Patellar taping is a common treatment for patellofemoral pain, but the mechanism of action remains unclear. There is some debate about whether the method works due to mechanical effects on patellar alignment, or changes in the brain due to alterations in sensory input. In my previous post I argued in favor of the latter interpretation and this study provides some supporting evidence.

The researchers recruited healthy volunteers and used functional magnetic resonance imaging to monitor their brain activity during knee movement with and without patellar taping.

They found that subjects moving without the tape demonstrated more brain activity in numerous parts of the brain related to motor output. So basically the brain did less work with the tape than without. I guess that’s a good thing.

Previous research has shown that knee taping appears to improve knee coordination in subjects with poor proprioception but not in those with normal proprioception.

Of course none of this means that taping does not work through some other more local mechanism, or that it works at all, but it does give some support to the theory that any potential benefit is achieved through modulating the nervous system.

Looking for fatigue in all the wrong places

Noakes starts with a review of the history of the study of fatigue, which mostly focused on efforts to find the ultimate limitations of human exercise capacity in the body, such as the muscles or the heart. The problem with this approach is that it does not explain why athletes almost invariably simply choose to stop exercising before such bodily limits are reached (some of which would result in catastrophic injury or death.) For Noakes “the presence of the noxious symptoms of fatigue must indicate that exercise cannot be regulated solely by an inevitable and unavoidable failure of skeletal and or cardiac muscle functions.”

Here are some common observations that are not explained by the theory that exercise is limited by some single factor in the body:

• athletes begin exercise at an intensity which is appropriate for the expected duration;
• athletes run harder in competition than in training;
• athletes speed up at the end of exercise (the end spurt).
• skeletal muscle is never fully recruited during any form of exercise – 35-50% in prolonged exercise and 60% during maximal efforts.

To explain these and other observations, Noakes and his colleagues helped develop the Central Governor Model for fatigue.

The central governor – it’s all in your head

The essence of the central governor model is that fatigue is not a physical event but rather an emotion that is used by the brain to regulate exercise stress. An important implication is that all forms of exercise are submaximal since there is always a reserve of motor units that are never fully utilized.

Research shows that motor recruitment and fatigue during exercise will be affected by a huge variety of factors, including emotional state, mental fatigue, recovery from previous exercise, motivation, self belief, prior knowledge of the duration of exercise, cerebral and arterial oxygenation, muscle glycogen storage, fluid loss, thirst, heat, and more. In fact, “the prediction of this model is that potentially everything … can potentially affect athletic performance. But that the most important of these effects begin and end in the brain.”

Because fatigue is produced by the brain based on its opinions about what is going on in the body, it is subject to error, as noted by Bainbridge in 1919:

the sense of fatigue is often a very fallacious index of the working capacity of the body there is not necessarily any correspondence between the subjective feelings of fatigue and the capacity of the muscles to perform work. It is a protective feeling which tends to restrain the man from continuing to perform muscular work when this would cause injury.

In support of this idea, Noakes cites to evidence that athletes can be “tricked’ into working harder in numerous ways, such as deceiving them about the time or distance they have exercised, cooling hands and palms to make core temperature appear less elevated, or using a carbohydrate mouth rinse to fool the brain about the availability of energy reserves.

Although Noakes does not mention it in the article, the idea that the fatigue can be a “fallacious index” of actual body state has interesting implications for chronic fatigue syndrome. And there are some obvious connections to what we are learning about pain science.

The difference between winning and losing?

Noakes ends the article with some very interesting speculations about the differences between coming in first or second in an endurance event. Here are some excerpts:

In the case of a close finish the CGM was clearly successful – neither athlete died. But if the second runner did not die, why did he not run just a little faster and so approach death a little closer? For surely he could have sped up by just a fraction without dying? Yet he did not. Why not?

My unproven hypothesis is it is that in the case of a close finish, physiology does not determine who wins. Rather somewhere in the final section of the race, the brains of the second, and lower placed finishers accept their respective finishing positions and no longer choose to challenge for a higher finish.

…

According to this model, the winning athlete is the one whose illusionary symptoms interfere the least with the actual performance

…

the winner is the athlete for whom defeat is the least acceptable rationalization.

…

“The fight,” wrote Muhammad Ali “is won or lost far away from witnesses, behind the lines, in the gym, out there on the road, long before I dance under the lights.”

A little romantic maybe, but it rings true. If it’s all about physiology, then why does this race feel meaningful?:

Or this one (complete with Rocky music):

I love it.

