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Healthy muscles are essential for more than just movement; they play a critical role in supporting our overall health and well-being. Muscles provide the strength and stability needed to perform daily activities, from lifting and carrying to walking and balancing. They also protect our joints by absorbing impact and reducing strain on bones and ligaments, helping prevent injuries. Additionally, healthy muscles enhance metabolism, as they burn more calories at rest than fat tissue, making them key to maintaining a healthy weight and energy levels. Strong, flexible muscles also support good posture, reduce the risk of chronic pain, and improve quality of life, ensuring we can stay active, independent, and resilient at every age. Here’s what defines a healthy muscle: Good Contractility
Full Range of Motion
Elasticity and Resilience
Balanced Strength
Endurance
 Proper Tone
Efficient Blood Supply
Minimal Tension or Trigger Points
Proper Neuromuscular Control
Effective Recovery and Adaptability
Low Levels of Fatigue or Pain
Together, these characteristics make muscles capable of handling both everyday and athletic activities while supporting joint stability, movement efficiency, and overall body mechanics.
 “Is that plum I’m tasting?” |
The Basic Units: Neurons At the heart of the nervous system are neurons, which are like the individual communication towers or hubs in our city. Each neuron is a specialized cell designed to transmit information throughout the body. The human brain contains roughly 86 billion neurons! When a neuron “fires” (sends a signal), it's akin to sending a message through a series of relay towers to get it from one place to another, fast and accurately. |  |
Structure of a Neuron:
Think of a neuron like a tree:
Think of a neuron like a tree:
- Dendrites: These are the branches of the tree. Dendrites receive signals (or information) from neighboring neurons, much like a cell tower receiving signals from phones or other towers.
- Cell Body (Soma): This is the trunk of the tree, which houses the nucleus (the control center of the neuron). The cell body integrates the information from the dendrites, deciding whether or not to pass on the message.
- Axon: The axon is like a long cable or power line extending from the trunk, transmitting electrical signals over long distances. In some cases, axons can be several feet long! For instance, the axon that runs from your spine to your toes can be over 3 feet long in adults.
- Myelin Sheath: Surrounding the axon is the myelin sheath, which works like the insulation on a power line, speeding up the transmission of electrical signals. This allows the nervous system to send information much faster, just as insulated cables help electricity flow more efficiently.
Synapses: The Information Highway
Neurons don’t touch each other directly; instead, they pass information across small gaps called synapses. This is where things get even more fascinating.
Imagine two towers in our city. Instead of being connected by a direct wire, they communicate by sending radio signals across a gap. In the nervous system, neurons release chemicals called neurotransmitters across the synapse. These neurotransmitters are like the radio signals or messages being sent across that gap. When the neurotransmitters reach the next neuron, they either tell it to pass the message along (excitation) or to stop (inhibition).
Imagine two towers in our city. Instead of being connected by a direct wire, they communicate by sending radio signals across a gap. In the nervous system, neurons release chemicals called neurotransmitters across the synapse. These neurotransmitters are like the radio signals or messages being sent across that gap. When the neurotransmitters reach the next neuron, they either tell it to pass the message along (excitation) or to stop (inhibition).
Types of Neurons: Specialization
Neurons are also highly specialized depending on their roles:
- Sensory neurons: These are like scouts stationed around the perimeter of the city. They detect information from the outside world (like heat, touch, sound) and send it to the brain for processing.
- Motor neurons: These are the commanders, sending signals from the brain or spinal cord out to the muscles, telling them to move.
- Interneurons: These are the middlemen, connecting sensory neurons to motor neurons and making sense of complex inputs in between.
The Central Nervous System (CNS): The Command Center
The brain and spinal cord make up the central nervous system (CNS), which you can think of as the city’s government and central control room. This is where decisions are made, information is processed, and responses are coordinated.
The brain itself is divided into various regions, each with its own role, like departments in a government:
- The Brain: The brain acts like the city’s main control center, where high-level decisions and computations happen. It processes sensory input, coordinates voluntary movement, and handles complex cognitive functions like thinking, memory, and emotion.
The brain itself is divided into various regions, each with its own role, like departments in a government:
- Cerebrum: Handles reasoning, planning, and sensory processing. Think of this as the city’s “headquarters.”
- Cerebellum: Coordinates movement and balance. Like a traffic control center, it ensures everything moves smoothly.
- Brainstem: Responsible for automatic functions like breathing and heart rate. This is the system that keeps essential operations running 24/7.
- The Spinal Cord: This is the city’s main communication highway. Information from the body gets sent up to the brain, and commands from the brain travel back down to the muscles and organs.
The Peripheral Nervous System (PNS):
| While the CNS is the command center, the peripheral nervous system (PNS) is like the network of couriers and messengers that relay information between the CNS and the rest of the body. The PNS has two main divisions:
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The autonomic nervous system is further divided into:
- Sympathetic Nervous System: Think of this as the city’s emergency response system. It kicks in during fight-or-flight situations, increasing heart rate, diverting blood to muscles, and preparing the body to handle a threat.
- Parasympathetic Nervous System: This system is responsible for “rest and digest” activities, like relaxing after a meal. It’s the city’s relaxation mode, ensuring resources are allocated for routine maintenance and recovery.
Complexity in Action: Reflexes
Reflexes demonstrate how the nervous system can act extremely quickly, bypassing complex decision-making. If you touch a hot stove, your hand pulls away instantly, often before you're consciously aware of the pain. This happens because reflex arcs are designed to route certain signals directly through the spinal cord, bypassing the brain for a faster response. It’s like a city-wide emergency system that can handle some crises automatically without consulting the main control room (the brain).
Neuroplasticity: The City's Ability to Rewire Itself
Perhaps the most astonishing feature of the nervous system is its ability to adapt and rewire itself—a process called neuroplasticity. If part of the brain is damaged, the system can sometimes reallocate functions to other areas, much like how a city might reroute traffic if a major road is closed. Over time, with practice or after injury, the nervous system can even build new pathways, much like a city expanding its infrastructure.
