From Pain to Possibility
[Transcript]
Episode 10: How Biomechanics Helps to Reduce Pain
Intro: You're listening to From Pain to Possibility, with Susi Hately. You’ll hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don't have to hear it scream. And now here's your host, Susi Hately.
Susi: With this episode, we get into a topic that I'm really passionate about, and that is the one of anatomy, biomechanics, and kinesiology, how they relate to yoga and how they relate to reduction of pain and then overall recovery and healing. I've outlined this episode into three segments, defining these concepts, and then sharing a little bit about why I'm so passionate about them, and then to give you a few examples.
So when we look at anatomy and biomechanics and kinesiology, I like to look at anatomy like a map. So we have a mapping of muscles, other tissue, lymphatic system, nervous system, blood vessels. We can look at a picture and say, “Hey, look, that's where all this stuff is.” We can look at a computerized diagram and say, “Hey, look, that's where all that stuff is.” When we start looking at biomechanics, we're seeing how forces move through those systems, so the kinematics, the kinetics of how movement happens. When we look at kinesiology, now we're looking at the study of human movement.
So there's interplay between all three of them, and understanding all three of them is really important. And it's why just the study of anatomy doesn't really make all that much sense, because it's interesting to know where all these pieces are. But if you don't know how forces move through them, it becomes a little bit more challenging when working with someone or working with yourself to reduce or eradicate pain.
So one of the reasons I get so charged up about these topics is that I love the physical plane. There’s a lot that we can resolve for people in the physical plane, particularly when we add in the concepts of awareness that yoga is so known for. So when I look at the physical plane, being the human body, what I'm seeing is that we can have structure and we can have posture. And structure I like to refer to as the skin sack that we all are. And the skin sack has all these pieces, the anatomy, that is in us. And that can be impacted by many different things of use and disuse, nutrition, how we sleep, don’t sleep—i.e. how rested we are. And then we have our posture, and posture is how we embody our structure. And so posture—I haven't seen a whole lot of success in going after the improvement of posture, but we can certainly improve posture as a result of improving our mechanics.
So when I talk about biomechanics and mechanics in this way, what I'm looking at is, really, how does the body move. When I'm seeing somebody, whatever their condition is—whether it's recovering from cancer or whether it is M.S. or rheumatoid arthritis or S.I. joint pain or back pain or knee pain or recovering from surgery—I have yet to meet any two people who move in the same way, because even before the condition, people have their own ways of moving. They have their own stuff. So lots of people have back pain that is not related to whatever their situation is. So we can't just say to someone, “Okay, let's just help your back pain without the other condition being thought about.” And we can't just look at the condition and say, “All right, let's just work with that condition and not think about these other factors like back pain or shoulder pain or fill in the blank.”
So this is why I understand mechanics become so vital no matter the condition, because the other piece—and I'm talking really fast because I'm super excited about this—is that when we can help someone move better, they will feel better, no matter the condition. Simply helping someone improve their embodiment of their structure, and as a result, have their posture improve, which has them standing better between the sky and the earth, often, often, oftentimes has them feeling really good because they're more effortless in being perpendicular between the sky and the earth. So it becomes really, really interesting.
Now, something I want to be really emphatic about, and this is what I was talking related to posture, is that I'm a big, big believer in that posture is a result. It's not the process, for me. So I'm not trying to improve people's posture, but out of helping them move better, their posture improves. And that's a really subtle but hugely, hugely important distinction to be able to support someone, because we could say, “Yeah, their pec minor is tight, and their lower traps are weak,” but let me tell you, I learned this a long, long time ago, that if I just went after trying to improve how those lower traps functioned and what was going on with that pec minor, I did not get results. However, if I help someone move better, then we saw a change.
All right. So what is this distinction, really, and what do I mean by that? Well, when I'm talking about moving better, I'm looking at their key joints and how those key joints move. And I tend to focus initially on the shoulders and hips. Now, why is that? Well, because they have the largest available range of motion. Lots of stuff can get congested and stuck and just ugh in those areas. And when those areas are not moving well—which came first, the chicken or the egg? I'm not sure—but when they're not moving well, other stuff is often not moving well. So when I see someone with knee issues, I often see hip issues. When I see people with ankle and foot issues, I can often see stuff with hip issues. Same with the shoulders, elbow, and wrist. And so I can see lots of stuff. I can see lots of condition. I can see lots of pain and strain improve when I start at the largest joints first.
