Lakshmi, PRI re-positioning, and the brilliance of DNS positions

I was at a yoga workshop last weekend where the teacher discussed some of the Hindu goddesses.  One of the goddesses, Lakshmi, is the goddess of wealth, both internal and external.  As the teacher explained Lakshmi's influence over fortune, she said that part of Lakshmi's power is that she tends to the details.  Tending to the details allows wealth to grow and will result in good fortune, not necessarily in the form of money, but in an internal sense.  It was one of those stories that stayed with me for the week and made me wish I had more patience for the Indian texts (I failed miserably at my one and only attempt at reading the Bhagahavad Gita.  I lasted half a page).

Fast forward 5 days.  I was training a lovely endurance athlete yesterday who has gone from pretty much bullet proof to having some things crop up.  This, unfortunately, happens to endurance athletes, and if they don't get a handle on the root of the problem, they end up spending the next 10 years of their careers "chasing pain" so they can participate in their respective sport.  I have worked with her off and on for a long time (4 years), and I decided yesterday to run her through some of the PRI tests to see what was going on and to give her a more directed, therapeutic program for the off season.  There was only one glaring issue (left AIC), so off to work we went.  After 10 minutes of re-positioning work, I re-tested her, tending to my details, found she was in a much better position, and we moved on with our session.  While we worked on the normal strength training stuff for her upper body, I used several DNS positions for her lower body to try and improve some of her firing patterns.  Her main issue seems to stem from an old ankle injury and her right glute max is taking a pretty intense vacation.  I started her in DNS side lying, couldn't really get any activity there, moved to 3 month supine mode, where I had much better success, and then skipped forward to tripod sit, which is far more developmentally advanced.  She is a crazy endurance athlete after all; I figured I should be able to get some activity going and add some challenge.

While I was moving her through the DNS positions, it occurred to me how brilliant the system really is.  The goal of PRI is reciprocal, alternating movement; DNS addresses movement dysfunction via developmental positions.  The goal of the baby ultimately is walking which is reciprocal, alternating movement.  The higher developmental positions do a wonderful job with pelvic orientation and  addressing strength and mobility needs specific to various stages in the gait cycle.  In many ways, it makes the job of the movement professional easier- make people walk well.  Only then are they going to be able to perform well athletically.  Tend to your details.

At the end of the session, I put her back on the table to re-test her position.  I do this with people when I begin working on improving position.  I want to make sure I am on the right track.  Her left leg didn't drop.  At all.  I had undone her position.  This has never happened to me before- my sessions always address the needs of the individual and I pay attention when there are significant imbalances.  But I had skipped steps.  When she couldn't activate in side lying, I moved her backwards, only to jump forward again.  The neurology wasn't ready for that.  I didn't tend to my details and instead of taking the proper steps, I tried to skip ahead.  I promptly re-positioned her using PRI techniques, re-tested, and she was back to the position I had attained at the beginning of the session.  The take away message: don't rush the process.  Systems exist for a reason and you cannot cheat the system when it is based on neurology.  And don't forget to tend to your details.

Yours in health and wellness,
Jenn

Some quick thoughts on high intensity exercise, breathing, and a potential philosophy shift

Let me start by saying I love hard exercise.  I always have- there is nothing quite like a hard workout, where all of your muscles are fatigued, you feel physically tired, and like you can conquer the world because nothing is quite as challenging as the 40 minutes you just spent killing yourself in the gym.  Whether it's circuit training, spinning, intervals of some sort, or HIIT, there are many different ways to effectively accomplish this, and I think it has a place.  However, what I have come to realize in the last two years is that if we can't shut our sympathetic nervous system off and bring it to a place of calm, we are inevitably setting ourselves up for injury.

