back pain

Psoas - Get To Know Your Muscles

Psoas - Get To Know Your Muscles

QUICK ANATOMY REVIEW:

The psoas (pronounced ‘so-az’) is one of the deepest core muscles in the body.

As you can see in the picture below, the psoas is a long muscle, attaching above to the upper part of the lower back as well as the intervertebral discs.

It then travels down through the abdomen and attaches to the inner part of the hip, making it one of only two muscles that attaches the spine to the lower limb.

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FUNCTION:

The psoas has a number of diverse functions, making it a key factor in health.

There is still some controversy concerning it’s exact role in the body.

The psoas is partly a hip flexor - that helps bend your hip when you walk and run.

It also has an important role in stabilising the lower back and posteriorly tilts the pelvis.

HOW PSOAS BECOMES OVERLOADED:

The psoas can become tight from spending extended periods of time in the following positions:

  • sitting

  • sleeping in the fetal position

  • standing with a swayed back and wearing high heels too often

  • sitting in a kayak/canoe

The psoas becomes overloaded with repeated use in the following situations:

  • driving

  • kicking

  • cycling

  • excessive sit-ups

Visceral pain

As it passes through, and has some attachments to the internal organs, the psoas can also be activated when there is irritation internally, (in particular the colon).

Stress

The psoas tends to tighten in response to general life stress (activated during the fight / flight response). Think of the fetal position protective response - that is the psoas causing your spine to contract.

SYMPTOMS:

The psoas is known as the ‘Hidden Prankster’ due to it being responsible for a lot of lower back pain (especially related to disc pain), without many people being aware of it.

Pain from a tight psoas muscle may be projected in a vertical direction in a ‘gutter’ along either side of the lowerback as well as to the sacroiliac region and buttock (see red areas marked below).

Pain may be felt during sitting and walking.

Overload of the psoas can also lead to pain and tightness in the front of the hip. 

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TREATMENT APPROACH:

Physiotherapy assessment will involve a comprehensive movement assessment to determine the cause of your psoas issue.

Some common manual therapy treatment approaches include:

  • joint mobilisation to the lower back

  • dry needling to the psoas insertion point in the hip and upper attachment point in the back

  • deep tissue and manual myofascial release on the mid-section of the muscle (pictured below). It is very difficult muscle to dry needle direclty due to its deep location and proximity to major organs.

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SELF-CARE TIPS

  • avoid extended periods of sitting. Think about ‘time in the posture’ vs trying to find a perfect posture

  • consider a standing desk

  • avoid walking and jogging uphills and on sloped surfaces in the short-term

  • apply heat to the front of abdomen 10 minutes each day

  • sleep on side with pillow between knees, avoiding the fetal position with the hip flexed right up

  • use cruise control on long car trips to stretch the legs

  • learn to breathe through your diaphragm and manage your stress

    Some of the following exercises you may find useful:

Psoas stretch  -  gently ease into it tucking the pelvis under as you lean forward   (Picture credit:  Fiona Melder Photography )

Psoas stretch - gently ease into it tucking the pelvis under as you lean forward (Picture credit: Fiona Melder Photography)

Bridge stretch  -  tuck your pelvis, squeeze your glutes but don’t overarch your back.  Breathe!  (Picture credit:  Fiona Melder Photography )

Bridge stretch - tuck your pelvis, squeeze your glutes but don’t overarch your back. Breathe! (Picture credit: Fiona Melder Photography)

Diaphragm breathing

As the psoas attaches to the diaphragm, when you breathe deeply you will naturally help decompress the psoas.

You can do this by putting your hands on the outside of your lower rib cage.

As you breathe in, expand the ribs from the sides, front and back - 360 degrees.

Aim for five seconds breathe in and five seconds breathe out for 1 minute.

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Building capacity in the Psoas

Weakness in the psoas causes decreased ability to flex the hip joint.

It’s really important for runners to have adequate capacity in the psoas.

Try this marching exercise below with a theraloop to help build some capacity in your hip flexors.

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Need some help with your lower back or hip pain?

We have a special interest in helping people overcome their pain and get back to what they love.

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813


6 Minutes To A Supple Spine

There are many options out there for addressing back pain.

But the one approach that has the best scientific support is exercise ✅

We are taught early on how to care for our teeth to prevent tooth decay.

But no one ever told us how to take care of our spines 🤔

Unfortunately this can lead to ongoing spot fires 🔥 and niggles, as the underlying issues aren't being addressed.

