Streamed live on 27 Jan 2014 All about movement Stability, Sport and Performance Movement Google+ interview with the awesome Joanne Elphinston by Perry NickelstonRead More
The scapular region can be a particularly challenging area to work with. It must be simultaneously stable and mobile, a tricky balance to strike when so many people have very little sense of connection to this area.
A very specific biomechanical misunderstanding about function in this area has led to the use of a cue which can inadvertently lead to development of shoulder pain, despite the good intentions behind them.
The structure of the shoulder is such that a bony roof made up of a projection from the scapula (the acromion) and its junction with the clavicle (collarbone) create a protective arch over the structures which nestle beneath, including the tendons which pass over the “ball” or the ball and socket joint of the shoulder.
Normal biomechanics of the scapula dictate that as the arm is lifted overhead, the scapula should rotate upwards, which moves the bony “roof” out of the way in order for the arm to freely lift without compressing the sensitive structures underneath. If this normal motion does not occur, these tendons can be subject to repetitive compression, which in turn can lead to impingement pain on lifting the arm.
So far so good.
Now one of the most common cues used in the fitness and rehabilitation fields is to “draw the shoulder blades back and down”.
This is understandable. If the individual uses an elevation pattern for upper limb motion i.e. the scapula is drawn upwards, shoulder mechanics are interrupted and increased load is directed to the neck. Similarly, for the person who habitually holds their shoulders in a forward position, biomechanics are compromised. Surely then the “back and down” cue is perfect?
Well, let’s look a little further into the issue.
While having the shoulders up or forward are not ideal, actively holding them in the opposite position, even “gently”, can have some undesirable effects.
The first is that it places the scapulae in a fixed position. As we know, the scapula must be mobile in order to support normal arm function. Imagine how unnatural it would be just to reach into the back of your kitchen cupboard while keeping your shoulders fixed back and down. Try winding up into a golf back swing without allowing one scapula to slide forward around your rib cage, and the other to slide back towards the spine. Feel how restrictive it is to reach upwards while keeping your scapula fixed back and down. It feels awkward for a reason, and that reason is that it interferes with your biomechanics. It quite simply is not normal movement.
It is routine for the “draw back and down” cue to be given to people to prepare them for lifting their arms overhead, whether in sitting, standing or lying down. However, this interferes with the scapula’s free upward rotation in response to arm movement, increasing the possibility of tendon compression. It is not surprising then that we see many people with shoulder impingement pain that has developed as an unfortunate consequence of their attempts to improve their posture and function.
The bilateral nature of the cue is also associated with diminished trunk rotation and arm swing. Normal, efficient gait requires alternating rotation of the upper torso against the lower torso. This centrally generated rotation initiates natural, connected arm swing. When the scapulae are actively drawn back and down, it blocks rotation and alters the mechanics of walking and running. (Incidentally, when this happens people can begin to over push with their calves to compensate for the loss of efficiency, so a cue at the top of the body can create issues at the other end of the chain).
Hmm. How do we avoid creating a problem while trying to solve another?
Our first priority is the foundation position against gravity. In standing, softly lengthen the spine through the top of the head, and then sense the balance point where your weight feels as though it falls through the centre of your feet. This position encourages the shoulders to fall away from the ears.
Note whether you are shorter on the front or the back of your upper body, or whether the shape of your body is convex on one side and concave on the other. It usually only takes a small adjustment to ease your shoulders into a position which evens out the length or shape, and it should not provoke any sense of tension.
Now the chest is open and the shoulders can hang freely. When cuing the arm lifting movement in those who elevate their shoulders to initiate the motion, there are many options. Ask for a soft hand to lead the motion, as tension in the hand frequently provokes tightness in the shoulder. Bring the focus to maintaining a lovely long neck, which attracts awareness to the area without the compromise on normal movement that drawing the shoulders down can cause. Finally, encourage a sense of lengthening through the body as the arm reaches overhead, to allow it to connect into the elastic support available in the trunk.
There are so many interactions in the body constantly influencing each other that seemingly logical solutions can be deceptive. To avoid the dark side of any cue, bear two things in mind. The first is to focus on what you positively do want to elicit rather than attempting to stop what you don’t want. The second is always to be aware of normal movement, to make sure that whatever we share with clients aligns with an enhancement in health and efficiency.
Let’s shed a little light on those shoulders!
If you’d like to know more about developing healthy, normal, functional movement, visit www.jemsmovement.com or email us at email@example.com about our upcoming JEMS course for Health, Fitness and Wellbeing Professionals.Read More
No matter how many times he has seen it before, my husband will sit glued to a Star Wars re-run on television, completely and blissfully absorbed.
Cup of tea in hand, I joined him on the sofa at a pivotal moment in young Luke Skywalker’s journey towards becoming a Jedi knight. When given the task of raising his ship from the murky depths of a swamp by Yoda, Luke shrugs and says, “I’ll try”, and Yoda sharply corrects him, with “No! Do. Or do not. There is no try“.
Language is a source of constant fascination for me, and this video clip highlighted something that I frequently pick up from clients. Many of them “try” to do this, “try” not to do that, and generally “try” really hard. Some will use the word “try” or “trying” several times in one sentence without realising it as they explain their situation to me.