Now, I want to emphasize, I don't know if the largest joints was what created or caused the other joint areas further afield to become a problem. I don't know. I don't know which came first, like I said. Was it the chicken or the egg? What's more important is this: when I can help those largest joints move better, I see results. So it's simply helping those areas first. And so lots of times, when I help someone improve their hips, we can see how their pelvis wants to kick in instead of the leg bone in the pelvis. I can see the rib cage want to brace. I can see the jaw wanted to kick in. I can even see the shoulder wanted to kick in or the feet or the knee wanted to kick in.
I remember someone I worked with who had neck pain, and any time she moved her leg, her neck would just tighten right up. And so part of the process was her helping her relax her neck while she moved her leg, and it was the first time in six years that she never had neck pain, simply by recognizing what her leg bone was doing. And it stunned her how limited her hip movement actually was, but it also opened up a possibility for her that was like, “Ooh, there's a connection here between my neck and my hip.” Really, really interesting.
So when I'm talking about pure movement and compensation, then, is that I'm looking to see where there are patterns of bracing and tension and gripping where we don't need them to be. So can we simply move the leg bone in the hip socket or the arm bone in the shoulder socket or the shoulder blade on the rib cage, without all those extraneous patterns. Can we make the movement purer and less compensated?
Now, what is interesting is over the years, I have yet to meet someone who has pain, that doesn't compensate. When I can help them improve their movement and reduce that compensation, I will see their pain levels reduce.
Now, one reason I see that this is happening is that there is more efficiency of movement. There's effortlessness. There's less tension. Not having to hold yourself in order in a move requires less energy, so it becomes less depleting, less draining.
Now, we can also talk a bit about internal locus of control, improving your own internal sense of support. And then what that does, from the SIMs and the DIMs, which are concepts that have come out of research in Australia, and I'll be talking about those more on an upcoming episode. Right now, I want to stick with the juiciness of just the anatomy, biomechanics, and kinesiology of the predicament that sometimes people can find themselves in. And when they start to move better, they feel better. And then when they're aware, we bring in the yoga piece to this, when they're aware of what is contributing to their movement patterns, they are able to change them.
So let me outline this in a way that might make some sense. Many of my clients have come to see me because they have a quadratus lumborum that is in spasm. Now, the quadratus lumborum sits between the lower ribs and the pelvis, and it can become quite spasm-y. People can be given exercises like Superman and side bending and breathing exercises and relaxation. And invariably, what I've seen is while those exercises have provided some symptom relief, the person hasn't had sustainable gain. When we look closely at how they're moving, we'll see that there is a lot of bracing in some areas of their body and poor movement through their shoulder joints and their hip joints. Now, how that movement is poor depends on the person. So I'm not going to say that this is exactly the way it goes. It just depends on who the person is. And then what contributes to why that hip joint or shoulder joint is not moving well is also distinct between each person.
What needs to be curious, from the place of the practitioner and even for the client, is what is the movement? because what we do know is that where the pain is is not the problem. It's a signal that there is dysfunction present. Those initial exercises are vital to help in symptom reduction. But just because we've had a symptom reduction doesn't mean we resolved anything. Once we've had that symptom reduction, we then need to start looking at some retraining. And that is what I'm really great at helping my clients do, is that, “Okay, great. You've seen that you can have a symptom reduction. That's awesome, because if you can have a symptom reduction, that means you can have symptom reduction. If your system has shown it to possible, your system has shown that it's possible. So now my job is to help you become aware of the things that you are unaware of, because like I said, where the pain is isn’t the problem. Where the problem is, is under our level of awareness, which is why that initial symptom relief provided some great insight and gains, but it didn't resolve the whole problem because it wasn't actually going after the whole problem. So now we get into the retraining conversation. That's why where we can look at these movement patterns at the hip and/or at the shoulder that might not be working as well as they could be. When you improve that, that's when you make some really significant change.”
I've seen over and over and over again with QL issues, or quadratus lumborum issues, poor movement—whether it's rotation or abduction or adduction through the hip; sticky shoulder blades; braced rib cage; an arm bone that doesn't move well going into flexion, and the rib cage wants to move; or the spine wants to move into extension instead of that arm bone moving. So I simply do this, and it's really quite simple, and that is have the person move in a range that doesn't have the compensation. So nurture the fact that they can do the movement, and quiet the fact that they're compensating. So quiet the compensation so that they can learn what their true range is, because when we have a limitation of range or a limitation of smoothness of movement, our brain and our body will find a great way to compensate the—we'll find some other way to get the thing done.