Below you'll find a short 6 minute set of exercises - that you can do once or twice per day to keep your spine healthy, supple and strong 👇

We have our own strengths and weaknesses so getting a personal assessment / set of exercises from your Physio would be best, but this would be a pretty good start.

Let me know how you go in the comments and please tag anyone you know who might benefit 🙌

Prevention is better than cure!

Here’s an outline of the moves:

  • Heel taps

  • Bridge

  • Single leg bridge

  • Hip abduction, clams

  • Side plank

  • Plank

  • Cat-cow

  • Superman

  • Child’s pose

  • Pigeon pose

  • Thoracic foam roller

  • Hip flexor stretch

The solution to keeping your spine healthy lies in finding the balance of mobility and stability.

Each part of our body has a specific function (as the picture below shows).

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This is know as the joint by joint approach.

Focusing on the giving what the body what it needs will lead to more efficient movement and a suppleness that you will leave you feeling energized and strong.

Research has showed that people who just focus only on stretching only had a higher incidence of lower back pain.

And people who focused only on strengthening (e.g machine based weights at the gym) had a higher incidence of back pain.

So this set of exercises has been specifically formulated to switch on the deep core stabilisers and creating mobility in the hips and back.

Doing this regularly will certainly help keep your spine supple and strong.

Let me know how you go in the comments.




Need some help with your lower back pain?

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813

Get To Know Your Muscles: Latissimus Dorsi

What are the lats?

If you’ve ever experienced ongoing upper back or neck pain / stiffness there’s a fairly chance you’ve had some issues with your lats.

The lats are the biggest (and most interesting) muscle in the upper body, as they have attachments to the upper and lower back, the front of the shoulder and have nerve supply from the neck, so they have a huge influence on your overall posture and spinal movement.

The anatomy of the Lats - they are like the ‘wings’ of our body

The anatomy of the Lats - they are like the ‘wings’ of our body

What are the symptoms of tight lats?

Surprisingly, tight lats can contribute to poor posture, as they connect your upper back to the front of your shoulder, causing you to adopt a rounded shoulders position.

Often we think of needing to strengthen the lats for good posture, but they can actually pull the shoulders too far down and rotate them forward when imbalanced.

When overly tight, the lats produce pain in the mid-upper back between the shoulder blades.

The pain can be felt as an constant, annoying ongoing upper back ache, that in generally unresponsive to stretching or change of position.

The pain doesn’t normally kick in until the there is significant tightness in the lat muscle, that generally has built up over many months or years, due to repetitive movement patterns or poor posture.

The person with ongoing upper back or neck pain often has tried various unsuccessful treatment methods applied directly to the area of referred pain rather than to its source (in the muscle itself).

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Referred pain may also extend down the back of the shoulder and down the inside of the arm (see picture above).

How the lats get tight:

  • poor posture (sitting or driving a lot)

  • going too hard at the gym e.g. lat pull down machine, chin ups

  • over many years of swimming , pulling through the water in freestyle

  • rock-climbing

  • gardening - pressing down to twist out weeds

  • cycling - gripping on too tightly on the handlebars

  • driving a car with no power steering

  • wearing tight bras that compress over the muscle

  • repetitively pulling down with the hands from overhead position

Tight lats - quick assessment:

An assessment from an experienced Physiotherapist would be the most reliable to determine if you have over-active lat muscles.

A quick test you can do yourself is a squat with your arms overhead. Try and squat as deep as you can, keeping your heels on the ground. If you can keep your arms upright your lats are probably ok (pic a), but if they drop forward or your feel stiffness in your back (pic b), you most likely have a lat issue.

Pic a = Good squat - arms stay upright and parallel with shins

Pic a = Good squat - arms stay upright and parallel with shins

Pic b  = Tight lats and upper back  - unable to keep arms upright in line with shins

Pic b = Tight lats and upper back - unable to keep arms upright in line with shins


How Physiotherapy Can Help:

  • perform a movement screening to identify the contributing factors

  • perform dry needling to the lat muscles to provide a fast, effective release

  • provided a personalised exercise program to maintain mobility and balance in the muscles


Stretches to help keep your lats mobile:

Lats stretch   Sit your hips back towards your ankles with your arms on the roller. Breathe in through the nose and expand the lower ribs. As you breathe out, gently sit the hips back further and lengthen the arms away. You should feel a nice stretch though the back of the shoulders and lower back.