The same language emerges from therapists, sports trainers and coaches, without them even realising: the very same “Try to …” or “Try not to …”. It is so insidious that it slips out before we can catch it.
What is this all about?
On the one hand, we have phrases like “he’s not a tryer” or “she didn’t even try”. Nobody wants to be that person! By “trying”, we feel that we demonstrate our worth, that we’ll have a go, make the effort, do our best. However, this often ramps up our muscle tension and suddenly we are getting in our own way. With success eluding us, we try harder. The harder we try, the more blocked we become.
For effective force production and fluent movement, we are aiming for effort-less. I have seen people fail to push, pull or lift loads which are well within their capabilities simply because they are trying so hard. When this self-generated hand brake is removed with a change of focus, they suddenly find strength or speed that they didn’t know they had.
Of course, on hearing this, there are people who then “try to relax” or “try to be effortless”. How likely is success?
On the other hand, by saying to a client “Try to …”, we rob them of conviction. We’re communicating that we’re not sure that they can do it, so they aren’t sure either. A tiny seed of doubt is sown…
Nike wasn’t far wrong when they coined the phrase “just do it”. When communicating with a client, I’ll tend towards “this is what we are about to do”. If it doesn’t pan out perfectly, they may hear, “that was reallyinteresting, what did you notice?” followed by “with that in mind, let’s do it again and see what we find out this time”, or perhaps, “I wonder what would happen if..”. It’s amazing how often the nudge into self-awareness elicits change without the person even realising it. The outcome changes without “trying”!
Approach the task with conviction. Remove the seed of doubt. Do.
This week, notice how much “trying” pops into the language of your interactions. Play with alternatives — it may make a big difference to some clients!Read More
Since we have published our review of Joanne’s workshop JEMS Functional Foundations for Pilates Teachers: Dynamic Movement Principles for Work, Sport and Life we have received numerous inquiries for further information and workshop dates. We decided to go to the source and ask:
Who is Joanne Elphinston?
That’s quite a tricky philosophical question to begin with!
I was born and raised in Australia, and after a wonderful five years working in Honolulu, transplanted to the UK in 1996.
I am and always have been an educator. My first clear memory of teaching is at age 6 – other kids wanted to know how I drew people who weren’t stick figures. Very little has changed – I’m still compelled to share my discoveries and experiences, both with other professionals and with clients, so that same six year old is alive and well all these years later.
Funnily enough, as a therapist I now draw stick figures all the time.
I was a fitness instructor, a swimming teacher, a volleyball coach, and then a physiotherapist. The same theme ran through all of these activities for me – beautiful, effortless movement, expressed with joy, confidence and enthusiasm, whether the person was a five year old swimmer, an eighteen year old athlete or an eighty year old war veteran at the repatriation hospital where I held my first post as a young physiotherapist.
When I eventually crossed the threshold of a university again it was to study philosophy of music, which empowered me not with what to think, but how to think. That is one of the greatest gifts that education can impart.
In the ensuing years, I have explored movement optimisation for both rehabilitation and performance. I was an external tutor for London Contemporary Dance School for several years, developed musician injury prevention education for the Royal Welsh College of Music, and have spent more than a decade working with the National Dance Company of Wales on performance enhancement. I have been Head of Performance Movement for the British Olympic Association, while at the same time teaching fun applications for learning disabilities, pediatrics and falls prevention for the elderly. I consult to professional and world class athletes and sporting organisations, and work with chronic pain patients through holistic methods.
Who am I? I’m just an inquisitive person who is fascinated with our bodies and their amazing capacity, and who believes that with the right support we have a natural drive towards positive healthy movement.
What led you to transform from being a physiotherapist to physiotherapist who teaches through movement into the art of movement…?
This is easier. There has been no transformation – this is who I always was, well before I was ever a physiotherapist
I have always seen movement in quite a specific way, because in fact it was often all I could see. My exceptional short sightedness as a child went undetected because I compensated so well by recognising people’s movement instead of their faces.
Many of your readers will no doubt have experienced the sensations of movement in their bodies while viewing other people in motion, and this is something that I also have deeply felt since I was a child. It is the route through which I first understand what I am seeing – my body understands immediately, and then my brain articulates it through the framework of biomechanics, neurology and psychology.
The art of beautiful movement cannot help but include the mind and emotional landscape of a person. Separating our “selves” from our bodies leads to self-consciousness, however self-awareness arises from integration. This is as much a part of my movement journey as any physical aspect.
So rather than transformation, it was evolution that has brought me to this point, and the kindness and interest of a number of people for whom I have great respect and gratitude. Suzanne Scott, Andy Nice, Sharon Thompson and Monika Zarebska have all encouraged me to share my work with the Pilates community, and their enthusiasm and support has been fundamental to my decision to further develop education and resources to meet this interest.
What is JEMS and what is its purpose?
JEMS (Joanne Elphinston Movement Systems) is a movement enhancement approach for people of all ages, walks of life, occupations and interests. It is a systematic, effective method which targets a person’s efficiency and ease of motion, and addresses physical performance as well as injury prevention and rehabilitation.