For example Greg Lehman recently wrote a nice blog post questioning the use of foam rollers in the management of ITB pain, which provoked a response from Mike Boyle, a well known strength and conditioning coach and strong advocate of foam rollers.

What does the research say? Until now there have been few studies addressing the effectiveness of foam rolling in doing anything at all. But wait!

Brett Contreras has just posted on a new study which suggests that foam rolling can do something other than allow us to waste ten minutes of time writhing in pain. The study found that foam rolling the quadriceps increased range of motion. Even more interesting is that it did not lead to any decrease in strength that is typically seen with other techniques that increase ROM, such as massage or stretching.

While I was in the middle of writing this post, Bret posted again with a detailed critique of the study by Greg Lehman. It’s a great analysis, and its accompanied by some excellent comments from Bret about the importance of questioning everything, especially your own biases.

So Bret’s post unfortunately made most of mine redundant or useless, so I scrapped most of it. But I will retain a few brief thoughts related to the issue of whether foam rolling can improve “tissue quality” by deforming fascia or breaking up adhesions.

For me, the idea that we can alter mature connective tissue through the pressures provided by an elbow or foam roller has always seemed implausible on its face.

Fascia is the stuff that gives our body stability and holds it together. Could the body have really been designed in such as way that its basic structural stuff starts to break down every time it sustains a little pressure? Hopefully my body is made of stronger stuff than that. And if it isn’t, I’m not getting anywhere near a foam roller.

Of course, the research on the strength of connective tissue suggests that it has nothing to fear from a foam roller. As Paul Ingraham notes, if you want to change the structure of your connective tissue, you better be prepared to get medieval. For example, in this study, researchers concluded that deformation of dense fascia such as the fascia lata or the plantar fascia would require forces far outside the range possible in manual therapy. But the thin nasal fascia is apparently deformable. Perhaps “adhesions” are more in the nature of nasal fascia than plantar fascia, and are likely to be broken even if the stronger structures remain intact.

There is a lot more to discuss and debate here, and many questions, but I guess the one thing I want to make clear is that this study is not evidence that foam rollers cause any form of structural change to fascia.

Thanks for reading this far and let me know what you think in the comments.

I’m probably not getting all the details of the story right, but here’s the gist.

A chiro, accupuncturist and Feldy walk into a bar …

Years ago and far away, Richard shared an office with an acupuncturist and a chiropractor. For some reason an injured cat was brought into the office and there was some sort of contest to see who could successfully treat the cat. (I know, it sounds like the set up for a joke.)

Of course, the therapists soon learned that the cat wasn’t very interested in receiving treatment. It basically attacked them if they got anywhere near the painful area.

But Richard was eventually able to win the trust of the cat by approaching very slowly and progressively. He started with interactions that were the least threatening – ones that didn’t involve any touching at all. And then he moved on to some very gentle contacts in areas far from the site of pain. Eventually some sort of good thing came of that, such as the cat being happy, or Richard winning the bet. I forget. But the point is that wild animals don’t like getting poked and prodded where it hurts.

Soothing the savage beast

We tend to forget this, but humans are animals too. Even if we aren’t so wild anymore, we certainly have the same basic operating systems as wild animals, including the ones that determine threat, activate stress responses, control muscle tension and create pain. We just have better manners than wounded cats, and don’t hiss at therapists when they approach our sore spots.

Or maybe we have even been convinced that pressing on sore spots is therapeutic, and that we need to grin and bear it until the treatment is done. But just because a client is grinning and being a good sport doesn’t mean there isn’t an angry cat hissing and scratching under the calm exterior.

Humans don’t get to decide what they find threatening, stressful or painful any more than a cat does. That decision is left to ancient unconscious systems that can’t really be reasoned with. So when you are working with a wounded animal, wild or human, make sure you communicate with those prerational systems, and not just the surface ones that know how to make polite conversation.

Ironic footnote – Richard mentioned that he originally heard the phrase “treat your client like a wild animal” from one of his trainers – Frank Wildman.

That being said, it is definitely the case that in many sports, some very important events happen near the end ranges of motion and this may require some very specific preparation. For example, in my own sport, squash, players are called upon to repeatedly strike the ball with full force while in a fully stretched out deep lunge position. While most people have the flexibility to get into this lunge, it does take quite a bit of training to be able to get there quickly and then hit a ball with maximum force. In this post I’ll share some thoughts on how to improve power, speed or skill at end ranges of motion.

