Showing posts with label movement. Show all posts
Showing posts with label movement. Show all posts
Thursday, August 12, 2010
The Eyes Have It - sometimes: using eye position to enhance strength
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I was fascinated by Geoff Neupert's article in the latest Power by Pavel Newsletter (issue 209, 08/09/10) about his experience using eye position in the press. Geoff is the author of Kettlebell Muscle. Absolutely awesome to see eye position highlighted in relation to how that action can support movement practice. That support is rather dependent on where and how in a compound move it's being used, and also what else may be happening in our somato-sensory systems. So let's look at eye position and postural reflexes and how they support muscle action a little more.
Geoff writes:
Geoff reports that this didn't work for him. When we understand the roll of vision in position, that result is not surprising, so we'll come onto why. He then proposes a revised move with a different head, jaw and eye position: the neck back a bit, chin up a bit and eyes slightly up.
Geoff says of this approach:
Test Early; Test Often The key thing to me in this article is that Geoff did "test" his new approach: did it improve his press? he says so an i believe him. Yet while he proposes a new technique for his press, and has some interesting theory to support it, whether or not that approach will be universally successful may be as likely as eyes down through the lift was successful for Geoff. May be. Dunno, maybe.
The take away from this story, at least for me, is less about a new technique that will work for everyone and more about: test it, because what works for you mayn't work for me, or for you later today, no matter how well we hypothesize why something works after the fact.
Let me step back a bit and say here's why i'm not surprised by GN reporting that eyes looking down *through the whole press* would likely/potentially not be a good idea: there's more going on than shoulder flexion in the press.
Eye Position and Reflexes when Reflexes work. Let me back up even further and say that the eyes are tied to reflexes that support extension, flexion, adduction, abduction, rotation. By reflex we mean involuntary automatic and near immediate response to a stimulus. Intriguingly, sometimes these reflexive responses can get buggered up, (and with the eyes, have particular effects on posture, among other things) but more on that anon.
When things are working right, we see looking down triggers flexion, looking up triggers extension looking in one direction triggers complementary adduction/abduction/rotation in the direction viewed.
Eye position is then used to complement/strengthen what can most benefit from that reflex. That may change throughout a lift. And what if while one thing is extending something else is flexing? What do we need help with the most? We'll look at an example to try in a sec.
Strengthening what needs to be strengthened throughout a lift
As an example of how eye position might change in a lift, let's take a look at the example from Geoff's article, the kettlebell press. The press is a rich movement: one may need eyes down to support shoulder flexion at the beginning of the lift coming out of the rack, then eyes towards the horizon and looking at the bell when the delts are at the weakest point, so strengthening rotator cuff movements, and post sticking point, eyes up to support the triceps extending (thanks to conversations last year with Zachariah Salazar Z-Health Master Trainer and RKC on these multiple positions in the press). In Pavel's pressing, as RKC Ken Froese pointed out to me, his eyes seem to follow the bell throughout, which may be great for someone with even strength, but not for someone with say a shoulder issue.
So keeping eyes down throughout the movement may be less productive for some people if where the weak link in the move shifts, and changing eye position will enhance that.
Try this at Home: A chin up (hands supinated) uses extension of the shoulder/lats firing, but it also uses elbow flexion (biceps coming into a curl). So what needs more help for you in a chin? Best way to find out: test either/or positions, depending if one's weaker link is shoulder extension/lats (eyes up) or biceps flexing (eyes down). Try both: what works better for you -when? Which is which may change as training progresses, or for just about any other reason, as we'll see below.
When reflexes seemingly aren't firing normally
Why would a doctor whack a knee if a reflex always fired as it was supposed to? We wouldn't need to test something that always works one way. Same thing with eye responses as demonstrated in what are referred to as postural reflexes, richly informed by the visual (and vestibular and proprioceptive) system(s):
Sometimes due to trauma or sometimes a long flight and jet lag, one's postural reflexes get really muted or actually cause the inverse effect reflexively in the body. There are tests for this (if you visit with a z-health certified coach who's done i-phase, for instance, they'll know these position/vision tests). The important thing to get is that our muscular responses - things as seemingly simple and immutable as flexion and extension - are intertwined with the somato-sensory system (visual, vestibular and proprioceptive function), and that these intertwined systems are constantly dealing with various stimuli. As Reiman and Lephart found in 2002:
Obviously, if one's visual responses to a direction are screwed up (say looking down doesn't strengthen your bicep curl, or cue an appropriate postural reflex), then using your eyes in a movement in that direction is also likely not going to help - in some cases it may seem to work against you if your body doesn't like that eye position, performance is going to suffer - until the thing gets fixed. And it is addressable.
Repetez après la model: Test It. So rather than getting super prescriptive about what will achieve what, great to have some heuristics about reflexes and eye position and of course form. But great too (a) to be sure to be able to refine application - like multiple eyes positions may be needed throughout a move and (b) to know that those reflexes are working as designed and (c) just test it.
If an eye position doesn't work - doesn't provide a performance boost or takes away from one - try something else. And if in a simple move like a biceps curl where eyes down should make that curl stronger and it doesn't work, maybe check with that qualified coach who knows how to work with these positions in case it's either a technique thing or something else that may need a bit of work.
We are Complex Integrated Systems There are 11 systems in the human being. They all interact with one another, from our skin to our reproductive system. There's no way we're going to be able know, a priori, what will unequicoably work for ourselves, little own everyone at all times. only salespeople seem to make such unequivocable claims about their products - it slices; it dices. always for everything. Really? What other domain is so certain?
In my main domain of human factors, this is why we can't make claims about the effectiveness of an interface based on how it works for ourselves alone, but have to test it rigerously so that we can say with some statistical power that it is effective to some degree, and even that is constrained like: for people aged x-y with these particular skill sets, they were able to use this tool to complete this task A% better than the previous tool design. Without that - even though we've developed that design with the best models of human performance from motor control to cognition available to us - the best we can say in our domain is "we liked it; why don't you give it a try and let us know if it worked for you."
Broken Record: Test it. Frequently, regularly. Vision is a potent system - the top of the somato sensory hierarchy. Makes sense that when it's firing well, it can help our other systems respond well. To use eye position to enhance a lift, therefore, means testing the eye position to see what action in a lift may need that enhancement - presuming that our visual reflexes are working as they're supposed to work. So again, if eyes down doesn't enhance that biceps curl, may be time to check vision, too. If it is, check eye position with the move. Test various positions through the move.
It's a really simple principle. It means having strategies to deal with a weak result to help make improvements. but at the very least it gives us information about tuning what we're doing.
Citation
Related Posts
I was fascinated by Geoff Neupert's article in the latest Power by Pavel Newsletter (issue 209, 08/09/10) about his experience using eye position in the press. Geoff is the author of Kettlebell Muscle. Absolutely awesome to see eye position highlighted in relation to how that action can support movement practice. That support is rather dependent on where and how in a compound move it's being used, and also what else may be happening in our somato-sensory systems. So let's look at eye position and postural reflexes and how they support muscle action a little more.Geoff writes:
For the last four years, until recently, I promoted a neutral head, eyes down posture for presses and jerks, thinking that this would increase flexion at the shoulder and therefore increase shoulder mobility and allow for the weight to go up easier.
Geoff reports that this didn't work for him. When we understand the roll of vision in position, that result is not surprising, so we'll come onto why. He then proposes a revised move with a different head, jaw and eye position: the neck back a bit, chin up a bit and eyes slightly up.
Geoff says of this approach:
This is excellent: Geoff tested the move to see if it worked better for him, today. Testing a technique is critical as adaptation is pretty individual; testing that neutral head / eyes down thing sooner might have been a good idea too for addressing four years of press frustration.I then corroborated my findings with what the absolute best in the world do, confirmed my position, applied my "new" techniques, and started making progress once again.
 | |
| For more ideas on how to train these eye muscles, see Eye Heatlh: How Fast can you switch focus? |
Test Early; Test Often The key thing to me in this article is that Geoff did "test" his new approach: did it improve his press? he says so an i believe him. Yet while he proposes a new technique for his press, and has some interesting theory to support it, whether or not that approach will be universally successful may be as likely as eyes down through the lift was successful for Geoff. May be. Dunno, maybe.
The take away from this story, at least for me, is less about a new technique that will work for everyone and more about: test it, because what works for you mayn't work for me, or for you later today, no matter how well we hypothesize why something works after the fact.
Let me step back a bit and say here's why i'm not surprised by GN reporting that eyes looking down *through the whole press* would likely/potentially not be a good idea: there's more going on than shoulder flexion in the press.
Eye Position and Reflexes when Reflexes work. Let me back up even further and say that the eyes are tied to reflexes that support extension, flexion, adduction, abduction, rotation. By reflex we mean involuntary automatic and near immediate response to a stimulus. Intriguingly, sometimes these reflexive responses can get buggered up, (and with the eyes, have particular effects on posture, among other things) but more on that anon.
When things are working right, we see looking down triggers flexion, looking up triggers extension looking in one direction triggers complementary adduction/abduction/rotation in the direction viewed.
Eye position is then used to complement/strengthen what can most benefit from that reflex. That may change throughout a lift. And what if while one thing is extending something else is flexing? What do we need help with the most? We'll look at an example to try in a sec.
Strengthening what needs to be strengthened throughout a lift
As an example of how eye position might change in a lift, let's take a look at the example from Geoff's article, the kettlebell press. The press is a rich movement: one may need eyes down to support shoulder flexion at the beginning of the lift coming out of the rack, then eyes towards the horizon and looking at the bell when the delts are at the weakest point, so strengthening rotator cuff movements, and post sticking point, eyes up to support the triceps extending (thanks to conversations last year with Zachariah Salazar Z-Health Master Trainer and RKC on these multiple positions in the press). In Pavel's pressing, as RKC Ken Froese pointed out to me, his eyes seem to follow the bell throughout, which may be great for someone with even strength, but not for someone with say a shoulder issue.
So keeping eyes down throughout the movement may be less productive for some people if where the weak link in the move shifts, and changing eye position will enhance that.
Try this at Home: A chin up (hands supinated) uses extension of the shoulder/lats firing, but it also uses elbow flexion (biceps coming into a curl). So what needs more help for you in a chin? Best way to find out: test either/or positions, depending if one's weaker link is shoulder extension/lats (eyes up) or biceps flexing (eyes down). Try both: what works better for you -when? Which is which may change as training progresses, or for just about any other reason, as we'll see below.
When reflexes seemingly aren't firing normally
Why would a doctor whack a knee if a reflex always fired as it was supposed to? We wouldn't need to test something that always works one way. Same thing with eye responses as demonstrated in what are referred to as postural reflexes, richly informed by the visual (and vestibular and proprioceptive) system(s):
Visual and vestibular input, as well as joint and soft tissue mechanoreceptors, are major players in the regulation of static upright posture. Each of these input sources detects and responds to specific types of postural stimulus and perturbations, and each region has specific pathways by which it communicates with other postural reflexes, as well as higher central nervous system structures.There's even work to suggest that blinking or performing visual sacades may improve postural stability.
Sometimes due to trauma or sometimes a long flight and jet lag, one's postural reflexes get really muted or actually cause the inverse effect reflexively in the body. There are tests for this (if you visit with a z-health certified coach who's done i-phase, for instance, they'll know these position/vision tests). The important thing to get is that our muscular responses - things as seemingly simple and immutable as flexion and extension - are intertwined with the somato-sensory system (visual, vestibular and proprioceptive function), and that these intertwined systems are constantly dealing with various stimuli. As Reiman and Lephart found in 2002:
Motor control for even simple tasks is a plastic process that undergoes constant review and modification based upon the integration and analysis of sensory input, efferent motorWe occaisionally really get how intertwined these actions are if we ever have an inner ear infection, or find ourselves experiencing sea sickness or dizziness.
commands, and resultant movements.
Obviously, if one's visual responses to a direction are screwed up (say looking down doesn't strengthen your bicep curl, or cue an appropriate postural reflex), then using your eyes in a movement in that direction is also likely not going to help - in some cases it may seem to work against you if your body doesn't like that eye position, performance is going to suffer - until the thing gets fixed. And it is addressable.
Repetez après la model: Test It. So rather than getting super prescriptive about what will achieve what, great to have some heuristics about reflexes and eye position and of course form. But great too (a) to be sure to be able to refine application - like multiple eyes positions may be needed throughout a move and (b) to know that those reflexes are working as designed and (c) just test it.
If an eye position doesn't work - doesn't provide a performance boost or takes away from one - try something else. And if in a simple move like a biceps curl where eyes down should make that curl stronger and it doesn't work, maybe check with that qualified coach who knows how to work with these positions in case it's either a technique thing or something else that may need a bit of work.
