Physical Therapy

What Would It Take To Get You To Change Your Mind?


They say life is all about change. We are told we need to embrace change, that change is the only constant in life. The clichés go on ad nauseum.

Yet we also hear praises for being steady as a rock, being able to stay the course, and for being consistent and reliable.

Is there any wonder why people have conflicts with each other with two seemingly opposing ideas being held as the thing one should do?

All this highlights the fact that there are times for change and times for stability in our lives. What is really needed by everyone is the ability to use either skill well. Yes, skills.

Creating and adapting to change and being stable are skills.

Which means there should be a means to practice and refine the components of each skill easily, without having our whole life on the line, so that when we need them we can put most of our energy into figuring out what to do, not how to do it.  It is analogous to training for a sport.

You don’t practice by playing a full game against a serious opponent each day. Instead, you look at what are the little things you need to be able to do like throwing, running, jumping, turning etc. so that when you do play a game you can do any of these things well should you need to. You get the equipment of your mind and body capable of doing these things so you can focus on the novel decisions you have to make, like whom to throw to, and not be trying to learn how to jump up, grab the ball and land with your feet in position to throw when it is time to do it.


So how can we practice the skills for change and stability? After all, these are mental constructs, not movements, aren’t they?


Consider this – volitional movement requires thinking, so changing your movement requires changing your thinking. Stability in movement requires continuous, consistent neural activity to maintain the stability. All gross movement requires an interchange of movement and stability, and the amounts and areas change as you move.

This means we can practice and enhance our skills of change and stability with conscious movement training. Even better, by doing so we are also practicing the skills that underlie the ability to change our minds. 


Try some experiments – just for a day, lift your coffee cup with the non-usual hand, put your belt on in the other way around your body, or stop and look up at the sky or ceiling randomly.

In each case you have to think about what you are doing - and think differently than usual - or else you would do the usual thing. Just as importantly you will feel something novel, a small but different sensory experience. You may even be surprised at how it feels, yet after a few times it may still feel odd but you won’t be surprised by the fact that it feels odd. (This is a big component of self-defense training, if you know how it feels to hit someone or to fall to the floor you won’t be surprised and lose your focus on your attacker when it comes time to actually do these things for your protection.)

Now try some stability experiments – when you bring your fork or cup to your mouth do not move your head forward to meet it, bring the food or drink all the way to your mouth with your hand. Or keep your feet planted on the floor and don’t move them at all when you adjust your position in a chair. Again, you had to think differently and feel something unusual.

The point of all this is that you have been able to practice the experience of change and stability without having to make some life changing alteration. You can practice a manageable bit that lets you see how it feels, practice how to fire the neurons, and how you deal with this kind of learning. You are practicing how to jump, catch the ball and plant your feet without having the fly ball come at you in the ninth inning of the championship game.


It has always seemed odd to me how this principle of practicing the real-life mental skills of being able to create and modify change and stability is integral to many movement practices but almost never spoken about. I have studied many disciplines such as karate, Tai Chi, yoga, dance, and multiple sports, and they all talk about change in movement or large life terms but never about how what you are doing is learning how to change your mind.

Change your mind.

That is what is happening when you consciously work on changing your movement: you have to change your higher-level neural activity to activate and control the movement pattern. You are using new neural pathways in the same brain that gives rise to your mind and so you are literally changing your mind.   The caveat is that you have to be doing this consciously because consciousness, while a small part of our neural activity, is the thing that makes the decisions for change and stability. The beauty of this is that you can go back to using the old pathways if you want to but now you have more options and you are keeping the cellular machinery that creates new neural connections in running order so it is easily available if you want to make some other new connections.  


There are some approaches that would seem to address this changing your mind principle, such as the many mindfulness training programs that are in vogue lately. My experience, however, is that they seem to focus on the conscious, higher neural side and slight the movement side of the equation. These are not bad programs, but for me, they don’t seem to understand that actual movement changes the brain.