Analogy Recap
Imagine your body as a bustling city. The neurons are like the communication towers or the fiber-optic cables connecting everything. The central nervous system (CNS) is the government and control center, making decisions and processing information. The peripheral nervous system (PNS) is the vast network of messengers that send information back and forth between the central hub and the outer edges of the city.
- Neurons are the messengers, sending signals like couriers delivering letters.
- Synapses are the relay stations where the messages are handed off.
- Sensory neurons act like scouts, gathering information from the environment.
- Motor neurons give commands to the muscles, like city officials giving orders for action.
- The brain is the ultimate decision-maker, and the spinal cord is the main highway through which messages travel.
"I never allowed my injury to evolve into a bigger problem, and I always trusted my body’s ability to regain strength and flexibility over time.”
The Injury
On Saturday morning, January 28, 2023, I was deadlifting when I felt a sharp, compressive sensation in my lower back. This pain was immediately followed by weakness in my spine and sharp pains with movement. Later that day, as I tried to stand, the pain was so severe that I buckled to my knees. As the hours passed, tingling sensations radiated through various parts of both legs.
In the days following the incident, I struggled with everyday activities—rolling over in bed, sitting, and bending forward or backward. Movements such as hinging at the hips were particularly excruciating, often causing my knees to buckle. Adding to the discomfort was a lingering ache in my tailbone when bending forward. I experienced reduced strength, muscle activation, and coordination, especially in movements requiring lumbar support, like leaning over treatment tables. My right foot would even go numb, reminding me of my limitations.
In the days following the incident, I struggled with everyday activities—rolling over in bed, sitting, and bending forward or backward. Movements such as hinging at the hips were particularly excruciating, often causing my knees to buckle. Adding to the discomfort was a lingering ache in my tailbone when bending forward. I experienced reduced strength, muscle activation, and coordination, especially in movements requiring lumbar support, like leaning over treatment tables. My right foot would even go numb, reminding me of my limitations.
My Diagnosis
Even as a Doctor of Physical Therapy, I couldn’t pinpoint the exact structure involved. I had pain in all directions of spinal motion. Extension-based movements would feel good, but often increased numbness in my feet. Flexion-based movements hurt but did not make symptoms worse. No direction would centralize the pain.
Based on the injury’s mechanism, I suspected facet joint overload in my lower lumbar spine. However, facet joint compression typically doesn’t result in radiating pain beyond the knees. More likely, localized inflammation of the nerve roots may have contributed to the nerve pain I experienced. This highlights how acute injuries can present a broad range of symptoms that don’t clearly match the pathoanatomical model.
Based on the injury’s mechanism, I suspected facet joint overload in my lower lumbar spine. However, facet joint compression typically doesn’t result in radiating pain beyond the knees. More likely, localized inflammation of the nerve roots may have contributed to the nerve pain I experienced. This highlights how acute injuries can present a broad range of symptoms that don’t clearly match the pathoanatomical model.
The Mindset
Despite all of this, I refused to let the pain dictate my outlook. I accepted my injury but remained confident that my body would heal. I observed my emotions but never allowed them to overwhelm me. I trusted the body’s natural healing process and knew I’d regain my strength and mobility through graded exposure. Each day I performed core strength exercises and spinal mobility to my end-range of motion. This routine included cat/cows, seated hip hinges, side to side mobility, basic deep core engagement, bodyweight squats as tolerated plus a combination of other easy hip and spine exercises. I would perform these exercises 4-5x each day to continually challenge my nervous system in these painful ranges of motion.
With a mindset rooted in resilience, I observed daily improvements. Morning stiffness and pain would subside as my body warmed up throughout the day. Light movement and consistent effort allowed me to gradually increase my range of motion, and each day I could push myself just a little bit further.
With a mindset rooted in resilience, I observed daily improvements. Morning stiffness and pain would subside as my body warmed up throughout the day. Light movement and consistent effort allowed me to gradually increase my range of motion, and each day I could push myself just a little bit further.
The Progress
While I’d love to say it was a linear recovery, it wasn’t—it was like riding a rollercoaster of good moments and bad moments. Movement often alleviated my symptoms, but fatigue from the day would cause my back to stiffen again. Understanding that healing involves both progress and setbacks allowed me to remain patient and focus on overall improvement, rather than obsessing over daily pain levels.
Six days after the injury, I returned to the gym, avoiding rapid, uncontrolled movements. I used machines to support my movements and control the loading through my spine. By the seventh day, I was back to using dumbbells and gradually reintroducing more dynamic spinal movements. That evening, I even tossed my kids in the air and caught them without any strain. Within 3-4 weeks, I had no fear or apprehension of movement or spinal loading.
Six days after the injury, I returned to the gym, avoiding rapid, uncontrolled movements. I used machines to support my movements and control the loading through my spine. By the seventh day, I was back to using dumbbells and gradually reintroducing more dynamic spinal movements. That evening, I even tossed my kids in the air and caught them without any strain. Within 3-4 weeks, I had no fear or apprehension of movement or spinal loading.
Conclusion
The concepts of graded exposure, active rest, and plenty of sleep were instrumental in my rapid recovery. As a movement professional, I understand the importance of finding patterns in symptoms—like assembling pieces of a puzzle. The pieces are all there, but putting them together is where the challenge lies.
-Jim Heafner PT, DPT, OCS
-Jim Heafner PT, DPT, OCS
The Lunge
In January 2023, my family and I went on a vacation to Florida. While playing football with my little brother on the beach, I accidentally jammed my big toe into a tough patch of sand. At first, I didn't think much of it and kept playing. However, in the following weeks, I experienced persistent pain in my big toe when running and lunging. This condition is commonly known as 'Turf Toe,' but the most important thing is knowing how to treat it.
Lunging, squatting, and hip-hinging are three of the strongest movement patterns for lifting things. Each of these movements requires different body mechanics. Since the big toe and ankle joints play a crucial role in providing stability during these exercises, I was experiencing pain while running and lunging. These movements require a significant amount of big toe extension, which I had lost due to the injury. Losing this seemingly small movement completely changed how I lunged. Although it may seem insignificant, I felt like I had lost one of the most efficient ways of lifting heavy things.