Lats stretch

Sit your hips back towards your ankles with your arms on the roller. Breathe in through the nose and expand the lower ribs. As you breathe out, gently sit the hips back further and lengthen the arms away. You should feel a nice stretch though the back of the shoulders and lower back.

Try 30 seconds straight ahead and then 30 seconds on each side. To stretch the left side. push the hips back to the left with the arms on the right side of the foam roller.

Try 30 seconds straight ahead and then 30 seconds on each side. To stretch the left side. push the hips back to the left with the arms on the right side of the foam roller.

Lats Trigger Point Release   Lie on your side and roll up and down along the outer part of your shoulder blade. If you feel a sensitive spot, breathe and hold the pressure for around 30-60 seconds until the trigger point releases.

Lats Trigger Point Release

Lie on your side and roll up and down along the outer part of your shoulder blade. If you feel a sensitive spot, breathe and hold the pressure for around 30-60 seconds until the trigger point releases.

Tips to keep your lats working well:

  • gradually increase your weights at the gym, don’t try and do too much too soon

  • if you are a swimmer, incorporate regular stretching to maintain the flexibility

  • if you are an office worker, try a standing stretch by reaching up to the ceiling and bending to the side (the Merv Hughes Stretch)

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If you still experience pain in your lats, shoulder, neck, arms or thoracic spine then come in for an assessment and treatment with your Kinfolk Adelaide Physiotherapist.

The Obstacle Is The Way

This blog post was inspired by Ryan Holiday’s book, The Obstacle Is The Way, which describes how employing the philosophy of Stoicism can turn our ‘trials into triumphs’.

This book got me thinking about how we approach issues such as sporting injuries, chronic pain and loss of function that we see in the clinic.

Obstacles such as chronic pain are becoming more prevalent in Australia, with one in five adults reporting they suffer with moderate to severe pain everyday.

It is clear, as a rehab community, we are collectively not doing a great job at helping.

The longer I work as a physio, the more I see how the right mindset and beliefs are a key factor in recovery.

Reading more about the Stoic philosophy, I could see how my values as a health care practitioner aligned closely with with this approach.

The average person has about 50,000 thoughts per day, and for someone who is in chronic pain, you could imagine a large percentage of those thoughts could be centered around these three questions:

  • what is going on?

  • how is this going to get better?

  • when is this going to get better?

When they experience injuries, it’s common for athlete’s (even weekend warriors) to feel anxious and depressed.

One study of 343 male college athletes found that 51 percent had some symptoms of depression after being injured.

Addressing beliefs and attitudes early on can provide the foundation to a successful return to full function.

Downward Spiral Of Injury

We know that a previous injury is the biggest risk factor for another injury.

And that means as a rehab community, we have some work to go in terms of educating and providing injured people a comprehensive rehabilitation program in order to prevent compensations and further issues.

Without inadequate rehab, a downward spiral of pain and injury can develop, eventually leading to burnout.

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Stoicism - a little background

Getting back on topic!

Stoic philosophy was founded in Athens in the early 3rd century BC, and was practiced by the likes of Epictetus, Seneca and Marcus Aurelius.

Ryan Holiday writes specifically of being inspired by Marcus Aurelius, whose quote inspired the book:

“The impediment to action advances action.

What stands in the way becomes the way.”


Marcus Aurelius, as well as being one of the most successful Roman Emperors, had his own private struggles with chronic pain in the chest and stomach.

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His personal notes practicing Stoic philosophy, The Meditations, refers many times to psychological strategies for coping with pain and illness.

His physical resilience and endurance was remarkable, despite not having ideal physical health he was to become one of the most respected emperors in Roman history.



Mindset Shift

One of the biggest lessons taught by the Stoics was to re-conceptualise your obstacles from something to avoid to something to welcome, as a means of growing stronger and more resilient.

Obstacles give you important clues as to where you may have some ‘weak links’ and provides an opportunity to turn them into strengths.

Following a Stoic philosophy involves re-wiring your thinking, shifting from negative emotions such as from worry, anger and frustration to calmness, gratitude and hope.

To be clear, negative emotions can be healthy and natural.

But at some point, they become more of a hindrance to your forward progress.

With the right plan in place, and plenty of patience, grit and perseverance according to leading sports scientist Tim Gabbett, you can turn yourself into an unbreakable athlete. 