Although based on the integration of neuroscience, biomechanics, motor control and psychology, JEMS is a holistic approach which teaches people to explore and uncover new movement possibilities and open new pathways. It is less cognitive and more sensory in its approach, using a variety of methods to access people’s movement potential in the simplest ways possible.
JEMS is about… engagement and exploration; warmth and accessibility; simplicity and clarity; science and art. It is about moving beautifully, no matter who you are.
How would Pilates Teachers benefit from attending a JEMS course?
The Pilates teachers who have attended courses that I have taught so far have been highly motivated, well informed, and really interested in finding links between their work to the functionality of normal movement.
JEMS brings a new perspective to the understanding of integrated, controlled but elastic dynamic movement. It extends the concept of control beyond core stability, and into understanding the Pillars of Functional Stability, the collection of factors which work together as the human body moves. These include mobility, balance, neuromuscular responses and dynamic control.
Designed specifically for Pilates teachers, bodyworkers and health and fitness professionals, the JEMS Health, Fitness and Wellbeing course equips practitioners with expanded skills and a greater understanding of movement biomechanics and muscle function in practical, easy-to-understand and immediately relatable ways.
Extending body knowledge in this manner engages clients through optimising movement performance in meaningful ways, and in more accurately understanding, accommodating and addressing their common injury presentations.
With its philosophy of moving beautifully with enjoyment, self-awareness and efficiency, JEMS is ideal for those practitioners wishing to extend their skills into functional, natural movement.
Are you planning to create a certification course for Pilates Teachers?
The enthusiasm shown from participants after our last course has certainly pointed me in this direction. We are planning a JEMS pathway for Health, Fitness and Wellbeing Professionals which would be ideal for Pilates teachers. The JEMS for Pilates Teachers course in Bristol in June hosted by the Pilates Foundation, and our own London JEMS for Health, Fitness and Wellbeing Professionals course in July both represent the start point for this. I’ll certainly keep PilatesTree up to date with developments!
What does the future hold for JEMS?
Goodness, what doesn’t it hold?
The exciting and somewhat daunting aspect of JEMS is that it applies in so many contexts. This means that my “to do” list keeps expanding!
More and more people in different parts of the world are switching on to JEMS, so there is a need to train professionals to a high standard. Teaching, resource development and support for the growing JEMS community will continue to inspire me. Providing more pathways to certification, and more ways to access JEMS material is pressingly important as demand grows.
I love that more and more JEMS practitioners are doing beautiful things with their clients with heart and integrity, and then coming back to me shining with enthusiasm and stories. They inspire me, lift me up and keep me flowing forward!
Dear Joanne we thank you for your generous answers.Read More
Further to our review of JEMS workshop we wanted to let you know about a new book coming out very soon. It’s a second edition of Stability, Sport and Performance Movement by Joanne Elphinston and here is Joanne’s summary on What’s new? .. You can find quick link to it on our Amazon Recommendations on the right of the screen.
“Edition Two of Stability, Sport and Performance Movement introduces a brand new model for understanding movement control and force expression: functional force management (FFM). The model of high and low threshold training that is commonly used is actually quite limited when considering the body in motion. FFM brings together biomechanics, myofascial concepts and motor control in a simple but immediately applicable way for both assessment and exercise programme design.
What, for example would be different between the trunk control work a golfer would do compared with a footballer, a swimmer or a skier? Why is an exercise good for one athlete and potentially performance detracting for another? FFM has the answers to this, and it is easier than you might expect to apply.
There is a whole new chapter on this concept, which is followed through in the applied anatomy chapter, where FFM principles are explored through the fundamental movement and force transmission behaviours in the upper, central and lower zones. It’s not enough to say that pelvic stability is compromised – you want to know exactly which lower zone behaviour is the issue so that you hit the right targets in your programme.
The premise of movement efficacy as the goal rather than “stability” is introduced, and throughout the first four chapters we have some new clinical and practical examples as well as new personal explorations to investigate this. There is more on posture as well as the feet, before we get to the movement testing chapter, where the tests are now seen through the lense of movement behaviours. This gives a richer understanding of the purposes of these commonly performed tests beyond simply “control”.
There is new material on the principles of progression and programme construction, and a small number of additions to the exercise library, with some new exercises also appearing in the first four chapters to illustrate clear points. These chapters retain their essential structure, character and content, however the instructions and explanations have been refined and extended in many cases to reflect the development of the approach.
I have taken out the children’s chapter, as it was lost in this book. I’m integrating it into a specific book on developing children to do it justice. More on that later…
The book’s audience was incredibly broad last time, reaching therapists, sports doctors, coaches, Pilates and yoga instructors, personal trainers, athletes and non athletes, many of whom wrote to me to tell me about what they learned about themselves and what they found useful. I’ve really tried to preserve that tone in the book, so that it is readable by anyone interested in the body no matter what their background.
So, there is a lot of change and evolution in this edition, and if you found the last edition helpful, this one should provide greater depth and insight. I really hope that it will be a valued companion for you for a long time.”Read More