Where can we find answers to solve intractable chronic pain, endless repetitive injuries and movement problems that seem to have no known cause?
When strengthening, stretching, joint manipulations, pain coaching, medications and even surgeries haven’t solved the problem, could there be something missing or blocking the healing process?
Why do these treatment protocols work for some, but not all?
How we move is ‘the human way’. It’s who we are. Right back in 1863, the Father of Russian Neurophysiology, Ivan Setchenov, said:
“All acts of conscious and unconscious life are reflexes by their origin.”
Acknowledged as being ahead of his time, he inspired the likes of Pavlov, Bernstein and Sherrington, who were all huge contributors to the behaviour, movement, neurone and reflex arc models which shape our understanding of the central nervous system today.
So, what if we took another look at chronic pain, repetitive injuries and movement problems through the lens of our movement origins? Are our reflexes, the motor patterns they produce, and the variations generated as they get us organised from ‘blob’ to ‘upright’, the missing connections?
Is there a relationship between them being somewhat disorganised, and bodies not being able to join up the healing dots?
Let’s start exploring a very complex subject with a metaphorical story. “The Story of Finding the Catalyst for Movement Efficiency” … aka The ‘Lego’ Story.
Meet the main characters: a boxed set of 30-odd different pieces of Lego, with no one piece the same as another.
Each piece of our Lego represents a specific foundational building block of human movement, and you might already be thinking we’re simply going to piece them all together. That comes in due course, but our story starts with the knobbles on the top of each Lego piece, because these are the keys to movement in the long run.
These knobbles represent the initial reflex pattern, unique to each piece: its stereotypical, automatic movement response to a stimulus.
The stimulus is sensory, and can come from the skin, the eardrums, the eyes, the nose, the inner ear and the changing loads through muscles, tendons and joint capsules.
The sensory input results in a predictable motor output and the elements together, creating a sensory-motor reflex arc, instigatethe development of movement patterns.
This is a reflexive response over which you have no control. The movement happens TO you, at speed, rather than through choice. Remember this part; it’s a fundamental ingredient in our movement life.
The scene is set in a house with 3 floors. Each floor represents an area of the brain, an organ so complex we don’t even fully understand it yet!
Keeping it simple, the basement equates to the brainstem: such an important communicator it has control of our vital signs – heart rate, breathing rate and blood pressure. Whilst connecting the majority of brain tissue to the rest of the body, it is still considered to be the least complex area of the brain.
The first floor corresponds to the basal ganglia – a group of brain nuclei sitting above the brainstem, in the middle of the brain. Their linked structures offer fast and efficient neural connections for learning, emotional processing and a vast array of complex motor movements.
And the top floor embodies the cerebral cortex, which is endlessly busy because it has so many functions and is the most complex area of the brain. We can count perception, awareness of sensory information, motor activity, planning, decision making, motivation, attention, learning, memory and problem-solving amongst its jobs.
And now, the Lego Story unfolds …
You move into the basement when you’re born, and you find your box and the complete set of 30-odd pieces of Lego there. But the Lego isn’t in the box, it’s scattered seemingly randomly around the floor.
Born as a bit of a ‘helpless blob’ physically, you’re wired with curiosity, driving you to move and pick up and play with each piece.
Of course, the Lego isn’t ‘scattered’ at all. It’s specifically laid out in a way that dictates which pieces get played with first, with the order of play developing movement along a DNA-timeline-driven, predictable and predetermined path.
It’s easy to feel the knobbly bits, with their numbers and layout giving instant information about that piece. The ‘game’ is to play with each piece of Lego long enough that you can recognise it viewed from all directions; you know it from its knobbly bits first, but then you get to know it from its shape, colour and size too.
Playing with each piece of Lego tones down the reflex action, organises it, modulates it, softens, calms or tames it. And the shape, colour and size information that emerges from play represent the modifications of the initial reflexive movement: opposite to the initial direction of movement and then variations of it.
Now, that piece of Lego is allowed to be stored in the box because it’s no longer a reflex, it’s no longer a stereotypical, automatic movement response to a stimulus. Whilst the knobbles on top of its shape, colour and size remain, you can now use it in any way you want, be it upside down, back to front, orientated to the left or to the right.
The movement the reflex created remains, but you’re no longer limited to it; now you have access to multiple variations of it.
- First only the knobbles were known: let’s call that untamed movement.
- Then shape, colour and size became known, ‘taming’ the movement so the Lego piece could go into the box.
- Each piece of Lego in the box represents a movement pattern over which you now have control; you have movement choice. The next fundamental ingredient in our movement life!
Playing with each piece of Lego long enough for it to earn its right to live in the box, strengthens the muscles involved in the movements.
Connecting pieces of Lego happens as soon as multiple pieces have made it into the box, enabling us to create more shape varieties and more complex movement patterns. Muscles get stronger and the time taken to connect the shapes gets shorter.
Many pieces of Lego are ‘shapes’ with elements of balance, because we need to develop the ability to be upright without falling over. Some are ‘shapes’ with acuity, creating the ability to hear, see and think accurately and clearly.
Organised movement and thought are rooted in the same place: playing A LOT with each piece of Lego, long enough for them to get off the floor and into the box.
And when the box is full, the lid appears to reveal the whole picture: the development of human movement and thought. You have progressed from ‘blob’ to balancing on two little feet with freedom from reflexive responses, and the ability to organise physical movement and mental movement.