We live in a high stress world.  We are always on the go, we multi-task, our brains are constantly being exposed to stimulation.  We don't get outside enough to enjoy our natural surroundings, we don't play enough, and we rarely relax and breathe.  In fact, our breathing often feeds into this inability to calm down.  We breathe into our chests, following a more "fight or flight" type of pattern, with our ribs up and our mouths open.  I ask clients to take a deep breath and I see their chests rise high towards the sky and their bellies not move, or sometimes cave in.  These same clients have upper trap tightness, "tight hips," and low back pain.  There is a general sense of fatigue that follows them, although they aren't sure why.  For these clients, I am going to argue that stimulating their sympathetic nervous more by having them perform high intensity exercise would be a mistake.  It would feed into this pattern of hyperactivity and chronic tightness.  These clients have to learn how to shut their superficial muscles off, find a state of calm, and learn how to breathe.  This is going to benefit them far more than further activating their sympathetic nervous system.  Once they learn how to come down, how to breathe, how to activate their deep stabilizers to keep them upright rather than hold on for dear life with their prime movers, then they can benefit from higher intensity exercise.  However, it is critical to make sure they have returned to a state of calm, with ribs that aren't flared, a sternum that's not lifted, and a breathing pattern that's not feeding into a hyperactive state, both mentally and physically before they walk out the door.  I strongly believe that people should be able to alternate from a state of hard physical work and physical ease seamlessly, with little fanfare.  If you watch the good movers move, you will notice this is what they do.  Watch Ido Portal or Erwan LeCorre, or Kino MacGregor, and you will see an easiness to their movements.  Continue to watch them move and you will see their breath is even, their mediastinum is open, their diaphragm is fully functional.  This is what we should want in our own movement practices and for our clients.  On occasion someone who has been doing lots of high intensity work shows up in my studio.  It could be someone practicing for TacFit, someone participating in Crossfit, or someone who loves HIIT classes at the gym.  All of the individuals want to get back to their respective activity and the one thing they have all had in common is faulty breathing patterns.  I encourage all of these individuals to practice breathing before and after their workouts in an effort to get them out of this pattern that is doing them harm.  I am not suggesting that learning how to breathe will prevent injuries; however, I believe it is a good place to start.

Yours in health and wellness,
Jenn

5 things I have learned studying neurologically based training methods (specifically, DNS and PRI)

Over the last 18 months I have become mildly obsessed with neurologically based training.  My accountant (who is also a client), claims it's because I am bored now that graduate school is finished and I need something to study.  This is partially true- there is something inherently rewarding about studying and implementing concepts that are somewhat challenging to grasp.  I am forced to think, try, and apply until I figure out how (and if) it works.  On a more basic level, neurologically based training simply makes sense to me.  It answers questions about things I have always noticed, but never really understood.  It examines patterns, and it supplies ways to correct patterns that might be inefficient.  It speaks to my yoga background, where I have trained with amazing individuals that have taught me effective techniques, but never fully explained "why" the techniques work.  However, this type of training isn't for everybody, and it definitely isn't the easiest way to approach human movement.  Outlined below are 5 lessons I have taken away during the last year and a half, and I am sure there are many more to come.

