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I have previously written a series of articles about the study of adverse neural tension and nerve mechanics. If you are not familiar with the idea of adverse neural tension and you want to understand why somethings hurts, you should definitely give these a read.

Anyway, I just saw a study (hat tip to Michael Reoch) which relates to an important point from this series – namely that adverse neural tension may play a role in many pains that are commonly attributed to other sources (such as hamstring strain.)

Some background

In case you didn’t go back and read those old articles, here is a brief review of some basics concepts related to adverse neural tension, how it causes pain, and how to detect its presence.

The nerves of the body cross many joints as shown in the picture to the right. As such, they need to slide, bend, elongate and withstand compression as the body moves. This motion is normal and helps keep the nerves healthy.

However, many of these movements, particularly ones that elongate or compress the nerves, will restrict blood flow. This causes stress at low levels of intensity and duration, and damage at higher levels. Nerves can become sensitized to this stress under certain circumstances, such as the presence of  inflammation or preexisting physical damage. In this event, normal ranges of motion can cause pain, numbness, tingling or other signs of nervy distress – this is called adverse neural tension.

A great way to determine whether certain symptoms result from adverse neural tension or mechanical stress to some other structure is to use the process of “structural differentiation.” This basically involves using a movement to cause some sort of pain, then moving a joint far from the area of pain to relieve tension on the nerves in the painful area (but not other structures) and see if this eases the symptoms.

Here is an example you can do on yourself quite easily. Move into a forward bend to touch your toes while moving your head and neck to stare at your navel. This lengthens the continuous line of tension of the nerves from the head to the feet through the spinal cord and sciatic nerve. When you go low enough, you may feel a familiar pain at the back of the knee. Or perhaps you will feel some other undesirable symptoms elsewhere, such as the low back.

To determine whether these symptoms are the result of adverse neural tension, you can release tension on the nerves in the low back and hamstring area by moving the head to look upwards while keeping the rest of the body in the same place. If this relieves symptoms at the hamstrings, the inference is that they were caused by tensioning the nerves, because these are the only structures in the knee or low back that would have been affected by the head movement. You can play with moving your head up and down to feel how releasing and increasing tension on the nerves form above affects how you feel below. You may convince yourself that these are the true “anatomy trains.”

The study

With that background, let’s look at the study, which tried to determine the extent to which adverse neural tension was present in 14 rugby players previously diagnosed with grade one hamstring strain.

Researchers asked the players to do the slump test, which is fairly similar to the test described above. A little more than half of the players had positive tests, compared to zero players in the control group. Based on this result, it is reasonable to guess that adverse tension is likely to be present in someone previously diagnosed with hamstring strain.

This leads to some interesting questions about the causative relationship between neural and muscular pathology in the case of pain in the back of the thigh. First, was there ever any actual hamstring strain in the first place? If so, was it caused by preexisting issues with neural mobility? Or did damage to the hamstring and associated inflammation and fibrosis limit neural mobility? The study was unable to answer those questions, but it does make clear that people looking to fix “hamstring” issues should consider the possibility that the real issue is with neural mobility. For some basic ideas on how to increase neural mobility, see here.

Or, if you are old school and aren’t interested in this new fangled neurospeak, then watch the video below for an excellent demonstration of how a dynamic warmup can increase power, athletic performance, and help prevent “pulling a hammy.”

Some definitions

My definition of exercise is that you move in some way that puts the body under enough stress to provoke a compensatory adaptation, such as making a muscle bigger, or more capable of generating energy. The best exercise is simply the one that applies the right type and amount of stress to get the sort of adaptation you want without hurting yourself in the process.

Motor Learning means you move in some way that provides the brain with experiences that will teach it how to move the body with more skill, coordination or efficiency. This process is far more complex, subtle, and individual than exercise.

The purpose of this post is not to argue that one process is more important than the other. Of course each is a very valuable tool in helping you improve your physical function. My point is that understanding the differences between these two tools is a good way to decide which one is right for the job you have in mind.

Of course, the line between exercise and motor learning is not always totally clear, and most workouts will have elements of both. Doing pushups or pullups, or squats or lunges place the body under stress in a way that will stimulate adaptations in muscle performance. They will also place demands on good balance and coordination, so doing them will teach you something about how to move more efficiently. “Functional training” might be considered as an attempt to combine exercise with learning along these lines. But there are other approaches to physical training that try to keep learning and exercise as separate as possible. The rationale here is that there may be a tradeoff between the two, so that excessive focus on one will tend to compromise the other, and neither goal is accomplished very efficiently.

Feldenkrais: all learning no exercise

The Feldenkrais Method is concerned exclusively with learning and not exercise. That is why Feldenkrais referred to his work as “lessons” and his clients as “students.” One common feature of a Feldenkrais lesson is minimizing physical stress, because stress interferes with the learning process. Imagine how hard it would be to learn to play the piano if you were hitting the keys as hard as possible and jogging in place during practice sessions. Or to use a less ridiculous example, imagine trying to learn proper squat form with a weight heavy enough to hurt you if you make a little mistake. Not an optimal learning environment. So the movements in a Feldenkrais lesson are typically done as gentle and slow and easy as possible. Other similar training methods would include Alexander Technique and some forms of tai chi.