At about 7 years old, you’ve developed the strength and movement co-ordination to climb up to the first floor where you can play with your box of Lego with more space and a much bigger view.
Now you can walk, run, gallop, skip, jump, roll, climb, swing, wrestle, play hopscotch, dance, you’ve got some degree of hand-eye co-ordination and foot-eye co-ordination.
You get more and more skilled at balancing your precious brain on top of an increasingly longer body, continuing to strengthen the muscular-skeletal system, the speeds of all the motor responses, and expanding your visual field. Your basal ganglia are developing nicely.
Taking the stairs to the top floor opens your movement world to the learned higher skills of particular sporting activities: those requiring even greater mobility, balance and motor response speeds and of course the ability to understand more complex game rules. Your cerebral cortex is getting busy.
But what if you missed a few pieces of Lego? What if they never made it into the box in the basement? “Out of the box Lego” isn’t necessarily ‘missing movement’, maybe more ‘missing organised movement patterns’: less smooth, more limited, degrees of awkward or clumsy, less ‘tamed’.
Your basal ganglia will do its best with whatever you’ve got, and your movement patterns will offer clues.
You might not have found the piece of Lego which drives your arms to support your torso, so crawling play might have been skipped. Your adult upper body might not have the strength and co-ordination it has the potential for, but you can still manage, albeit in a somewhat slouchy kind of way.
What if the ‘turn left’ piece of Lego was tucked in a corner of the basement, out of reach? No worries. You’ve got your ‘turn right’ to fall back on … until perhaps you start writing at school and keep getting told off by the teacher because you don’t start at the left-hand margin … or until you sprain your right ankle, which as far as your Lego set is concerned, is the only one waiting and willing to connect with the other shapes in the box.
Maybe one foot is still ticklish; a particular piece of Lego prompting big toe extension probably didn’t make it into the box. It’s still kicking around on the basement floor, and you keep standing on it (literally).
The sensory element of the knobby bit (the instigation of the reflex response) stubbornly remains along the outside of the foot.
Your central nervous system has options:
- It can default you to walk on it, squashing it hard and locking you into ‘high arches’ and/or endless inversion ankle sprain cycles. Stomping feet, wear pattern on the outside of shoes and ‘bow-shaped’ legs are also clues.
- It can send you in the opposite direction, avoiding the outside of the foot entirely and gifting you the label of an ‘over-pronator’. Bunions, knock-knees and orthotics are also clues.
- And it can go with the flow – allowing your big toe to ping up endlessly, breaking through the fabric of socks and even shoe uppers in the process.
And if your glutes are ‘sleepy’ no matter how many crab walks and bridges you’ve repped out, you’ve got to wonder if the piece of Lego pulling the tailbone out from its original ’tucked’ position, ever saw the light of day. That piece of Lego is probably still in the basement …
Let’s say that all is well, the full set of Lego is happily boxed, and you’re moving confidently between the first and top floors, with co-ordinated movement and the capacity to overlay fresh movement skills as you discover new sporting activities.
And then, an accident. Your head gets a good bash, and whilst you don’t lose consciousness, you’re told you have a minor concussion. After a few months of maybe headaches, dizziness, attention or visual tracking difficulties, memory loss or nausea, the symptoms have eased, but you don’t feel the same.
It’s hard to put your finger on it, but you know you’re not as co-ordinated as you were before your brain bounced against the inside of your skull; perhaps your balance seems less controlled or your reaction times slower.
Concussions can shake one or more pieces of Lego out of the box; they’re back on the basement floor, where those knobbly bits of ‘motor reflex patterning’ are throwing the timing and muscle tone regulation ‘off’.
When movement invokes pain that doesn’t go away, when injuries are on a spin cycle of repeat, when efficiency of movement has disappeared, perhaps we should be doing an inventory of the fundamental ingredients for a full movement life: a full set of organised Lego in its box.
If playing with the Lego organises or ‘tames’ the reflex, creating freedom from the automaticity of the original reflex pattern, and access to an enormous variety of movement shapes and thoughts, smoothly and efficiently …
… then the corollary is limitations of speed, smoothness and variety of movement patterns and thoughts, when the Lego is in a bit of a mess, or ‘untamed’.
My metaphoric Lego Story is, of course, describing what is commonly understood as ‘infant development’. And I feel passionately that’s the problem: the label. Whilst initial Lego play happens whilst we’re very young, that doesn’t mean it isn’t relevant to movement throughout our lives.
I invite you to REMIND the body and brain of the INNATELY AVAILABLE basic movement patterns by finding and playing with any missing or disorganised Lego pieces. By taking advantage of how movement started happening in the first place, by talking to the body in a way it understands because it’s how we’re made, messy motor patterns can be more easily organised. You can’t reach the top floor if the basement door is jammed by stuck Lego that never made it into the box.
Let’s portray the limitless narrative:
LEGO is Movement Development, which is non-ageist and offers life-long opportunities to explore movement with the goal of finding ‘MORE’ and ‘BETTER’ in the context of motor co-ordination and postural control; these form the bedrock of smooth, efficient muscle sequencing and movement.
And given the difference between strain and strength is muscle sequencing, wouldn’t it be wonderful to help EVERYONE find this?
No matter our age, once we’ve identified which piece of Lego isn’t in the box, we can go and find it, play with it and organise it. Tidy up our basement floor. In PFM PilotPFM Pilot, I’ve identified my Top Six collections of Lego culprits.
And never forgetting that it can’t be that difficult … after all, a baby does it …
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