Newsflash! Movement ain't rocket surgery. Movement is a fundamental birthright. No one taught us how to move; we just did it. We had to make lots of mistakes along the way and subtle adjustments to failure in order to accomplish a given task. There was no one best way.
That's life. Nobody was standing over us saying the movements were all wrong. Mother Nature is pretty smart. She never does anything without a reason and her natural selection process is the most economical way to get from point A to point B.
Rule #1: If Movement Isn't Fun...
The body craves energy and takes the path of least resistance to get it. In other words, if given the chance to cheat, the brain will take it every time. If the brain chooses an energy-expensive way to move, you'd better be enjoying it so you can override the primal instinct to take the easy way out.
Pain is a great motivator of action when it reaches the emotional tipping point of change. Pain is a request for change. You might not like doing the movements, but the pain keeps you motivated. Long-term, daily life habits and behaviors are necessary. Fun is the catalyst.
How to accomplish rule #1: Let the patient choose a movement they enjoy doing. Ask them what they like to do and have them do more of it. If they can't do it because of pain, let them explore different pain-free variations of the movement. It might simply be decreasing the range of motion, tempo, load, or level (on two feet, on knees, on ground). Let the patient be a part of designing their own program.
Rule #2: Sensation Drives Motion
Mobility is the ability to move. Stability is the ability to restore movement. Patterning them together in synchronicity is called motor control. The more sensory input, the more proprioceptive awareness of the environment and the brain has more options available to accomplish a given task.
The skin and the brain come from the same neurodevelopmental tissue: the ectoderm. Stimulation of the skin gives fast-track access to neural connections in the brain. The more skin you have in the game, the better your resilience and increased chances for success. Sensation to the skin is an external cue for options.
How to accomplish rule #2: Have patients take off their shoes when they do the movements. Feet are highly neurosensitive. Feet in contact with the ground gives massive information to the brain. Increasing sensation to the feet ignites the nervous system.
Do more movements on the ground. The more points of stabilization and skin sensation from the ground, the better. Stability always precedes force production. Movement is force production.
Use kinesiology tape to increase proprioceptive awareness. The tape is the cue. Superficial nerve endings are stimulated with the tape and the tape also adds stabilization. The safer your brain feels, the more movement it permits. For a double effect, try putting tape on the bottom of both feet.
Rule #3: Get Comfortable Feeling Uncomfortable
The faster you make mistakes, the quicker you learn. The brain learns from failure. If you keep getting it right all the time, there is no room for improvement. The brain craves novelty. When it gets bored, it falls into habit. Behaviors form habits and habits drive motion.
Injury happens when you can no longer adapt to the stresses of life. Adaptation capability hits the wall and the only option left for the body is pain. Movement needs variety, variability and variation. Corrective movements need to explore the extreme boundaries of end-range capabilities. The further you go toward the edge of control, the more comfortable your brain feels when you get there. Assure patients there is no wrong way to move; there is only feedback.
How to accomplish rule #3: Allow patients to get movements wrong. Let them do movements the way they wish first before trying to correct. Once they feel comfortable, encourage them to explore end ranges of control without fear of judgment. Show them a movement. Let them do the movement their way. Make suggestions. Let exploration take place.
Movement doesn't have to be complicated in order to have significant and profound positive effects on the quality of life. Follow these three rules above and patients will be in the fast track to success.
Click here for more information about Perry Nickelston, DC, FMS, SFMA.