Physical Therapy

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

Turning Chores into Cheerfulness: PT in the Kitchen

How often do we all find ourselves in the kitchen, scrubbing away at the never-ending pile of dishes, chopping, cooking, wiping surfaces, sweeping, and otherwise trying to get back to the baseline cleanliness that we hope to maintain? For many of us, these activities are a chore, and we look forward to being able to put our feet up and bid the kitchen farewell. For those of us with mobility issues and/or pain, standing for a long time in the kitchen while performing these highly physical tasks of bending, reaching, and turning can become extremely tiresome and even insurmountable on a bad day.

Here are a few tips and tricks for turning these dreaded chores into a much more enjoyable experience:

Try silly moves!

Turn your kitchen activities into a dance. Turn on your favorite music that gets you moving and grooving. Sing along and dance to the music as you wipe down counters. Glide your hips around as you scrub the dishes. Take a break every so often from the task and just move to the beat. This will make the activity far less repetitive, it will allow you to move your body in a variety of ways, and you will begin to associate an otherwise unenjoyable activity with joy. 

Make it a practice in mindfulness

If you have a regular meditation practice, you may be familiar that the intention of mindfulness is to be fully present (and non-judgmental) at any given time. For many of us, we may intend to meditate regularly but perhaps feel like we don’t have the time, and easily let the habit slip away throughout the business of life. So why not make something we already have to do a practice in mindfulness? Practice bringing your full, complete attention into the task at hand, breaking free of judgment and reactivity. Feel the wetness and heat of the water, the weight of the dishes in your hand. Notice where your mind goes when the task may present with frustration, such as dried food caked onto the dishes, accidentally dropping a fork into the metal sink, etc. Can we flex our “mindful muscle” as we perform this activity that we don’t love to become more present in what we are doing? You may find that this makes the chore more engaging, interesting, and enjoyable.

Consider biomechanics

Many Wellness Station clients describe activities in the kitchen as extremely limited due to pain or mobility challenges. Trying silly moves and mindfulness can help in these situations. In addition, we want to consider some biomechanical principles to make sure we are moving with the least strain on our joints as we do these physical tasks. Here are some tips: 

  • Whenever bending to lift something (such as a dish from the bottom rack), send your pelvis back as you bend down, and tuck your pelvis under as you stand up. Read our blog post on Bending & Lifting. When in doubt, consider moving your pelvis opposite of where you are reaching. 

  • When reaching overhead (e.g. putting a glass on the top shelf), consider how you can use your body more efficiently. If reaching up with the right hand, glide your pelvis to the right, and allow your left heel to lift up. You should feel the right side of your body lengthening, and the left side shortening. 

  • Use your body weight to help with repetitive tasks. For example, when wiping down a surface, sweeping, or vacuuming, try shifting your weight from side to side. In other words, don’t wipe with your arms, but wipe with your hips. 

If these cues are not fully clear, your Wellness Station therapist can help clarify by providing individualized movement lessons to help you and your brain figure out how to perform any of these tasks with greater efficiency and ease.

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

Creating a Safe Space for Healing

Take a moment to reflect on a visit you have had with a provider (doctor, dentist, physical therapist, etc.) for an issue you have had. Consider if there has been a time where something did not feel quite right- perhaps you did not feel listened to or you were interrupted. Or maybe the plan of action that was suggested (medication, procedure, or exercise) did not feel aligned with your values, beliefs, or otherwise consistent with what you felt like the best treatment would be for your unique situation. What about the language, verbal and non-verbal, that the provider used? Did you ever feel talked down to, disregarded, or rushed? Were you treated as an equal player in your healing journey, or was your condition described as something that was out of your control, requiring care that only the practitioner could provide? 

The manner in which care is provided is extremely important, and is a significant determinant of the outcome that is achieved.

Unfortunately in our current healthcare system, there are several factors that can hinder the healing process. Aside from the Western mentality of treating symptoms rather than the root causes, the environment in which care is provided also plays a significant role in outcome. Many clinics are extremely busy, with therapists and doctors pressured to achieve unrealistic productivity standards. A shortage of practitioners as well as systemic issues related to the pandemic play into this situation as well. These factors will certainly impact a practitioner’s ability to provide their undivided attention and to engage in deep listening. In fact, the average amount of time before a doctor interrupts a patient is 11 seconds! For physical therapists, it is not much better at around 15 seconds. This leads to a sense of rush, and greatly impacts the communication and therapeutic relationship between patient and practitioner. In addition to time pressure, many clinics are set up to trigger our sympathetic nervous system (fight or flight) with bright lights, loud noises, and lack of privacy. Interacting with a rushed provider in this kind of environment instills a sense of unease within us as well, and can limit our ability to feel safe and comfortable.

At the Wellness Station, we take these factors into account. We recognize the importance of creating a strong therapeutic alliance, as the patient-provider relationship is an extremely significant element of the healing process. We strive to keep our environment conducive to healing by providing our care in a relaxing environment with appropriate aesthetics, adjustable lighting, and gentle background music upon request. We are able to provide individualized care for our patients for close to an hour every session without a sense of rush.

The environmental factors that we implement allow us (patient and provider) to operate in a parasympathetic state, the rest and digest division of our nervous system. This safe time and space allows our patients to feel comfortable letting their walls down and developing a trusting relationship with the practitioner. By creating this safe environment for healing, the patient and practitioner can dive deeper into the care that will be the most suitable, sustainable, and effective.

Consider these factors when you are engaging in your movement program at home or at a studio or gym. How is the environment affecting your ability to pay attention to your body and develop a positive relationship with yourself? What are some changes you might make to your environment to create a safe space and time for healing?

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