To get out of pain, I had to gradually retrain my lunge. In the post below, I will review lunge mechanics and break down the movement into smaller, more digestible pieces.
Lunging, squatting, and hip-hinging are three of the strongest movement patterns for lifting things. Each of these movements requires different body mechanics. Since the big toe and ankle joints play a crucial role in providing stability during these exercises, I was experiencing pain while running and lunging. These movements require a significant amount of big toe extension, which I had lost due to the injury. Losing this seemingly small movement completely changed how I lunged. Although it may seem insignificant, I felt like I had lost one of the most efficient ways of lifting heavy things.
To get out of pain, I had to gradually retrain my lunge. In the post below, I will review lunge mechanics and break down the movement into smaller, more digestible pieces.
Lunge Mechanics
The lunge involves hip, knee, and ankle flexion as one foot steps forward, engaging the hip flexors, quadriceps, and glutes eccentrically. The rear leg extends, activating the hamstrings, while the core stabilizes the torso. The body descends until the front thigh is parallel to the ground, then reverses direction through hip, knee, and ankle extension, with the glutes, quadriceps, and calf muscles concentrically contracting. Throughout, the core maintains stability, and proper alignment is essential for joint integrity. The lunge enhances lower body strength, balance, and mobility, making it a fundamental exercise in fitness programs.
Ankle and Big Toe Mobility
Big toe mobility is essential for a lunge movement as it contributes to proper foot positioning and weight distribution. Adequate mobility in the big toe allows for efficient toe extension, which helps stabilize the foot and create a solid base of support during lunging. Improved mobility in the big toe facilitates better balance, proprioception, and force transmission through the foot, enhancing overall movement quality and performance. Limited big toe mobility can lead to compensations such as foot pronation or reduced push-off power, increasing the risk of instability, inefficiency, and injury during lunging exercises.
Hip Flexor Mobility
Hip flexor mobility is essential for a lunge movement as it allows for proper hip extension and alignment. Adequate mobility in the hip flexors, particularly the iliopsoas, permits a deep lunge position with the front knee positioned directly over the ankle and the back knee close to the ground. Limited hip flexor mobility can lead to compensations, such as leaning the torso forward or arching the lower back, compromising form and stability. Improved hip flexor mobility enhances range of motion, promotes proper alignment, and reduces the risk of injury during lunging exercises.
Adductor (Inner Thigh) Mobility
Hip adductor mobility is crucial for a lunge movement as it allows for proper alignment and stability of the lower body. Adequate mobility in the hip adductors permits the legs to move freely in the frontal plane, enabling a smooth and controlled lunge motion without restrictions or discomfort. Limited hip adductor mobility can result in compensations such as excessive knee valgus (inward collapse) or reduced range of motion, leading to poor form and increased risk of injury. Improved hip adductor mobility enhances the effectiveness of lunging exercises by promoting proper alignment, balance, and movement mechanics.
World's Greatest Stretch
The "World's Greatest Stretch" is a dynamic stretching exercise that targets multiple muscle groups and joints simultaneously, providing a comprehensive stretch for the entire body. It typically involves a series of movements that incorporate elements of hip flexor, hamstring, quadriceps, calf, chest, shoulder, and thoracic spine stretching, along with core activation and stability. While there's no single universally agreed-upon version of the "World's Greatest Stretch," a common sequence might involve a combination of the following movements:
Single Limb Stability
Single-leg stability in the lunge is crucial for maintaining balance and controlling movement throughout the exercise. As the body lowers into the lunge position, the supporting leg must stabilize against gravitational forces and resist lateral or rotational movements. This enhances proprioception and neuromuscular control, improving overall balance and coordination. Additionally, single-leg stability helps prevent compensatory movements and reduces the risk of injury by promoting proper alignment of the lower body joints. Strengthening single-leg stability in the lunge translates to improved functional movement patterns and enhanced athletic performance.
Lunge Closing Thoughts
The lunge movement offers numerous benefits, including improved lower body strength, muscle tone, and endurance. It targets multiple muscle groups, such as the quadriceps, hamstrings, glutes, and calves, while also engaging the core for stabilization. Lunges enhance balance, coordination, and proprioception, promoting functional movement patterns and reducing the risk of injury. Additionally, they can be modified to suit various fitness levels and goals, making them a versatile exercise for individuals of all abilities. Incorporating lunges into a workout routine can lead to greater overall fitness, mobility, and athletic performance.
Want to Improve Your Squat Technique?Check out my recent blog post 'Understanding How to Squat." |  |
I have to confess that I used to hate squatting. And I had a good reason for it! Whenever I used to squat, I experienced pain in the front of my right hip and my lower back. The movement felt awkward and disconnected. My ankles, hips, and lower back didn't move smoothly, so I couldn't properly engage my muscles.
Over the past several years, I have gained a better understanding of how the body moves and functions. As a result, I have improved my mobility in the spine, hips, and ankles. I have also learned how to use my hip muscles to generate power. Now, when I squat, I can feel the work in my quadriceps, deep inner thigh muscles, and glutes. I no longer experience any joint pain and my lifts have gotten significantly stronger.
Over the past several years, I have gained a better understanding of how the body moves and functions. As a result, I have improved my mobility in the spine, hips, and ankles. I have also learned how to use my hip muscles to generate power. Now, when I squat, I can feel the work in my quadriceps, deep inner thigh muscles, and glutes. I no longer experience any joint pain and my lifts have gotten significantly stronger.
Benefits of Squatting
Squatting is a compound movement that engages multiple muscle groups simultaneously, making it one of the most beneficial exercises for the whole body. Primarily targeting the lower body muscles such as quadriceps, hamstrings, and glutes, squats also recruit core muscles for stabilization and balance. This comprehensive engagement not only strengthens the muscles involved but also enhances overall functional strength, facilitating everyday activities like walking, climbing stairs, and lifting objects with greater ease. Furthermore, squats promote joint health by increasing the strength and stability of the knee, hip, and ankle joints, potentially reducing the risk of injury and improving mobility.
