Pain science, movement science, and skills acquisition

 
icehorse
 
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icehorse
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08 June 2019 09:06
 

I don’t know about you guys, but for me, aches and pains are becoming more common.

Recently there have been some HUGE shifts in the way pain researchers think about pain. And, like in many other disciplines, doctors, physical therapists, and sports coaches are converging on a more unified vision of how the body works, heals, learns new skills, and can be its most resilient. It’s a big topic, but I’ll try to highlight a few key ideas:

- Pain is originated in the BRAIN to protect the body: When tissue is damaged, nerve endings send messages to the brain. But the brain decides whether or not to categorize those signals as being worthy of creating a “pain” reaction. Even across healthy brains, not all similar signals are interpreted the same way.

- Healed tissue often still feels painful: When we damage some part of our body, it’s often painful. Pain is the brain’s way of protecting the tissue, usually by restricting movement. But the brain is mostly concerned with short term survival. One of the downsides of “protecting” damaged tissue by restricting movement, is that the normal, rich communication channels between the brain and the tissue are stunted. Proprioception is reduced. An extremely common result is that days, weeks, months or years after some tissue is healed, the brain is still sending pain signals. If exercises are done to re-establish good - proprioceptive - communications between the brain and the healed tissue, years of pain can just go away.

- Not restoring proprioception can create new problems: It’s extremely common that when a part of our body is in pain, we alter our movement patterns. We compensate. This often puts unnatural stress on other parts of the body. So, for example, favoring a leg makes the whole system degrade. In order to prevent a negative cascade, a whole range of exercises, approaches, and activities have been developed. A small sampling includes: movement exploration exercises, controlled articular rotations (CARs), symmetry-first movement patterns, and mobility (i.e., controlled range of motion), as opposed to flexibility exercises (which put some aspects of yoga in doubt).

- Be skeptical of proposed joint or spine surgeries: Yikes! We all hear about “slipped disks” or “compressed disks”. Imagine we collect spine X-Rays from a collection of people. Some sedentary, some athletic, some in pain, some not. If you show this collection of X-Rays to a group of doctors, their ability to predict who’s in pain and who isn’t is very poor. We all get wear and tear on our joints and our spine. A lot of so-called “spine injuries” are just normal wear and tear. Some forward looking doctors are doing fewer X-Rays and performing fewer surgeries and favoring the kinds of exercises I mentioned above.

==

I’m not a doctor. Doh! But my sincere advice is to look into these new approaches. Here are just a few links to get you started:

basics of pain science

workbook

Shawn Myszka - coaching

Gray Cook

And a few names: Todd Hargrove, Gray Cook, Shawn Myszka

 
 
proximacentauri
 
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proximacentauri
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08 June 2019 14:09
 

Like most of us, I’ve had my fair share of injuries including a ruptured lumbar disc a few years back. Diet and Yoga have been key for me personally to reduce post injury and age related joint and muscle pain. Maintaining a moderate body weight is also important, and what has worked for me is eating a primarily Mediterranean diet and eating only when I’m actually hungry. Lastly, I would add that eliminating or limiting sugar and gluten may also help as both have been shown to be inflammation drivers.

 
icehorse
 
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icehorse
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08 June 2019 14:17
 
proximacentauri - 08 June 2019 02:09 PM

Like most of us, I’ve had my fair share of injuries including a ruptured lumbar disc a few years back. Diet and Yoga have been key for me personally to reduce post injury and age related joint and muscle pain. Maintaining a moderate body weight is also important, and what has worked for me is eating a primarily Mediterranean diet and eating only when I’m actually hungry. Lastly, I would add that eliminating or limiting sugar and gluten may also help as both have been shown to be inflammation drivers.

agreed on all the diet points.

As for yoga, I’d say it’s mostly aligned with movement science except in one area: mobility vs. flexibility. Yoga often promotes flexibility, whereas movement science prefers mobility. Mobility is range of motion under the control of your muscles. Flexibility is more like range of motion that doesn’t hurt. So there are probably postures you can achieve with the aid of gravity that you could not achieve without the gravity assist. For example, let’s say you can do a wonderful downward dog, and achieve a perfect 90 degree hinging at your hips. That demonstrates a degree of flexibility. But can you lie on your back and bring your legs up so that they are straight and vertical - under your own power? That’s mobility. Many people can do the downward dog, but cannot bring their legs to a vertical position when on their backs.

You can apply similar comparison tests to other yoga postures.

 
 
EN
 
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EN
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08 June 2019 14:39
 

Exercise and limiting sugar and starch are going to keep you younger. At almost 67 I am stronger than I was at 20.  You don’t have to lose muscle mass or strength.

 
proximacentauri
 
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proximacentauri
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08 June 2019 15:00
 
icehorse - 08 June 2019 02:17 PM
proximacentauri - 08 June 2019 02:09 PM

Like most of us, I’ve had my fair share of injuries including a ruptured lumbar disc a few years back. Diet and Yoga have been key for me personally to reduce post injury and age related joint and muscle pain. Maintaining a moderate body weight is also important, and what has worked for me is eating a primarily Mediterranean diet and eating only when I’m actually hungry. Lastly, I would add that eliminating or limiting sugar and gluten may also help as both have been shown to be inflammation drivers.

agreed on all the diet points.

