school or college, are well exposed to strength training and conditioning. Traditional rehabilitation for sports injuries tends to follow this formula of repetitive and progressive loading of the injured area.

What these athletes are not exposed to is neuromuscular re-education and self-care strategies that will help them heal from their injury and minimize the chance that future issues will occur.

When it comes to athletes, our approach truly shines when it comes to recurring injuries. Traditional PT may be great for an athlete with an acute one-off situation, e.g. a football player is tackled and sprains their ACL, etc. However, more often there is an underlying pattern at play, particularly for athletes with a history of repeated injuries. This may look something like tendonitis that pops up in multiple places, a history of concussions, back pain following athletic events, and so on. What we address here is not one body part in isolation, but how the body works together as a whole using biomechanical principles. Traditional rehab generally does not address the underlying movement patterns that may be setting these athletes up for injuries in the first place. We can help athletes to become aware of dysfunctional patterns and habits that may be detrimental to their performance, and provide movement lessons to stimulate kinesthetic learning and positive changes in these areas.

Athletes are very used to being told to push, push, push. Train harder, faster, and stronger. If dysfunctional movement patterns are at play, pushing harder will only add fuel to the fire. Additionally, the mindset of only pushing harder creates a relationship in which the athlete only works on their body, and has difficulty working with their body. The sport itself becomes work, and joy can start to be removed from the equation, potentially leading to burnout.

For sustainable performance, the athlete must unite mind and body into a state of flow, recognizing their own limits and honoring them.

The ability to slow down and listen to one’s body is often completely missing for most athletes, as they are so accustomed to being rewarded only for external achievement. The approach here at the Wellness Station can help athletes to reconnect to their bodies and find joy in movement. This facilitates a deeper connection with one’s body, thereby improving intrinsic motivation for the sport. This will help athletes improve their performance over the long term, avoid repetitive strain injuries, and find more enjoyment in their sport and daily lives. 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Effort vs Discipline: Creating a Sustainable Home Exercise Program

A sustainable movement practice is not about doing easy things- it’s about making difficult things easy, and even elegant.

Think back to a time where you may have had difficulty with the sustainability of your home exercise program. Perhaps you attended physical therapy for a while, but would not find time to practice your exercises at home. Or you did for a while, but after stopping therapy, the exercise routine started to fade away. Maybe you found you lacked the discipline or the motivation to perform the exercises regularly.

On the other hand, perhaps you had an exercise routine that was simply too much. You put in excessive effort into it, and you found that it was energy-draining, and perhaps actually felt worse after doing the exercise rather than better, and eventually you began to avoid it. These kinds of routines are not sustainable- they do not last over time. 

What are some keys to creating a sustainable routine to maximize the therapeutic effects? Finding the balance between effort and discipline is very important. We want to have discipline- the ability to train ourselves in a consistent, habitual way. However, we don’t want our movement routine to be overly effortful. If we put in too much effort into the movements, we won’t look forward to doing our routine, because it will drain our energy and not be very enjoyable.

You may recall that Feldenkrais-inspired movement lessons emphasize whole body coordination and thus the same action is now accomplished with LESS EFFORT -that is why, especially to children, highly skilled athletes make very difficult activities look easy!

Rather than striving for a strict discipline in which we force ourselves to go through effortful motions, how can we develop a sense of playful discipline, in which we regularly engage in enjoyable movements?

One mantra to consider is a little bit, very often, with ease. It can be difficult to develop a consistent routine in which we are engaging in movement very often. Some helpful strategies could be creating a safe space to dedicate to movement at the same time every day, perhaps first thing in the morning. This may start out as a very short time, five or 10 minutes, and may gradually expand as it becomes more habitual. Gentle movements should also be sprinkled throughout the day, especially during prolonged sitting. One might consider a reminder system such as a phone timer for a brief movement break each hour, or putting up sticky notes near the computer screen. After the initial growing pains of establishing these lifestyle habits of moving very often with ease, positive habits will be formed that will make it much easier to sustain these changes over time. 

An excellent way to build discipline and improve motivation is to focus less on the outcome, and more on the experience. For example, consider healthy eating habits. One strategy is to educate people on how terrible sugar is for you, and all the health benefits of green vegetables. This strategy actually might not be that helpful because it focuses too much on what we should and should not do. However, most of us have a tendency to crave things that perhaps we would be better off without. Only engaging in things we “should” be doing can be draining on our will power. A better strategy would be to fully engage in the experience of a positive health behavior. Take time to slow down and enjoy that delicious veggie bowl. Consider all the nutrients that soaked in from the soil and sunlight, the stunning visual of all the colors, the smooth or crunchy textures, the explosion of tastes in your mouth, and the embodied sense of nourishment after giving your body the building blocks it needs.