We are Complex Integrated Systems There are 11 systems in the human being. They all interact with one another, from our skin to our reproductive system. There's no way we're going to be able know, a priori, what will unequicoably work for ourselves, little own everyone at all times. only salespeople seem to make such unequivocable claims about their products - it slices; it dices. always for everything. Really? What other domain is so certain?
In my main domain of human factors, this is why we can't make claims about the effectiveness of an interface based on how it works for ourselves alone, but have to test it rigerously so that we can say with some statistical power that it is effective to some degree, and even that is constrained like: for people aged x-y with these particular skill sets, they were able to use this tool to complete this task A% better than the previous tool design. Without that - even though we've developed that design with the best models of human performance from motor control to cognition available to us - the best we can say in our domain is "we liked it; why don't you give it a try and let us know if it worked for you."
Broken Record: Test it. Frequently, regularly. Vision is a potent system - the top of the somato sensory hierarchy. Makes sense that when it's firing well, it can help our other systems respond well. To use eye position to enhance a lift, therefore, means testing the eye position to see what action in a lift may need that enhancement - presuming that our visual reflexes are working as they're supposed to work. So again, if eyes down doesn't enhance that biceps curl, may be time to check vision, too. If it is, check eye position with the move. Test various positions through the move.
It's a really simple principle. It means having strategies to deal with a weak result to help make improvements. but at the very least it gives us information about tuning what we're doing.
Citation
Morningstar, M., Pettibon, B., Schlappi, H., Schlappi, M., & Ireland, T. (2005). Reflex control of the spine and posture: a review of the literature from a chiropractic perspective Chiropractic & Osteopathy, 13 (1) DOI: 10.1186/1746-1340-13-16
Riemann BL, & Lephart SM (2002). The Sensorimotor System, Part II: The Role of Proprioception in Motor Control and Functional Joint Stability. Journal of athletic training, 37 (1), 80-4 PMID: 16558671
Rougier P, Garin M (2007). Performing saccadic eye movements or blinking improves postural control. Motor control, 11 (3), 213-23 PMID: 17715456
Related Posts
- Why I - train for the sprain
- THe other side of the gym - training the somato-sensory system
- more stuff about integration of systems: z-health overviews.
PDF
Saturday, May 29, 2010
How to Get outsdide and Move better fast: right water, safe barefeet and sun cover, rather than sun screen
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Now that we've seen and felt the sun in the UK/EU for a few days, one turns there thoughts to summer. And summer means sweat, and sweat means hydration, so a few notes about hydration, sun screen and barefooting.
Why these three?
we'd like to stay out side for fresh air - and not burn like a crispy critter OR be outside and NOT get the vitamin D we need; we'd likely like to move better and hydration actually helps our bodies move better. really. and while our muscles, skin and fascia move better with some H2O, we move better when we let our joints (in parts like our feet) move as designed. Sounds right, right?
So a few thoughts/tips on water, feet and sun (screen).
a quick note about hydration: amount
here's a few pointers about how much water to drink - it may be less than we usually think:
Water is a biggie for lots of reasons, but one is that it lets muscles and fascia (our connective tissue) actually move better. A hydrated body is a happy body.
Too much of a good thing? And if you've been chugging gallons for awhile, any extreme can be a problem - with too much water consumption (rare) it's called hyponatremia:
About Sun Screen
Well what can i say? time to think different, as it were.
Likewise those spray on tans (and tanning beds) aren't necessarily helping. Seems we need to relearn our relationship to the sun, sanely.
About running about barefoot or near barefoot. Nothing like splish splashing barefoot; or feeling the grass (or mud) between one's toes. And it's great to do with minimal shodness - yes i'm thinking vibram fivefingers (and i keep hearing great things about the bikilia's too - will report when i get a chance to try them, too). Here's a few starters.
In rare rare cases, pain (like in a toe or heal) may be something else showing up that's been in train for awhile. There's stuff called freiburgs syndrome and heal spurs. Pain is a signal to change something; sometimes we need help to figure out how to make that change. If you have sharp pain in your foot at any point, see your doc.
Cramps? Shin SplinAnd if you are all gung ho in your new not suede shoes, and find yourself getting cramps, here's a few notes on what may be happening, and suggestions on how to deal with that. Remember: stretching is for dealing with the cramp; dun't work in avoiding 'em.
But on the up side
Reasonable hydration, reasonable sun exposure/sun cover, and reasonable movement towards moving as we're designed to move, greater happiness is ours. really. Water helps us move better; better foot mobility helps us move better. Moving helps us feel better.
Amen!
Related Notes:
Why these three?
we'd like to stay out side for fresh air - and not burn like a crispy critter OR be outside and NOT get the vitamin D we need; we'd likely like to move better and hydration actually helps our bodies move better. really. and while our muscles, skin and fascia move better with some H2O, we move better when we let our joints (in parts like our feet) move as designed. Sounds right, right?
So a few thoughts/tips on water, feet and sun (screen).
a quick note about hydration: amount
here's a few pointers about how much water to drink - it may be less than we usually think:
water by metabolic rate: for every 100kcal of metabolic rate, 80-110mL wateror
So 2000kcal mr = 1.6-2L a day.
every KG bw = 30-40mL of water, so 50kg= 1.5-2L a day; 100kg 3-4L
Generally, consensus seems to be around 3L (12cups) a day, with 1L coming from food, so 2L (8cups) from drinking water.Also exercise usually (duh) ups the requirements. Here's what the ACSM recommends for exercise, sun and hydration: chug it, rather than sip it; don't rely on thirst, but the goal is still simply "replacing body fluid loss during exercise is to maintain normal hydration" - not overdoing it. There's some good recs about carb/electrolyte intake during exercise to offset fatigue, too.
This is modified by body size (not thirst - thirst is similar to when the oil gage is on RED).
Water is a biggie for lots of reasons, but one is that it lets muscles and fascia (our connective tissue) actually move better. A hydrated body is a happy body.
Too much of a good thing? And if you've been chugging gallons for awhile, any extreme can be a problem - with too much water consumption (rare) it's called hyponatremia:
Common symptoms of hyponatremia include fatigue, irritability, headache, and water retention, loss of appetite, and nausea or vomiting.Just had a discussion recently with a person who said that their fatigue was found to be down to excessive water intake. Went to a more reasonable (2L for them) a day level and voila. Feeling betterness ensues. But again, this condition is pretty rare.
About Sun Screen
Well what can i say? time to think different, as it were.
- sunscreen will kill you (i know i was surprised)
Likewise those spray on tans (and tanning beds) aren't necessarily helping. Seems we need to relearn our relationship to the sun, sanely.
About running about barefoot or near barefoot. Nothing like splish splashing barefoot; or feeling the grass (or mud) between one's toes. And it's great to do with minimal shodness - yes i'm thinking vibram fivefingers (and i keep hearing great things about the bikilia's too - will report when i get a chance to try them, too). Here's a few starters.
- fitting vffs and injinji toe socks
- relation to pose/chi running
- cheap massage (especially in semi muddy pebbly trails)
In rare rare cases, pain (like in a toe or heal) may be something else showing up that's been in train for awhile. There's stuff called freiburgs syndrome and heal spurs. Pain is a signal to change something; sometimes we need help to figure out how to make that change. If you have sharp pain in your foot at any point, see your doc. Cramps? Shin SplinAnd if you are all gung ho in your new not suede shoes, and find yourself getting cramps, here's a few notes on what may be happening, and suggestions on how to deal with that. Remember: stretching is for dealing with the cramp; dun't work in avoiding 'em.
But on the up side
Reasonable hydration, reasonable sun exposure/sun cover, and reasonable movement towards moving as we're designed to move, greater happiness is ours. really. Water helps us move better; better foot mobility helps us move better. Moving helps us feel better.
Amen!
Related Notes:
- drink responsibly: get a refillable water bottle
- choosing a water bottle
- the b2d vibram fivefinger article index
- what is z-health?
Sunday, May 23, 2010
Building & Protecting Bone: Odd Angle Exercise, Resistance, Movement (and shaking) Work
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A fear for many women is that as we age, we seem to be more vulnerable to the "Help Help, i've fallen and i can't get up" hip fracture and related. Awhile ago, i wrote about bone building, and what's known about strategies to keep it together and enhance it. Quick review: bone builds in response to demand. Woolf's law is "use it or lose it" - our bone is "remodeling" all the time. So while calcium, magnesium, zinc and vitamin d are all important, these nutrients alone don't really go into bone building mode unless there's demand on the bones. That means load. Likewise, even with strong bones, we don't stay upright if our movement is compromised by various aches and pains.
A new research survey on non-invasive approaches to bone building puts these points together in a really nice review called "Physical approach for prevention and treatment of osteoporosis" The nice thing is it's free.
Summary: Here's a summary of the approaches that look good for building up bone mineral density:
BONE BUILDING
Resistance training - that's good but it's also site specific. In other words, lower body work helps the lower body (hip/pelvis); upper body work helps the upper body (including the critical spine).
Impact Training - this is stop and start and "odd angle" activities like soccer or squash (not running so much), but also for the more frail, even dancing and ball games have been proposed as ways to help keep demand up on bones.
Combinations. Meta analysis of research suggests that the best approach, unsurprisingly is a mixed approach of resistance training and impact training. Fortunately such practice can be fun and have bone building effect.
Vibration. the next time someone pooh poohs force plates, you might want to suggest that they've been shown - repeatedly - to help build up bone. It's not a HUGE gain, but it could be an excellent modality for the initially infirm:
BALNANCE - Physical and Hormonal
T'ai Chi - does nothing for bone building at all, BUT helps get on with movement and balance and the breathing can help destress, so hormonally very helpful in supporting staying safe. Research has mainly focused on T'ai Chi for these effects, but it might be interesting to consider that other approaches that emphasize mobility, balance, de-stressing, and the whole sensory motor apparatus might not benefit here too?
BUILDING & REPAIR
New & Approved. The review also considers several other forms of "physical agents" like Low Intensity Pulsed Ultrasound (LIPUS) that has been shown to stimulate bone repair. Electrical stimulation has also now been approved by the FDA for "bone repair."
Experimental. Pulsed electro magnetic fields (PEMF) is a newer approach, nothing conclusive there yet. Low Level Laser Therapy is also being trialed in animal models, but again nothing yet in human studies.
Role for Movement Practice & Assessment?
Where we seem to be at is that concern about bone mineral density has two components: first is to ensure practices for maintianing and building BMD, but second is the development of practices to help people feel stable and mobile rather than vulnerable to falls - improving range of motion, visual accuity and balance. It's not just Range of Motion - thought that's important - it's the whole sensory-motor awareness package.
It doesn't matter if we're younger or older - we can have issues with our movement that can compromise our ability to respond with agility to a tricky situation. The entire functional movement screen program is based on the premise that there's no point building strength on top of dysfunction, hence the screen for movement issues.
But likewise, we can have issues with our balance or visual accuity or our brains ability to perceive our selves clearly in motion. Indeed, i've written quite a bit about the benefit of just kicking off our restrictive shoes to get more info to the brain about where we are in space, and how doing so has pretty big benefits for movement and also feel of one's own mobility (as the feet move more and better, it seems so do other joints).
So it seems pretty basic that as part of our quest for better bone health, a related quest for optimizing our body's ability to move in space is pretty important. I've said before, this awareness development is part of why i like I-Phase so much: it's prepping the body for the Real.
In other words, as we build better bones, there's a real benefit in openning up our body's awareness of itself in space, and simultaneously, it's ability to respond better to what's happening.
Simple example: better range of motion combined with better practice of movement into multiple positions, and better balance and visual processing means the brain has more knowledge about its being able to Zig rather than having to Zag around that wet spot on the floor, and thus, us not going for a tumble.
Stronger bones PLUS less risk of falling in the first place (and not being able to get up) - that seems to be more a complete package.
Conclusion: Why is osteoperosis such the women's issue?
One advantage that guys have is the size of their muscles puts more load on their bones so that the bones are under more demand. More demand on the bones, more continued adapting to load.
Women have not been encouraged to do as much manual labour or high resistance workouts as guys.
Similarly our formal worlds are increasingly desk bound, so less movement is part of our daily lives. As we age, this decrease in multi-plane motion seems to increase. Let us say phooey to this increasingly restricted mode of being.
It will be interesting to see as the culture shifts towards it being ok for gals to work out, and as muscle tissue can be built up at any age, that perhaps hip and related fractures will become a fate of a by-gone age.