1. Breathing is important.  Not just important, paramount to good movement patterns, decreased pain, good shoulder mobility, and good hip function.  If breathing is dysfunctional and isn't corrected, it can be very difficult (if not impossible) to get good quality movement.  I have sat through almost 40 hours of lecture on this topic, and am just beginning to sort of grasp it.
2. Reciprocal inhibition is critical to good movement patterns.  Physical therapist and PRI instructor James Anderson says something along the lines of, "anyone can turn a muscle on.  An expert knows how to turn muscles off."  (This comes from the moykinematics home study course).  Certain things we see over and over again as fitness professionals- tight upper traps, overactive IT band, quad dominance, overactive lats...  The list goes on.  Over the years I have learned to train around things so that I don't flare something up.  A better solution is to turn things off so they aren't active, freeing up the proper stabilizers to do their job.
3. There are many different ways to skin a cat (I think that's the saying.  I have always wondered where that phrase comes from- aren't cats pets?  And who wants to skin one?  But that's a different blog post).  Some people respond well to simply moving more.  Yoga works really well for some, probably because it activates several muscle chains, there is an element of focusing what you are doing and telling your body how to move (neuro training).  Pilates works well for others.  Primal movement, CST, NKT, z-health...  There are several acronyms that are effective at training the neuromuscular system.  DNS and PRI resonated with me.  This doesn't make them the end all, be all.  My clients are making very positive gains and many of my clients are suddenly practicing breathing when they aren't with me, moving better, and feeling better.  This is important to me.  As a result, I will continue to learn these two methodologies, but that doesn't mean I will discount other techniques or be unwilling to listen to experts discuss them.
4. Just because you go to a workshop, you are not an expert in the topic.  These methodologies take time to learn.  And practice.  And a willingness to ask for help.  If you aren't willing to do these things, I recommend learning something else.  I not only do PRI and DNS regularly (it is not unusual to walk by my studio and see me with 2 or 3 manuals out, trying different things, figuring out how it all fits together), I attend workshops, ask questions of more advanced practitioners, and re-read informational material.  I am willing to sit through lectures multiple times in an effort to understand the material better, and am constantly practicing on my clients.  Again, this is hard, and more intensive than other training techniques I have studied.
5. Test/Re-test is invaluable.  I know other methodologies use this philosophy. Prior to PRI in particular, and DNS to a lesser extent, I hadn't fully understood how valuable it is to know whether or not you are on the right track.  Watching someone improve in a matter of minutes is not only exciting to the practitioner; it boosts the client's confidence as well.  I don't test every session, but when someone has something going on or I am working on something specific, it is a good way to test progress.

Learning is a process, and I am hopeful that as I continue to deepen my understanding of human movement, I will be able to have positive impacts on my clients lives and share my knowledge and experiences with others in the human movement field.

"The secret to mastery in any field is to forever be a student." Martin Palmer

Yours in health and wellness,
Jenn

The handstand chronicles

I posted recently on Facebook that I had held my first handstand in the middle of the room.  Clearly, I was excited, slightly overjoyed actually, that I finally accomplished this and felt the need to share.  In the week following, I was surprised how many people asked me about it.  Some people wanted to know “how" I had accomplished this while others wanted to share why they “couldn’t" perform a handstand.

I have been intrigued by handstands for decades.  I used to try them when I was an adolescent, inspired by the gymnasts at the olympics who could lift up with control and hold the position for minutes on end.  I never managed to stay up for longer than a nanosecond, and the ceremonious flop that always resulted never deterred me.  Over and over again I would try, until I became bored and moved on to whatever I deemed more interesting.  Eventually, my interests grew away from handstands, as I moved into running and lifting weights, focusing on more of an external strength rather than an internal one.

When I took up yoga in 2004, my fascination with handstands returned.  I would watch with amazement as women in their 30s, 40s, and 50s would lift up in a controlled manner and hover with their feet in the air.  I was fixated, and after building a consistent practice, I found myself throwing them in on occasion against the wall.  There, I could work on refining the position, feet pressing up while supported, shoulder girdle finding the proper engagement.  

And so this went for years.  About a year ago, Kino MacGregor wrote a blog called “Let her fall," where she discussed her journey with Pincha Mayurasana.  When she began working on that posture, she was weak and fearful.  She realized that to build both the strength needed to conquer the pose and to overcome her fear of falling, she needed to get away from the wall and fall.  For some reason, this resonated with me.  Once a person knows how to fall and has the flexibility to go into a backbend, it’s really not a big deal to fall over.  I had both of these things, and after figuring out how to do pincha mayurasana in the middle of the room, I moved on to handstand.

And fall I did, though not as spectacularly as I expected.  There was frustration, as I figured out how much energy was needed to lift my legs up (I was used to purposely overshooting a little bit because the wall would catch me).  There were the times I ended up in backbend, only to quickly lower myself down and try again.  And then, just like I had always hoped to do, I found myself in it, not shaking, not unstable in any way, just holding.  After five breaths (I didn’t want to press my luck), I slowly lowered down, only to realize my relationship with handstand is a lot like my relationship to life.  Whenever there is a risk of failure, I explore my options at the wall first.  Once I have gained the confidence that I know how to fall and not get hurt, I move to the middle of the room.  Failure is really only a glorified backbend.  As long as I can get back up and try again, it will all be okay.