“It is a rough road that leads to the heights of greatness” - Seneca

“It is a rough road that leads to the heights of greatness” - Seneca

Short Term Pain Coping Strategies

Of course if your only goal is to avoid pain, there are some strategies that can bring about some fast relief.

Using pain-relieving medication has it’s time and place.

But unfortunately we’ve seen the long term consequences of opioid medications (e.g. tramadol, oxycontin and codeine) that can sometimes lead to addiction and other serious side effects.

And we now know from the research that these drugs create a long-term increased pain sensitivity, making your pain levels greater than before you started taking them.

The other problem is once you come off the medications, you haven’t any had an opportunity to learn from your pain and injuries, so you essentially need to start all over again.


Instead of relying on pain medications, here’s eight practical strategies, inspired by the Stoic Philosophers, over 2000 years ago, to help you overcome your pain and live the best life you possibly can:

  1. Accept Pain And Injuries 100%

The Stoic philosophers were big on understanding the rhythms of nature.

Just like stormy weather, it would unwise and naive to believe you would never have a pain or flare-up in your body.

No one gets out of life without serious challenges along the way and no one is immune to experiencing pain.

However, the difference lies in how we perceive and respond to it.

A real life example world would be to consider how a sailing boat gets from point A to point B if there is a direct headwind blowing in their direction?

Would the sailor just give up and think it’s not worth the hassle?

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The experienced sailor would no doubt accept that unfavourable winds are going to happen some of the time - that is a normal part of life, and they wouldn’t get overly emotional when it occurs.

For the sailor who is committed to reaching point B, the solution, is to change tack.

If the boat turns onto a 45 degree angle, then the sails are able to pick up the wind and use it to the boats advantage.

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Progress is no doubt slow and frustrating, but it is still forward momentum and getting you closer towards your goal.

When the winds eventually turn favourably, you would have built up a decent reserve of resilience and capacity.

Bottom line: there is a season for pain and it is a normal and inevitable part of life.

Keep breathing, batten down the hatches if necessary.

The storm will pass.

2. Let Go Of Your Fight Against Pain

Following on from the first point, counter-intuitively, to overcome your pain, you must be at peace with your pain and fully accept it.

The struggle, the fight and the mental battle against your pain only ends up wasting precious energy and resources, that could otherwise be better spent.

Being trapped in a state of resistance and anxiety leads to your body into a fight or flight mode where your muscles are held in a constant state of tension.

This can lead to even more problems than your initial injury.

Common muscles that are involved in the fight / flight response are:

  • neck / trapezius

  • hip flexors

  • lower back

  • TMJ jaw

  • shoulders

Once you can find acceptance, a significant burden is literally lifted from your shoulders.

With the guidance of a health care professional, it’s important to let go of your anxiety and find a place inside that is relaxed.

“Sometimes, your only way out of the pain is through the pain”


3. Imagine The Worst Case Scenario

The Stoics proposed, rather than avoiding the pain, we must accept it and then confront it.

Once you are feeling more relaxed and in control of your emotions, Stoicism actually encourages you to imagine the worst case scenario in terms of your pain experience.

If you could courageously come to terms with the worst case scenario - and see how, while it would be difficult, you would definitely still be able to cope.

Practicing this exercise mindfully can help reduce the fear around pain, injury and loss of function, knowing that you will be able to manage, no matter how bad things get.

4. Good vs Bad?

Injuries can often be thought of as ‘bad’.

But are they really?

This reminds me a of a story about a farmer.

One day his horse runs away. And his neighbor comes over and says, to commiserate, “I’m so sorry about your horse.” And the farmer says “Who Knows What’s Good or Bad?”. The neighbor is confused because this is clearly terrible. The horse is the most valuable thing he owns.

But the horse comes back the next day and he brings with him 12 feral horses. The neighbor comes back over to celebrate, “Congratulations on your great fortune!” And the farmer replies again: “Who Knows What’s Good or Bad?”

And the next day the farmer’s son is taming one of the wild horses and he’s thrown and breaks his leg. The neighbor comes back over, “I’m so sorry about your son.” The farmer repeats: “Who Knows What’s Good or Bad?”

Sure enough, the next day the army comes through their village and is conscripting able-bodied young men to go and fight in war, but the son is spared because of his broken leg.

And this story can go on and on like that. Good. Bad. Who knows?

Be at peace with your path and have faith that everything happens for a reason.

There is no good or bad to the practicing Stoic, there is only perception.