The Alexander Technique clearly addresses both sides of this, something F.M. Alexander emphasized in his books and writings.

 It focuses on having people learn how to make small changes in the little things they do throughout the day with an eye to making those movements more effective and efficient. In the process people learn how to practice changing how they think and how that changes their interaction with the world around them.

The Feldenkrais method similarly combines conscious awareness of movement and movement change which results in changes in how people think and act. It differs from the Alexander Technique by being more scripted and programmatic in its practice generally but it combines both our thinking and our movement simultaneously to address both parts of the equation.

The bottom line is that you can run an amazing amount of entertaining experiments with your thinking and movement all in the privacy of your own mind and body without any risk or long-term commitments (you can always go back to putting your belt on the usual way.) You also will be increasing your ability to be stable when you choose to and to change when you choose to. You will be improving your ability to change your mind and thereby give yourself more options in how to deal with the world.  

So, raise a toast to your ability to change your mind (other hand, please) and see what comes of being more facile at being who you choose to be.


Scientific Inquiry and Movement Education: What Do You Know and How Do You Know It?

In science, two questions are asked all the time, “What do you know?” and “How do you know it?”. Together these two questions are really at the heart of figuring out anything from sub-atomic particles to what restaurant to eat at. It has been my experience, however, that people frequently are confident about what they know without asking how they know it, often to their detriment.

If Michele, your favorite foodie, tells you a place is awful and Tony, who thinks cockroaches are great dinner company, tells you the same place is great, where are you eating tonight and why?

My field is movement education and it often happens that people think they know how they are moving and what they are doing with their bodies as they go through the day - after all, rarely do we intentionally harm ourselves. But here they are in my office with musculoskeletal injuries caused by how they used their bodies. Arthritic knees and shoulders, strained necks and low backs, unable to take a deep breath.  So how does that happen?


It happens because we are taught that what we “feel” is correct and accurate, but the reality is that the sensory data your mind gets is just a fraction of what is available. In short, we fail to ask how we know that what we feel is accurate or complete.  

The sensory system reports in a tremendous amount of information on the world around us, far too much to attend to at one time, so we have to edit it before it even gets to our consciousness. To do this, we make assumptions on what data should come from the sensors and set the system to send an alarm to our consciousness only if the data varies too far from expectations. We can vary those expectations as needed. For example, if I stuck your buttocks with a needle you would jump away from it. But if you had pneumonia and expected a shot of penicillin you would reset the alarm state and stay still (mostly still, anyway) when you got stuck. If you got stuck again five minutes later you would jump again because you did not expect it.

We assume that if no alarms go off all is okay in the body, and this works well enough a lot of the time. But when was the last time you really looked at the assumptions you make about your movement?

 Walk across the room a few times and think about what you are doing. You get from one place to another and don’t fall down or get injured so you know you can walk just fine.

Now ask the next question – How do you know you walk “just fine”? How do you know you are not straining your back or knees excessively or your coordination makes you use a lot more energy than you have to? What information and assumptions are you using to decide your walking is not damaging your frame over the long run?

This is not a pleasant exercise to do for most of us because asking how we know things reveals what we don’t know. But that is precisely why it is the critical question in scientific inquiries, so researchers can figure out the truth about how the world works.

Taking the time to ask “What do I know?” and “How do I know it?” is a powerful way to make yourself smarter and healthier, all in the comfort of your own body.



Congruency: A discerning tool for movement education clients

Choosing ways to help ourselves from the myriad of techniques, treatments and methods out there can be a real challenge. It is definitely a buyer-beware world. Once you think a technique may be useful then you need to determine if the practitioner is the right one for you.

One approach I have given a lot of thought to lately is the idea of congruency.

congruency movement education

Before we get further let’s define congruent. The non-mathematical definition of congruent, according to Cambridge Dictionary of English language is:

…similar to or in agreement with something, so that the two things can both exist or can be combined without problems.

