When we get down to biomechanical basics our bodies are not that hard to understand. We are like a piece of machinery that is beautifully crafted to move. Smooth, coordinated pain-free movement is the result of good alignment and muscle recruitment and knowledge of where our bodies are in space. These 3 factors are key to ensuring not only smooth, coordinated movement but can also improve performance of numerous tasks, from a simple stand from a chair to something as complex as a golf swing. Let’s break down these factors individually to explore them further.
Alignment simply refers to exactly where your body parts are positioned. To maintain an upright alignment, we need to keep our centre of gravity over our base of support. When we are positioned correctly muscles can work efficiently to maintain an upright posture.
Good body alignment requires body awareness or proprioception. This enables us to recognise where our body is positioned in space and requires a good body map in our brains. Unfortunately, pain can distort this body map and it can become a bit smudged. That is why your body might feel weird or things might feel out of place after an injury. Sometimes we might neglect that body part and not use it as much to avoid pain and this can cause movement to become more difficult or require more effort. On the flip side after injury, we may become hyper aware of the injured body part and hypervigilant about where it is placed. This can cause very unnatural, inefficient posturing or movement and this can perpetuate pain. People often alter how they move or hold a body part after injury and sometimes this altered movement can persist well after healing has occurred.
When considering alignment, we can also talk about the neutral joint position, which is the position of least stress and strain at a joint. In the neutral position there is no strain on the ligaments and low-level muscle activity occurs about the joint sufficient to maintain this position. It is not a set point we lock into but rather a zone that we work in.
If we are going to be in a position for a prolonged period, it may be desirable to be reasonably close to neutral for efficiency and less stress, but we do not need to spend all our time in neutral. It is ok to slump and slouch and move out of a neutral position and indeed this is the reality that we all live in. Our bodies are amazingly resilient and adaptable, and we generally reflexively activate our muscles in a coordinated manner. But sometimes after pain and altered movement and posturing we need to revisit neutral as well as movements outside of this and reset our body map. Therefore it is so important to stay relatively active when we injure ourselves to get you back to normal as soon as possible.
We have certain muscles that work to maintain this neutral position. In the picture below the main antigravity muscles are shown, but in addition to these we also have certain muscles commonly referred to as our stabilisers and when the activation of these muscles is insufficient problems persist in certain areas of the body. In addition, when we have pain, these muscles are often inhibited, or they don’t work as well as we would like. Examples of these muscles are the deep neck flexors in the neck, the shoulder blade stabilisers and rotator cuff in the shoulder, the transverse abdominus and multifidis around the lower back, the gluteus medius at the hip and the vastus medialis at the knee. Physio often targets recruitment of these muscles to improve functioning and alignment through the spine, the shoulder, the hip, or the knee.
Sometimes there may be an imbalance of muscles about a joint or body part and this can lead to inefficient functioning of the joint. Sometimes overloading of the joint can occur from insufficient muscle activity. Pain may also be due to over recruitment of certain muscles, muscle spasm or active trigger points where muscles may be working too much and be unable to relax. Often when pain is present protective muscle guarding occurs around the area and whilst this may be beneficial in acute pain when damaged tissue requires protecting, this excessive muscle activation is not helpful in the long-term as it perpetuates altered recruitment patterns which can in turn perpetuate pain.
In addition to all this there is the very important area around how you think and feel about your movement, activity, and pain. Unhelpful thoughts and beliefs can lead to pain behaviours, which include altered posturing and movement, and this too can perpetuate pain. So, we need to be mindful of what we are telling ourselves. For example, ‘I am broken and will never be the same again’, is a belief that can be self-fulfilled by translating into what we then do with our bodies, for example walk less, go out less, move less. With this type of belief and action plan you could not possibly expect to be the same! We must be mindful of both our thoughts and actions.
Looking at movement after injury we aim to normalise it as quickly as possible so we can get back to functioning just like we used to prior to the injury. At times this will require bringing your awareness to certain posturing or alignment and even thoughts we have. Sometimes we need to strengthen certain muscles and at other times we need to learn to relax certain muscles. But how do you know where to hold your body, which muscles to use and what movements or activity is appropriate?
This is where our physio sessions and particularly our group exercise sessions come into play. Your physio will break your presentation down for you and let you know exactly what to do and what to focus on. The benefit of the classes is that you get to work with your physio to change your habits. Being told to do something is a physio session is one thing, but just because you were told, doesn’t mean you are going to do it. You may have very ingrained bad habits or a poor or incorrect concept of what the physio has asked you to do. By practising movements and asking your physio for clarification in the sessions everything will evolve and change. Your physio will give you direct, relevant feedback on how you are moving, and they will be able to see when you are ready to progress and implement changes as needed.
What are you waiting for? We have our spring sale on now so you can start moving better and moving more. Call to start group exercise sessions and with a pack purchase you will get your initial program session, one-on-one with the physio for half price! Call now 3200 8541!
