Wednesday, October 20, 2010

We're Walking Here - and feeling much better as a result: walking to rep in performance improvements

ResearchBlogging.org
Walking is an action most of us take for granted. It's such an automatic, effortless, thoughtless practice that we tend to forget it's actually a learned, practiced, skill. But it's this natural effortlessness of this deeply rep'ed & acquired practice that makes it so valuable for locking in better movement practice - what we practice when say working with a coach to tune dynamic joint movements (like those in z-health's R-Phase (overview) and  I-Phase (overview) drills) into our lives.

Indeed, walking is a huge component of Z-Health (overview). Folks familiar with Z-Health assessments know that they usually begin and end a session with a walk – and often walk in between various drills done within a session. But folks are also encouraged to walk on their own immediately after their own practice to help dial in the work they do during their session. It’s this part of the role of the walk ithat is the focus of this article, but to get at that part, we need to understand a little bit more about why the walk is so valuable in general.

Thoughtless Action – in a good way. Walking is a powerful communicator: it tells us a lot about our movement for a two key reasons we've touched on above: it’s autonomous, and its reflexive. Autonomous, from  the greek auto, means can act on its own. So we can walk while we do other things. Like chew gum and talk all at the same time.

Walking, as noted, is not innate; it is rather like riding a bicycle: a learned skill. Indeed, research shows two interesting things (at least) about this skill acquisition: (1) that when we begin to acquire the skill has been pretty steady for us for hundreds of millions of years (Garwicz09) but (2) that this motor skill acquisition is also affected by cultural practices (Karasik10).

Once we do get going, we learn and practice this skill millions of times (each step is a practice) it becomes not only autonomous but  reflexive. Reflexive means that the function moves from an act where we are thinking about it to something that is pre-cognitive – happens without having to think consciously about what to do. So with these two related qualities – autonomous and reflexive – we have an action that gives us a pretty good picture of how a person actually moves when they’re not thinking about it vs how a person may perform a less familiar action that requires their cognition and concentration.  Something that is, in effect, thoughtless, therefore seems to give us a more accurate picture of the quality of a person’s movement

From this picture of the walk, Z-Health practitioners starting at an R-Phase certification level (the first cert, overviewed here) have a repertoire of drills available to help address the performance issue identified. Kinaesthetically, the person themselves also get feedback from the walk: it’s not unusual for the person walking to volunteer comments at the end of a session like “that feels more open” or “that’s looser” or “something’s easier.” In this respect, the walk forms a kind of assessment/reality check for the person to see how all those little z-drills have had not only a local but a more systemic effect on their performance.

Loading Action More than just a self-check, because of its very systemic nature, walking is a great way to begin to enpattern (to coin a phrase) the better-ness being experienced in that self-check.
 In other words, our walking at the end of a session begins to practice the new way we are moving as a result of the drills we practiced to move better. By checking to see if we are moving better, rather ironically, when we are moving better (shown in the better walk), we are helping to practice the better-ness. That’s why if we’re not moving better after a drill and a re-walk, we keep working out more drills until there is a betterness. And then we practice betterness – not by doing the drills that helped open up the paths – or not them alone – but by putting the positive effect of the drill into a real and fundamental movement. Thereby improving the movement (which is what we care about really more than an isolated gesture) into a positive feedback loop.

Making Music vs Playing Scales Walking post session or for that matter after doing our own mobility practice is rather like after doing scales on an instrument, playing the real piece; the real piece benefits not because the piece is playing scales, but because the scales give us skills that are useful in playing real pieces – any piece - better. But then, the magic is likewise that by playing the tune with these enhanced skills, the tune playing is itself also practice of the specific movement – as a whole. Feedback loop. Thus drills give us skills that improve movement such as the very familiar autonomous walking, and walking itself with this practice makes walking better. That post-session walk-in is a rather Magic Walk that captures and integrates into the Real Movement the experience built from the (corrective) drills.

But wait! There’s more. This practice of engraining drill practice, as it were, within the real movement – translating the skills of the scales to enhancing the quality of the performance – that work itself changes the shape of the movement.

That change in the walk is a physical thing: those physical changes are effectively structural. Consider if to improve the walk, the walk shows us that ankle work may help; we do ankle drills; re-walk. Better. That improved movement in the ankle is practiced within the walk itself. Improved movement means improved function; improved function, with many reps, leads quickly to fundamentally enhanced structure. Thus function creates structure.

 This cycle of improving function to create improved structure occurs because we are plastic people. Woolf’s law demonstrates this effect with bone tissue (Frost01). Davis’s law shows this with our other tissues, like skin and fascia. And the SAID principle (specific adaptation to imposed demand) (Wallis & Logan) suggests this process of adaptation begins as soon as we introduce a demand upon the system. 