It is the last part, “both exist or can be combined without problems”, which leads me to think the underlying idea of almost all therapeutic interventions is to increase some type of congruency in an individual.  Whether it is of mind and body, nerves and muscles, thoughts and feelings, congruency is at the heart of what is being sought.

If this is the case, it follows that we can assess any intervention by asking what is to be made congruent and why and if the techniques employed actually do that.


For example, I have developed a technique called ReTensioning™ that aims to give clients the ability to have minimal muscle activity at a specific joint when they are resting that joint.  (Often people are actively putting unnecessary forces across the joint when they think it is at rest.) 

The technique seeks to make the perception of a joint-at-rest congruent with the mechanical minimum of activity across that joint.

Its methodology involves ascertaining the relationships of the bones at perceived rest and at minimal mechanical activity, and then actively giving the client the experience of resting with the joint at minimal activity in order to retrain the nervous system to use minimal activity when resting the joint.

ReTensioning™ has a clear congruence it seeks between the tension across a joint and the minimizing of this tension at rest, and the techniques have been shown to create this congruence in many clients. So as a consumer, I can consider this technique as a possible means to help me if I want to change the mechanical stress in my body, and I can tell in a session or two if the techniques being used are able to get this congruence for me. 


The Alexander Technique is another example of a methodology that we can apply such an analysis to. It aims to help people change how they use themselves in daily activity by using their rational mind to determine how they move instead of relying on instinctive or unconscious habitual responses to stimuli.

A component of that is teaching people the mechanisms we have in our design that allows humans to easily control movements so we can use ourselves with minimal strain without having to think about every little muscle contraction and timing.

In short, it seeks to have our ideas of how we use ourselves congruent with how we actually use ourselves.

In its methodology there is a great deal of variance by practitioners: some will say nothing to a client and only have them do simple movements repeatedly with manual guidance, while others will talk with clients and have them do various experiments in changing their thinking to see the effect it has on their movement. And there are many combinations in between.    It makes sense that there should be variation in teaching people as there is great variation in how people learn, but the criteria of whether the actual methodology is working to address the congruency sought is a valuable means for the consumer to assess if an Alexander Technique practitioner’s approach is right for them. If, after a few sessions the client is unable to see the desired congruency being brought about then it may be time to seek a different practitioner or methodology.


Nothing fits for everyone and nothing works for everything - even things that on their surface seem to be the same problem someone else has may respond differently to the same intervention – but using this criterion of congruency may help sort out what you need. The idea of identifying the desired congruence and then assessing if the practitioner is able to guide you towards it is a clear way to understand and assess the value of any technique or method you use to improve yourself and your life. 

Should I Stay or Should I Go Now? Stability and Mobility in Movement and Life

When I was in training to teach Pilates I was struck by how different the activities were from standard exercises I had been taught in sports or physical therapy.

The difference was that the Pilates activities required me to often change what part of me was moving and what stayed stable with a strong emphasis on being able to truly maintain the stability as the main focus of the activity.

If there was a choice between moving through space with some muscles while losing the stabilizing contraction or staying stable and not moving any further, the latter was always the correct answer.  No real surprise given that Josef Pilates called his work Contrology, learning to control your body and mind. What I realized, however, is that the function of stability and the interplay with mobility is often overlooked in movement training

I have found in my practice with clients that understanding this idea can greatly increase a person’s exercise or movement ability.


First, let’s define a few terms in the context of human movement. 

Stability is the ability to maintain the relationship of body parts to each other. There is static stability as when you do a plank and hold the whole body still, and there is dynamic stability where you keep some parts in the same relationship while other parts are moving, such as when you keep your torso stable and aimed forward and upright when you walk across a side hill.


Mobility is the ability to change the relationships of body parts, such as when you lift your arm above your head when reach up to get a mug off the top shelf.

Notice that you can, and often are, doing some of both when you move; some parts stay stable while others are moving.