I will start with the recognition that all our movements are to some extent governed by the central nervous system.

The central governors

I have previously discussed the idea that the brain is a “governor” on strength. For example, too much strength is a potential danger to the body, so the brain makes sure it is only used in a manner that is known to be safe. Because of this, any form of training that makes you stronger can be understood as a way of “convincing” the brain that more strength is a good idea. We can look at flexibility, or any movement away from neutral, in a very similar fashion.

Too much flexibility is dangerous

The further a joint moves away from neutral into an extended position, the less safe it is. When a joint is in neutral, the connective tissues that hold it in place are on slack and not in any danger of lengthening beyond their capacity. The joint surfaces are well aligned and capable of absorbing compressive forces. The muscles are in a mechanically advantageous position to create or prevent movements. All of these factors are reversed when the joint moves into an extended position. Thus, any movement of a joint away from neutral is inherently threatening to joint integrity.

For example, extended ranges of motion that are safe at low speeds or forces can become dangerous when larger speeds and forces are applied. For example, while I may be able to easily stand with my feet wide apart, I would not want to land a jump in that position. Oh no.

So any movement away from neutral carries an inherent threat, and it is reasonable to assume that the brain is constantly taking measures to prevent potential damage. How does the brain protect against the threat of movements made in extended positions? Four obvious measures would be: limiting flexibility or strength, altering movement patterns, or creating pain. These are all undesirable outcomes. With that in mind, it makes sense to look at the threat of extended movements from the perspective of the brain. This might help you answer the question of how you can convince the brain that a particular movement at an extended range of motion is safe.

If I was my brain

If I was my brain, and I thought that joint damage would significantly impair my chances of passing my DNA to future generations, I might consider the following before allowing my body to get funky at an end range of motion.

First, I would want to be assured that any end range movements do not cause even the slightest hint of pain. This might be a clue that something very bad is about to happen.

Second, I would be suspicious of movements that are not familiar. Unfamiliar movements are guilty until proven innocent by many safe repetitions.

Third, I would fear movements that are not well coordinated. If balance is poor, if coordination is not there, if stuff happens I don’t expect, then that movement needs to be shut down. But If I can feel that a joint is well stabilized, moving accurately towards the target, and that the rest of the body is well-balanced and free to move for counterbalance and support, I’m going to interpret that as a safe situation.

Finally, and perhaps most importantly, I would want to know that the joint is capable of returning to the neutral position with some power and speed. In other words, that the joint knows how to return to home base quickly.

Based on these speculations, I might guess that my brain would be less threatened by end range movements that are familiar, coordinated, pain free and easily reversed back to a neutral position. And with that in mind I can develop a plan to train better movement at an end range of motion. Let’s take my squash lunge as an example.

Better lunging

First I would slowly and carefully get into the extended lunge position where I want to hit balls. I will make sure I am as comfortable as possible to convince my brain that it is safe.

Once there I will start to explore the position slowly and carefully to get familiar with it – to basically map out the whole area in as much detail as possible. For example, I could pay attention to how my hip feels if I shift my pelvis left or right, forward or back. I could ask the same questions about many other small movements in my foot, or chest, or shoulders, or head. Any movement of any other joint will have some impact on the comfort, stability or quality of the lunge, and the more my brain can become familiar with these subtleties, the better it will be able to build a clear “lunge map” that it can use to anticipate what may happen there.

Then I could spend some time adding some speed and force to the movements, like swinging a racquet at speed.

Then I could practice getting out of the lunge, or maybe show the brain through isometric contraction of the glutes or hamstrings that the extended muscles are capable of taking me back home.

After some practice, the movement should be familiar, coordinated, pain free and reversible, and therefore doable without an overprotective brain getting in there and protecting me from ever reaching a squash ball.

PNF, PIR, CR?

What about the many forms of stretching techniques that incorporate neurological “tricks”, such as PNF, contract/relax, post isometric relaxation, reciprocal inhibition, etc. In my opinion, these methods are essentially just ways to convince the nervous system that the movement is safe. For example, contracting the stretched muscle is way to show that the movement is reversible. Activating the antagonist to the stretched muscle is way to show that the movement is controlled. Other movements are a way to map the joint and get familiar in the position.

If you follow my approach of treating the central nervous system as an intelligent and overprotective mother (as opposed to a dumb set of reflexes that can be fooled with some tricks) than you are bound to get the benefit of all the above techniques. And more. (And without having to remember a bunch of acronyms for your stretches and the names of stretch reflexes.)