Hamstring strain, running, and prevention options

Hamstring injuries can be a real pain in the butt (literally).  Hamstring strain is a common injury in all sports that involve running, and in distance runners can be the cause of deep gluteal pain (White, 2011).  This is the one running related injury that shows up in my life occasionally, and I can attest to how irritating it is.  Perhaps more frustrating is the conflicting research showing how to "deal" with it.  Interestingly, the cause of the injury is often forceful eccentric contraction, which occurs during the swing phase of running gait, when the hip is flexed and the knee extended.  If the pelvis is in an anterior tilt, the hamstring is a lengthened position (see image below).  As Panayi (2010) points out, both anterior pelvic tilt and/or pelvic asymmetry puts increased demand on the biceps femoris origin and increases functional demand of the hamstring group because the synergist muscles (glute max) are inhibited.  I have had a number of clients suffer from hamstring strains, all have been female, and all have been prone to excessive anterior pelvic tilt.  The literature shows the best way to treat hamstring strain is using an eccentric approach to improve flexibility and strengthen the musculotendinous junction (White, 2010).  The rationale for this is that eccentric strength training might allow active tension to return to normal by restoring the musculotendon length (Heiderscheit, Sherry, Silder, Chumanov, & Thelen, 2010).  However, by ignoring the lumbo-pelvo-hip complex, the issue of why the hamstring was injured in the first place is being ignored.  Heiderschei et.al, cite a study by Sherry and Best that found a progressive agility and trunk stabilization program emphasizing neuromuscular control was more effective than a progressive stretching and strengthening program at reducing hamstring reinjury risk- after 1 year, 70% of the S&S group had been reinjured, while only 8% of the neuromuscular group had experienced reinjury.  This is more closely related to my experience; eccentrically training my hamstrings when they have been injured doesn't feel good.  I have always felt I needed a different approach to training my hamstrings, I just wasn't sure what it was.

Enter Eric Cressey's blog on hamstring strains and me learning some PRI techniques.  I have already written about how DNS had a positive impact on changing my thoracic position.  PRI takes it a step further and begins to address pelvic position, thoracic position, and thoracic and pelvic asymmetry.  Some of the lower body PRI exercises are specifically designed to integrate hamstring and glute function using a slight posterior pelvic tilt and proper thoracic positioning.  I was learning these when I read Eric's blog here: http://www.ericcressey.com/5-reasons-tight-hamstrings-strain.  Even though he works with baseball players and probably doesn't spend a lot of time assessing runners, I finally felt like someone was giving me permission to avoid end-range movements while trying to improve my hamstring strength and stability.  Up until this point, I was getting ART once every three or four months, which makes my hamstring feel fantastic, but (as is the case with most manual therapy work), wasn't "fixing" the problem.  I was fully aware that my movement patterns were causing the hamstring to flare up again (although to a lesser extent and in a different spot, oddly enough).  It's only been a month, but I can honestly say the hamstring feels like it's healing.  It doesn't bother me after riding (which seemed to be the biggest culprit, although I am sure running wasn't helping), and yoga no longer seems to aggravate it.  I am doing a lot of spinal mobility/breathing/PRI/DNS type work, and throwing in the occasional backwards stair walk.  The strengthening movements I am doing in the gym, such as deadlifts, are performed after some glute/hamstring integration work and no longer feel like they might be doing more harm than good.  The crazy thing is, training the hamstring in a shortened position with a posterior pelvic tilt feels really good- more how you expect something to feel when it is rehabbing an injured area.  I am all for a little mobility, but as Eric states in his blog, you have to assess the individual.  Not every rehab protocol will work for every person.  And sometimes, the research focuses a little too much on the site of pain rather than the source of pain.