All skeletal muscles can hold things together or move things relative to each other (stabilize or mobilize) depending on the position you are in and how you want to move but because of their position and connections most muscles PRIMARILY stabilize or PRIMARILY mobilize. The ones that mainly stabilize are generally closer into the midline or center of the body or deep around the large joints to add control to how the joint contact surfaces mate.  The ones that mainly mobilize are closer to the surface of the body and out in the limbs.

Generally speaking (some would argue too generally but I like to think big), the muscles whose PRIMARY  function is to stabilize in daily movement can be considered the core. There is debate on exactly who every member of the core group is but to my thinking that means all the way from the inside of your big toe (adductor hallicus) up medial leg to the pelvic floor and on up the abdominals and paraspinal muscles to the deep muscles of the neck at the cranial base along with the deep muscle of the hip and shoulders.


So how does this interplay of mobility and stability play out in real life?

Think about walking for a minute. You swing the right leg forward and set your foot on the ground. Now the foot needs to stay there and not slide around because you are about to put all your weight on it to swing the other leg past. So once your foot lands you have to keep it in place on the ground (using ankle muscles), the knee stays straight and the hip has to come forward and stack the femur on the knee because the muscles have to make the leg a stable post (no change in bone relationships at the joints) so you can put your weight onto it.  Now you swing the left leg by and place it on the ground in front and it’s time for the right leg to pick up and move. This means you have to pick up the foot, bend the knee and swing the hip, mobilizing (changing the bone relationships at the joints) of the various parts of the leg. But it’s not the same muscles in the leg that stabilized it that will now move the leg.  Within the leg the various muscles have different jobs, some mainly stabilizing, some mainly mobilizing and some do a bit of both.

This variety of muscle functions is true not just in the leg but throughout the entire body. It is the constant shift of stabilizing and mobilizing that enables us to move in a controlled fashion. It follows that if we improve our control of that shifting and our ability to use our muscles for the job they are best suited (stabilizing or mobilizing) for we can improve performance.

Many of the injuries and problems I see in people related to exercise and training stem from problems in assigning the right jobs to their muscles. Going back to the walking example- think of what happens when it is time to get the weight off the back leg and onto the front one. You can use the large gluteals (buttocks) with their connections from the pelvis to the hip to push the weight forward as the lower leg pushes off the ground while you keep the vertebrae and pelvic floor stable. Alternatively, you can thrust the stomach forward, arch the back and compress the discs as you throw the pelvis to fall forward off the rear leg which you just use like a pole vaulter’s pole.  Both will get your weight forward.

However, the first one is using mobilizers as mobilizers and stabilizers as stabilizers while the other has reversed the roles. If your reason for walking is to strengthen your legs for dynamic activity like lifting and squatting then which pattern is going to achieve that goal? Clearly using the gluteals and leg muscles to move your weight forward puts you on track for that goal. But if you want to compress your discs and strain the pelvic floor muscles and overstretch the hip ligaments the latter is a much more effective choice. You get to decide!

The concepts of stability and mobility and the interchange and control of them is what I consider one of the primary concepts in understanding how to learn and enhance movement in ourselves and our clients.

Next time you exercise try experimenting with:

·         what has to move and what doesn’t

·         how stable you can be

·         what are the fewest muscles you can use to do a motion

·         can you remain stable in an area while something else moves

This type of self-discovery and analysis, where you ask what really needs to move and should or could remain stable in any activity, is a means to really tune in on how to adapt and change your movements and exercise patterns and keep things interesting.  It lets you train the body and the brain at the same time. Neural and muscular training, two for the price of one! Who doesn’t like a deal like that?

Movement is life – have some fun.


What is full rest?

Did you ever try looking at a tree and then shift your vision to see the spaces between the leaves? It is still the same light coming into your eye but the conscious shift changes the experience.

I have been doing this with movement and what I see between movements is rest, the time spent not moving. Sometimes it is very long as when I look at my sleeping spouse beside me at three AM. Other times it is mere milliseconds as when a dancer lands a jump and has not begun the next.

These observations made me ask, “What is rest?”