As for yoga, I’d say it’s mostly aligned with movement science except in one area: mobility vs. flexibility. Yoga often promotes flexibility, whereas movement science prefers mobility. Mobility is range of motion under the control of your muscles. Flexibility is more like range of motion that doesn’t hurt. So there are probably postures you can achieve with the aid of gravity that you could not achieve without the gravity assist. For example, let’s say you can do a wonderful downward dog, and achieve a perfect 90 degree hinging at your hips. That demonstrates a degree of flexibility. But can you lie on your back and bring your legs up so that they are straight and vertical - under your own power? That’s mobility. Many people can do the downward dog, but cannot bring their legs to a vertical position when on their backs.

You can apply similar comparison tests to other yoga postures.

I found the exercises prescribed by my doctors to be helpful during the acute phase of my back injury, but yoga was extremely helpful later in terms of achieving better overall flexibility, including fuller functionality, and further pain reduction. I also found the same to be true when I suffered a major tear to a calf muscle. Modern medicine got the injury to a certain point with ultrasound and range of motion rehabilitation, then yoga seemed to improve on both flexibility and strength.

I think that both modern medicine and yoga has their place. IMO though, yoga will work for most to help stave off achy joints and reduced range of motion that naturally happens with the aging process. You can injure yourself with yoga, like anything else, so good technique and paying attention to your body’s idiosyncrasies and limits is important.

 

 

 

 
icehorse
 
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icehorse
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08 June 2019 15:41
 

In my mind “modern medicine” is quite distinct from “movement science”. I think that for a lot of people movement science might seem to be a little “out there”.

I would probably prefer yoga to traditional “modern medicine” physical therapy, but I think movement science is way beyond what most MDs know about. And I noticed in your response that you were talking about flexibility. I think it’s worth really thinking about the distinction between flexibility and mobility.

 
 
proximacentauri
 
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proximacentauri
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08 June 2019 18:35
 
icehorse - 08 June 2019 03:41 PM

In my mind “modern medicine” is quite distinct from “movement science”. I think that for a lot of people movement science might seem to be a little “out there”.

I would probably prefer yoga to traditional “modern medicine” physical therapy, but I think movement science is way beyond what most MDs know about. And I noticed in your response that you were talking about flexibility. I think it’s worth really thinking about the distinction between flexibility and mobility.

Agree that there’s a distinction between “modern medicine” and “movement science”. I assumed the physical therapy and movement science overlap but that may not be the case. As to the mobility vs flexibility question for yoga, I would argue that yoga can improve mobility as well. Yoga encompasses a variety of practices. Vinyasa or “Flow” yoga, and Power Yoga are two variations of Yoga practice that I’ve practiced for years. Yoga’s not just about being limber.

 
icehorse
 
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icehorse
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08 June 2019 19:33
 
proximacentauri - 08 June 2019 06:35 PM
icehorse - 08 June 2019 03:41 PM

In my mind “modern medicine” is quite distinct from “movement science”. I think that for a lot of people movement science might seem to be a little “out there”.

I would probably prefer yoga to traditional “modern medicine” physical therapy, but I think movement science is way beyond what most MDs know about. And I noticed in your response that you were talking about flexibility. I think it’s worth really thinking about the distinction between flexibility and mobility.

Agree that there’s a distinction between “modern medicine” and “movement science”. I assumed the physical therapy and movement science overlap but that may not be the case. As to the mobility vs flexibility question for yoga, I would argue that yoga can improve mobility as well. Yoga encompasses a variety of practices. Vinyasa or “Flow” yoga, and Power Yoga are two variations of Yoga practice that I’ve practiced for years. Yoga’s not just about being limber.

In some circles, PT has undergone a revolution in the last 10-20 years, and that hasn’t been spread around equally quite yet. My sense is that most PTs are still old school.

As for yoga, of course much of yoga is just fine. I’m mostly calling out those instances in which yoga pursues flexibility beyond the student’s mobility. Put another way, it’s pretty awesome that yoga holds up so well, when assessed by the most modern standards. It should come as no surprise that aspects of yoga should be retired. Let’s say that 80% of yoga is still valid. That’s incredible, and why would anyone care if the other 20% is no longer valid?

 
 
proximacentauri
 
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proximacentauri
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09 June 2019 13:36
 
icehorse - 08 June 2019 07:33 PM
proximacentauri - 08 June 2019 06:35 PM
icehorse - 08 June 2019 03:41 PM

In my mind “modern medicine” is quite distinct from “movement science”. I think that for a lot of people movement science might seem to be a little “out there”.

I would probably prefer yoga to traditional “modern medicine” physical therapy, but I think movement science is way beyond what most MDs know about. And I noticed in your response that you were talking about flexibility. I think it’s worth really thinking about the distinction between flexibility and mobility.

Agree that there’s a distinction between “modern medicine” and “movement science”. I assumed the physical therapy and movement science overlap but that may not be the case. As to the mobility vs flexibility question for yoga, I would argue that yoga can improve mobility as well. Yoga encompasses a variety of practices. Vinyasa or “Flow” yoga, and Power Yoga are two variations of Yoga practice that I’ve practiced for years. Yoga’s not just about being limber.

In some circles, PT has undergone a revolution in the last 10-20 years, and that hasn’t been spread around equally quite yet. My sense is that most PTs are still old school.

As for yoga, of course much of yoga is just fine. I’m mostly calling out those instances in which yoga pursues flexibility beyond the student’s mobility. Put another way, it’s pretty awesome that yoga holds up so well, when assessed by the most modern standards. It should come as no surprise that aspects of yoga should be retired. Let’s say that 80% of yoga is still valid. That’s incredible, and why would anyone care if the other 20% is no longer valid?

Glad to see that you aren’t discounting yoga altogether. And btw, this thread has spurred my interest about how I might supplement my personal yoga practice in areas where my mobility could use some assist. So thanks.