What do you think? Is it foolish to anthropomorphize the CNS? Leave a comment below. And share the article if you liked it.

Flexibility defined

Flexibility is basically the range of motion at a particular joint – how far it can move from A to B. I like to think of flexibility as the quantity of movement, because this is a good reminder that it tells us nothing about the quality of the movement. The quality is defined by other factors such as speed, strength, power, or control. For most functional purposes, quality of movement is far more important than quantity.

Most sports require only average flexibility

Imagine you took an assortment of elite athletes into a lab and measured their physical qualities to determine what makes them great. You might find that they had exceptional levels of strength, power, endurance or balance. But their flexibility would probably be pretty average. For the most part, athleticism is not about how large your range of motion is, it’s what you do with the range you have.

The vast majority of movements in sport take place within ranges of motion easily achievable by the average person. If you watch football, soccer, tennis, or basketball, you rarely see unusual displays of flexibility. You can prove this for yourself by looking through pictures of athletes in action. You can probably mimic almost all the joint positions displayed in the pictures. Of course you probably cannot move into these positions quickly, powerfully, smoothly, painlessly, accurately, and with the coordinated activity of other joints. But these deficiencies usually have nothing to do with range of motion. These are issues of strength, power, mobility, or coordination, not flexibility.

More isn’t better

But all things equal, isn’t more flexibility better than less? Not necessarily. It is plausible that increasing range of motion could have negative effects on certain aspects of sports performance. For example, studies show that flexibility in the muscles of the posterior chain correlates with slower running and poorer running economy. Of course, this does not prove that increasing hamstring extensibility would slow you down, but it definitely doesn’t make me want to do some hamstring stretches as a way to improve my running.

Looks aren’t everything

Of course there are some sports or physical activities where high levels of flexibility are required. I find it interesting that many of these activities involve an aesthetic element, such as dance, gymnastics, diving, or certain forms of martial arts. There is something about a large range of motion that is very pleasing to the eye, and this is why we see dancers, gymnasts, and Jean Claude Van Damme getting into the splits a lot. But you won’t see the splits very often in sports where there are no points awarded for style. Of course there are exceptions, but for the most part, if you tell an athlete what to do, and not how to look while doing it, they will choose to move in a way that does not involve extreme ranges of motion.

Flexibility and injury

One common rationale for increasing range of motion at a joint is to prevent injury from overextension of the joint, such as a pulled muscle. So for example if you want to be able to prevent a groin strain, you would try to increase your range of motion into hip abduction. This makes sense in theory but the evidence in support appears weak.

Prospective studies looking for correlations between preseason flexibility and in season injury rate show only mixed results. For example, two studies on soccer players and hockey players show that players with more flexible groins do not suffer fewer groin injuries. Interestingly, the players with stronger adductors had less strains. It should be noted that there are a few studies showing that preseason flexibility in the groin or hamstring does correlate a little the rate of muscle pulls in the season. But these are only correlations. It is a big jump to conclude that the reduced flexibility was the cause of the injuries. My guess is that some unmeasured third factor, like adverse neural tension or poor strength at the end range of motion caused both the reduced flexibility and the injuries.

Further, we also know that stretching seems to do nothing to prevent injuries, and if we believe that it increases range of motion, we must also conclude that any increased range of motion caused by stretching is useless in terms of injury prevention.

Conclusion

For most athletes in most sports, there is probably little to be gained by increasing flexibility or range of motion. Of course there are exceptions, but the bread and butter for movement is in the neutral zones, and this is where you should direct most of your efforts. It may very well be that you need additional control or strength at a particular end range of motion, but again this has nothing to do with flexibility. It is a specific form of strength or mobility, to be developed by spending some time at that range of motion, and practicing whatever it is you need to do there, e.g. apply force, move quickly, move other joints, etc. I will talk a little bit about how I do that in my sport, squash, in the next article. I know, huge cliffhanger, you can hardly wait to hear about squash training. You’ll just have to be patient.

I’ve written several times before on this blog about how unilateral exercise can have significant effects on the contralateral side. I find this interesting not just because it’s kind of cool but because it is an elegant way to prove the extent to which adaptations to exercise are central as opposed to local. I’ve also written about how stretching seems to suck. Well I recently read a study which shows that stretching is good for something, and that it can have cool effects on the opposite side of the body. Here’s a brief discussion of the study.