The short answer seems to be – no volitional movement through space, as when I drop onto the couch and put my feet up. But what about the offensive lineman down in his stance waiting for the snap of the ball? He would be the last one to tell you he is resting. Even more extreme is isometric exercises where muscles are contracted fully without generating movement in space. In fact, the usual instructions are to fully contract a muscle group by pressing on an immovable object like a wall for eight to ten seconds then “rest” for eight to ten seconds and repeat. So rest, full rest is more than not moving. What else is there to this?


full rest movement education

The missing part in full rest is not moving through space AND a coordination so that you are not pulling on yourself internally (that is all muscles can do, pull).

Full rest is both a muscular and neurologic cessation or diminishment, no matter how brief, that results in minimal activity in the body or any given part of it.

Consider this – if movement in a body part, say the left arm below the shoulder, is stopped, but the muscles that can generate movement there are not dialed down to the minimum needed for overall balance, then there is still tension in the arm. Excessive tension, which strains the arm internally. If, during a brief period of quiet in an activity, the motion AND the strain are at minimum then full rest can occur.


Good pianists know this. They can play a fast or difficult passage of music but when they get a chance to rest a hand, even just a few beats, they fully rest the hand, losing the tension of the previous passage before they continue. The ones who don’t do this get fatigue and strain in their arms by the end of the piece and the audience can hear the difference.


Rest shapes and balances movement. The sharpest musicians, quickest athletes, and most compelling dancers know this, and during whole body movement they let the body parts that are not engaged in active, volitional motion rest, even if just for milliseconds. It makes all the difference in the world in the quality of their performance.


So if you or I are not fully resting - we are stopping motion through space but not the tension underlying - then what can we do about it?

I have been working on a technique called ReTensioning that teaches people how to re-coordinate so they really can stop moving and use minimal tension at the same time. Other methodologies like the Alexander Technique, CranioSacral therapy and yoga provide approaches to the problem from different angles but they all look to address, in part, restoring the ability to fully rest. Which makes me realize what a great idea that is! I am going to go take a nap.


You Know the Dance But Can You Teach It To Me?


Movement is a kinesthetic experience.  Getting someone else to independently activate their body in a manner that will generate a new kinesthetic experience is the role of a movement teacher.  In order to be effective, in addition to knowing the movements to teach, a teacher also needs some other skills.  What are they?

In my 40 years of studying and teaching human movement I have thought about this a lot.  In fact, I still work regularly with colleagues and clients in order to continually refine my ability to teach movement. I have come to the conclusion that the critical skills for teaching movement fall into four distinct categories.

1.  A sharp eye for movement.  The teacher is able to clearly and accurately observe what a student is doing - with their individual body parts, the relationship of those parts, their overall movement through space, and the quality of their movements. All parts are connected and a teacher must be able to discern how all the parts are working as each specific movement is learned.

2.  An ability to think a movement through.  You are always moving.  No stopping until you die, i.e., breathing.  Where you just were and where you intend to go affect your movement choices in the now. Consequently, when teaching movement to a student, the context of the movement - what comes before and what comes after - is important.  Selected well, the context can make learning much easier. Done poorly or ignored, things can be much harder.  Look at it this way - you can learn a new word individually but if it comes in a sentence, a flow of mostly familiar words, how much easier is it to learn and retain the new word?

3.  An understanding of the different ways people learn.  Scholars have identified several different learning styles and types, each benefitting from a particular style of information presentation.  Teachers do not need to know all the details of these types but they do need to recognize that a significant percentage of their students will not learn in the same way as the teacher.  A good teacher can and does present information in ways that address multiple learning styles.  A teacher also needs to sort out how to optimize his teaching method to each individual.