I mean, that's what's so amazing about us. I really want to emphasize that just because you compensate it doesn't mean it's bad. It means that you're highly adaptable and flexible and can find a gazillion different ways to get a job done. I love that about you. I love that about my clients.
The thing is, it's not currently helping you, because you're in pain or you're not at the place you want to be functionally and physically and maybe even emotionally and spiritually. So if we can resolve that movement pattern and we can retrain that movement pattern, we can make a whole lot of difference.
So then I get to show people, “All right, look. See where your movement actually is.” And invariably, they'll be horrified. They'll say, “Oh, my god. I'm in trouble here.” I'm like, “No, no, no, no, no. No, you're not. No, you're not. We just need to keep improving this movement pattern, and then we can go about improving that movement pattern.” And then as a result of improving that movement pattern, they have longer-lasting change because they've retrained the pattern. They've improved the neuromuscular dynamics. They’ve improved the conversation between their brain and their body. They've improved the way their anatomy is moving force through it. Mm-hmm. Their human movement has shifted. It's become more efficient. It's become smoother. It's become more effortless. Really, really powerful.
So what we're doing here is we're blending the concepts of yoga, the awareness piece, with the movement piece, of how is somebody actually moving their body? Where are they bracing? Where are they gripping? Where are they pushing past a range of motion that they really shouldn't be pushing past?
We've heard time and time again, you might have the range of motion, you might have a great, like, a big, big range of motion. It doesn't mean you need to go into that range of motion. And here's what's interesting. If you look really closely at those people who feel they have a big range of motion, you will see time and time and time again how limited their movement actually is. Yes, they can get their foot all the way over that direction, but at what cost? What else is having to brace or grip to enable that movement to happen?
I've even seen it in people who will tell me that they're hyper mobile. I will see all sorts of areas that are hypo mobile that are helping to compensate or correct for the mobility, or said another way, the high mobility is compensating or correcting for the hypo mobility—which came first, the chicken or the egg? We don't know. But again, if we can bring better and better movement patterns and better and better awareness of those movement patterns into the mix, they can become more aware, they can become more connected, and just more clued in to their internal feedback mechanisms. So they can be attentive to the sensation, they can be attentive to their movement pattern, they can see when that movement pattern is slowly starting to not work anymore, and then they can make an intervention.
So it's a process that requires some connection. It's subtle. It requires attentiveness and awareness. It's not just throwing an exercise or a template at somebody. Well, you might be using components of a template or a protocol that helps improve movement, but rather than looking at a movement as an exercise or a to-do item that you simply just need to get done and then you're done and you're good, you're actually paying attention to how you're doing the movement. You're paying attention to the quality of the movement, not just doing it, or even the quantity.
So when a client says to me, “So should I do like, what, 10 of these, 15 of these, three sets of 30?” And I'll say, “I want you to pay attention to the how, not the number.” Now, if they push me and say, “Oh, just give me something,” I'll say, “All right. I'd like you to do this movement for five breaths,” or “I want you to stop the movement when you notice that the tension in your body is starting to go up.”
Now, what we’ll have likely noticed in the session together, before I’ve given them their program, is that they have tension patterns that they become aware of, that they might not have been aware of previously. So they might become aware of their jaw or their neck being involved or a part of their ribcage being involved when they do a movement further down the chain. So then I'll say to them, “Notice when that tension starts to arise. And when that tension starts to arise, you’ve gone too far.”
I'll also suggest to them, “See if you can notice the signal before that tension, because there is always something to let us know that that tension is about to arise. So can you perceive the thing before the thing?” And oftentimes, they’ll look at me like I'm crazy, and I'll say, “Just give it a shot. See what you notice.” And then oftentimes, they will begin to notice other mechanical contributors to their movement that don't need to be contributors. And they become more and more and more refined in their movement patterns, more easeful, stronger, more stable, because the areas of their body that are meant to be doing the movement are the areas of the body that are meant to be doing the movement. And because there's less compensation, there's a lot more strength. The structural integrity is a lot more intact. And the way that they absorb load, the way that they dissipate load, the way that they transfer load is much more effective.
Now, if you find yourself feeling a spark of “Ooh, that is so cool, the way that you are utilizing awareness and integrating that into the Western methodology of anatomy, biomechanics, and kinesiology and how these two worlds do meet,” then reach out to me. Let's have a conversation about how this can fuel you in a personal way, in a professional way, and what next steps that you can take to integrate this into your life.
Have a great time exploring.