But wait! There’s Even More.

Keeping it Real; Keeping it Cool
Another aspect of the walk to dial in the drills we do for our performance improvement is that it may well also be neurologically soothing . The dynamic joint mobility drills in R-phase for instance help open up new signalling to the nervous system to say that a joint is moving better; a muscle is firing better and so we can move better.

To walk means to move. To move helps reduce stress (overview of why in 10 tips to de-stress); to move well means that a familiar, autonomous, reflexive act – something that therefore is in itself very low threat to the nervous system - is becoming better, easier, even less threatening – especially if there’s been any pain in the walk that’s lessened from our practice.. This better-ness amplifies all the positive benefits of movement. Easier, better, too, means less stress. We learn quickly from our body's responses that better movement means inner peace, happiness and perhaps improved prospects for a better incarnation: feeling better means easier to be nice rather than grumpy. And who wants to be grumpy and go to hell? Or reincarnate in a nasty place?

So we practice our drills, and then we walk them in. Beautiful music; beautiful movement.

PS - running and practicing running gait to reduce pain in running
Recent research (Noehren10) considered that gosh, knee pain in runners (Patellofemoral pain syndrome) seems to be connected to hip mechanics. The approach to address this problem was to wire up study participants not unlike the way folks are wired up to map computer animation to human movement. In this case markers were placed on areas of the hip, low back, knee, shin and foot.

Runners were then asked to run on a treadmill and look at their movement performance data against a Normal Curve (shown below). Participants were asked over the course of 8 sessions of running on a treadmill to get their movement curve (the white line) to match the normal curve of treadmill running (the white line in the grey band). The amount of feedback given was tailed off over time to see how well the training was being internalized. Participants were also retested a month after the trial to see if the new patterns had stuck.

 
While the results were not statistically significant (but very close to being so), they showed that hip mechanics did change/improve, and that most importantly, knee pain went down. The paper is free and worth reading.

From a neurological/SAID principle lens, there are a couple of points here. First, if someone is having hip issues, is that all that's going on? sometimes hip issues are the result of low back stuff, upper back stuff and in particular foot/ankle stuff. Focusing on the hip alone may be part of why the results in improvement were not significant. One might argue, though, that in order for the person to "move their curve" as shown above, perhaps they were also working on the ankle and back position issues to achieve the hip effect.

Second, running on a treadmill is a kind of weird thing relative to normal running or walking gait. When we run we choose our pace and stride length - it varries. On a treadmill, there's not much room for those subtle variations; the vestibular/visual dissonance also seems to create a performance hit vs land running/walking (ever feel a bit dizzy coming off a treadmill?)

Third of course, these folks all seem to be running with squishy largely not bendy heal-striking shoes. How about just thinking about getting out of those shoes or perhaps learning to get up into more natural/barefoot running type gait??

So what i wonder to myself is that if some of these folks with knee pain had come to see a Z-Health person with even just an R-Phase cert under their belts, and they'd been asked by said Zed folks to go for a walk (rather than step on a treadmill) to look at how they move at their own pace, in their own way, what might have been seen? Would a few reps with a few simple but very precicise R-Phase drills, followed by the Magic Post Session Walk have helped set up this better function sooner, faster, easier, and potentially have even greater benefit since the practice is located in the every day of the walk (using the SAID principle of specific adaptation) rather than the artifice of the treadmill? Just a question, but i'm guessing based on practice the answer is "uh huh."

And the beat goes on.
pps - if you're interested in the R-Phase cert, or in checking out zed (via the essentials of elite performance dvd or course) here's more info about z-health and the approaches here; if you do decide to take a cert, please consider indicating you came in via mc (that's me). We don't get paid money for any referals, but we do get some money off our own continuing ed with zed. Which is cool. And appreciated. 

A few Refs
Frost HM (2001). From Wolff's law to the Utah paradigm: insights about bone physiology and its clinical applications. The Anatomical record, 262 (4), 398-419 PMID: 11275971
Garwicz, M., Christensson, M., & Psouni, E. (2009). A unifying model for timing of walking onset in humans and other mammals Proceedings of the National Academy of Sciences, 106 (51), 21889-21893 DOI: 10.1073/pnas.0905777106

Karasik LB, Adolph KE, Tamis-Lemonda CS, & Bornstein MH (2010). WEIRD walking: cross-cultural research on motor development. The Behavioral and brain sciences, 33 (2-3), 95-6 PMID: 20546664
Noehren, B., Scholz, J., & Davis, I. (2010). The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome British Journal of Sports Medicine DOI: 10.1136/bjsm.2009.069112
Wallis, Earl L and Logan, Gene Adams, 1964 Figure improvement and body conditioning through exercise, Prentice Hall, NY. [presentation of SAID principle]

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