Movement or Anti-movement? What are you teaching?
In this article, we are going to go a little sci-fi and talk about an alternate reality. In this alternate reality, the training of movement is actually unknowingly the training of anti- movement. The health and fitness industry inhabits this alternate reality on a regular basis, through all sorts of interesting but not quite accurate takes on what normal movement might be.
In the “Dark Side of Scapular Cuing” article, I looked at the conflict between common cues and shoulder biomechanics, and this time I’d like to extend the discussion on the overhead arm movement to consider a common cue for the central body.
Let us first consider the normal biomechanics of reaching an arm overhead, whether lying down or upright. Think of this as a fern frond unfurling. The trunk is lengthening as the flow of force is directed up into the arm. The trunk lengthening impulse triggers transversus abdominis to respond, creating a foundation of elastic support for the arm motion. The movement impulse travels from the lower trunk up through the spine, with the thoracic spine extending and segmentally rotating to free the shoulder and integrate its motion with the spine. The scapula continues the flow of movement impulse by rotating upwards to create space between the humeral head and the acromion (the bony arch which is the roof of the shoulder joint), thus protecting the sensitive structures on top of the shoulder from being squeezed as the arm is raised. It is a symphony of force management.
Now let’s consider how the abdominal wall is often cued in an overhead movement. A prevalent approach is to maintain a consistent distance between ribs and pelvis. The reasoning behind it is that if the spine extends as the arm moves overhead, the front of the torso is opening and widening, so the cue is intended to prevent that from happening. However, in attempting to prevent one problem, another is created.
When the trunk and ribs are held in a static relationship, the normal accompanying biomechanics of thoracic extension and segmental rotation are blocked. There is no lengthening impulse through the trunk, so the abdomen does not respond automatically to make its elastic connection with the shoulder. The arm is then isolated, disconnected from the whole. It moves like a plastic doll’s arm, stuck onto the body but not integrated with it. The dynamic relationship of force transfer between trunk and arm is compromised, and flow, such a central principle in Pilates, is lost.
The alternate reality of movement has struck. Normal biomechanics have been sacrificed through speaking the language of flow and lengthening, but then cuing actively against it. I meet many people who have acquired secondary shoulder pain through their efforts to address their back pain. Their response is usually to focus even more on their “core” and their “drawing down” of the scapulae, not realising that they are exacerbating the problem by interfering with normal biomechanics. They are practicing anti-movement.
The first step towards recovery for my shoulder patients is learning to establish the elastic supportive relationship between their trunk and shoulder. However, to achieve this, the abdominal wall must not be statically held. The ribs must be allowed to open a little on the moving side, and for the space between iliac crest and lower ribs to expand lengthwise. This idea initially causes panic! How can we prevent inappropriate back extension, people say, if you ask us to release the abdominal wall?
Let us start by reframing the unwanted back extension movement. Back extension in an overhead movement is usually interpreted as lack of control. In fact it is quite the opposite – it is demonstrating that back extensor activation is the person’s dominant control strategy in response to movement. This muscle group fires to provide a stable point to move from. It is a control strategy, but just doesn’t happen to be the ideal strategy from a force management point of view.
Countering this back tension by cuing abdominal tension frequently achieves a generalised increase in overall tension. Simply put, if you fight tension with tension, you get… more tension. More tension means movement compromise somewhere in the system. That is rarely good news when it comes to the free flow of a movement impulse through the body.
The key is not in fighting an unwanted movement, in this case back extension, but in inviting the body to move in a more desirable direction. The optimal impulse of the body in raising the arm is in an axial direction, so the body lengthens and decompresses, allowing the spine to open in response to the raising arm.
How might we achieve this?
Releasing a dominant strategy invites the body to find a new solution for control. In the case of the back extensors, the alternative proposition is the abdominals. Thus, instead of actively countering the impulse to extend the spine by pre setting the positional relationship of ribs to pelvis, we introduce the person to the sense of releasing the back and allowing it to follow the movement impulse along the floor if lying down, or towards the ceiling if sitting or standing. The movement then allows for unrestricted flow, which aligns nicely with Pilates.
The abdominals are still active, but they are simply no longer being used at a fixed length. This allows a person to reach, twist and move freely without restriction, yet remain elastically connected. Without the need to fight a back extension impulse, the abdominal wall is able to achieve a deeper, quieter activation. The result is a very organic sensation which requires minimal muscle activity for control, and allows for freedom of joint motion. This is in essence, the definition of efficiency.
The challenge for any movement practitioner is to constantly re-evaluate the solutions we offer, the cues we use and the purpose for which we use them. As we learn more and more about the body and as new research emerges, cues that were widely accepted may need to be held up to the light and examined carefully to ensure that we are upholding our goals to support and develop our clients’ and patients’ movement, rather than interfering with it.
The purpose of control is, after all, to enable more effective movement, not to limit it. In our practice then, we must ensure that we are indeed training for movement, not anti-movement.
If you’d like to know more about developing healthy, normal, functional movement, the second edition of Joanne’s popular book, Stability, Sport and Performance Movement: Practical Biomechanics and Systematic Training for Movement Efficacy and Injury Preventionis available on Amazon.co.uk.