Researchers asked subjects to stretch their right calf muscle 3 times per week for 10 weeks. After this time, subjects experienced an 8% increase in range of motion at the ankle, as well as a 29% increase in the one repetition maximum strength at the ankle. They also gained 11% greater 1RM strength on the contralateral leg, which didn’t do any work at all.

Nice job stretching!

Interesting information to keep in mind next time you are trying to preserve strength and/or range of motion in an injured limb during a rehab period.

Update: There are some interesting discussions on Facebook about what this study means. Tony Ingram has offered his opinion here, most of which I agree with. Here is one of my comments:

To me this is just a curiosity, or a little hack or trick, not something I think will change the way people train. But I do think it illustrates a general principle that is very applicable – that strength and other qualities we assume to be local are in fact more centrally governed than we imagine, and the governor can be effected by a wide variety of factors, including simple sensory feedback.

I don’t have the full text of the paper but a summary prepared by Chris Beardsley and Bret Contreras states that one of the mechanisms for crossover in the case of unilateral strength training is thought to be modulation at the spinal cord level. For example, unilateral electrical stim has a crossover strength effect. So they wondered whether stretching would do the same as the stim. And it did. Cool, but it won’t get me stretching.

What do you think? Let me know in the comments below.

The subjects were soldiers entering a 16 week training program to become combat medics in the U.S. Army. They were between the ages of 18 and 35 years old and had no prior history of low back pain. The soldiers were doing divided into 4 groups: traditional exercise; traditional exercise with “psychosocial education”; core stabilization exercise; and core stabilization exercise with psychosocial education.

“Traditional exercises” basically meant situps, rotating situps and crunches. “Core stabilization exercise” was designed to target the notorious transversus abdominis and multifidus, and was comprised of abdominal draw ins, side planks, flexor squats, bridges and quadruped “bird dogs.” Both groups did 5-6 exercises for one minute each, every day for 12 weeks. It should be noted that in addition to these exercises, all the groups did the daily physical work that is part of the training and assessment of the soldiers. Which included situps. Hey, it’s the army.

The “psychosocial education program” was one 45 minute session providing evidence-based information on low back pain designed to reduce its threat value and encourage active coping strategies.

After the program, the soldiers were off to Afghanistan, Iraq and elsewhere. And two years later researchers measured who sought healthcare for low back pain and for how long.

Of all the soldiers, 17% sought healthcare for low back pain. Core stabilization exercise had no protective effect. But the groups that received education had 3.3% less low back incidence over the years.

So what can we conclude? That education rules and core stabilization drools? Well maybe so but I don’t see this study as any great proof of that fact. The education group had only a small protective effect, meaning that you would need to educate 30 people before expecting even one less to seek healthcare for low back pain.

And, we need to remember that the study didn’t measure low back pain, but visits to the doctor for low back pain. There’s a big difference, particularly in light of the fact that one of the very things the education group learned was that doctors aren’t very good at finding a cause for back pain, and that they should employ active coping strategies. Of course these guys went to the doctor less, they were told doctors can’t help. Did they also have less pain? Maybe, but we don’t know.

Further, before we decide that this study provides strong evidence that core stabilization exercise is useless, we need to consider the context in which the exercise was used – in a sea of situps, pushups and other activities that would be expected to have a large effect on low back mechanics good or bad. For example, maybe all those situps made their backs as resistant to back pain as they could get, so that core stabilization could add no further benefit. Or maybe the sit ups were bad, and the core stabilization would have worked much better if those recruits didn’t have to do so many repeated spinal flexions, like some pig spine in Stu McGill’s lab.

Finally, one of the primary justifications in favor of core stabilization exercise is that it useful to activate muscles that  have somehow become sleepy with the onset of low back pain. But this group did not have a previous history of back pain, so there was no opportunity to test the purported merits of core stabilization training in this context.

So what can we conclude from this? At a minimum, that pain education is probably a good thing. And, in a group that is already healthy and getting a good dose of general exercise, maybe it’s the best thing we have. Or maybe not.

What do you think? What did I miss? Let me know in the comments.

Why skeletal shape matters

The shape of the bones at a particular joint will determine the neutral position for that joint. I am going to define “neutral” as a mechanically optimal position for a wide variety of functions, such as moving in any direction, or being capable of sustaining heavy compressive forces with maximum stability and safety. For example, when the shoulder joint is in a neutral position, the ball of the humerus is well located in the socket of the scapula so that arm can move left, right, up and down without running out of room in the joint or impinging bone on bone. And it can withstand a compressive force down the shaft and transfer it to the scapula with a minimum of shearing forces and risk for damage.