Beyond its impact on musculoskeletal health, squatting offers numerous additional benefits for the entire body. By stimulating the release of growth hormone and testosterone, squats promote muscle growth and fat loss, contributing to a leaner and more toned physique. Additionally, squatting engages the cardiovascular system, leading to increased heart rate and calorie expenditure, which can aid in weight management and improve cardiovascular health. Moreover, the functional nature of squats promotes better posture and body mechanics, translating into improved overall movement patterns and decreased likelihood of injury in daily activities and athletic endeavors.
Beyond its impact on musculoskeletal health, squatting offers numerous additional benefits for the entire body. By stimulating the release of growth hormone and testosterone, squats promote muscle growth and fat loss, contributing to a leaner and more toned physique. Additionally, squatting engages the cardiovascular system, leading to increased heart rate and calorie expenditure, which can aid in weight management and improve cardiovascular health. Moreover, the functional nature of squats promotes better posture and body mechanics, translating into improved overall movement patterns and decreased likelihood of injury in daily activities and athletic endeavors.
Mastering the Squat
In the videos that follow, I have broken down the squat movement into its various biomechanical components. Through these videos, I will guide you on how to effectively reassemble these components to create a powerful, functional, and pain-free movement.
Hip Flexion: Getting Knees to Chest and Finding the Posterior Chain
During the squat, hip flexion refers to the bending of the hips as the lifter lowers their body toward the ground. Hip flexion allows for proper depth and range of motion in the squat, enabling the lifter to achieve a full or parallel squat position. It also helps to engage the quadriceps, glutes, and core muscles more effectively, distributing the load across multiple muscle groups and joints.
Upright Spine Position: Middle and Lower Back Extension Mobility
Extension is vital in a squat as it helps maintain an upright torso position, reducing stress on the lower back and promoting alignment of the spine. During squatting, the lumbar spine undergoes both flexion and extension movements. Initially, it flexes slightly as the hips hinge backward, allowing the torso to tilt forward. As the lifter descends into the squat, the lumbar spine maintains a stable, neutral position, with slight extension to counterbalance the forward lean of the torso. It allows for better breathing mechanics, enhances stability, and enables a more efficient transfer of force from the lower body to the weight being lifted.
Ankle Mobility: Allowing the Knees to Flex into the Squat
Ankle mobility is crucial in the squat as it allows for proper depth and alignment. Sufficient ankle dorsiflexion enables the knees to travel forward over the toes, facilitating a more upright torso position and optimal distribution of weight. Limited ankle mobility can lead to compensations such as excessive forward lean or lifting the heels, increasing the risk of injury to the knees, lower back, and ankles. Improved ankle mobility enhances squat performance, reduces strain on joints, and promotes better movement mechanics.
Compound Movement: Practicing the Entire Motion
Using assistance, such as a resistance band or a support structure, can help practice a squat movement by providing stability and support. Assistance allows beginners or individuals with limited mobility to gradually acclimate to the proper movement pattern without fear of falling or losing balance. It also helps to reinforce correct alignment and technique, allowing for a safer and more controlled descent and ascent during the squat. Over time, as strength and confidence improve, assistance can be gradually reduced until the individual can perform the squat movement independently and with proper form.
Squat Closing Thoughts
The squat movement is a fundamental exercise that engages multiple muscle groups and joints, making it a cornerstone of strength training and functional fitness. While there may not be a one-size-fits-all definition of perfect form due to individual differences in anatomy and mobility, adhering to general principles is paramount. These principles include maintaining a neutral spine, engaging the core and glutes, tracking the knees over the toes, and achieving sufficient depth while maintaining proper alignment. Following these principles helps distribute the load evenly across the body, minimizes the risk of injury, and maximizes the benefits of the exercise. Whether performing bodyweight squats, front squats, or back squats, focusing on these principles ensures a solid foundation for building strength, stability, and mobility in the squat movement.
Each year I write down the most important things I read, see, hear, and think about. These notes help me reflect on what I am learning and how I am growing both personally and professionally. Here are several of my 2023 thoughts. I hope it inspires you to keep your own list!
- We can’t control the things that happen to us, but we can control how we respond.
- If you want time, you must make it!
- Secrets lead to lies. Tell the truth!
- Once you can make sense of a loss, you can grieve because you know what you’re letting go of.
- We are the authors of our own story!
- Pain is not a problem. It’s just a signal that demands your attention.
- While it is always important to believe in oneself, a little help from others is a great blessing.
- Lose an hour in the morning and you’ll spend all day looking for it.
- Larger lungs = longer lives
- The pattern of disease or injury that affects any group of people is never a matter of chance. It is invariable the expression of stresses and strains to which they were exposed, a response to everything in their environment and behavior.
- There is no doing it right, but there is doing it better.
- How you feel is the early indicator of your health on a cellular level.
- The purpose of your life is to enjoy and learn from your experiences. You are not helping anybody by being miserable. You gain nothing by being bothered by Life’s events. It doesn’t change the world; you just suffer.
- Put life into your fitness not the opposite.
- Age is not about disease, it’s disuse.
- You cannot spend energy worrying about your future health. These are passive thoughts that cause negative emotions such as fear, worry, doubt, and blame. These are emotions of stress. Stress is at the center of dis-ease in the body. In practice: instead of worrying about your heart, ask yourself what positive action could I take keep my heart healthy.
- Focus on progression, not perfection.
- It is not about knowing it all, but rather caring to know more.
- Sometimes the truth can ruin a perfectly good story.
- The aim of all religion is self-development and inner refinement.
- Think of the body and mind as a garden needing tended too.
- Thought becomes habit and habit becomes circumstance.
- Four fundamental emotions: fear, anger, sadness, and joy.
- BE INTERESTED! Be Engaged!
- Sometimes it is not about escaping, but finding whatever comfort in hell.
- Emotions are the end product of past experiences.
- You learn more when you are interested and motivated in what you are learning.
- To make change, you need to think about the things you’ve been thinking about and make new thoughts.
- There is always room for imagination in science.
- Become the scientist of your life.
- You must always make time for things that are important.
- Meditation is like planting a garden. We need to get rid of the weeds.
- Be proactive not preventative.