Citation:
Related Resources
A fear for many women is that as we age, we seem to be more vulnerable to the "Help Help, i've fallen and i can't get up" hip fracture and related. Awhile ago, i wrote about bone building, and what's known about strategies to keep it together and enhance it. Quick review: bone builds in response to demand. Woolf's law is "use it or lose it" - our bone is "remodeling" all the time. So while calcium, magnesium, zinc and vitamin d are all important, these nutrients alone don't really go into bone building mode unless there's demand on the bones. That means load. Likewise, even with strong bones, we don't stay upright if our movement is compromised by various aches and pains.A new research survey on non-invasive approaches to bone building puts these points together in a really nice review called "Physical approach for prevention and treatment of osteoporosis" The nice thing is it's free.
Summary: Here's a summary of the approaches that look good for building up bone mineral density:
BONE BUILDING
Resistance training - that's good but it's also site specific. In other words, lower body work helps the lower body (hip/pelvis); upper body work helps the upper body (including the critical spine).
Impact Training - this is stop and start and "odd angle" activities like soccer or squash (not running so much), but also for the more frail, even dancing and ball games have been proposed as ways to help keep demand up on bones.
Combinations. Meta analysis of research suggests that the best approach, unsurprisingly is a mixed approach of resistance training and impact training. Fortunately such practice can be fun and have bone building effect.
Vibration. the next time someone pooh poohs force plates, you might want to suggest that they've been shown - repeatedly - to help build up bone. It's not a HUGE gain, but it could be an excellent modality for the initially infirm:
A 1-year prospective, randomized, double-blind, and placebo-controlled trial of postmenopausal women demonstrated that 20 minutes of a low-level vibration applied during quiet standing can effectively inhibit bone loss in the spine and femur. Placebo subjects lost 2.13% in the femoral neck over 1 year, whereas treatment was associated with a gain of 0.04%, reflecting a 2.17% relative benefit of treatment. In the spine, the 1.6% decrease observed over 1 year in the placebo group was reduced to a 0.10% loss in the active group, indicating a 1.5% relative benefit of treatment (40).
BALNANCE - Physical and Hormonal
T'ai Chi - does nothing for bone building at all, BUT helps get on with movement and balance and the breathing can help destress, so hormonally very helpful in supporting staying safe. Research has mainly focused on T'ai Chi for these effects, but it might be interesting to consider that other approaches that emphasize mobility, balance, de-stressing, and the whole sensory motor apparatus might not benefit here too?BUILDING & REPAIR
New & Approved. The review also considers several other forms of "physical agents" like Low Intensity Pulsed Ultrasound (LIPUS) that has been shown to stimulate bone repair. Electrical stimulation has also now been approved by the FDA for "bone repair."
Experimental. Pulsed electro magnetic fields (PEMF) is a newer approach, nothing conclusive there yet. Low Level Laser Therapy is also being trialed in animal models, but again nothing yet in human studies.
Role for Movement Practice & Assessment?
Where we seem to be at is that concern about bone mineral density has two components: first is to ensure practices for maintianing and building BMD, but second is the development of practices to help people feel stable and mobile rather than vulnerable to falls - improving range of motion, visual accuity and balance. It's not just Range of Motion - thought that's important - it's the whole sensory-motor awareness package.
It doesn't matter if we're younger or older - we can have issues with our movement that can compromise our ability to respond with agility to a tricky situation. The entire functional movement screen program is based on the premise that there's no point building strength on top of dysfunction, hence the screen for movement issues.
But likewise, we can have issues with our balance or visual accuity or our brains ability to perceive our selves clearly in motion. Indeed, i've written quite a bit about the benefit of just kicking off our restrictive shoes to get more info to the brain about where we are in space, and how doing so has pretty big benefits for movement and also feel of one's own mobility (as the feet move more and better, it seems so do other joints). So it seems pretty basic that as part of our quest for better bone health, a related quest for optimizing our body's ability to move in space is pretty important. I've said before, this awareness development is part of why i like I-Phase so much: it's prepping the body for the Real.
In other words, as we build better bones, there's a real benefit in openning up our body's awareness of itself in space, and simultaneously, it's ability to respond better to what's happening.
Simple example: better range of motion combined with better practice of movement into multiple positions, and better balance and visual processing means the brain has more knowledge about its being able to Zig rather than having to Zag around that wet spot on the floor, and thus, us not going for a tumble.
Stronger bones PLUS less risk of falling in the first place (and not being able to get up) - that seems to be more a complete package.
Conclusion: Why is osteoperosis such the women's issue?
One advantage that guys have is the size of their muscles puts more load on their bones so that the bones are under more demand. More demand on the bones, more continued adapting to load.
Women have not been encouraged to do as much manual labour or high resistance workouts as guys.
Similarly our formal worlds are increasingly desk bound, so less movement is part of our daily lives. As we age, this decrease in multi-plane motion seems to increase. Let us say phooey to this increasingly restricted mode of being.
It will be interesting to see as the culture shifts towards it being ok for gals to work out, and as muscle tissue can be built up at any age, that perhaps hip and related fractures will become a fate of a by-gone age.
Citation:
Lirani-Galvão, A., Lazaretti-Castro, M. (2010). Physical approach for prevention and treatment of osteoporosis Arquivos Brasileiros de Endocrinologia & Metabologia, 54 (2) DOI: 10.1590/S0004-27302010000200013
Related Resources
- What is z-health
- ck-fms - what is it
- the other side of the gym: developing sensory motor performance
- DO YOUR SHOES PASS THE TWIST TEST?
Sunday, January 10, 2010
Range of Motion demonstration: KB Long Cycle and Yut of Today
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Part of the impetus of z-health mobility work is to get better Range of Motion (ROM) - and better control of it. We're often told this ROM is something we lose as we age, get sedinary and that kids have it in spades. Note a wee child squatting or deadlift'ing to pick something up. Well here's a somewhat older than typical example of form and function. Coach Randy Hauer says the person is coached by Chris Wells:
Great examples here of thoracic mobility, shoulder range of motion, good hip flexibility in particular. These can be helped not by stretching, but mobility work. R-phase Z-health drills like ankle tilts, toe pulls, hip circles. Then thoracic glides back and forth and side to side and some shoulder cam shafts. Combining these in sport-specific movement positions, as in I-phase, also sweet sweet sweet.
Related Links
Tweet Follow @begin2dig
Great examples here of thoracic mobility, shoulder range of motion, good hip flexibility in particular. These can be helped not by stretching, but mobility work. R-phase Z-health drills like ankle tilts, toe pulls, hip circles. Then thoracic glides back and forth and side to side and some shoulder cam shafts. Combining these in sport-specific movement positions, as in I-phase, also sweet sweet sweet.
Related Links
Tweet Follow @begin2dig
Wednesday, January 6, 2010
Running Shoes as Single Factor Thinking
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This is a post about Shoes not as evil, but as it seems a Great Feat of Misdirection. It's a wee bit about our biases towards single factor solutions for complex problems, and the arguments we will have around the Chosen Factor rather than pulling up and back to consider the wider view. In science, there's a strong bias towards studying the effect of a single factor in various circumstances, but you'll rarely find a scientist who will say that single factor study or finding is The Solution - as we'll see below. That's down usually to the media who tries to promote such results, or companies that like the sound of same.
We are such complex (and complicated) organisms, yet we yearn for the Single Factor Solution to complex issues. We usually see this with respect to struggles for fat loss, where single approaches - the right diet, the right workout, the right diet pill, the right diet surgery - are put to address what involves a cornucopia of issues, as described here just the other day. The same single factor thinking is evident in running shoes, too. The Shoe is the Solution. Get the Right Shoe before daring a Run. And so this post focuses around a response to a study. About sneakers.
So let's back up: why putitively are there so many durn sneakers out there such that there are studies about their effects? Selling that great shoe that's just right for your running gait peculiarities to reduce injury and let you run like blazes is of course an important thing. And of course the more you can afford the better the protection you can buy. More cushioning, more multiparts of rubber density in the sole etc etc. Or so the sales pitch goes.
But this is also a kind of single factor approach to good mechanics for running. It says let the shoe take care of any weirdness in your gait, cuz that's just the way you are, you're stuck, and so need to be "corrected" . That's a much faster solution (seemingly) than taking the more complex view of IF something is off with the gait that may be problematic for performance, how best deal with that? After all, we're plastic people, as Woolf's Law and Davis's Law have shown: bone and tissue are responsive to what we do. Is this something that can be addressed more holistically perhaps?
And so, as readers of b2d may know, there's a growing movement around "less is more" for foot wear, and indeed "free your feet" anytime of day, and in sports like running as well (with the b2d index of vibram fivefingers stories as a wee illustration) - where the emphasis is on (a) trust our own engineering and (b) work actively with our own engineering to improve it, rather than rely on prosthetics. Prosthetics *may* have knock on consequences, like reinforcing rather than solving an issue.
More Support for Less Support? So it was with happiness that i received the note from Chris from Conditioning research on a Science Daily story: Running Shoes May Cause Damage to Knees, Hips and Ankles, New Study Suggests. Ah good! a study that shoes what we of the Free Your Feet persuasion have been saying for some time. One more piece in the Trust your Foot - it's engineering is older than a shoe company's. There's a study i covered from the summer that showed as well that no matter what shoes for what supposed gait issues a person had, they didn't reduce incidence of injury. That's an important result, since of course these special shoe designs are all supposed to do exactly that: help reduce injuries.
I've written before about why any kind of thick padding and movement restricting of the joints of the food would have a hard time reducing injury when it so limits proprioceptive feedback (our positioning/speed in space), so it's not a surprise that more work is finding specific results showing other issues with running shoes.
Violent Agreement. The following day of the above post, Chris sent me another pointer, this time to Amby Burfoot, a runner's world editor at large commenting on the "dismal science" of the original study. The response is on the Runners World.com blog. And so i was taken aback when the author accused the study's author of being biased because she'd developed a flat shoe.
It's pretty hard to get more circumspect about findings that this. Indeed the study concludes with
Right. The same result does not always mean the same process is operating to get that result. And that's just force not torque. But even so, so what? And even more, how possible is it to sustain that tension in a run over time/distance? Burfoot's a runner. How long is it possible to keep up tension when running distances, if that's what's causing less of a strike force or less of a joint torque? It may be possible to psych up and hold forces for one jump at a time, but continuous running?
Is there a Problem Here? Well, the big question is which approach is better for less injuries. Thing is, we don't know. We have lots more data on footwear than on minimal footwear or no footwear. It's a current area of research. AND KERRIGAN'S STUDY ISN'T OVER CLAIMING ANYTHING. It's: here's the data; in the discussion, we THINK this is what it might mean. There are limits to these results, and we may need to check that further.
Burfoot doesn't like that Kerrigan says that the forces at the knee measured in this study of sneakers are higher than those measured comparing highheels to non. He says walking is different than running. True. But the comparisons are RELATIVE. Walking is compared to walking and running to running. And that does indeed as Kerrigan says "represent substantial biomechanical changes" and Kerrigan's paper also states "However, given the substantial increases, there may be other factors as well." How about that. Multifactor thinking.
What Kerrigan's work has done is provide some data to have for later correlations when we start to get bare or near barefoot running population study results.
Anecdotally i know more folks than not who say going to things like vibram fivefingers has improved their experience of stability and confidence and speed and movement and...
Burfoot says he's in favour of as little shoe'ing as possible,
But all that aside, there's a few more things to think about here in a post finally about single factor thinking. And unlike Kerrigan's speculation about her team's results and their meanings for injury, burfoot has certain certanties, like the last point about "that's the only shoe that will work for them"
Which finally brings me back around to Single Factor Thinking. Here, it's the shoe is the solution. Maybe that's not what Burfoot meant entirely, but when we consider the context of Runner's World again, that's certainly what Runner's World's content is about. The Shoe is the Solution.
Final Fallacy? Let's ask the question WHY would that Beast be "the only shoe that would work for them"? Burfoot doesn't say what "works" means. Is it because their foot position is shite according to some norm, and this shoe is trying to oh i dunno correct stride? to maybe oh reduce injuries? when we KNOW that no specific shoe design does that? It seems that such an assertion is kind of at least partially crap.
Burfoot talks about "an experiment of one" quoting running guru George Sheehan. Well ok, what's the value of an experiment of one? In most cases in science it's zip. zero. nada. And a poorly designed experiment with such a tiny population is even worse. So what IS the experiment of one here supposed to be to determine "works"?