4.  A good knowledge of the human structure on which we move - the anatomy and physics of the musculoskeletal system.  Without this knowledge, a teacher might ask someone to do something that is either dangerous or impossible to do.  Most often, the teacher is simply not asking what is really desired because she does not understand the underlying mechanics, which can lead to injury but more often creates confusion and wastes everyones time. For example - asking someone to breathe and “get the air down into the belly.”  Unfortunately, the only way to get air into the abdominal cavity on the inhale is if the diaphragm, the pleura and probably a lung are torn, at which point you have a life threatening situation. (I have it on good authority that it is also incredibly painful.)  Why not just ask the student to stick the gut out and drop the lower ribs in front as she inhales? That is what is really being asked for.


Students come in all sorts of sizes and shapes, none of which are the textbook standard body, and a teacher needs to be able to look at a student (see #1 above) and determine how to modify the intended lesson for that individual body structure.  It may mean a different order of progression or body positioning, but is based on asking the student to do things that are actually possible.

There is, of course, much more that great movement teachers do (plan out classes, remember student's names, show up on time, throw a great holiday party, etc.) but being competent in the above four areas is a great beginning.

Strengthening (Cont.)

Stretches are exercises to make tissues longer so things can work better. Tissue that is tight may be muscles, tendon, ligament or fascia, depending on your particular situation. In order to get the most out of the time you spend stretching (and to keep you from making things worse), follow a few basic rules:

  • Go slowly: Ease into and out of a stretch. Some of the tissues don’t have many sense organs so your brain is slow to get the message of how much strain is on an area. Go slowly so you don’t unknowingly go too far.
  • Gentle to moderate intensity: You should feel some stretch but not painfully so. If the stretch hurts it will trigger a reflex that tightens the muscles to prevent you from moving – not useful if the idea is to move more.
  •  Once you reach the optimum point of the stretch for your body, stop and breathe. Breathing makes everything in the body move a little, so each breath adds a very gentle nudge to your stretch.

How far you move will vary day to day and even week to week depending on multiple factors. Be sure you have the right form and feel the stretch in the right place. If you do that, long term progress is inevitable. If you focus on how you are stretching and where you feel it -  instead of being distracted or talking to someone - your brain will acknowledge much more quickly that those joints can do those movements. As a result, you will use the joint more during the day, adding to your speed of progress.


Strength is defined and maintained in many ways. In general strengthening means being able to do more activity with some part of your body.  Most of the strengthening exercises we use at Great Plains focus on getting particular muscles or groups of muscles to improve functioning by:

  • Getting you to use more of the cells in your muscles at the same time so you can lift or pull harder
  •  Improving the endurance of the muscle cells so they let you do more things for longer periods
  • Making the muscles cells bigger so you have more muscle

Strength increases in response to a challenge – muscles without challenge equates to losing strength. That’s why sitting around makes you weaker. But how you challenge your muscles can make a big difference in how quickly you get results. Too little or too much can slow you down and waste your time. To get the most out of your exercises there are a few general principles:

  • Be regular. Daily (especially same time of day) at first to get things going. After several weeks taking two (2) days off a week is okay.
  • Use good form. Don’t rush through, flinging your body parts around, as you will only use the parts of you that are already strong. Strength exercise should be challenging – to the muscles that need to be challenged, not the ones that are doing fine.
  • Breathe! The whole idea of doing the exercises is so your body parts can be relied on to do what you need done in life eventually. That means they need to be able to do their part while you go through your day. A life where you breathe all the time. You don’t want to have to hold your breath to go upstairs because you trained your glutes to only work when you hold your breath do you?
  • Know that from a therapy perspective there is an endpoint. For most problems you don’t have to do these for life, once the muscles work well again you will use them automatically during the day and that will keep them strong. (Provided you keep moving. If you take up residence on the couch all bets are off!)
  • Things improve stepwise – not steadily. You will have a period of big change and then it will seem like nothing for days and weeks. Then it all improves in a hurry again. It is not a steady improvement. When you think you are not getting stronger your body is actually busy making all the proteins and enzymes and blood vessels it needs to be stronger, but you won’t notice that until it is all done and your system comes online all together. Continuing to exercise during those periods stimulates the body to keep making all that internal stuff you need for strength improvement.