- Risk should not be avoided but rather analyzed, understood and worked with.
- Peace and intuition go hand in hand.
- Health and fitness are not extrinsically linked— as one goes up, the other doesn’t necessarily go with it.
- Freedom means knowing who you are, what your purpose is, and acting on it.
- Don’t tell, but show!
- Think about your body as something you can teach.
- We are organisms, not mechanisms.
- Doubt is torture.
- People burden themselves with so many choices.
- The sooner you cut the head off the snake, the less likely it is to bite you.
- What’s good for the heart is good for the brain.
- Live a life that’s worth talking about.
- Measurement informs uncertain decisions.
- True fun: confluence of playfulness, connection and Flow
- You are as old as your spine!
- The price of anything is the amount of life you exchange for it.
- Stress dampens creativity.
- We don’t see things as they are, we see things as we are. It is inside of us.
- A plan is simply a system for engineering the desired outcome.
- Genetic is a term we’ve made synonymous with beyond our control.
- Your body adapts to the position you spend the most time in.
- The presence of oxygen means the absence of disease.
- Understanding your physiology is paramount for optimal health.
- Focused effort is at the heart of success. Therefore, narrow your focus, and you have much less to focus on and worry about. Make decisions, whether or not what you are thinking about matches what you are focused on.
- You are in charge HERE. It’s YOUR own Ride!
- The science of how the body works is relatively new, and therefore the science of how to enhance performance is even newer.
- We prepare our bodies for sleep with brushing teeth, etc... We need to put our minds in a position for sleep as well.
**The notes above are a combination of my own thoughts, adaptations of other people's thoughts, and likely even a few direct quotes from others. I'm grateful for the many brilliant people teaching me along the way!**
Most of my clients come to the clinic because a certain movement or activity is causing them pain. For example, it hurts when they go down stairs or it hurts when they are bending forward to brush their teeth. A certain way of moving and a certain pattern of muscle activation is setting off the alarm signals. In these moments, we need to unload and unwind the nervous system. Keep moving, but without triggering the pain response. The way to accomplish this is to gradually move into and around painful ranges of motion. Controlled movement around the pain slowly desensitizes the painful movements and teaches the brain that movement is safe.
This whole experience is a learning process. Many movement patterns become so habitual that they go unnoticed. We don’t think about how our knees bend when walking down the stairs or how the spine bends when we brush our teeth. Movement becomes automatic and subconscious. When pain occurs, movement all of a sudden becomes very conscious. Painful movements are sensitive movements, and the body develops new patterns to minimize pain.
The process of identifying pain and retraining it can be complex. At times, the learning process can feel like pushing a large rock up a mountain. The more chronic the pain, the longer that rock has settled into the earth. Just as the rock doesn't want to budge, our old habits can be hard to change. To help someone out of pain, we need to identify the specific pattern causing someone’s pain and retrain a new pattern. We need to unlearn certain movement habits and engrain a new muscle memory. This entails calming things down and gradually building them back up.
In this post, I am going to share several of the movement principles I incorporate with my clients to help them calm down symptoms and gradually learn new movement habits to get out of pain (and prevent injury in the future).
This whole experience is a learning process. Many movement patterns become so habitual that they go unnoticed. We don’t think about how our knees bend when walking down the stairs or how the spine bends when we brush our teeth. Movement becomes automatic and subconscious. When pain occurs, movement all of a sudden becomes very conscious. Painful movements are sensitive movements, and the body develops new patterns to minimize pain.
The process of identifying pain and retraining it can be complex. At times, the learning process can feel like pushing a large rock up a mountain. The more chronic the pain, the longer that rock has settled into the earth. Just as the rock doesn't want to budge, our old habits can be hard to change. To help someone out of pain, we need to identify the specific pattern causing someone’s pain and retrain a new pattern. We need to unlearn certain movement habits and engrain a new muscle memory. This entails calming things down and gradually building them back up.
In this post, I am going to share several of the movement principles I incorporate with my clients to help them calm down symptoms and gradually learn new movement habits to get out of pain (and prevent injury in the future).
Principle 1: Slow before Fast
Movement gives our brain tons of input about location of our joints, amount of pressure, speed of movement, and more. This input is important for body awareness and preventing injury. If the input comes in too quickly, the body has to react to the movement and no learning occurs. One of the ways to slow down the input to the brain is to slow down the pace of movement. A slower pace helps someone feel when and where a movement starts hurting. Controlling the speed of movement helps control the speed of learning. In the clinic, I’ll use a TRX or some other form of assistance to help slow down a movement to make the learning curve easier.
Principle 2: Single and Simple before Compound and Complex
Breaking down a compound movement into smaller parts is a highly effective strategy for retraining movement. The process of disassembling then reassembling allows us to separate the parts from the whole movement. During this process, you can identify a weakness or inflexibility that is driving the problem. For example, if someone has pain going down the stairs, we can isolate the major joints performing the motion. Instead of multiple joints receiving input, we can train each joint how to move without triggering pain. Joint by joint we rebuilt the entire sequence.
Principle 3: Stable before Unstable Surfaces
The sensors within muscles, tendons, and ligaments are constantly providing the brain with feedback about position, pressure, pain, temperature and more. This barometer is important for how our muscles adapt and react to the outside world. Starting with a stable surface allows these receptors to find a set point. In the clinic, I’ll start on a solid, firm ground before training on unstable surfaces. I make sure the client can find their balance and center of gravity on the ground before adding a more complex variable.
Principle 4: Partial Range of Motion before Full Range of Motion
As our movements get bigger and our tissues stretch further, we put strain on the input sensors that I’ve mentioned above. When these sensors are repetitively strained at their end-ranges, their ability to provide reliable information becomes hypersensitive. When getting out of pain, we need to start in a range of motion that doesn’t aggravate these joint sensors. Beginning in a neutral position where our muscles are strongest is typically the best way to calm down symptoms. In the clinic, I'll start people in an open joint position where there is the least strain on the joints and soft tissue. As their pain subsides and tolerance increases, we gradually start challenging their nervous system through full ranges of motion.