To go try on a bunch of shoes and say "this is the shoe hat 'works' for me" is a pretty crap trial if the Shoe is the Single Factor in the assessment - and if all what one is going for is a comfortable feeling shoe. Unless of course you're not trying on a bunch of shoes, but the sales person has already said "you overpronate; you should only try these" so your selection has just gone down. How many people have said those spring loaded Nikes are the best shoe that works for them? Or what about those totally inflexible Masai's? What are the measures of the experiment there as one's back continues to ache? But they feet feel great so heck you have the right shoes?
That's just poor study design - if you're interested in the performance of an entire system, not just the foot.
If the Shoe Fits as More Single Factor Thinking Kerrigan's group's study's conclusions aren't my happy place either, personally, but close. Their take away is that shoe design has focused on the foot's mechanics to the exclusion of the rest of the gait - or at least the knee. One joint further up the chain. Her work is saying that for good or ill those designs are having knock on effects up the chain. And for her, designing a shoe that minimizes those effects seems like a good idea.
Ok, what potentially debilitating effect of switching to barefoot running? The "potentially debilitating effect of switching to barefoot running" sounds so much like the same old rationales for selling cushy sneakers in the first place. Be afraid. Be very afraid of putting your foot down in a running gait without some kind of Protection.
Getting Shod of Being Shod Here's an idea: start with your bare feet. Are you happy walking around in your bare feet? Neutral? Great. Why not move more that way? Why not find shoes that will enable that to happen? Some folks even recommend progressions - from whatever one is in now, to Nike Frees, and from there to thin soled shoes like running flats, and then to Vibram FiveFingers, and THEN - gosh, ya just gotta try au naturale as PART of a program of enhanced mobility?
In my experience working with athletes who have running issues, the ONLY time i've seen going to a no shoe (what Burfoot prefers) is when they've had some particular issue with a bone or otherwise that requires more often than not some cushioning and some support TEMPORARILY as they work out of PAIN AND work on other parts of their movement.
The Non Single Factor. In one case, this working towards let's call it raw or natural movement involved strategies to address inflamation (some diet changes in that case), some movement work, AND some foot orthotics and very neutral shoes with cushioning as said to help move the person out of pain.
In other cases, dealing with achiles issues, i've seen folks slowly, progressively moving into shoes that pass the twist test (bend from one end to the other, not just at the ball; twist like ringing out a tea towel) as PART of their rehab experience accelerated recovery.
And more, folks who have switched to twist test passing footwear as PART of a program to better global movement also seem to report other aches etc going.
So i'm not going to claim that better quality of physical life is all down to twist passing footwear - that would be single factor - but why that footwear seems to help is that it lets us find a truth about our movement, work with that movement, improve that movement, and not have a device like a shoe type mess up that work. In fact by using the most flexible footware possible for the person, it seems, we get a whole lot more reps for our bodies to practice that movement.
I say this typing having hoofed it up to work in a pair of vivo boots (snowing outside) and having changed into a pair of VFF's for the office. So it is possible to respect our feet even in winter weather. Snow shoe boots with rubber grips are also awesome possibilities.
So my combo? As i've suggested many times now:
The above list does not take into account all of the other factors that can play havoc with movement quality/injury suseptibility like nutrition, rest, stress, recovery etc. All of these things need to be considered as well as part of the whole system. My wee combo set is that a more rich place to begin thinking about running, is to think about running, the whole movement - and moving well - and looking at how to enhance that for ourselves rather than hitting a crutch first - especially one that has been shown to have no effect on the very thing it's been claimed to do: reduce injuries.
citations
Kerrigan, D., Franz, J., Keenan, G., Dicharry, J., Della Croce, U., & Wilder, R. (2009). The Effect of Running Shoes on Lower Extremity Joint Torques PM&R, 1 (12), 1058-1063 DOI: 10.1016/j.pmrj.2009.09.011
Knapik JJ, Swedler DI, Grier TL, Hauret KG, Bullock SH, Williams KW, Darakjy SS, Lester ME, Tobler SK, & Jones BH (2009). Injury reduction effectiveness of selecting running shoes based on plantar shape. Journal of strength and conditioning research / National Strength & Conditioning Association, 23 (3), 685-97 PMID: 19387413 Tweet Follow @begin2dig
This is a post about Shoes not as evil, but as it seems a Great Feat of Misdirection. It's a wee bit about our biases towards single factor solutions for complex problems, and the arguments we will have around the Chosen Factor rather than pulling up and back to consider the wider view. In science, there's a strong bias towards studying the effect of a single factor in various circumstances, but you'll rarely find a scientist who will say that single factor study or finding is The Solution - as we'll see below. That's down usually to the media who tries to promote such results, or companies that like the sound of same.We are such complex (and complicated) organisms, yet we yearn for the Single Factor Solution to complex issues. We usually see this with respect to struggles for fat loss, where single approaches - the right diet, the right workout, the right diet pill, the right diet surgery - are put to address what involves a cornucopia of issues, as described here just the other day. The same single factor thinking is evident in running shoes, too. The Shoe is the Solution. Get the Right Shoe before daring a Run. And so this post focuses around a response to a study. About sneakers.
So let's back up: why putitively are there so many durn sneakers out there such that there are studies about their effects? Selling that great shoe that's just right for your running gait peculiarities to reduce injury and let you run like blazes is of course an important thing. And of course the more you can afford the better the protection you can buy. More cushioning, more multiparts of rubber density in the sole etc etc. Or so the sales pitch goes.
But this is also a kind of single factor approach to good mechanics for running. It says let the shoe take care of any weirdness in your gait, cuz that's just the way you are, you're stuck, and so need to be "corrected" . That's a much faster solution (seemingly) than taking the more complex view of IF something is off with the gait that may be problematic for performance, how best deal with that? After all, we're plastic people, as Woolf's Law and Davis's Law have shown: bone and tissue are responsive to what we do. Is this something that can be addressed more holistically perhaps?And so, as readers of b2d may know, there's a growing movement around "less is more" for foot wear, and indeed "free your feet" anytime of day, and in sports like running as well (with the b2d index of vibram fivefingers stories as a wee illustration) - where the emphasis is on (a) trust our own engineering and (b) work actively with our own engineering to improve it, rather than rely on prosthetics. Prosthetics *may* have knock on consequences, like reinforcing rather than solving an issue.
More Support for Less Support? So it was with happiness that i received the note from Chris from Conditioning research on a Science Daily story: Running Shoes May Cause Damage to Knees, Hips and Ankles, New Study Suggests. Ah good! a study that shoes what we of the Free Your Feet persuasion have been saying for some time. One more piece in the Trust your Foot - it's engineering is older than a shoe company's. There's a study i covered from the summer that showed as well that no matter what shoes for what supposed gait issues a person had, they didn't reduce incidence of injury. That's an important result, since of course these special shoe designs are all supposed to do exactly that: help reduce injuries.
I've written before about why any kind of thick padding and movement restricting of the joints of the food would have a hard time reducing injury when it so limits proprioceptive feedback (our positioning/speed in space), so it's not a surprise that more work is finding specific results showing other issues with running shoes.
Violent Agreement. The following day of the above post, Chris sent me another pointer, this time to Amby Burfoot, a runner's world editor at large commenting on the "dismal science" of the original study. The response is on the Runners World.com blog. And so i was taken aback when the author accused the study's author of being biased because she'd developed a flat shoe.
This from an editor of runner's world, where the companies best selling issues are their seasonal reviews of new shoes? Likewise, Kerrigan's disclosed company's technology is not what's studied in the reported experiments. It's pretty hard to find a scientist who doesn't formulate a hypothesis or an objective before beginning a study. What was Kerrigan's?
I'm not calling Kerrigan and Richards liars. Far from it, I agree with Richards's conclusion. But we should understand the motivation behind their writing and their research projects.
Objective: To determine the effect of modern-day running shoes on lower extremity joint torques during running.And what were the conclusions?
The findings at the knee suggest relatively greater pressures at anatomical sites that are typically more prone to knee osteoarthritis, the medial and patellofemoral compartments. It is important to note the limitations of these findings and of current 3-dimensional gait analysis in general, that only resultant joint torques were assessed. It is unknown to what extent actual joint contact forces could be affected by compliance that a shoe might provide, a potentially valuable design characteristic that may offset the observed increases in joint torques.Ok - knees are places that are more prone to a certain type of nasty arthritis. You'd think that more force at the knee would be problematic. We don't know, but we can say that there's more force with running shoes than not, but heck we only have the start of a partial picture here, and something more we'd need to know to enhance footware design we still don't have.
It's pretty hard to get more circumspect about findings that this. Indeed the study concludes with
Although increased repetitive loading has been shown to be a critical factor for the degeneration of articular cartilage at the knee, the forces experienced by distance runners have not been consistently found to increase the risk of onset of knee OA.But it seems Burfoot is not happy, saying that you can't make connections between forces and injuries. Kerrigan isn't saying that, but Burfoot points to a study where supposedly athletes were asked to jump onto matts they were told were of varying thicknesses, when they were all the same, and the forces measured varied according to one hypothesis goes - expectation - so various degrees of relaxation rather than tensing pre jump had effects on forces. Remember - this is an hypothesis of what's going on. But Burfoot instead says that the same thing is happening in Kerrigan's study BECAUSE the results are the same in terms of more padding; higher forces; less padding more tensed forces. etc.
Right. The same result does not always mean the same process is operating to get that result. And that's just force not torque. But even so, so what? And even more, how possible is it to sustain that tension in a run over time/distance? Burfoot's a runner. How long is it possible to keep up tension when running distances, if that's what's causing less of a strike force or less of a joint torque? It may be possible to psych up and hold forces for one jump at a time, but continuous running?
Is there a Problem Here? Well, the big question is which approach is better for less injuries. Thing is, we don't know. We have lots more data on footwear than on minimal footwear or no footwear. It's a current area of research. AND KERRIGAN'S STUDY ISN'T OVER CLAIMING ANYTHING. It's: here's the data; in the discussion, we THINK this is what it might mean. There are limits to these results, and we may need to check that further.
Burfoot doesn't like that Kerrigan says that the forces at the knee measured in this study of sneakers are higher than those measured comparing highheels to non. He says walking is different than running. True. But the comparisons are RELATIVE. Walking is compared to walking and running to running. And that does indeed as Kerrigan says "represent substantial biomechanical changes" and Kerrigan's paper also states "However, given the substantial increases, there may be other factors as well." How about that. Multifactor thinking.
What Kerrigan's work has done is provide some data to have for later correlations when we start to get bare or near barefoot running population study results.
Anecdotally i know more folks than not who say going to things like vibram fivefingers has improved their experience of stability and confidence and speed and movement and...
Burfoot says he's in favour of as little shoe'ing as possible,
That said, I agree with her apparent position on one important point: Much of what we put under our feet has the potential to do more harm than good. You can't "raise the platform" without increasing instabilities. When you build one of those house-of-cards structures, the higher you go, the closer you get to collapse.Wow, so all that article comes down to agreement about the main tenants of the "interested party"s findings. Strum and Drang in a teapot?
I believe many of us should buy the lowest-tech running shoe we can get away with. For the few who live in Shangri-La, that might mean no shoe at all. For others, it might mean a simple racing flat. For others, the very Brooks Adrenalines that were used in Kerrigan's study.
But some runners shouldn't even look at any shoe other the Brooks Beast, or a similarly built-up shoe. Because, in their experiment of one, that's the only shoe that will work for them
But all that aside, there's a few more things to think about here in a post finally about single factor thinking. And unlike Kerrigan's speculation about her team's results and their meanings for injury, burfoot has certain certanties, like the last point about "that's the only shoe that will work for them"
Which finally brings me back around to Single Factor Thinking. Here, it's the shoe is the solution. Maybe that's not what Burfoot meant entirely, but when we consider the context of Runner's World again, that's certainly what Runner's World's content is about. The Shoe is the Solution.
Final Fallacy? Let's ask the question WHY would that Beast be "the only shoe that would work for them"? Burfoot doesn't say what "works" means. Is it because their foot position is shite according to some norm, and this shoe is trying to oh i dunno correct stride? to maybe oh reduce injuries? when we KNOW that no specific shoe design does that? It seems that such an assertion is kind of at least partially crap.
Burfoot talks about "an experiment of one" quoting running guru George Sheehan. Well ok, what's the value of an experiment of one? In most cases in science it's zip. zero. nada. And a poorly designed experiment with such a tiny population is even worse. So what IS the experiment of one here supposed to be to determine "works"?