5. Switch From Goal Oriented To Process Oriented

While you can learn the principles of Stoicism, the philosophy is actually one of action.

A Stoic needs to focus his attention on action in the present moment of time because neither the past nor the future can be changed.

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Being process orientated, you start to focus on all of the small daily things you need to do that all add up to produce the end result.

Come back to the present moment.

That is where the power is to change your life for the better.

Take the focus off being pain-free and instead put your focus on the process.

What are the small daily tasks you need to do to become pain free?

“Luck is what happens when preparation meets opportunity.” ― Seneca


6. Understand Your Pain

“We are more often frightened than hurt; and we suffer more in imagination than in reality.” Seneca

There is no doubt that ongoing pain that is unexplained can be frightening.

With the help of your Physio and Doctor, if you can understand that some degree of pain is a normal part of the healing process, you can relax in that knowledge.

It’s important to realise that whatever pain you experience should be related to a certain physiological process.

For example:

Ankle sprain —> inflammation around the ligament, you can expect some soreness for 4-6 weeks

Lower Back pain —> occasional flare-ups, especially if sitting too long. Disc injury takes around 3 months to heal

Tendon degeneration —> worst in the morning and with sudden changes in training volume, hills or speed work

Knee - patello-femoral syndrome —> (pain in front of the knee cap) take on average 3 months to get better and pain relates to irritation behind the knee cap and gets worse with squats, kneeling and stairs

Nerve related irritation or damage —> could be many months or years of altered sensation in the affected area

Muscle pain —> the most common source of musculo-skeletal pain - lack of oxygen to the muscle from poor posture, excess muscle tightness or injury.

Chronic pain (more than 6 months) —> relates to increased sensitivity in the nervous system which magnifies minor tissue problems. It may come down to the fact, that we all have wear and tear and issues in our body, for whatever reason, the body and nervous system has decided to heavily focus on that particular area.

If there is ongoing pain and you are not sure why, then you may need to talk to your health care provider in more detail.

7. Develop A Growth Mindset

Stoic philosophy has a lot in common with the Growth Mindset approach, developed by Carol Dweck.

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According to this approach, the most important word in the dictionary is ‘yet’.

Re-frame your challenges…

“I haven’t completed the marathon…yet”

“I haven’t felt strong and pain-free in my lower back…yet”

“I’m not sure what it feels like to walk without pain…yet”


8. Train Your Mind To Endure Pain And Discomfort

It takes practice to exhibit self-control with our perceptions of life’s obstacles.

You can practice - the next time your stub your toe or get a paper cut.

Pause for a moment and see if you can absorb the sensation of discomfort - without reacting to it.

One of the great things about exercise is that it is a form of discipline where you willingly put yourself in a position of discomfort for a period of time, with the hope that you will come out the other side better off physically or more importantly mentally afterwards.

As you practice pushing yourself to the threshold, you will build a reserve of willpower to draw from as necessary, creating a “Inner Citadel” of strength and resilience.

For me personally, that is one of the reasons I enjoy the process of running so much.

Every time I go for a run, I know I will confront the pain of a body wanting to stop.

To achieve any sort of reasonable time, you need to learn to listen to your bodies pain, but constantly re-directing your attention and keep pushing to achieve your goal.

“Faced with pain, you will discover the power of endurance” - Epictetus


Conclusion

Pain and injuries are never easy.

But with the right attitude, they can be an valuable internal guide to making you better and stronger than before.

What seem like insurmountable obstacles become once in a lifetime opportunities.

If you’d like to find out more about Stoic philosophy, I’d highly recommend you check out the book, The Obstacle Is The Way.

Now it’s over to you,

What’s the biggest obstacle you’ve faced? What benefits were you able to derive from it?

I’d love to hear your thoughts in the comments section below.

The Power Of Plasticity - Helping You Move Better - Part 1

"We are all sculptors and painters.  Our material is our own flesh, blood and bones." - Henry David Thoreau

This post takes a look at why we move the way we do, and how we can tap into the 'Power Of Plasticity' to start moving (and feeling) well again.

Warning: This post is long.

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As the New Year ticks over, many of us find ourselves reflecting on our health and making some goals for the year ahead.

I can understand you may be reluctant to set a new years resolution.

But from the body’s view point, it desperately needs a goal to work towards.

It needs direction, positive growth, a challenge and a reason to get out of bed in the morning.

Your goal might be a run a marathon. Or it could be taking a challenging hike. Or spending the day in the garden.