Conclusion
Using these principles (among others) allows clients to understand which movements, postures, and environments are causing their pain. By starting slow, small, and simple the learning process can occur with less distraction. This allows us to calm down symptoms while keeping the patient in control of their symptoms as they gradually retrain their nervous system!
We need to have very strong primary movement patterns,
and also the resiliency to deviate outside of those patterns!
In the post below, I am going to discuss CrossFit world champion Tia Toomey's 1 repetition max (RM) clean and jerk from the 2019 Crossfit Games. When watching the lift, it is apparent that her knees move into valgus (collapse inward) while accelerating upward from the front squat. I am using this video in particular because it has gained some attention as an example where movement biomechanics are not related to pain. In other words, the video demonstrates that a high level performer can have a ‘movement dysfunction’ without any pain. While this statement is absolutely true, it is important to take a broader perspective when discussing the multi-faceted subjects of pain and biomechanics.
Watch the video below and continue reading!
Watch the video below and continue reading!
Context is Everything
When analyzing movement, context is everything. In this video, Tia Toomey is performing a 1 repetition max lift at the Crossfit Games. The context is a very heavy lift with very high stakes. In these moments of maximal output, we see the extremes of human potential and the capacity of the human body to find any possible strategy to succeed. Her two options for this movement are 1. fail the lift or 2. win the event. Tia Toomey utilizes knee valgus on this lift because it is an all out, 100% max effort event. Under normal circumstances Tia Toomey does not valgus every time she squats. If you watch her front squat on a non-1RM lift, her form is biomechanically clean and efficient. Valgus doesn't cause pain, but let's not confuse it to be a good movement pattern.
You may notice that I use the word efficient. Below, I will discuss how movement efficiency minimizes stress and strain on our tissues.
You may notice that I use the word efficient. Below, I will discuss how movement efficiency minimizes stress and strain on our tissues.
Biomechanics of a Squat
Good biomechanics refers to our ability to use our anatomical levers, pulleys, and springs to minimize the physical stress placed on tissues & maximize the energy efficiency of the movement.
Squatting is a complex motion; and therefore, it has complex biomechanics. Many joints equals many parts simultaneously moving. For this reason, breaking down the squat into phases, joint actions, and muscles simplifies the equation.
During the deceleration phase of the squat, the knee flexes as the hip flexes. With knee flexion, the tibia naturally and involuntarily internally rotates. This is commonly known as the unlocking phase of the screw-home mechanism. Tibial internal rotation provides access to the subtalar joint and medial arch of the foot. This trio of joint motions- knee flexion, tibial IR, and controlled subtalar pronation- are important because it unlocks all the main rotational joints from the floor to the core. These movements are functionally significant because rotational leverage is our means of generating torque and power. During the squat, the quadriceps, adductor magnus, and glutes are our prime movers. Using good mechanics, including but not limited to a hip hinge, knee flexion, and ankle dorsiflexion, allows for these muscles to function at an optimal muscles length to tension relationship. Good biomechanics don't waste extra metabolic energy. They are efficient!
During the deceleration phase of the squat, the knee flexes as the hip flexes. With knee flexion, the tibia naturally and involuntarily internally rotates. This is commonly known as the unlocking phase of the screw-home mechanism. Tibial internal rotation provides access to the subtalar joint and medial arch of the foot. This trio of joint motions- knee flexion, tibial IR, and controlled subtalar pronation- are important because it unlocks all the main rotational joints from the floor to the core. These movements are functionally significant because rotational leverage is our means of generating torque and power. During the squat, the quadriceps, adductor magnus, and glutes are our prime movers. Using good mechanics, including but not limited to a hip hinge, knee flexion, and ankle dorsiflexion, allows for these muscles to function at an optimal muscles length to tension relationship. Good biomechanics don't waste extra metabolic energy. They are efficient!
Toomey's Biomechanical Analysis
The Set-up Position: Deceleration Phase
In the Toomey Technique video, she loads the weight properly down into her squat (see picture right). Toomey maintains an upright spine, good hip to ankle alignment, and strong posterior chain tension. Her proper mechanics during the deceleration phase allow her kinetic chain to load symmetrically and maintain her center of mass over her feet. This is important because we are our strongest when rooted over our center of gravity. Additionally, this position maintains stability around the pelvic ring, which functions to disperse forces throughout the body. Maintaining integrity through the pelvic ring allows the sacrum to wedge deeper into the ilia, which creates a more stable base to generate torque from.
This wedging mechanism is the reason that the sacrum is shaped like an upside down triangle. As load increases, the ability to balance force and form closure of the SI joints becomes increasingly important.
In the Toomey Technique video, she loads the weight properly down into her squat (see picture right). Toomey maintains an upright spine, good hip to ankle alignment, and strong posterior chain tension. Her proper mechanics during the deceleration phase allow her kinetic chain to load symmetrically and maintain her center of mass over her feet. This is important because we are our strongest when rooted over our center of gravity. Additionally, this position maintains stability around the pelvic ring, which functions to disperse forces throughout the body. Maintaining integrity through the pelvic ring allows the sacrum to wedge deeper into the ilia, which creates a more stable base to generate torque from.
This wedging mechanism is the reason that the sacrum is shaped like an upside down triangle. As load increases, the ability to balance force and form closure of the SI joints becomes increasingly important.
Maximizing Elastic Tension
From her bottom position, she then lightly bounces the weight 1x to take up more posterior chain tension and position herself directly under the bar. Then, Toomey uses the timing of the bounce to accelerate and spring herself upward. Much like a loaded spring, the bounce and catapult action leverages the elastic components of her myofascial system.
If the bounce was removed, she would lose her kinetic energy and momentum would be lost. The kinetic energy would turn into thermal energy absorbed into the tissues. Too much heat leads to stress on the tissues and fatigue is felt.
Load and Explode: Acceleration Phase
As Tia Toomey accelerates from her light bounce, the weight of the bar is near her maximal myofascial force capacity. For this reason, Toomey’s hips adduct and internally rotate as she pushes herself upright. This creates the valgus position at her knee and momentarily puts her joints in a relative closed pack position. The valgus compensation functions as a means to seek stability. She momentarily ‘locks’ her joint structure so that her muscles can pull through the most challenging range of the movement.
