Demonstration: Edgework for the Knee, Part 2 (Weight bearing)

Another of my video demonstrations produced by Will Stewart of 3D Optimal Performance.

Demonstration: Edgework for the Knee, Part 1

We put together another one. This one demonstrates some applications for knee pain. Enjoy!

The "3 Nails" of the Foot

This is a concept that I teach quite often as a way to monitor through the foot. I learned the technique in a tai chi for balance class. This is another production by Will Stewart of 3D Optimal Performance.

Demonstration: EdgeWork for the Foot and Ankle, progression to standing

This is part 2 of the series where I demonstrate the concept of EdgeWork as applied to the foot and ankle. Once again produced by Will Stewart of 3D Optimal Performance.



In case you missed it, here is part one.

Demonstration: EdgeWork for the Foot and Ankle

Special thanks to Will Stewart at 3-D Optimal Performance. Will produced this video and did a great job.

Get In and Drive

I recently wrote about the balanced diet of movement and how important the movement repertoire can be. But I want to be clear that just having options isn’t enough. After all, just having a car and map doesn’t get you to the grocery store. You’ve got to get in and drive.

If a broad movement repertoire were all you needed then gymnasts, dancers and contortionists would all be pain free. But, alas, they hurt like the rest of us.

Let’s try an experiment . Place a cup upside down on the table in front of you. Now, turn it upright with one hand. Which way did you grab it? Did you grab it with your thumb pointing down or up? Most people will grab it with the thumb down so that they end up with the thumb up. You reached in a way so that you would end up in the most comfortable position versus starting out that way.

This is demonstrates the end state comfort effect.

subjects usually grabbed objects to be moved from one location to another in a way that afforded a comfortable final posture rather than a comfortable initial posture (the end-state comfort effect)

All things being equal, it appears that we tend to automatically move in ways to end up in a comfortable position.

An automatic mechanism for comfort has some interesting implications for therapy. Why is getting comfortable often so hard if it is supposed to happen automatically?

Now let’s try a thought experiment. Let’s say that your neck and shoulder were hurting and all you had to do to find relief was to stick your arm straight up in the air. Easy enough, right? Well, you are also sitting front row in a class. Not only that, but the class is filled with people that may hire you next week for a job you really want. Would you stick your arm straight up in the air to make your shoulder feel better? Or, would you be too worried about looking goofy?

Fear, expectation, and social taboo all could easily get in the way of letting this mechanism take place. This is the power of context. Competing desires can be derailing. Instead of getting comfortable we may act on the desire to not look silly. We may act on an expectation, like “sit up straight” or “don’t fidget.” In short, it is quite easy to get in our own way especially with a culture obsessed with appearance like ours.

An expanded repertoire might be enough when all that is holding you back is tendency, but otherwise I can’t think that it’s enough. Similarly, I’ve written that novelty is not enough. Both need a context or circumstance that is conducive to comfort.

Quote taken from:
Rosenbaum D.A., Van Heugten C.M., Caldwell G.E.
From cognition to biomechanics and back: The end-state comfort effect and the middle-is-faster effect
(1996) Acta Psychologica, 94 (1), pp. 59-85.

The Movement Diet

Ever heard of the Irish Potato Famine?

The Irish had found the perfect food. The potato was energy dense and plentiful and for reasons that are easy to understand, it became a staple. Eventually as much as 30% of the population took it beyond the status of staple and became totally dependent on the potato. And then it happened. Disease destroyed the potato crop. Without a viable substitute, widespread famine, starvation, and death resulted.

Pain with movement is often similar to this. Well, except for the starvation and death part.

We all have our staple movements that we use regularly. We tend to be confronted with similar scenarios from day to day and of course must always approach them with the same body and so, not surprisingly, we develop tendencies and habits. This option of autopilot usually serves us well since they free up attention for other things.

Sometimes, however, a level of entrenchment is reached in which the option of autopilot becomes the only choice. Now the habit has become a dependency. This is the dark side of habit because if that dependent movement happens to become a problem and we can’t access it anymore, we have no other options.

As the Irish made clear, dependency only works out if the crop is available. If we are dependent on a movement that becomes painful and we lose access to it, what will we do?

As an example, I routinely see people who perform literally every movement from a flexed position of the low back. If asked to move otherwise, they can’t. They’ve lost this ability because flexion has become so entrenched. This serves them fine until the day that the flexed position of the low back becomes painful. Now they’ve got a problem because they can’t find their way out of the uncomfortable position. They don’t know how to not be flexed. The potato famine has struck.

Luckily in the case of painful movement you won’t starve to death.

My advice is give yourself a varied movement diet so that you don’t become dependent on any particular movement or way of moving. This gives you options for finding the way to comfort.

This was the third in a three post series. The other two were:
The Ticking Time Bomb
When Pain Appears Everything Changes