Now, apply this to movement! Try not to force yourself to do something just because you think you should be doing it. How can you fully experience the movement? What sensations can you feel? How might it be nourishing your tissues? What can you learn about your body and your tendencies while engaging in movement? What can you have gratitude for in regards to how your body functions? How might this impact the quality of your experience and your relationship with healthy movement practices- and your whole self?

Rather than striving for a strict discipline in which we force ourselves to go through effortful motions, how can we develop a sense of playful discipline, in which we regularly engage in enjoyable movements?

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

All About Awareness

What is awareness, and why is it important?

Awareness can be loosely defined as perception of a situation. If we are in a state of awareness, we are perceiving what is happening in the present moment with clarity. Focusing our attention into the present moment, also known as mindfulness, has been shown to improve our health and well-being in many ways. Randomized controlled trials have demonstrated that mindfulness interventions can improve pain for those of us suffering from chronic pain, and also may be helpful in the outcomes of stress-related illnesses such as PTSD, Irritable Bowel Syndrome and more.1

The state of our mind greatly impacts the state of our bodies. If our mind is frequently jumping around to anxieties rooted in the future or regrets from the past, it is likely that we are operating in a sympathetic nervous system state, which comes with the release of cortisol and adrenaline, contributing to tense muscles, rapid breathing, raised blood pressure, and impaired well-being. What we do with our attention has been shown to impact many physiological functions in our body- by training the mind to focus in the present moment, we can boost the vitality of our immune system, improve our cardiovascular health, support healthy sleep, deepen our relationships with others, and even increase longevity.2

How does awareness apply to movement?

By paying attention to movement in the present moment without being shackled by self-criticism and judgment, we can find joy and relaxation during our movement practice. By making movement a meditation, we can shift into a parasympathetic state of the nervous system, which is consistent with our relaxation response (decreased stress hormones, blood pressure, etc.) This is contrary to distracted movement in which we may be rushing, thinking about other things, and neglecting to respond to sensations in our bodies. Awareness during movement also facilitates learning: where attention goes, neural activity flows. By paying attention to how certain body parts are moving, we increase connections in our brain that help us to feel and move these areas, as well as integrate these body parts with our whole being. Attention combined with consistent practice over time can actually change our brain structures, facilitating healthy adaptations in our physiology and the ability to move with greater ease and efficiency.

Over time, awareness practices help to change the relationship we have with our body. Judgment, criticism, and fear begin to melt away, and are replaced with self-compassion, body wisdom, and enjoyment of moving for the sake of moving. By paying attention to our movement in this way, we can calm our nervous system, decrease pain, improve our movement, and turn a seemingly simple motion into a profound learning experience.

Well, what about when I’m doing other things? Do I always have to pay such careful attention?

An excellent question that many clients will ask. For most people, it isn’t realistic to be 100% attentive during every waking moment! With a Feldenkrais-inspired movement program you are improving old or learning new action patterns. By the very nature of engaging in challenging but not overwhelming movement patterns, you are stimulating the neuromuscular system in such a way that inherently brings us to an attentive state. And once that pattern has been established and repeated, myelin thickening around the nerves improves the responsiveness of our intent and subsequent actions, we no longer have to think about it so much, it becomes automatic.

A Mindful Movement Practice

Take a couple minutes to practice this gentle lesson:

Begin by lying comfortably on the floor with bent knees (or a bed if the floor is not accessible). Imagine there is a little clock underneath the back of your pelvis, with 12 o’clock pointing towards your head, and 6 o’clock towards your feet. Begin to tip your pelvis between 12 and 6. This pelvis tilt goes along with an arch of the low back towards 6, and rounding of the low back towards 12.

Rather than just going through the motion and assigning any judgment to how far you’re able to go in each direction, if you are doing it “right” or “wrong”, or what “benefit” this exercise might have, try to tap into your embodied senses. Notice any sensations you feel. Pressure? Tightness? Where exactly do you feel the sensations? Can you feel certain muscles engaging or releasing?

Is there a way to carry on the same movement but in a way that feels more comfortable or easy? What micro changes can you make to improve the experience for you?

Then begin to notice what is moving. We know the pelvis is moving, and the low back is as well. As you continue to move, what other parts of you seem to be moving or engaging? What do you notice in your hips? Rib cage? Head? What seems to be pressing down, and what is lifting up? Perhaps you notice that as you pay close attention to your movement, the more you become aware of.

References: 

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613793/#:~:text=The%20effects%20of%20mindfulness%20on,and%20ultimately%20improves%20health%20outcomes).

2. https://health.usnews.com/wellness/for-parents/articles/2018-05-30/enhance-your-awareness-to-improve-the-well-being-of-your-family

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team