The transition from up-phase 1 to up-phase 2 (pictures below) utilize all the built in rotational torque of our joints. The transition from pronation, tibial IR, and femoral IR TO supination, tibial ER, and femoral ER was controlled. These joint motions essentially ‘screw home’ the movement up the entire chain. The knee valgus is Toomey’s strategy to find stability in the low phase of the front squat to complete the goal-directed movement.
From her bottom position, she then lightly bounces the weight 1x to take up more posterior chain tension and position herself directly under the bar. Then, Toomey uses the timing of the bounce to accelerate and spring herself upward. Much like a loaded spring, the bounce and catapult action leverages the elastic components of her myofascial system.
If the bounce was removed, she would lose her kinetic energy and momentum would be lost. The kinetic energy would turn into thermal energy absorbed into the tissues. Too much heat leads to stress on the tissues and fatigue is felt.
Load and Explode: Acceleration Phase
As Tia Toomey accelerates from her light bounce, the weight of the bar is near her maximal myofascial force capacity. For this reason, Toomey’s hips adduct and internally rotate as she pushes herself upright. This creates the valgus position at her knee and momentarily puts her joints in a relative closed pack position. The valgus compensation functions as a means to seek stability. She momentarily ‘locks’ her joint structure so that her muscles can pull through the most challenging range of the movement.
The transition from up-phase 1 to up-phase 2 (pictures below) utilize all the built in rotational torque of our joints. The transition from pronation, tibial IR, and femoral IR TO supination, tibial ER, and femoral ER was controlled. These joint motions essentially ‘screw home’ the movement up the entire chain. The knee valgus is Toomey’s strategy to find stability in the low phase of the front squat to complete the goal-directed movement.
So...Is Knee Valgus Good or Bad?
I would argue that asking ‘good or bad’ is the wrong question. When discussing valgus (and all ‘movement faults’), we must have a clear definition of valgus. So, what is knee valgus? Is knee valgus from femoral internal rotation or femoral adduction and/or a flat footed posture? What degree of alignment do you classify valgus vs. normal alignment? And, maybe most importantly, does your client always squat with valgus or is it because of their current context? These contextual factors are essential to determining quality of movement and likelihood of injury.
With that being said, typically valgus positionally inhibits the glutes, impinges the anterior hips, and collapses the arch. It is not a strong position and it locks out regional joints. These consequences of valgus decrease our degree of freedom, which could increase a person's risk of injury. For Toomey, the valgus is an exaggerated position of the normal mechanics. As her hips clear her knees, the knees return to their original stacked position. Since the technique video is a 1 rep maximum lift, it should be expected that her form and mechanics will be pushed to the limit.
In my opinion, valgus should be a movement strategy that we can tolerate, but it should not be our primary strategy.
With that being said, typically valgus positionally inhibits the glutes, impinges the anterior hips, and collapses the arch. It is not a strong position and it locks out regional joints. These consequences of valgus decrease our degree of freedom, which could increase a person's risk of injury. For Toomey, the valgus is an exaggerated position of the normal mechanics. As her hips clear her knees, the knees return to their original stacked position. Since the technique video is a 1 rep maximum lift, it should be expected that her form and mechanics will be pushed to the limit.
In my opinion, valgus should be a movement strategy that we can tolerate, but it should not be our primary strategy.
Closing Thoughts
It is well established that isolated movement faults do not cause pain. However, this does not mean that pain and movement biomechanics are unrelated. How we move determines where physical stress transfers into our body. If I squat on my toes, I use my quads to a greater degree. If I squat on my heels, I am more likely to engage the posterior chain. In either scenario, some tissue is going to take on stress. Stress creates disturbance and imbalance, and too much stress of any kind decreases our recovery capacity and increases our risk of injury.
When someone chooses an inefficient movement as the primary strategy, the joint mechanics, muscle-length tension, and torque capacity all suffer. Does this cause someone pain? No, not in the moment, but it adds stress into the system. We need to have very strong primary movement patterns, and also resiliency to deviate outside of those patterns!
When someone chooses an inefficient movement as the primary strategy, the joint mechanics, muscle-length tension, and torque capacity all suffer. Does this cause someone pain? No, not in the moment, but it adds stress into the system. We need to have very strong primary movement patterns, and also resiliency to deviate outside of those patterns!
To give a sense of our complexity, scientists estimate that there are >7 trillion nerves in the entire body. A 1 inch by 1 inch square box on your arm is estimated to contain 3 yards of blood vessels, 4 yards of nerve fibers, 100 sweat glands, 3 million cells, and 32 million bacteria. Numbers this large are almost unfathomable. While the exact number is not important, it speaks to the sophistication and complexity of the human nervous system.
The nervous system is responsible for two very important functions. First, it provides all of the sensory input to the brain- “that’s too hot,” “my arm itches,” and “my shoulder feels tight,” as examples. This raw data about the state of the body is translated into usable information in the brain. Second, the nervous system coordinates the movement of the body. These movements are both voluntary and involuntary, meaning we can choose to perform a movement or we reflexively move out of habit or for safety. Bending forward to pick up your groceries is a voluntary movement, and crossing your legs when you sit on the couch is an involuntary movement. Becoming familiar with these two nervous system functions is important for understanding how it directs our feelings, actions, and emotions.
From End to End
When thinking about the nervous system, I like to imagine the nerves as small roots of a tree that each connect back to a larger central root system. The nerves on the bottom of your toes run through the arch of the foot to the inner ankle, up the back of the calf and thigh, into the spinal column, and finally into the brain. In other words, almost all nerves travel from the body, into a specific region of the spine, and eventually arrive at the brain. As the nerves travel throughout the body, each one winds through the skin and muscles, around bones, and across joints. Just like the roots of a tree, our entire nervous system is connected; and therefore, responds as a single unit.
Each of these nerves communicate via special receptors that interpret temperature, vibration, pressure, body position, pain, and more. While there is plenty of variation in each individual’s anatomy, the general pathways are consistent for almost all people. For this reason, if you have tingling in your little finger, we know that somewhere along the nerve pathway is involved. Each part of this pathway- body, spinal cord, and brain- needs to be in balance to efficiently and appropriately pass information back and forth.