Whatever it is, it should be something you enjoy and something that will motivate you to get you moving more often.

As soon as you become complacent about your body and your health, it can lead to a downward spiral of pain, injury and de-conditioning.

In modern day life with our attention being drawn into our devices, internet and netflix we can find ourselves completely out of touch with our bodies.

Months or years can easily slip by and all of a sudden we can find ourselves in a ‘movement rut’.

“Change is the only constant in life” - Heraclitus

Whether we are conscious of it or not, the body is always changing and adapting to the stresses we put it under.

From our bodies perspective you are either growing or stagnating.

There’s not much middle ground.

Plasticity: the adaptability of an organism to changes in its environment

That continual growth or stagnation that takes place is also known as plasticity.

As humans, we are highly adaptable and this can be a very positive thing.

The entire body is capable of plasticity

Professor Lorimer Mosely, from the University of South Australia, writes:

All our body systems respond to demand – in obvious ways such as:

  • growing muscle cells when we lift weights – myoplasticity

  • sweating more when we acclimatise – endoplasticity

  • learning to recognise a pathogen and eliminating it on next contact – immunoplasticity

  • increasing our heart-rate earlier on a hill after running up it a few times – cardioplasticity

  • adjusting the aperture of our pupil to improve our underwater vision – obiculoplasticity

  • the toughening of skin on well trodden heels – dermoplasticity.

In fact the body that you have today, is different is quite a bit different to the body you had a few days/weeks/years ago.

Regeneration Speeds Of The Human Body:

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“The body is a powerful healing machine” - Kelly Starrett

These info-graphs refer to how our body parts are under a constant state of repair and regeneration (plasticity).

I’m not sure about you, but I find this knowledge really empowering and inspiring.

If you are in a difficult place right now, keep the faith and stick it out.

“Everything will be okay in the end. If it's not okay, it's not the end”. - John Lennon

With the right guidance and plan in place, good times are ahead for you.

If you can harness the power of positive plasticity you can get stronger, more resilient and eventually become pain-free.

Movement and Neuro-plasticity

This blog post is mainly focused on the neurological and muscular plasticity that happens in the body in response to movement.

We will take a look at how the healthy brain-body system operates when it’s fully “connected,” and conversely, what happens when things become dysfunctional.

Body Maps In The Brain

In many ways, our understanding of the brain has only just begun.

One of the most exciting developments in the 20th century was the identification of ‘body-maps’ in the brain.

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The body maps refer to two of the principal areas in the brain involved in movement.

These include:


1. The Somato-Sensory Cortex - Encodes the representation of the entire body (i.e. body maps). Representational space correlates with how much a body part is used (i.e. use it or lose it)

2. The Motor Cortex - Generates conscious movement and stores subconscious movement patterns (i.e. muscle memory).

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Our Body Maps Are Plastic

Neuroscience research suggests our brains are ‘plastic’ meaning that areas change depending on the amount and quality of use. 

The more time and attention moving a certain body part, will result in a bigger representation of that area in the brain.

For example:

  • people who use braille have a larger finger representation in the brain than the average person

  • similarly guitar players will have a bigger hand representation in the brain

Body maps (and movement) comes to down to habits

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Imagine you’re heading down to Aldinga for a day trip, (which is a beautiful beach an hours drive south of Adelaide, that allows cars onto the sand).

You arrive at the beach and follow the ramp down, driving your car onto the beach.

As you drive along the sand, your car makes tracks in the sand.

You find a nice spot to park the car and get yourself set-up. After you’ve had a swim, you’re feeling refreshed…but then you realise you’ve forgotten to buy some snacks.

So you jump back in the car and as you start driving, you can see the tracks you’ve made earlier.

As the sand is harder under the tracks, it’s easier for your car to move along the same tracks and reduce the likelihood of you getting bogged.

Each time you make a trip along the beach, the tracks get a little deeper and it gets a little easier to drive because the sand gets a little firmer and the track is becoming more worn.

You automatically keep using the same track without even thinking about it.

Using the same track is very similar to what happens with our bodies - the car represents our bodies movement and the tracks represent the neural pathways in our brain.

As our brains begin to use this pathway more, it becomes second nature.

This process of re-wiring the brain and forming new connections is plasticity in action.

Essentially using the same habitual movement patterns over and over again without ever thinking about it.

To create new movement patterns is like carving out a new road.