Yours in health and wellness,
Jenn



White, K.E., (2011).  High hamstring tendinopathy in 3 female long distance runners.  Journal of Chiropractic Medicine, 10(2), pp. 93-99.
Panayi, S., (2010).  The need for lumbar-pelvic assessment in the resolution of chronic hamstring strain.  Journal of Bodywork and Movement Therapy, 14(3), pp. 294-298.
Heiderscheit, B.C., Sherry, M.A., Silder, A., Chumanov, E.S., Thelen, D.G., (2010).  Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention.

The real reason I can't squat, compliments of the PRI postural respiration workshop

My bodyweight squat leaves something to be desired.  I can squat all of the way down, heels remaining on the floor, and look pretty good once I am down there.  My knees stay straight ahead, my feet stay in good contact with the floor and don't rotate, and my pelvis remains level.  So, where is the problem, you ask?  My torso.  It folds neatly forward, with good alignment in the spine, rather than remaining upright and vertical with my tibia (proper squat form).  It kills me when I do videos of myself squatting because it is the one area I can't seem to improve.  I have elevated my heels on little risers to see if it's an ankle mobility restriction (it's not).  I have worked on my deep intrinsic core muscles, ala NASM's CES protocol, because according to NASM, it's an intrinsic core issue.  I thought maybe my regular DNS work would improve pelvic positioning, thus improving my squat pattern.  All of this has been to no avail.  Still, when I would squat in front of a mirror, I would watch with dismay as my torso folded forward.  The slightly analytical (and perhaps overly compulsive) part of me wanted to be able to squat well.  It's the signature of a good movement pattern, always the first thing people look at when they begin to understand how you move.  I began to feel resigned to the fact that maybe I would never squat well and my movement pattern would forever be less than perfect.

Enter the Postural Restoration Institute Postural Respiration workshop.  I went because a) Eric Cressey mentioned PRI in his blog, b) it was local (this never happens in Monterey) and c) it sounded neurologically based, which seems to resonate with me.  Something that should be understood about these types of workshops is no matter how well you think you move, you are going to discover you have areas you need to work on.  Like most people in the industry who spend oodles of time analyzing others movement patterns and helping them move better, I apply that same overzealousness to my own training and (with the exception of the squat) think I move pretty well.

It turns out, of course, that I was mistaken.  There were all kinds of things wrong with me, most notably my lack of thoracic curve.  When you are a short, athletic female, you spend a lot of time "standing up tall."  Part of that "standing up tall" means pulling the shoulders back and, prior to my DNS training, retracting the scapula.  (I have gotten completely away from that, and have noticed a HUGE improvement in my clients' shoulder function.  I now cringe when I either attend a class that encourage scapular retraction or read a blog/watch a youtube video that encourages this motion).  While scapular retraction is no longer part of my movement pattern, thoracic flexion is something I have never given much thought to, or, more appropriately, my complete lack of thoracic flexion in just about any movement.  I have very good hip flexion (probably to spare my lumbar spine), and because of that bending forward has never been an issue.  However, (and I couldn't find anything online to support this theory), if you take away one of the curves of the spinal column, it only makes sense that the balance of the spine would be thrown off during activities such as hip flexion.  Instead of being able to keep my spine parallel to my tibia during squatting, my lack of thoracic flexion caused me to fold forward to balance the weight of my hips.  In fact, when I hold a medicine ball or kettlebell in front me, I can suddenly stay more upright (again, makes sense.  I am counterbalancing with my upper torso superficially).  Once I realized I lacked sagittal plane mobility in the thoracic spine, I started playing around with things to improve it.  I also tried maintaining a more neutral spine (read: a little bit of thoracic flexion) during my bodyweight squat and low and behold, I could actually squat past 45 degrees with a more upright torso!  Now, I still can't get down to 90, but this has been a huge improvement.  It also led me to think about something that was mentioned during the workshop.  James, the instructor, noted many of us are in an extension dominant pattern,  I thought he was nuts.  With all of the sitting and screen time, how can this be the case?  However, after my squat discovery, I reflected on all of the women I have worked with over the years who have a very similar squat pattern as mine.  They all have a flat thoracic region and, like me, are "stuck" in a more extension dominant pattern.  Restoring flexion in the thoracic spine makes a lot of sense and will further improve lumbar spine and pelvis stability and position.

