Sunday, February 10, 2013
In August, I became fascinated with using golf balls to release the fascia in my feet. I discussed it in my blog here. I have been using a small ball on my foot every evening, and can officially say it has definitely improved the way my feet feel. They aren't tender at all, the intrinsic muscles seem to engage more easily during movement, and, considering that I am on my feet for hours every day, they feel great. More interestingly, however, is how this has affected my clients' movement patterns.
Before I get too far ahead of myself, it is worthwhile to note some of the discussions that are taking place in the movement/rehabilitation world, specifically in regard to trigger point therapy. In a fascinating blog by Diane Jacobs, she theorizes trigger points are actually neural in nature, rather than a structural issue, either fascial or muscular. As a result, trigger points provide temporary relief via the CNS, but it's short lived. I can get behind all of this. We aren't changing or lengthening the fascia when we perform SMR or trigger point work. We are providing a short moment of neurological change. During this window, I would argue it's possible to invoke potentially more permanent change if the trigger point is biomechanical in nature, not the result of an internal issue such as a cyst or tumor. If, for instance, we do trigger point work on our foot, mobilize the ankle, and begin working on short foot and better movement patterns in the lower limb, I don't think the trigger point will repeatedly return, especially if we are diligent with our training. This is the general theory behind the NASM CES course which, while it has its flaws, in my opinion has some merit.
Now, back to my clients. I have a client I have been working with for years who has trouble with back spasms. Her hamstrings and foot complex have always been incredibly tight, no matter what I tried (and I tried it all. Hamstring SMR, activating the tibialis anterior to release the calves, PNF on the hamstrings, etc). I began using the "golf ball trick," in addition to short foot activation, single leg stance with short foot activation, and diaphragmatic breathing. Supine leg flexion is close to 90 degrees and her foot is incredibly normal, not internally rotated and slightly plantar flexed like it has been. You might argue this was related to the breathing, and I think that played a role, but she says the trigger points in her foot are almost completely gone. She actually looks forward to our barefoot work,and sometimes requests it at the beginning of our sessions. I have another client who had low back surgery 11 months ago for a disc repair. He has had trouble with tightness in his calves and hamstrings since prior to the surgery. Again, I utilized a variety of techniques to improve mobility and function, but it wasn't until we added the trigger point work to his feet that he noticed substantial improvement in hip flexion and mobility while walking and jogging. Maybe these are outliers, or maybe other factors are at play, but I will continue to use the golf ball trick on clients with trigger points in their feet. Even if relief is short term in nature, the more tools I have to help people move better, the more likely they are to move more.
Yours in health and wellness,
Sunday, February 3, 2013
I am completely fascinated by the subjects of mastery and expertise, both what it takes to become a master of a given movement or craft and how one becomes an expert in coaching/teaching the movement or craft. The former is mysterious to me; I get bored relatively easily and wonder if I will ever truly master anything. The latter, of course, is my profession and the more I learn, the more I realize how little I know.
When it comes to what it actually takes to become an expert at one thing, the research seems to be pretty clear. Ericsoon, Krampe, and Tesch Romer (1993) established that expertise occurs after 10 years of intense practice or 10,000 hours, whichever comes first (Magill, 2011). Intense practice consists of practice that is deliberate, or designed by a coach or teacher to address aspects of performance through repetition and refinement. This is very different than simply going through the motions and is done in a mindful way. All of this practice and refinement allows experts to process information differently. Experts of specific skills recognize patterns more quickly. This allows them to anticipate and act more quickly than non-experts. Daniel Coyle discusses the concept of focused practice in his book "Talent Code." Deliberate practice, or deep practice, as he refers to it, is focused. This is accomplished by performing practice where mistakes are made, tending to the mistakes, and practicing again until it is performed correctly. This, of course, means working slightly outside of one's comfort zone and perfecting something before moving on (interestingly, Ashtanga Yoga works much this way. It is traditionally taught so that the teacher only gives the student one pose at a time. The student doesn't receive the next posture, or asana, until the current asana is perfected. The founder of Ashtanga, Pattahbi Jois, is known for saying it takes 7 years to perfect the first series. This would be approximately 4000 hours of practice, not including immersion weekends, weeks, or months where more deep practice typically occurs. I understand many of the martial arts are taught the same way, with black belt status usually taking about 10 years to complete). This also requires the person performing the deep practice to be passionate about the skill. Last summer, during a graduate school presentation by legendary running coach Dr. Jack Daniels, he said the hardest athletes to coach were the ones with the most talent and low internal drive. Because things come easily to these athletes, they don't feel the need to participate in deep practice, relying instead on their innate talent. This, of course, eventually leads to a person "not reaching his potential," with the less talented person participating in much more deep practice, analyzing his mistakes, and eventually realizing a more favorable outcome.
Research also shows that how the practice is performed can affect the outcome of learning. Massed practice, or practice with little rest between sessions or trials, is less effective than distributed practice, or practice that is much shorter in length. This prevents both physical and cognitive fatigue, leading to faster acquisition of the skill. I use this often when I train; I introduce a movement that is challenging for someone at the beginning of the session. The person inevitably struggles because it is new and more complex than what we had previously been doing. We perform one set and move on to something else, coming back to it 10 minutes later after doing other movements or exercises. The second set is almost always better than the first, and it's always fun to watch the surprise on the client's face when he realizes he is more successful the second time around. Usually, after 2-3 weeks of interspersing the difficult movement into the routine, the movement is no longer intimidating or threatening for the client and progression can occur, in terms of load/reps/sets. Grooving a movement pattern is a rewarding feeling, both for the client and for the trainer.
Movement is something we should all want to master. This doesn't mean performing complex gymnastics routines or being an elite level athlete. It simply means having a sense of mastery over what our bodies can do and regularly challenging it to perform in ways that require focus and practice. As I mentioned earlier, I am prone to boredom. As a result, I will probably never be an expert at any one yoga practice, or any one movement system, for that matter. I have been running for 17 years, more than half of my life, and I certainly don't feel like an expert runner. I am, however, in tune with my body. I regularly challenge it to do things that are hard, and I practice until I can perform these things with some level of ease. I am currently training for the MovNat level I certification. One of the requirements involves hanging from a bar and pulling the body up using a leg, elbows, and arms. Two months ago, hanging from a bar for longer than 15 seconds was really challenging for me, let along actually performing the movement. I began practicing the movement 4 times a week, sporadically throughout the day, about 10 minutes each day. Now, I can get up easily with my right leg; my left leg isn't quite as smooth, but considering I couldn't get up using my left leg at all 8 weeks ago, I am pleased with the progress. I think we are generally scared of things we can't do physically and instead of picking small challenges and working on them in a focused manner, we practice avoidance. Instead of masters of our bodies, we are merely inhabiting them, allowing them to dictate what we "can" and "can't" do. In order to maintain function and ability, we have to change the way we look at physical challenges and aspire to a sense of physical expertise. Rather than shy away from physical challenges, we should embrace them, remembering that with deep practice, what is a physical challenge today won't be in a month. And even if it still is in a month, that doesn't mean that one day, with focus and determination, it won't be accomplished.
Yours in health and wellness,
Magill, R.A., (2011). Motor Learning and Control, ninth edition. McGraw-Hill: New York.
Coyle, D., (2009). The Talent Code. Bantam: New York.