Wednesday, February 22, 2012

I thought this stretching crap was supposed to be good for me, so why does it hurt??

I got a really great question from someone on my last post, and I decided to put my answer a separate blog post.  Here's the shorthand version:  "You mention yoga and pilates in opposition to alignment, please comment further.  Also, I am strong and flexible, but classical yoga poses hurt me. What's up with that?" 

First of all, it's not that I see anything in opposition to alignment, but rather lacking in alignment.  In fact, some of the stretches and movements we learn from the insitute are very similar to some yoga poses.  The difference is form.  You can do the same pose in alignment and out of alignment and get totally different results.  Take downward dog.  It's a great pose to stretch the backs of the legs and open up the shoulders, but if you're doing it with your quadriceps contracted (legs straight with knees flexed) and your elbow pits facing each other instead of pointing straight ahead, you either a.) dont' stretch what you think you're stretching (shoulders) or b.) do damage to a joint while you're stretching (knees).  So it's not that there's anything inherently wrong with the stuff you do in yoga, but how you align your body while you do it can be wrong and potentially damaging. 

Another thing to remember is that the poses in yoga were developed a very long time ago when people used their bodies in different ways.  People walked to get where they were going, squat to go to the bathroom, and used their bodies all day in many different positions.  The poses in yoga were appropriate movements for the population they were developed for. In a population that spends too much time in a chair, in the car, on a bike, on the couch, and that doesn't use their body in various different positions throughout the day, their muscles may be too short to properly execute a pose so it gets done in a way that puts strain on other parts of the body.

Lets use a forward bend as an example.  For a population not constantly in hip and knee flexion, the hamstrings would be long enough to allow a person to hinge at the hips and maintain an aligned spine (with lumbar curve).  When you do the pose, you want your hands to touch the floor, or you want to get your head as close to your knees as you can.  So you tilt your pelvis, bend your knees ever so slightly, and sacrifice your lumbar curve to get the "right" position.  If you weren't already doing this all.the.time (while sitting, or while walking) then it might not be quite as stressful on your joints.  But when you already have unhealthy habits or muscles that are at the wrong length or joints that are already being over used (knees) then this pose can be really painful, even harmful to you.  Doing an exercise like this is just doing more of the same damaging joint loading that you already do, only you're probably pushing yourself a lot harder in the "exercise" context, so it begins to hurt.

The problem with being strong or fit is that it can be arbitrary.  Sure you can ride a bike for an hour, or do a really impressive bicep curl, but are you able to hang on a bar and pull your weight up?  Are you able to do a pushup without bringing your shoulder blades together? Do you know how to use the back of your leg to hold your body weight instead of the front? It's cool to be strong, but of you aren't strong in the right places then it doesn't really matter.  What's more important is that your muscles are the right length, and you have a one to one strength to weight ratio in your body parts.  When your muscles are the right length they are better able to stabilize and keep space in your joints, so they don't start to hurt and wear out half way through your life. 

See why I didn't want to just put that in the comments section?  And this is the nutshell version.  I'm probably leaving out a lot, and I didnt' even put in any pictures, but there you have it: Why stretching hurts. 

Monday, February 20, 2012

Die Gestalt.

The key difference between alignment theory and other exercise/stretching practises (yoga, pilates, etc.) is that alignment not only focuses on where your body is in space, but also evaluates the position of your parts relative to your other parts. Like when we evaluate someone's spine, we also look at the ribs and pelvis and legs.  Or when we look at someone's feet, we also have to look at their knees and pelvis and torso...and also shoulders...and the head.  The body is really one unit that depends on all its parts to work together properly.  You'll never get to the root cause of problems if you don't look at all parts of the body.  Cervical disk degeneration can originate in the foot and calf, and if you aren't looking at the body as a whole, you're going to miss the root cause of the problem. 

Take this shoulder stretch.  In the first picture, sure, my arm is on the door frame and my body is going past the door frame.  But in actuality, I'm NOT stretching my shoulder.  I'm just collapsing through the back to make it look like I'm stretching my shoulder.  There isn't much regard for the position of the upper arm relative to the actual shoulder joint, and the fact that half my back is displaced is a big clue that this stretch isn't doing what it's supposed to. 

In this second picture, you can see that my shoulder blade is stabilized, and I'm not allowing my body to hinge in the center to allow my arm to come back further than it actually can.  Here I am actually opening the shoulder joint and getting a good stretch.  It might not seem like a big difference, but if someone is supposed to be doing physio for their shoulder (to heal an injury or something) and they're doing the stretch by collapsing their back instead of just moving the arm, they're not going to get the results they could get if they did the stretch properly.  It's the difference between a full recovery and a life long "bad shoulder".  This applies to every stretch you do.  The position of other parts, besides the part you're stretching, can make a difference to what you're actually doing, vs. what you look like you're doing.

Ok, ok, so what.  It looks like I'm stretching, but really I'm not.  Call an ambulance, right?  Well, this concept can actually be applied to a much more dangerous situation.  An example of this is when people are told they are swaybacked when really they are thrusting their ribs into the air to make it look like they are swaybacked.  That's because the diagnosis is often made looking only at the the spine, ignoring the position of the ribs relative to the spine, and the pelvis relative to the spine, and the position of the femurs relative to the pelvis.  Even the way you carry your weight (either on the front of your foot vs. the heel) can add to the illusion and make things appear like something they're not.

So you go to a doctor or a physiotherapist who gives you the wrong diagnosis because they miss this critical concept of evaluating your parts (spine) to your other parts (pelvis, ribs).  With this wrong diagnosis comes the wrong advice to fix the problem.  Usually a "sway backed" person will be told to tuck their pelvis under to decrease the amount of curve.  When you tuck your pelvis you can expect a drastic decline in the health of your knees, hips, and feet.  You can start stocking up on adult diapers now, because you're going to end up with pelvic floor disorder.  You can expect your back pain that sent you to the doctor in the first place to stick around (oh cool!) because you HAVEN'T FIXED THE PROBLEM, which is a rib thrust.  The scariest part is that thrusting your ribs out/up is asking cardiovascular disease to be your bff 4 evr.  So you think you've taken care of this problem, but really you still have the problem and you've created even more problems to keep your other problem company.  Now THAT'S a problem.  :(

It's really important to understand the difference between the way things look or seem and the way things are.  It's like katy says about fixing a flower pot on a crooked table.  The flowers on the crooked stand LOOK crooked, but really it's the table that's the problem.  Until you fix the crooked table, nothing you do with the flowers is going to help.  So if you have a bad back, it's time you started looking at other parts of your body to fix the problem.  You're not Astar the robot with all these separate functioning parts.  You are one unit, and what you do with one part affects all the others.