To go try on a bunch of shoes and say "this is the shoe hat 'works' for me" is a pretty crap trial if the Shoe is the Single Factor in the assessment - and if all what one is going for is a comfortable feeling shoe. Unless of course you're not trying on a bunch of shoes, but the sales person has already said "you overpronate; you should only try these" so your selection has just gone down. How many people have said those spring loaded Nikes are the best shoe that works for them? Or what about those totally inflexible Masai's? What are the measures of the experiment there as one's back continues to ache? But they feet feel great so heck you have the right shoes?
That's just poor study design - if you're interested in the performance of an entire system, not just the foot.
If the Shoe Fits as More Single Factor Thinking Kerrigan's group's study's conclusions aren't my happy place either, personally, but close. Their take away is that shoe design has focused on the foot's mechanics to the exclusion of the rest of the gait - or at least the knee. One joint further up the chain. Her work is saying that for good or ill those designs are having knock on effects up the chain. And for her, designing a shoe that minimizes those effects seems like a good idea.
The development of new footwear designs that encourage or mimic the natural compliance that normal foot function provides while minimizing knee and hip joint torques is warranted. Reducing joint torques with footwear completely to that of barefoot running, while providing meaningful footwear functions, especially compliance, should be the goal of new footwear designs.Gosh, that sounds like vibram fivefingers - for example - to me. Just get out of the way of the foot. But then we have tricky words like "compliance " as "meaningful footware functions." Hmm. One can now go to kerrigan's company's page for what she thinks is a good compromise answer for the problem that, "The use of athletic footwear in running as a means to protect the foot from acute injury and the potentially debilitating effect of switching to barefoot running on foot health excludes such an alternative"
Ok, what potentially debilitating effect of switching to barefoot running? The "potentially debilitating effect of switching to barefoot running" sounds so much like the same old rationales for selling cushy sneakers in the first place. Be afraid. Be very afraid of putting your foot down in a running gait without some kind of Protection.
Getting Shod of Being Shod Here's an idea: start with your bare feet. Are you happy walking around in your bare feet? Neutral? Great. Why not move more that way? Why not find shoes that will enable that to happen? Some folks even recommend progressions - from whatever one is in now, to Nike Frees, and from there to thin soled shoes like running flats, and then to Vibram FiveFingers, and THEN - gosh, ya just gotta try au naturale as PART of a program of enhanced mobility?
In my experience working with athletes who have running issues, the ONLY time i've seen going to a no shoe (what Burfoot prefers) is when they've had some particular issue with a bone or otherwise that requires more often than not some cushioning and some support TEMPORARILY as they work out of PAIN AND work on other parts of their movement.
The Non Single Factor. In one case, this working towards let's call it raw or natural movement involved strategies to address inflamation (some diet changes in that case), some movement work, AND some foot orthotics and very neutral shoes with cushioning as said to help move the person out of pain.
In other cases, dealing with achiles issues, i've seen folks slowly, progressively moving into shoes that pass the twist test (bend from one end to the other, not just at the ball; twist like ringing out a tea towel) as PART of their rehab experience accelerated recovery.
And more, folks who have switched to twist test passing footwear as PART of a program to better global movement also seem to report other aches etc going.
So i'm not going to claim that better quality of physical life is all down to twist passing footwear - that would be single factor - but why that footwear seems to help is that it lets us find a truth about our movement, work with that movement, improve that movement, and not have a device like a shoe type mess up that work. In fact by using the most flexible footware possible for the person, it seems, we get a whole lot more reps for our bodies to practice that movement.
I say this typing having hoofed it up to work in a pair of vivo boots (snowing outside) and having changed into a pair of VFF's for the office. So it is possible to respect our feet even in winter weather. Snow shoe boots with rubber grips are also awesome possibilities.
So my combo? As i've suggested many times now:
- - get a movement assessment to check out your WHOLE way of moving so you're not, as gray cook says, putting strength on top of dysfunction. Such an assessment will give you some strategies/movements to practice to optimize your athletic movement. Here's a list of z-health movement coaches (i do video consults too via skype - email me, link end of post)
- - take up a mobility practice to support and enhance full joint well being for better movemen and injury prevention. Some folks like t'ai Chi and related. Sure. i like z-health. Here's why in comparison with those other approaches.
- - move towards footwear that increasingly passes the twist test (gets closer to letting our feet be our feet without interuption). CAVEAT If anything causes pain/discomfort, stop, go back a step, slow down. Check with your movement specialist. Pain is a signal to change. So worth attending.
The above list does not take into account all of the other factors that can play havoc with movement quality/injury suseptibility like nutrition, rest, stress, recovery etc. All of these things need to be considered as well as part of the whole system. My wee combo set is that a more rich place to begin thinking about running, is to think about running, the whole movement - and moving well - and looking at how to enhance that for ourselves rather than hitting a crutch first - especially one that has been shown to have no effect on the very thing it's been claimed to do: reduce injuries.
citations
Kerrigan, D., Franz, J., Keenan, G., Dicharry, J., Della Croce, U., & Wilder, R. (2009). The Effect of Running Shoes on Lower Extremity Joint Torques PM&R, 1 (12), 1058-1063 DOI: 10.1016/j.pmrj.2009.09.011
Knapik JJ, Swedler DI, Grier TL, Hauret KG, Bullock SH, Williams KW, Darakjy SS, Lester ME, Tobler SK, & Jones BH (2009). Injury reduction effectiveness of selecting running shoes based on plantar shape. Journal of strength and conditioning research / National Strength & Conditioning Association, 23 (3), 685-97 PMID: 19387413 Tweet Follow @begin2dig
Friday, December 18, 2009
Motivation as Skill: a Functional Definition of same
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If asked, "what is motivation" what's the reply you'd give? Is it practical? Useful? Most definitions are not. They are amorphously about goals, ambition, drive. Wikipedia talks about "activation of goal oriented behaviour" but doesn't talk about what that behaviour is. Then there's "desire or aspiration, combined with effort" to achieve a goal. How far does just Will Power get one? One article refered to it as a specific "characteristic to achieve anything in life." Does that mean one might not have that gene? And to be Goal directed sounds so Big rather than immediate (more about various processes of coping with goals here). you'd swear from the way it's discussed, motivation is the key to any success. And yet how do such urfy flurfy definitions help us achieve anything?
For instance, if one looks out the window in the morning and it's snowing (as it is in southern england right now) and one is cold a 'bed, and well, as the Stanislovski inspired actor might say "What's my motivation?" to leave this happy state, what "goal" is there to which we might appeal to say "i have to go into work. blast"
Somehow going to work on a regular basis just does not seem like a goal, does it? It's rather a Maslow-ish necessity if that's how we maintain food, shelter, and not least that nice, warm bed? Let's get real - with motivation.
Getting Functional. In the i-phase z-health certification, motivation is a key component of the course as a key part of good coaching practice, and Eric Cobb, one of the most de-mystifying people i've heard present, takes what i've come to understand is a typically Cobbish/Cobbsian, view of motivation in terms of what can be turned into actual practice. That is, it's functional rather than personal. Motivation is the assessment between two consequences. That is we tend to weigh up the cost of doing the thing and not doing the thing, and go from there. So, in my mind, is the cost of not trudging through this untenable blustering british snow and going to work greater than the cost of getting up and going and out the door to work?
There's a certain appeal to this approach to motivation, not the least because, as Cobb puts it, one doesn't have to be all chipper to take the necessary action - something else that motivation seems typically to imply. One can be in a dreadful mood and still do the deed. One might even sulk a bit, and still have the Force of Negative Consequences to motivate one out the door. And if you dear reader need help with letting go of a dire mood cuz such things just suck one's energy, i have another post/idea for you here.
Death to the term "unmotivated" But then on the other side of the non-chipper doing, is the potentially happy decision to work from home rahter than work if such is an option. By putting the decision in terms of a cost/benefit analysis, removing the personal character traits, one may not be tarred with the offending brush that one is simply therefore "unmotivated." That is so disparaging. It seems to assert that there is a deep problem at the character level if one decides the costs outweigh the benefits of taking action.
The other context of course in which we see the harmful use of the term "unmotivated" is with folks who have struggled to acheive something -say a body comp goal - and repeatedly diet and miss or rebound. They are "unmotivated" or they'd succeed. Piffle. Lack of strategies for success is not the same as lack of decision to act.
Getting Practical: Skills rather than Flurfiness. But to the point, the idea of what i'm calling a functional definition of motivation is that it takes the Mystical and Emotional and Innate Characteristic out of the concept and makes it a practicable skill.
That is, rather than being about the right attitude - whatever that may be - it's about good, informed analysis. And it's way easier to chart out skills (that's the functional part) for analysis of consequences, and to define practicable skills to support any other practice one wants to perform (like getting to work or lifting a heavy object), than it is to develop something as mystical as Attitude. After all, if work required one always to be desperately in love with what one were doing to be motivated to do it, how much work would get done?
Aside - in discussing these ideas with colleagues at the dragondoor forum, someone brought up
Mihaly Csikszentmihalyi's Flow. Excellent book. If you haven't read it, or heard it, by all means, recommended.
The flow state is where one is doing something such that one is taxed sufficiently that skills are being called to bear so that one is engaged enough to find an action challenging and interesting. If one is overtaxed - say by a far more skilled opponent in a match of some kind - the task is hopeless - no place for purchase. Likewise if the task is underengaging one becomes bored and can be depressed or frustrated as well though for other reasons. So the author argues for any task, it is optimal to find a way to be in flow. But to get to flow, we assume that one has decided to engage in the activity, knows what they're doing to exectute it at an appropirate level of demand.
Familiarity of Cost/Benefit Analysis. The thing about this working definition of motivation is that it's based on something we already do quite regularly: i have to go to work lest i be fired. I must teach this class else folks take their money back and i starve.
What having the definition made explicit does, it seems to me, is it takes it outside of some innate mystical quality and makes it something accessible for discussion and analysis. So we can take apart our regular practice, interrogate it, and find ways to address obstacles. For instance Cobb has a tip that if we don't want to do something, find a way to get moving with it for three minutes and after that it will get into gear. Cool.
Likewise, thinking about the Season of Regret nigh upon us with body comp oriented goals or other New Years oriented deferrals of action promised, we have a very functional way to look at, say, food: we know that eating this additional mince pie will mean 40 more minutes of HIIT that we mayn't have in our bodies to erase. But what happens if that particular negative consequence isn't enough of a cost-as-motivation (rather than benefit as motivation) for the immediate denial of the extra Mince Tart? The consequence seems too far away for immediate payment. And so we still keep chomping?
What this suggests are potential opportunities to build up a bunch of things:
interrogating the perceived cost/benefits.
are the reasons what colleagues talk about as intrinsic or extrinsic? immediate or long term? I will be fired (extrinsic) or i will gain weight (too far away to be perceived) vs i have promised to do this thing and i value my word (intrinsic & immediate). Moving towards cost benefit analysis that focuses on intrinsic & immediate costs and benefits can help sustain a practice when extrinsic motivators may weaken.
In the mince tart example, this kind of instrinsic cost/benefit analysis framing may have more immediate usefulness. For instance, i made a promise to myself that i would only have one tart at this party, and i can keep that promise to myself. It's an important principle to me to do what i say, even to myself.
Skills in Motivation Analysis: Finding out what these both more intrinsic & immediately effective motivators are SKILLS based, not innate knowledge. It's not because we're a bad person and have no Will Power that we may fail in what we are motivated to do. We may have that in spades, but without the techniques of how to develop the analysis (recognise intrinsic vs extrinsic; what will be helpful at an immediate decision point rather than some far away goal etc)
Hence the value of seeing motivation as an assessment of consequences first (analysis not character), and then getting a set of related skills going (the right level of analysis) that will best support the desired consequence throughout practice. In other words, finding the right cost/benefit analysis that will keep mince tart munching to an acceptable level.
If we work with others, coaching, teaching, whatever, this also gives us a framework, it seems, to help
them look achieving what they want: what are the extrinsic and intrinsic benefits and costs?
It's this kind of skills and functional approach around developing habits that i've been finding particularly fascinating of late because it says knowing how to make change per se isn't the main issue; knowing how to make change sustainable is, and that sustenance is NOT innate knowledge.
Sustaining Successful Change
There are a couple of books i've found that really touch on getting and the sustance-as-skills part of change. One of the, in the diet space, is Martha Beck's 4 Day Win. Not unlike Cobb's Three Minutes of Movement to Get Stuck In, Beck finds strategies that are completely and totally doable, and sets up a 4 day win strategy for each towards building better habits for change in the diet space. Her work in psychology has shown that if you can get a new practice going for 4 days, you can get some important re-wiring done.
If you're interested in this kind of plastic brain rewiring, there are other related books recommended here.