When thinking about the nervous system, I like to imagine the nerves as small roots of a tree that each connect back to a larger central root system. The nerves on the bottom of your toes run through the arch of the foot to the inner ankle, up the back of the calf and thigh, into the spinal column, and finally into the brain. In other words, almost all nerves travel from the body, into a specific region of the spine, and eventually arrive at the brain. As the nerves travel throughout the body, each one winds through the skin and muscles, around bones, and across joints. Just like the roots of a tree, our entire nervous system is connected; and therefore, responds as a single unit.
Each of these nerves communicate via special receptors that interpret temperature, vibration, pressure, body position, pain, and more. While there is plenty of variation in each individual’s anatomy, the general pathways are consistent for almost all people. For this reason, if you have tingling in your little finger, we know that somewhere along the nerve pathway is involved. Each part of this pathway- body, spinal cord, and brain- needs to be in balance to efficiently and appropriately pass information back and forth.
Tension & Compression
While the nervous system is highly resilient and adaptable, it is also very protective against injury. As a result, the nerves are highly sensitive to local changes in blood flow and oxygen. Normal, healthy movement is important for a well-tuned nervous system. Contrarily, nerves become less resilient with poor postural and training habits. Limited movement and imbalanced training only stimulates the nerve receptors in a small range of totally capacity. If something occurs outside of that range, the nervous system does not know how to respond, and the chance of injury increases.
Specific to movement and training, nerves are sensitive to tensile and compression forces. Tensile forces on a nerve can be compared to stretching a rubber band from both ends. A common posture that tensions the nervous system is prolonged slouching through the lower back while sitting. The slouched posture stretches the lower back nerves as it runs from the spine into the glute muscles. Compression forces- on the other hand- are any pinching (or narrowing) forces on the nerve. Similar to how a blood pressure cuff shunts blood, certain postures or movements compress our nerves. For example, compression from a blood pressure cuff is a relatable example. You can tolerate a blood pressure cuff at a low intensity for a very long time. As the cuff gets tighter, the duration of time decreases. The nerves register the increased compression and send signals to the brain about potential threat. The result is often tingling, temperature changes, and a feeling of muscular agitation. The key is remain strong and mobile through a wide range of tensile and compression forces.
While the nervous system is highly resilient and adaptable, it is also very protective against injury. As a result, the nerves are highly sensitive to local changes in blood flow and oxygen. Normal, healthy movement is important for a well-tuned nervous system. Contrarily, nerves become less resilient with poor postural and training habits. Limited movement and imbalanced training only stimulates the nerve receptors in a small range of totally capacity. If something occurs outside of that range, the nervous system does not know how to respond, and the chance of injury increases.
Specific to movement and training, nerves are sensitive to tensile and compression forces. Tensile forces on a nerve can be compared to stretching a rubber band from both ends. A common posture that tensions the nervous system is prolonged slouching through the lower back while sitting. The slouched posture stretches the lower back nerves as it runs from the spine into the glute muscles. Compression forces- on the other hand- are any pinching (or narrowing) forces on the nerve. Similar to how a blood pressure cuff shunts blood, certain postures or movements compress our nerves. For example, compression from a blood pressure cuff is a relatable example. You can tolerate a blood pressure cuff at a low intensity for a very long time. As the cuff gets tighter, the duration of time decreases. The nerves register the increased compression and send signals to the brain about potential threat. The result is often tingling, temperature changes, and a feeling of muscular agitation. The key is remain strong and mobile through a wide range of tensile and compression forces.
Homeostasis
All systems in the body strive for an internal state of equilibrium, which is known as homeostasis. Since the nervous system is the command center of the other systems, maintaining equilibrium is especially important. Both physical and mental stressors significantly impacts the ability to regulate the nervous system. When a nerve reaches its capacity for tolerating stress, nerve related symptoms will present. Symptoms can range from numbness and tingling to itchiness, and even to muscle atrophy in more pronounced cases.
Having had intermittent nerve pain in my right arm, this concept is intimate to me. My nerve pain presented as itchiness in my elbow during the middle of the night. The itchiness was so intense that I would wake up scratching my skin raw. After becoming familiar with the pattern, it became apparent that my nerve symptoms were largely related to prolonged sitting at the computer, a lack of physical exercise during these time periods, and poor sleep habits. No single factor induced the nerve pain, but rather the cumulative stressors eventually led to nerve irritation. While I primarily experienced itchiness, each person’s nerve symptoms will depend on the specific pathways that are perceiving stress.
All systems in the body strive for an internal state of equilibrium, which is known as homeostasis. Since the nervous system is the command center of the other systems, maintaining equilibrium is especially important. Both physical and mental stressors significantly impacts the ability to regulate the nervous system. When a nerve reaches its capacity for tolerating stress, nerve related symptoms will present. Symptoms can range from numbness and tingling to itchiness, and even to muscle atrophy in more pronounced cases.
Having had intermittent nerve pain in my right arm, this concept is intimate to me. My nerve pain presented as itchiness in my elbow during the middle of the night. The itchiness was so intense that I would wake up scratching my skin raw. After becoming familiar with the pattern, it became apparent that my nerve symptoms were largely related to prolonged sitting at the computer, a lack of physical exercise during these time periods, and poor sleep habits. No single factor induced the nerve pain, but rather the cumulative stressors eventually led to nerve irritation. While I primarily experienced itchiness, each person’s nerve symptoms will depend on the specific pathways that are perceiving stress.
Low Quality Input= Low Quality Output
In this post, we have discussed how the body sends input to the brain, how the brain translates this data into usable information, and how mental and physical stress impacts the nervous system. This information provides the necessary framework for understanding how to maintain a healthy and responsive nervous system. Additionally, it highlights the importance of both the input from the body & the output from the brain. In other words, the quality of input influences the quality of output. Our nervous system is strong, complex, reslient, and adaptable. The more we use and test our bodies, the better understanding we will have of our nervous system!
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