If you’ve had pain for some time, your body goes into protective mode. Movement expression becomes limited and breaking out of this stereo-typed response is going to take considerable energy, effort and some serious intent.

In an ideal world…

In an ideal world, the brain has a perfectly sharp representation of the body and the brain/body have a variety of quality movement patterns (muscle memory) to handle the demands placed on it.

The body and mind are perfectly synchronised.

An example of this might be watching Roger Federer playing tennis or Eddy Betts playing AFL.

They make highly complex skills look easy and effortless.

Body maps change when you’re in pain

Initially, when you’ve injured yourself or are in pain, the body map representation of the involved area actually gets bigger.

This explains why you may feel an increase in pain sensitivity and mild pains can become magnified.

This is especially true if the body part is very important to you e.g. if you injured your finger if you’re a concert pianist or your knee if you’re a runner.

The Negative Side Of Plasticity - Smudging

Smudging refers to the reduced accuracy of the body maps in the brain that happens when you don’t use a particular area for a period of time.

Smudging can be caused by things like:

  • poor posture

  • ongoing pain

  • injury

  • inactivity

More about brain smudging with David Butler:

Smudging of the brain maps, otherwise known as the Homunculus, latin for ‘little person’ in your brain   Credit: Explain Pain (Butler & Mosely)

Smudging of the brain maps, otherwise known as the Homunculus, latin for ‘little person’ in your brain

Credit: Explain Pain (Butler & Mosely)

“Pain and body image are closely related” – Norman Doidge

Studies have shown now that smudging of the body maps is related to the severity of lower back pain.

For example if you have injured your spine and you feel intense pain and muscle spasms for a few weeks, naturally, you may limit the amount of movement you will do for your spine.

Over time, there is less sensory input from the spine to the brain.

With limited input, the brain hasn’t got an accurate sense of what’s happening in the body (smudging of the body maps) and starts to perceives this as a threatening situation.

This is an important point because the pain you feel may not be related exclusively to a structural issue.

The fact is many people have degeneration / wear and tear and have absolutely no pain at all (see the chart below).

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Pain, especially as it becomes more chronic, may be more related to changes in the nervous system (specifically the body maps in the brain).

The key point is that physical pain doesn’t necessarily have (only) physical causes.

Credit: Explain Pain (Butler & Mosely)

Credit: Explain Pain (Butler & Mosely)

Key Point: A very large part of the way we move, comes to down the accuracy of our body maps

A large body of evidence shows that pain and injury causes a change in activity in the regions of our brains that control movement.

This is true for things like:

Everyone has their own unique response to pain and injury and I can’t emphasize enough the importance of getting a personalised movement assessment to find our your own individual patterning.

The first step is becoming aware, and then you can go about re-wiring your neural pathways and re-building your movement foundation.

If you aren’t consciously creating your movement patterns, you are in default mode - where your environment creates and dictates your movement.

Re-building Movement Patterns

“The more richer, the more varied the possibilities of your movement landscapes, the powerful you are” - Michael Merzencich

Back to our person with lower back pain example mentioned earlier.

Through pain and fear of doing more damage, their movement repertoire has become limited.

This results in:

  1. A reduced ability to adapt to changes in their environment, leading to a higher chance of re-injury

  2. Overload of tissues in the movement patterns that the person feels safe in e.g. they may have been told to always ‘sit up straight’ and the posterior back muscles are in a constant state of tension and activity

The original injury most likely has healed and the person now is dealing with the consequences of the changed movement patterns.

For optimal long term health, gradually adding variability to your movement and posture is a critical skill to learn.

In the world or ergonomics, having a variety of movements trumps locking into a narrow and restricted definition of ‘good posture’.

Creating the right conditions and environment to learn new movement patterns and strategies is what we’ll spend more time discussing this in Part 2 of this blog.



Key Take Home Messages:

  • The key to tapping into your bodies potential is neuro-plasticity, the process of creating new neural pathways

  • Understanding neuro-plasticity is the most revolutionary discovery of neuroscience in the past century.

  • There is great hope for people with chronic pain if you can access the power of movement neuro-plasticity

  • “The relationship between pain and the state of the tissues becomes weaker as pain persists” - D Lorimer Mosely

  • Widening our treatment approach to integrate the research on neuro-plasticity may be the missing link in helping people with chronic pain conditions

In Part 2 of the blog, we’ll go into depth about how to optimise your lifestyle to enhance and encourage the benefits of movement neuro-plasticity.