The other book i'd recommend for consideration coming into the new year is Stephen Covey and R&A Merril's First Things First. This book is focused on re-wiring habits and perspectives to help get things done.
I like it because it is NOT about how to make To Do lists; it's about figuring out one's real and foundational motivation for something - principles as Covey calls them - and having pracitces to support those principles. Very functional. He talks about how to keep the first things the first things. Or, a fave: don't prioritize your schedule; schedule your priorities. No kidding.
Habits as Skill Sets; Skill Sets as Habits: Both these books represent approaches to develop habits - or what we might call automatic or reflexive or neurologically wired, practiced responses to situations - to help us rather than achieve goals per se, live principled lives. As Covey and colleagues argue, once we know what we're saying "yes" to - what's important to us - it's easier to say "no" to what is not. The heuristics offered in the book for getting to a place in life where, for instance, most activities are Important but Not Urgent is very cool (the other parts of this quad are Not Important and Not Urgent, Urgent (for usually someone else) but not Important (for your Yes), and Urgent and Important. First things First argues that the goal is to get as much as possible happening in that quality quadrant that is non-reactive and then has room for the real and unexpected emergencies, rather than living regularly in the reactive, as many of us do. Functional.
Covey's Quadrants
Who's Involved? Covey, Merril and Merril also tend to look at those Important but Not Urgent things relative to Roles and Relationships. In which of my roles is this task assigned; what trust relationship does that engage? It seems when we situate our responsibilities or things we're motivated to do relative to relationships that we care about because they feature Real People, those actions can become more meaningful. Am i not eating this tart just for myself, or because i care about my family and a commitment i've made to them to get healthy, and this frickin' little tart is one part of that commitment? Or if not to family, i've made a promise to myself that i'll stop at one, and whether it matters or not, in terms of calories, i'm practicing doing what i say i'll do. This is one small act i will have at the end of the day to say i did what i said i would do.
Beck likewise spends time getting to grips with real inner self parts who tend to look out for opposing interests (the wild child and the judge for instance) and come to a place that by understanding these positions, and observing them, and learning some new skills for working with them, we can get our collective acts together.
Skills Aren't Innate, but they can become Wired. Where this all gets to for me, as you can probably
tell, is the notion of being more gentle with ourselves because we ain't born knowing how to do stuff we ain't wired to do.
Consider the fascinating work by Susan Roberts of Tufts around the ways we seem to be wired almost instinctively to go for just the kinds of foods that when there's an abundance of 'um, they become "bad" foods, but at just about any other time than now (now being our supra abundant food always in reach affluent culture), really survival smart: energy dense, familiar, available, satisfy hunger, and even variety rich.
In other words, we need to rewire ourselves to have new instinct-like responses to our 21st C affluent environment, where motivation is more subtle than move or die (though actually that's still the case).
It's Neurological and it's a Skill and So needs Reps. Rewiring is achieved through learning, repping in new neural pathways. And when we learn something, the best teaching is usually that which breaks a practice down into manageable, practicable, learn-able skill sets.
My suggestion is that if you're in doubt about some of those skill sets, the above framing and books may be a useful ways to begin to get to grips with practice, and tune up the motivation to something that can fire up the behaviours, once learned, we want to fire up reflexively to help keep us happy, healthy and wise into the new year.
And coaching: When we work with others - supervising, teaching, coaching - what's good for the
goose is good for the coaching space too. I used to teach a lot of so called "required courses" - courses students had to take as part of their program, and so did not meet with love. One thing found out there is that often students doing a required course hit boredom pretty fast. If we have the Flow model, we can get pretty quickly that the material is either too simple to engage them or too far out of reach to find a way to get engaged. So that's one problem - how to help get to a flow place to provide a pathway.
The same can happen with movement-related goals: the person doesn't have something that allows them to hit a flow state: the prospect of sitting on a stationary bike and pedalling for 40mins is too tedious to endure. So finding flowful practice (to coin a term) is coaching job one.
But let's assume we hit that flow. How stick with it?
In the required course, helping to figure out ways to make a course relevant for a 300 students in one lecture is a bit of a challenge, but actually taking time to talk about what their reason is for being in the room via Covey-like unpacking can be useful: what principle does doing this course support? What are the uber goals to which this particular course is part of the process? How find relevance (and if we can't, well, perhaps that is a Sign Unto Us to Find Something that Is).
That's one tack. Creating a craving may be another. Finding the hook to associating the action with pleasure (reward) such that there's a gap, a loss, when it's not there, is a Good Thing, too. So we can imagine that finding flow may help find the reward/pleasure in something and doing that thing becomes one way to get that feeling back. How do we find that hook?
Assuming someone wants to figure that out, wants to get to that place of Doing the Thing, Motivational Interviewing
is a strategy for helping folks self-talk towards supporting these behaviours they've already decided they want to undertake. Generally the strategy is about how to listen effectively and affectively. I mention this in passing right now for reference if you are working especially one on one coaching (whether athletically or otherwise) someone towards that intrinsic motivation path.
Move along little doogie, move along. A quickie path to better days seems to be movement in general. One of the best things about creating a habit of moving (and if we walk we already have some of that habit to build upon) is that we're designed to move; not moving is not as much fun as moving. We feel better when we do it.
The challenge for a coach may be making the case that there are LOADS of options that fulfil the movement criteria. Don't want to lift heavy today? Fine. Let's do something else. The movement is the habbit. That's the pleasure; not the guilt trip of not doing *exactly* what one imagined one was supposed to do. Shoot that word "should" please.
IT seems easier to stay motivated - to get the cost/benefit effect when the practice of the action becomes pleasurable, desireable rather than a chore. A good coach - of movement or any activity - will help make that happen with us.
Practice: it never frickin' stops
The intriguing thing i have found is that like any skill, to stay razor sharp, or even just half way effective, even these skills have to be practiced regularly. They need their 10thousand hours, too. And right now that's exactly what i need (am motivated) to do. Get my 3 min. dig in going. And heh, it's actually stopped snowing and there's a blue sky. In the UK. In december. Wow, makes me feel, oh i dunno, motivated? Na. The consequences haven't changed from 5 mins ago, but there's one less obstacle now to getting down to it.
All the best to you and your practice.
Related Posts
For instance, if one looks out the window in the morning and it's snowing (as it is in southern england right now) and one is cold a 'bed, and well, as the Stanislovski inspired actor might say "What's my motivation?" to leave this happy state, what "goal" is there to which we might appeal to say "i have to go into work. blast"Somehow going to work on a regular basis just does not seem like a goal, does it? It's rather a Maslow-ish necessity if that's how we maintain food, shelter, and not least that nice, warm bed? Let's get real - with motivation.
Getting Functional. In the i-phase z-health certification, motivation is a key component of the course as a key part of good coaching practice, and Eric Cobb, one of the most de-mystifying people i've heard present, takes what i've come to understand is a typically Cobbish/Cobbsian, view of motivation in terms of what can be turned into actual practice. That is, it's functional rather than personal. Motivation is the assessment between two consequences. That is we tend to weigh up the cost of doing the thing and not doing the thing, and go from there. So, in my mind, is the cost of not trudging through this untenable blustering british snow and going to work greater than the cost of getting up and going and out the door to work?
There's a certain appeal to this approach to motivation, not the least because, as Cobb puts it, one doesn't have to be all chipper to take the necessary action - something else that motivation seems typically to imply. One can be in a dreadful mood and still do the deed. One might even sulk a bit, and still have the Force of Negative Consequences to motivate one out the door. And if you dear reader need help with letting go of a dire mood cuz such things just suck one's energy, i have another post/idea for you here.
Death to the term "unmotivated" But then on the other side of the non-chipper doing, is the potentially happy decision to work from home rahter than work if such is an option. By putting the decision in terms of a cost/benefit analysis, removing the personal character traits, one may not be tarred with the offending brush that one is simply therefore "unmotivated." That is so disparaging. It seems to assert that there is a deep problem at the character level if one decides the costs outweigh the benefits of taking action.
The other context of course in which we see the harmful use of the term "unmotivated" is with folks who have struggled to acheive something -say a body comp goal - and repeatedly diet and miss or rebound. They are "unmotivated" or they'd succeed. Piffle. Lack of strategies for success is not the same as lack of decision to act.
Getting Practical: Skills rather than Flurfiness. But to the point, the idea of what i'm calling a functional definition of motivation is that it takes the Mystical and Emotional and Innate Characteristic out of the concept and makes it a practicable skill.
That is, rather than being about the right attitude - whatever that may be - it's about good, informed analysis. And it's way easier to chart out skills (that's the functional part) for analysis of consequences, and to define practicable skills to support any other practice one wants to perform (like getting to work or lifting a heavy object), than it is to develop something as mystical as Attitude. After all, if work required one always to be desperately in love with what one were doing to be motivated to do it, how much work would get done?
Aside - in discussing these ideas with colleagues at the dragondoor forum, someone brought up Mihaly Csikszentmihalyi's Flow. Excellent book. If you haven't read it, or heard it, by all means, recommended.
The flow state is where one is doing something such that one is taxed sufficiently that skills are being called to bear so that one is engaged enough to find an action challenging and interesting. If one is overtaxed - say by a far more skilled opponent in a match of some kind - the task is hopeless - no place for purchase. Likewise if the task is underengaging one becomes bored and can be depressed or frustrated as well though for other reasons. So the author argues for any task, it is optimal to find a way to be in flow. But to get to flow, we assume that one has decided to engage in the activity, knows what they're doing to exectute it at an appropirate level of demand.
Familiarity of Cost/Benefit Analysis. The thing about this working definition of motivation is that it's based on something we already do quite regularly: i have to go to work lest i be fired. I must teach this class else folks take their money back and i starve.
What having the definition made explicit does, it seems to me, is it takes it outside of some innate mystical quality and makes it something accessible for discussion and analysis. So we can take apart our regular practice, interrogate it, and find ways to address obstacles. For instance Cobb has a tip that if we don't want to do something, find a way to get moving with it for three minutes and after that it will get into gear. Cool.
Likewise, thinking about the Season of Regret nigh upon us with body comp oriented goals or other New Years oriented deferrals of action promised, we have a very functional way to look at, say, food: we know that eating this additional mince pie will mean 40 more minutes of HIIT that we mayn't have in our bodies to erase. But what happens if that particular negative consequence isn't enough of a cost-as-motivation (rather than benefit as motivation) for the immediate denial of the extra Mince Tart? The consequence seems too far away for immediate payment. And so we still keep chomping?
What this suggests are potential opportunities to build up a bunch of things:
interrogating the perceived cost/benefits.
are the reasons what colleagues talk about as intrinsic or extrinsic? immediate or long term? I will be fired (extrinsic) or i will gain weight (too far away to be perceived) vs i have promised to do this thing and i value my word (intrinsic & immediate). Moving towards cost benefit analysis that focuses on intrinsic & immediate costs and benefits can help sustain a practice when extrinsic motivators may weaken.
In the mince tart example, this kind of instrinsic cost/benefit analysis framing may have more immediate usefulness. For instance, i made a promise to myself that i would only have one tart at this party, and i can keep that promise to myself. It's an important principle to me to do what i say, even to myself.
Skills in Motivation Analysis: Finding out what these both more intrinsic & immediately effective motivators are SKILLS based, not innate knowledge. It's not because we're a bad person and have no Will Power that we may fail in what we are motivated to do. We may have that in spades, but without the techniques of how to develop the analysis (recognise intrinsic vs extrinsic; what will be helpful at an immediate decision point rather than some far away goal etc)
Mince Tart Eating Analysis
| Motivation Cost/Benefit | immediate | longer term |
| intrinsic | promise to self | health |
| extrinsic | maybe not a lot | - public image: fat - lower cost & effort of calories to make up |
Hence the value of seeing motivation as an assessment of consequences first (analysis not character), and then getting a set of related skills going (the right level of analysis) that will best support the desired consequence throughout practice. In other words, finding the right cost/benefit analysis that will keep mince tart munching to an acceptable level.
If we work with others, coaching, teaching, whatever, this also gives us a framework, it seems, to help
them look achieving what they want: what are the extrinsic and intrinsic benefits and costs? It's this kind of skills and functional approach around developing habits that i've been finding particularly fascinating of late because it says knowing how to make change per se isn't the main issue; knowing how to make change sustainable is, and that sustenance is NOT innate knowledge.