Optimal alignment or posture for a certain function is partly a result of having as many joints in neutral as possible at any one time. And the shape of the bones will determine how many of your joints you can keep in neutral at the same time in a particular functional task. Here’s a very simple example. An internal tibial torsion means that the shape of the tibia bone tends to twist inward as it moves down from the knee to the ankle. If this is the case, then it is impossible to have the knee and ankle pointing directly forward and in neutral at the same. Any effort to point the knee directly forward will tend to point the neutral ankle a little inward, causing pigeon toes.

Another commonly identified bony variation is hip anteversion. Someone with hip anteversion has a particular angle of the femoral neck which causes the lower end of the femur to rotate inward while the femoral head is centered in the hip socket. A person with an anteverted hip will stand with their knees pointed inward, and be able to demonstrate a large range of motion into internal rotation with very little external rotation. This makes it very easy for them to sit in the “W” position.

Personally I have the opposite situation – my hips are relatively retroverted. This makes it impossible for me to do various movements that require a significant amount of internal rotation at the hip that I can see other people doing quite easily. My sensation as I try to do these movements is not that any muscular tightness is preventing me, but instead that I would literally have to dislocate some joints to do the movements.

Of course, these bony asymmetries are not “conditions” that you either have or you don’t. They all exist on a spectrum, and they are not limited to the tibia and femur. Every bone in the body can be shaped relatively closer or further from an optimal shape for certain functions.

Based on this logic and my own observations with clients and myself, the shape of the skeleton is a huge determinant of functional or athletic ability. I think part of the reason we can recognize a great athlete by a few simple movements is not just the quality of their function but the quality of their structure. An optimal skeletal structure makes it quite easy and natural to place all of the joints in neutral positions at the same time. People with skeletons that do not allow them to do so must make compromises, and these reveal themselves in suboptimal alignment, decreased ranges of motion, and reduced efficiency.

Practical implications

So what can we do with this information? Other than form some plausible excuses about our athletic failures? (which I find particularly appealing).

First, we should be very wary about anyone dictating to us what proper form is in regard to a particular activity without considering our individual variations in structure. Let’s go back to the example of tibial torsion to understand why. It is commonly recommended that proper alignment of the foot and knee in running, walking, standing or squatting should involve the knee and the foot pointing in the same direction. This is certainly a good guideline, but let’s look how it plays out in the case of someone with a tibial torsion.

If you have a tibial torsion you cannot have both the ankle and knee pointing directly forward while both joints are in neutral. Perhaps you can achieve this by taking one or both joints out of neutral, i.e. positioning one joint closer to the end range of motion on one side than the other. This arrangement of the bones might look good in a picture or be appealing to a coach who is overly concerned with alignment. But it will probably have several drawbacks: it might require extra muscular effort to hold the joints away from neutral; it will reduce the available range of motion in at least one direction; it will reduce the ability of the joints to bear compressive forces. These negative factors may very well outweigh any positives gained by getting the knee and foot to point in the same direction. Of course we can think of similar scenarios in regard to any joint and the advice that is commonly prescribed in regard to the optimal alignment of that joint.

And here is where I diverge into one of my many sidelines on why I like the Feldenkrais Method. The Feldenkrais Method attempts to teach coordinated movement not by dictating any particular form or alignment, but by allowing the student to determine this issue for themselves based on their own experiments. The idea is to create the circumstances for the student to play with different forms of alignment or body use, assess the relative outcomes, and then make their own choice. This will hopefully result in the student gaining more awareness about which movements are optimal for their particular structure. This will lead to a more individualized and authentic movement pattern than one imposed top down by a coach according to some Platonic ideal.

What about trying to change the shape of the skeleton? The shape of the skeleton is not that changeable after maturity. Of course it will change slowly. According to Wolf’s law, bones will tend to remodel along the lines of stress caused by compressional forces and pulls from the muscles. But this is of course a lengthy process that takes many years. And there are probably not many people that have the discipline or skill to strategically apply targeted stresses to their bones frequently enough and long enough to affect significant changes in their skeletal shape over the course of time. So in other words, the skeletal shape you have as an adult is one that you will probably be living with for some time. Deal with it.

What do you think? Is this post just a way for me to whine about my tibial torsion and retroverted hips? Leave a comment and let me know.

If you enjoyed this article, maybe you will like this one, about visualizing the skeleton while moving, or this one about the obsession with symmetry, which is a guest post I did at Saveyourself.ca.