Friday, August 12, 2011

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

6 comments:

Diane Jacobs said...

Hi Cory,
Could you put links to the first two posts in this series, into this post? That would be very helpful for readers.
Great post - thanks!
Diane

Cory Blickenstaff said...

Done. Thanks for catching that Diane!

Kyle Ridgeway said...

Excellent series of posts Cory. I think you did a great job of explaining (debunking) some of the misconceptions about movement and posture and mechanics. Your examples and explanations were phenomenal!!

Cory Blickenstaff said...

Appreciate that, Kyle. Glad you liked them.

Cody said...

Hi Cory,
Great series. I have a question though. My take is that you're making the argument that poor movement variability is potentially a predictor of experiencing pain and disability, and that either improving movement variability or have a good movement diet to begin with can improve or prevent pain/disability. But, I think if we apply this idea to the cerebral palsy example, as you applied it to biomechanics in the "Time Bomb" post, we would come to the same erroneous conclusion that biomechanics led us to. Those with cerebral palsy don't have good movement variability, so we'd still expect them to be time bombs. Am I misinterpreting something? Is there research looking at movement variability and pain/disability (I haven't searched for it yet).
Thanks again for the great content!
Cody

Cory Blickenstaff said...

Hi Cody. This is a great, great question. I wrote this post to follow up this series that partially addresses this:

http://blog.forwardmotionpt.com/2011/08/get-in-and-drive.html

Also, I wouldn't say that movement variability predicts pain. However, I do feel that a person with a poor movement repertoire will have a tougher time in finding their way to comfort. I believe there is a study in the work population in support of this that I'll try to dig up the reference for you this week. As I say in the follow up post though, having options is still not enough. The context or circumstance of recovery must be conducive to comfort.

Thanks for the question and feedback.