Sustaining Successful Change
There are a couple of books i've found that really touch on getting and the sustance-as-skills part of change. One of the, in the diet space, is Martha Beck's 4 Day Win. Not unlike Cobb's Three Minutes of Movement to Get Stuck In, Beck finds strategies that are completely and totally doable, and sets up a 4 day win strategy for each towards building better habits for change in the diet space. Her work in psychology has shown that if you can get a new practice going for 4 days, you can get some important re-wiring done.If you're interested in this kind of plastic brain rewiring, there are other related books recommended here.
The other book i'd recommend for consideration coming into the new year is Stephen Covey and R&A Merril's First Things First. This book is focused on re-wiring habits and perspectives to help get things done.I like it because it is NOT about how to make To Do lists; it's about figuring out one's real and foundational motivation for something - principles as Covey calls them - and having pracitces to support those principles. Very functional. He talks about how to keep the first things the first things. Or, a fave: don't prioritize your schedule; schedule your priorities. No kidding.
Habits as Skill Sets; Skill Sets as Habits: Both these books represent approaches to develop habits - or what we might call automatic or reflexive or neurologically wired, practiced responses to situations - to help us rather than achieve goals per se, live principled lives. As Covey and colleagues argue, once we know what we're saying "yes" to - what's important to us - it's easier to say "no" to what is not. The heuristics offered in the book for getting to a place in life where, for instance, most activities are Important but Not Urgent is very cool (the other parts of this quad are Not Important and Not Urgent, Urgent (for usually someone else) but not Important (for your Yes), and Urgent and Important. First things First argues that the goal is to get as much as possible happening in that quality quadrant that is non-reactive and then has room for the real and unexpected emergencies, rather than living regularly in the reactive, as many of us do. Functional.
Covey's QuadrantsWho's Involved? Covey, Merril and Merril also tend to look at those Important but Not Urgent things relative to Roles and Relationships. In which of my roles is this task assigned; what trust relationship does that engage? It seems when we situate our responsibilities or things we're motivated to do relative to relationships that we care about because they feature Real People, those actions can become more meaningful. Am i not eating this tart just for myself, or because i care about my family and a commitment i've made to them to get healthy, and this frickin' little tart is one part of that commitment? Or if not to family, i've made a promise to myself that i'll stop at one, and whether it matters or not, in terms of calories, i'm practicing doing what i say i'll do. This is one small act i will have at the end of the day to say i did what i said i would do.
Beck likewise spends time getting to grips with real inner self parts who tend to look out for opposing interests (the wild child and the judge for instance) and come to a place that by understanding these positions, and observing them, and learning some new skills for working with them, we can get our collective acts together.
Skills Aren't Innate, but they can become Wired. Where this all gets to for me, as you can probably
tell, is the notion of being more gentle with ourselves because we ain't born knowing how to do stuff we ain't wired to do.Consider the fascinating work by Susan Roberts of Tufts around the ways we seem to be wired almost instinctively to go for just the kinds of foods that when there's an abundance of 'um, they become "bad" foods, but at just about any other time than now (now being our supra abundant food always in reach affluent culture), really survival smart: energy dense, familiar, available, satisfy hunger, and even variety rich.In other words, we need to rewire ourselves to have new instinct-like responses to our 21st C affluent environment, where motivation is more subtle than move or die (though actually that's still the case).
It's Neurological and it's a Skill and So needs Reps. Rewiring is achieved through learning, repping in new neural pathways. And when we learn something, the best teaching is usually that which breaks a practice down into manageable, practicable, learn-able skill sets.
My suggestion is that if you're in doubt about some of those skill sets, the above framing and books may be a useful ways to begin to get to grips with practice, and tune up the motivation to something that can fire up the behaviours, once learned, we want to fire up reflexively to help keep us happy, healthy and wise into the new year.
And coaching: When we work with others - supervising, teaching, coaching - what's good for the
goose is good for the coaching space too. I used to teach a lot of so called "required courses" - courses students had to take as part of their program, and so did not meet with love. One thing found out there is that often students doing a required course hit boredom pretty fast. If we have the Flow model, we can get pretty quickly that the material is either too simple to engage them or too far out of reach to find a way to get engaged. So that's one problem - how to help get to a flow place to provide a pathway.The same can happen with movement-related goals: the person doesn't have something that allows them to hit a flow state: the prospect of sitting on a stationary bike and pedalling for 40mins is too tedious to endure. So finding flowful practice (to coin a term) is coaching job one.
But let's assume we hit that flow. How stick with it?
In the required course, helping to figure out ways to make a course relevant for a 300 students in one lecture is a bit of a challenge, but actually taking time to talk about what their reason is for being in the room via Covey-like unpacking can be useful: what principle does doing this course support? What are the uber goals to which this particular course is part of the process? How find relevance (and if we can't, well, perhaps that is a Sign Unto Us to Find Something that Is).
That's one tack. Creating a craving may be another. Finding the hook to associating the action with pleasure (reward) such that there's a gap, a loss, when it's not there, is a Good Thing, too. So we can imagine that finding flow may help find the reward/pleasure in something and doing that thing becomes one way to get that feeling back. How do we find that hook?
Assuming someone wants to figure that out, wants to get to that place of Doing the Thing, Motivational Interviewing
is a strategy for helping folks self-talk towards supporting these behaviours they've already decided they want to undertake. Generally the strategy is about how to listen effectively and affectively. I mention this in passing right now for reference if you are working especially one on one coaching (whether athletically or otherwise) someone towards that intrinsic motivation path. Move along little doogie, move along. A quickie path to better days seems to be movement in general. One of the best things about creating a habit of moving (and if we walk we already have some of that habit to build upon) is that we're designed to move; not moving is not as much fun as moving. We feel better when we do it.
The challenge for a coach may be making the case that there are LOADS of options that fulfil the movement criteria. Don't want to lift heavy today? Fine. Let's do something else. The movement is the habbit. That's the pleasure; not the guilt trip of not doing *exactly* what one imagined one was supposed to do. Shoot that word "should" please.
IT seems easier to stay motivated - to get the cost/benefit effect when the practice of the action becomes pleasurable, desireable rather than a chore. A good coach - of movement or any activity - will help make that happen with us.
Practice: it never frickin' stops
The intriguing thing i have found is that like any skill, to stay razor sharp, or even just half way effective, even these skills have to be practiced regularly. They need their 10thousand hours, too. And right now that's exactly what i need (am motivated) to do. Get my 3 min. dig in going. And heh, it's actually stopped snowing and there's a blue sky. In the UK. In december. Wow, makes me feel, oh i dunno, motivated? Na. The consequences haven't changed from 5 mins ago, but there's one less obstacle now to getting down to it.
All the best to you and your practice.
Related Posts
- - Habits in Eating - not about the food - practice approaches.
- - Mentor and Group support as part of reaching goals/changing habits
- - review of precition nutrition, habit-based eating.
- - getting rid of crap around goals
- - the perfect rep quest series
Tuesday, December 8, 2009
Thoughts on Low Back Pain - When in Chronic Pain Hell
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THis post started life as a reply to someone having "horrible back pain". I'd seen three of these "what can i do about my low back pain" in one day. No kidding it's one of the biggest reasons that stop folks from working or working out. It is hell.
The point of this post is to offer what may be an alternative perspective about back pain that says it mayn't be about the back; it may be about pain processes in the brain, and if we work with a model of pain, and of movement, even chronic stuff like the seemingly unsurmountable of low standing back pain can unwind. Let me further preface this by saying, in no way am i saying the pain is "all in one's head" or not real. It's real, alright. The shape of that reality, however, may be richer that we initially may think.
Going Chronic This post is motivated by the fact that a lot of folks ask about low back pain issues after they've had them for awhile. They've gone from acute - a sudden sharp pain brought on by a specific movement pretty predictably - to something chronic that can be a constant presence, as well as flaring up from time to time, but without a specific acute area that's sharp. It's a nasty thing that can, when flaring, debilitate a person. It is the proverbial monkey on the back, and it can make ya cry. I could go on and on.
In such advice-seeking experiences, many folks recommend chiros, phyiscal therapists, massage, exercises for the low back muscles and so on. All these things can bring benefit. In my experience though, if that back pain has been going on for months/years we're talking chronic, manually therapy has a much harder time addressing this. In my own experience, muscle work like yoga and kettlebells has brought some relief - more so than manual therapies - but not eliminated the problem.
The following offers some other ideas for dealing with low back pain - both at an early and definitely at an ongoing stage. The focus is really on models of pain as opposed to particular back issues.
context
First of all some context: me: like most folks with low back stuff - compressed l4/l5, long history of chronic back stuff. Chiro, pt, acupuncture, orthotics, heel lifts. shots and surgery offered - na thanks.
On the more physical approaches, as said, Yoga therapy worked a bit better than anything else; kettlebell swinging really helped but still chronic flare ups. Both these approaches were based on the theory that the muscles in the back are potentially weak or out of balance and needed to be rebuilt. As said, helped a lot but the chronic flare ups were not addressed; ROM still limited by pain etc. So rebuilding alone is not (at least for me) a complete answer.
Like a few who've been dealing with low back pain for awhile, a lot of money has already been spent for treatments that would hold for only a short time getting off the table. likewise there are models of back pain that suggest it's related to promarily to an emotional state - like anger or job dissatisfaction. Treat the anger; get rid of the pain. I'd encourage folks who are interested in this to investigate further with work like John Sarno's Mind/Body connection, where back pain is seen as psychosomatic, and an example of "Tension myosititis syndrome"
aside. I'd note that the first key study, the Boeing Prospective Study, widely studied and critiqued, that first suggested that the only consistent correlation with back pain was job dissatisfaction was done with shop floor workers (people who spend a lot of time on their feet). When the study was re-run with people who work at desks and also have high incidence of back pain that specific correlation did not, alas hold (pdf). What did hold is that, as we know about pain now, context plays a not insignificant role in pain creation/management. Or as some put it, psychosocial AND biomechanical issues can promote causes.
Work in what pain is, and how it works in the brain, however, shows that pain is toujours deja multi-factorial, and highly context dependent. BUT work in pain also shows that as it does manifest itself in very real neural adaptations. More on this below around "central wind up."
Breakthrough with the Percpetual Systems
During the six days of the Z-health R-phase certification, i had a couple sessions with Eric Cobb. He looked at not only movement (what Z-health is perhaps best known for) but vision and balance stuff as well. The experience was huge and transformative.
Since then i and colleagues have worked with TONS of athletes with chronic low back issues and have been able to help them move through the chronic-icity. How does this approach succeed where so many have not?
getting to the nervous system
Z-health puts the nervous system first by focusing on proprioception, and visual and vestibular perceptions of the world. The approach of nervous system first (aka threat modulation) always seems to have immediate benefit. The main approach is to check a person's responses to movement, and also visual and vestibular cues. The approach is critically largely active on the part of the participant, likewise invoking motor learning in grooving pain free patterns.
To summarise some reasons for this integrated approach:
low back: location of pain receptors for ANY pain event?
Here's something else about low back stuff. Lots of folks have compressed disks or degenerated discs, or scoliosis and have NO pain - so, especially when the pain becomes chronic - is the site of pain the source of the pain? maybe not.
site of pain mayn't be source of pain
Here's why: The back is a hugely important and highly stressed area of the body. An anthropologist colleague of mine swears it's an example of terrible/incomplete evolution. In some models of the body, the back like a big X - things cross from the right side on the lower body up to the left side of the upper body. So the low back again is a HUGE junction for LOTS of information.
As pain goes up, ironically sometimes with repeated poking via movement during an acute stage (that wretched "train through pain" thing), the number of nociceptors (the nerves that detect noxious stimulus) go up; mechanorecpetors that signal movement/position go down or get shut down. Normally, when mechanoreceptive stimulation more or less outnumbers nociceptive stimulation, the pain signal is effectively drownd out. That effect, in other words, can get broken.
AND what's worse is that there seems to be evidence that MORE nociceptive nerves sprout with increased immobility: the more we might reflexively try to protect our back by not moving it, the more we may be contributing to signaling that will continue to amp up any pain signal.
rewiring the back over time to be THE pain receiver
What these changes amount to with chronic pain, or as pain goes chronic is sometimes refered to as neural chunking or central wind up (more here and here). In other words, at this point, any pain/stress signals from anywhere may just start to manifest in the low back - that's become our response zone. That doesn't mean the pain is not happening; just that the brain/nervous system is now routing pain signaling through that super sensitive place. and it has been super sensitized, and so it may well be amplifying what's happening, too.
It's because of all this neuro-chemical soup (to use david butler's analogies from the Senstive Nervous System) happening that sometimes looking for issues in a back joint is not going to "unwind" the pain issue.
So to all you folks who have tried everything and are frustrated and in low back hell? may i recommend considering an active/neurologically sensitive approach? In brief, this means in part, begin to move. But also check what else may be inhibiting good movement.