Yours in health and wellness,
Jenn

MovNat level I- a certification review

Last weekend, I was fortunate enough to attend the MovNat level I certification course in Monrovia, CA.  Kellen Milad and Jeff Kuhland were our coaches and people came from all over the western US to participate in either the certification or the Power & Agility workshop.  While there have been reviews written about the workshop, my goal is to offer a trainer's perspective of the certification portion of the weekend.

I wasn't sure what to expect.  I registered for it because my husband and I did the 4 weeks of MovNat workouts on Breaking Muscle and he wanted to do the workshop, so I figured if I was going to go to the workshop, I might as well get certified (I am a fitness professional, after all).  I had watched the crazy video of Erwan LeCorre moving in this incredibly fluid fashion years ago, after I read the first Outside Magazine article discussing Erwan and his fitness philosophy and was intrigued, to say the least.  I followed the evolution of the company over the years, and this opportunity seemed like a good time to take my curiosity to the next step.

My fellow certification attendees came from extremely varied backgrounds.  One was a successful personal training studio owner with a background in training fitness models.  Another was an acupuncturist with a background in Crossfit and Chinese medicine.  There was a rock climber, a recent college graduate with a genuine interest in bringing outside movement to people in Boulder, and a former chef making a career change.  There were also two people going through the certification simply to help their family and friends.  I work primarily one on one with people and my clientele is generally baby boomers with injuries or endurance athletes, so it was interesting to be in an environment with other fitness professionals that weren't necessarily so corrective exercise based.  Kellen and Jeff did an extremely good job dealing with the varied level of coaching experience and provided a very safe environment for us to learn and help each other.

The workshop portion of the event was physically challenging.  Because MovNat covers so many elements of fitness (strength, power, agility, endurance), it is almost impossible to excel in all areas, although there were a couple of attendees that came close (note to self.  Climbing rocks and trail running seems to improve overall fitness.  The trail running I already do.  The climbing rocks I started this week).  I received the best jump coaching I have ever received and can finally land somewhat quietly, although the height I can jump leaves something to be desired.  Swinging from bars is fun.  So is learning how to climb trees, which has become a small area of fixation (performing a handstand in the middle of the room is a slightly larger area of fixation.  Both should be accomplished by the end of the summer).  The lifting and throwing techniques were taught well, and the different crawls and rolls were fun to execute- however, I felt maybe a little more attention could have been given to bad crawling technique.  Maybe it's just my clientele, but it is not unusual for me to put a new client in a quadraped position and see scapular winging and an increase in spinal lordosis, which would have to be addressed before adding locomotion.  The highlight of the workshop came on Sunday, when we created our own combos in small groups and played outside for 3 hours.  Both activities cultivated a team environment and allowed us to put the skills learned over the weekend to use.

The certification portion of the weekend meant we started an hour earlier and ended an hour later than the workshop participants.  During that time, we discussed coaching and programming, were assessed on our proficiency in the movements, took a written exam, and were asked to design a small group program for participants of varying levels.  I was grateful I had been practicing some of the movements since early January (things like tuck swings can tear apart your hands if you don't have blisters), and I didn't find any one aspect overly challenging.  I actually enjoyed the practical portions of the certification- I have a number of certifications and with the exception of ACSM over a decade ago, I have never been asked to actually teach a movement and prove I have any level of coaching competency.  Jeff and Kellen gave excellent feedback, and they did a nice job with the diversity of professionals in attendance.

While I don't know if I will go on and get my level II and III certification, I definitely enjoyed the experience and would recommend it to anyone looking to have a more diverse movement background.  One of the things I really like about philosophies such as MovNat is they are fun; you get to lift some things, throw some things, maybe dynamically balance and swing from things, in a much less regimented way than most training.  If you work with the general population, performing these types of movements well are more functional than most open chained activities.  Overall, a very positive experience.

Yours in health and wellness,

Jenn