As to the first part of that suggestion, if you'd like to see the research, Mike Nelson did a nice piece a year ago looking at the literature on why lumbar motion is such a good tonic for the back.
This doesn't necessarily mean huge movements, but it does mean, it seems, working towards full range of motion work in the back - and of course muscular work can be hugely beneficial for a number of reasons here to support that mobility (controlled movement) - but without that specific attention to ROM - something back muscle work alone does not necessarily afford - the benefit mayn't be complete.
Additionally, it may be critical to connect that proprioceptive signaling (nociceptors and mechanoreceptors that modulate signals that get interpretted as pain or not) with the rest of the perceptual systems: vestibular and visual.
Speaking for myself, it was not until my mobility work got hooked up with what turned out to be visual rehab work that my back pain started unwinding. Not this is necessarily the case with everyone, but with me, once the visual work got going, the speed of the unwinding was profound. I mean super rapid, overnight kind of profound.
Release. For anyone who's had low back pain, or has it now, you know what a prison it can feel like: will i ever be able to put my socks on without pain? pick something up from the ground without pain? drive or get in or out of a car without pain? sit and work without pain? bathe without pain?
Speaking for myself, yes. Before working with this approach, i used to get pain-free moments when i'd bend over to pick something up, and there'd be no pain. Nothing. normal. It was like a miracle. The number of times this happened over a decade i could count on one hand. i remember once starting to cry because it felt so incredible and i knew it wasn't going to last, and i so wanted it to last. Perhaps some of you can relate to that?
Understanding Pain and the Role of Movement to Reclaim Life
So, what all the above is speaking to is two things: getting a handle on what's happening with
pain, and getting an approach to movement/nervous system communication that can start to rewire the very neurological and brain-based experience of pain. In the book Explain Pain, this is largely David Butler's advice: learn how pain works; learn how to move.
To this i have only added what z-health refines a wee bit: movement is a great way to talk to the nervous system. Remember that visual and vestibular issues may also be contributors to pain, so find a way to check that and engage them in one's movement rehab practice.
Doing It for Herself/Himself
What is a movement rehab practice that will also check the visual and vestibular?
Best approach: see a movement specialist for a Movement Assessment (what that is). In this list, preferably look for someone with either S or T certifications (or both), or a master trainer.
Likewise, if someone's not close with the qualifications, i do video consults, too (use the email link on this post to request info).
Secondary & Complementary approach: get a joint mobility program into your life. Moving each joint through a range of motion is an amazingly good way to talk to the nervous system. here's more on why and if you scroll down to "dig in" there's some recommended places of guided packages for that, eg the "level 1" kit.
The best part is, really, when we have an better understanding of how pain works, and how the nervous system works in terms of proprioception, vision and the vestibular sysetms, there's a path to start unwinding that. AND YOU DO IT FOR YOURSELF so it sticks.
The big take away seems to be that especially chronic low back pain is frequently not about the joints - pain is way more interesting and intriguing it seems than that, but it does make sense that the low back is where so much chronic pain gets filtered.
Moving towards an active, neurologically centered approach, based on an understanding of pain, may well offer the breakthrough that you seek.
The best part is, you will know, more or less on the spot, if this practice offers you the relief you seek, and each practice session will only enhance that benefit. Really - that's just how fast the nervous system works. Tweet Follow @begin2dig
Going Chronic This post is motivated by the fact that a lot of folks ask about low back pain issues after they've had them for awhile. They've gone from acute - a sudden sharp pain brought on by a specific movement pretty predictably - to something chronic that can be a constant presence, as well as flaring up from time to time, but without a specific acute area that's sharp. It's a nasty thing that can, when flaring, debilitate a person. It is the proverbial monkey on the back, and it can make ya cry. I could go on and on.
In such advice-seeking experiences, many folks recommend chiros, phyiscal therapists, massage, exercises for the low back muscles and so on. All these things can bring benefit. In my experience though, if that back pain has been going on for months/years we're talking chronic, manually therapy has a much harder time addressing this. In my own experience, muscle work like yoga and kettlebells has brought some relief - more so than manual therapies - but not eliminated the problem.
The following offers some other ideas for dealing with low back pain - both at an early and definitely at an ongoing stage. The focus is really on models of pain as opposed to particular back issues.
context
First of all some context: me: like most folks with low back stuff - compressed l4/l5, long history of chronic back stuff. Chiro, pt, acupuncture, orthotics, heel lifts. shots and surgery offered - na thanks.
On the more physical approaches, as said, Yoga therapy worked a bit better than anything else; kettlebell swinging really helped but still chronic flare ups. Both these approaches were based on the theory that the muscles in the back are potentially weak or out of balance and needed to be rebuilt. As said, helped a lot but the chronic flare ups were not addressed; ROM still limited by pain etc. So rebuilding alone is not (at least for me) a complete answer.
Like a few who've been dealing with low back pain for awhile, a lot of money has already been spent for treatments that would hold for only a short time getting off the table. likewise there are models of back pain that suggest it's related to promarily to an emotional state - like anger or job dissatisfaction. Treat the anger; get rid of the pain. I'd encourage folks who are interested in this to investigate further with work like John Sarno's Mind/Body connection, where back pain is seen as psychosomatic, and an example of "Tension myosititis syndrome"
aside. I'd note that the first key study, the Boeing Prospective Study, widely studied and critiqued, that first suggested that the only consistent correlation with back pain was job dissatisfaction was done with shop floor workers (people who spend a lot of time on their feet). When the study was re-run with people who work at desks and also have high incidence of back pain that specific correlation did not, alas hold (pdf). What did hold is that, as we know about pain now, context plays a not insignificant role in pain creation/management. Or as some put it, psychosocial AND biomechanical issues can promote causes.
Work in what pain is, and how it works in the brain, however, shows that pain is toujours deja multi-factorial, and highly context dependent. BUT work in pain also shows that as it does manifest itself in very real neural adaptations. More on this below around "central wind up."
Breakthrough with the Percpetual Systems
During the six days of the Z-health R-phase certification, i had a couple sessions with Eric Cobb. He looked at not only movement (what Z-health is perhaps best known for) but vision and balance stuff as well. The experience was huge and transformative.
Since then i and colleagues have worked with TONS of athletes with chronic low back issues and have been able to help them move through the chronic-icity. How does this approach succeed where so many have not?
getting to the nervous system
Z-health puts the nervous system first by focusing on proprioception, and visual and vestibular perceptions of the world. The approach of nervous system first (aka threat modulation) always seems to have immediate benefit. The main approach is to check a person's responses to movement, and also visual and vestibular cues. The approach is critically largely active on the part of the participant, likewise invoking motor learning in grooving pain free patterns.
To summarise some reasons for this integrated approach:
- it works with the nervous system - the body's governing system (what runs joints and muscles)
- it is active rather than passive (about the differences between the two, with video): you are moving yourself rather than being manipulated, which fires of thousands more signals in the body to learn new patterns than manipulations so benefits stick.
- it works in large part on threat reduction: the latest work on pain says pain is an action signal. it means change something. finding the right thing to change is part of the assessment process. i've yet to work with anyone who hasn't had immediate and significant pain reduction (or elimination) and that only improves as they continue to do the work FOR THEMSELVES.
low back: location of pain receptors for ANY pain event?
Here's something else about low back stuff. Lots of folks have compressed disks or degenerated discs, or scoliosis and have NO pain - so, especially when the pain becomes chronic - is the site of pain the source of the pain? maybe not.
site of pain mayn't be source of pain
Here's why: The back is a hugely important and highly stressed area of the body. An anthropologist colleague of mine swears it's an example of terrible/incomplete evolution. In some models of the body, the back like a big X - things cross from the right side on the lower body up to the left side of the upper body. So the low back again is a HUGE junction for LOTS of information.
As pain goes up, ironically sometimes with repeated poking via movement during an acute stage (that wretched "train through pain" thing), the number of nociceptors (the nerves that detect noxious stimulus) go up; mechanorecpetors that signal movement/position go down or get shut down. Normally, when mechanoreceptive stimulation more or less outnumbers nociceptive stimulation, the pain signal is effectively drownd out. That effect, in other words, can get broken.
AND what's worse is that there seems to be evidence that MORE nociceptive nerves sprout with increased immobility: the more we might reflexively try to protect our back by not moving it, the more we may be contributing to signaling that will continue to amp up any pain signal.
rewiring the back over time to be THE pain receiver
What these changes amount to with chronic pain, or as pain goes chronic is sometimes refered to as neural chunking or central wind up (more here and here). In other words, at this point, any pain/stress signals from anywhere may just start to manifest in the low back - that's become our response zone. That doesn't mean the pain is not happening; just that the brain/nervous system is now routing pain signaling through that super sensitive place. and it has been super sensitized, and so it may well be amplifying what's happening, too.
It's because of all this neuro-chemical soup (to use david butler's analogies from the Senstive Nervous System) happening that sometimes looking for issues in a back joint is not going to "unwind" the pain issue.So to all you folks who have tried everything and are frustrated and in low back hell? may i recommend considering an active/neurologically sensitive approach? In brief, this means in part, begin to move. But also check what else may be inhibiting good movement.
As to the first part of that suggestion, if you'd like to see the research, Mike Nelson did a nice piece a year ago looking at the literature on why lumbar motion is such a good tonic for the back.
This doesn't necessarily mean huge movements, but it does mean, it seems, working towards full range of motion work in the back - and of course muscular work can be hugely beneficial for a number of reasons here to support that mobility (controlled movement) - but without that specific attention to ROM - something back muscle work alone does not necessarily afford - the benefit mayn't be complete.
Additionally, it may be critical to connect that proprioceptive signaling (nociceptors and mechanoreceptors that modulate signals that get interpretted as pain or not) with the rest of the perceptual systems: vestibular and visual.
Speaking for myself, it was not until my mobility work got hooked up with what turned out to be visual rehab work that my back pain started unwinding. Not this is necessarily the case with everyone, but with me, once the visual work got going, the speed of the unwinding was profound. I mean super rapid, overnight kind of profound.
i remember once starting to cry because for a moment - i was out of pain - i knew it because could put on my socks without my back killing me - it felt so incredible and i knew it wasn't going to last, and i so wanted it to last...
Release. For anyone who's had low back pain, or has it now, you know what a prison it can feel like: will i ever be able to put my socks on without pain? pick something up from the ground without pain? drive or get in or out of a car without pain? sit and work without pain? bathe without pain?
Speaking for myself, yes. Before working with this approach, i used to get pain-free moments when i'd bend over to pick something up, and there'd be no pain. Nothing. normal. It was like a miracle. The number of times this happened over a decade i could count on one hand. i remember once starting to cry because it felt so incredible and i knew it wasn't going to last, and i so wanted it to last. Perhaps some of you can relate to that?
Understanding Pain and the Role of Movement to Reclaim Life
So, what all the above is speaking to is two things: getting a handle on what's happening with
pain, and getting an approach to movement/nervous system communication that can start to rewire the very neurological and brain-based experience of pain. In the book Explain Pain, this is largely David Butler's advice: learn how pain works; learn how to move.To this i have only added what z-health refines a wee bit: movement is a great way to talk to the nervous system. Remember that visual and vestibular issues may also be contributors to pain, so find a way to check that and engage them in one's movement rehab practice.
Doing It for Herself/Himself
What is a movement rehab practice that will also check the visual and vestibular?
Best approach: see a movement specialist for a Movement Assessment (what that is). In this list, preferably look for someone with either S or T certifications (or both), or a master trainer.
Likewise, if someone's not close with the qualifications, i do video consults, too (use the email link on this post to request info).
Secondary & Complementary approach: get a joint mobility program into your life. Moving each joint through a range of motion is an amazingly good way to talk to the nervous system. here's more on why and if you scroll down to "dig in" there's some recommended places of guided packages for that, eg the "level 1" kit.
The best part is, really, when we have an better understanding of how pain works, and how the nervous system works in terms of proprioception, vision and the vestibular sysetms, there's a path to start unwinding that. AND YOU DO IT FOR YOURSELF so it sticks.
The big take away seems to be that especially chronic low back pain is frequently not about the joints - pain is way more interesting and intriguing it seems than that, but it does make sense that the low back is where so much chronic pain gets filtered.
Moving towards an active, neurologically centered approach, based on an understanding of pain, may well offer the breakthrough that you seek.
The best part is, you will know, more or less on the spot, if this practice offers you the relief you seek, and each practice session will only enhance that benefit. Really - that's just how fast the nervous system works. Tweet Follow @begin2dig
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