HIT: all exercise no learning

High Intensity “HIT” style weight training takes the complete opposite of this approach, focusing exclusively on safely stressing the muscles. This is done in part by minimizing the necessity of using any skill to perform the movements. This is why HIT advocates often prefer machines to the use of free weights or other exercises that require more skill and balance to perform. For example, in a squat or lunge you must use proper form, and you risk injury or even falling over if you don’t:

But on a leg press machine all your joints are stabilized and the path of movement is controlled by the machine. So all that’s left to do is focus on pushing as hard as possible – you are not distracted by concerns with safety, proper form, balance, etc. So you maximize the exercise stress by minimizing the skill demand.

The middle ground

As I said earlier, most forms of training fall somewhere in between these two extremes, incorporating elements of physical stress and skill acquisition in the same workout.

For example, running leans more toward exercise stress than motor learning. But running is also a lesson in efficient gait, perhaps especially so if you pay attention to form.

A yoga class leans more toward the development of good movement skill and body awareness, but some classes shift the focus more toward creating exercise stress (often at the expense of any beneficial learning).

Functional training done properly is a nice combination of skill and exercise stress. But sometimes it is biased too much in favor of developing (useless) movement skills, say balancing on a swiss ball while doing squats. In this event, it can degenerate into a circus act, where you have to choose between being safe and while using a tiny amount of weight, or using more weight and killing yourself in the process. Check this out:

The risk/reward here looks rather poor.

I think that part of the reason exercises such as squats, deadlifts, lunges, pullups and pushups have stood the test of time is that they are a nice combination of skill and stress, and a good way to get a large bang for your buck in the gym with a minimum of time and effort. Of course many people will not benefit from these exercises for one reason or another, and might be better served by a program that keeps skill training separate from exercise and vice versa.

What do you think? What type of training program do you prefer? Are these useful distinctions? Let me know in the comments.

The top pic is a cross section of the thigh of a 40 year old triathlete. The bottom is a triathlete at 70. The middle is a sedentary 74 year old man.

Notice any differences? I bet these legs look a LOT more similar on the outside.

The whole study is available for free here. Thanks to Alex for pointing this out.

Hell no. The brain is designed for movement, and movement is what wires it up. To grow a child’s brain, give them a safe place to play.

Here’s an amazing video of Charles-Edward, a nine month old boy who knows how to go to work. Check out what he does when given four hours to play in a room full of toys. Filmed and time lapsed down to two minutes by his father Francis:

Beautiful. Well done Charles, you are well on your way to world domination.

What may look like chaos here is actually a series of highly controlled movement experiments performed one after the other by a master scientist. Every second Charles is making a plan, checking the results, comparing the resulting data to expectation, and then making adustments for the next round of experiments.

Thanks to Francis for making this beautiful video and to Irene Gutteridge, the creator of the baby liv video for pointing it out.

A new study shows that altering posture can also have effects on strength and pain tolerance.

In the first experiment, participants who assumed a dominant posture displayed higher pain tolerance than those in submissive postures.

In the second experiment, subjects had differing strength and pain tolerance levels depending on whether they interacted with a partner who used either dominant or submissive posturing.

For example, if a subject was paired with a partner with dominant body language, this encouraged the subject to adopt a submissive posture in response, which made him weaker and less pain tolerant.

Remember this next time you hire a buff alpha male as a personal trainer.

Hat tip to Diane for the study (again.)

The myth of the pink dumbbell

Many people use the word “toned” to refer to muscles that appear attractively fit, defined and healthy without being too bulky. Women are usually more interested in toned muscles than men, who are typically not averse to the development of conspicuously bulging muscles.

The most commonly prescribed exercise to make you “toned” is high repetition resistance training with a relatively light weight, preferably colored pink. Part of the reasoning here seems to be that using large weights would give an undesirable bulky look to the muscle (which apparently would be permanent). An unspoken rationale for the high reps is that this will lead to fat loss around the area of the working muscle.

Let’s clarify why this reasoning is misguided on several levels.

What toned really means

First, the real meaning of the word muscle “tone” has nothing to do with the size or definition of a muscle. Tone means the degree of its continuous, involuntary and very small contraction during rest. And this has absolutely nothing to do with the way a muscle looks. For example, a properly pumped up bodybuilding champion might have less tone in his pecs than me as I sit here typing this post.

So the difference between a toned and untoned bicep is not illustrated by comparing the arms of Jennifer Aniston to Oprah Winfrey. It is the difference between being fast asleep and using a computer mouse. Which by the way is probably just as good a workout for your bicep as many of the arm “toning” routines you may find recommended in many magazines.

How exercise affects muscle appearance

So if exercise doesn’t “tone” muscles, what can it do to change their appearance? There’s only two things that a muscle can do to change it’s appearance – get smaller or get larger. Despite what is often claimed by many pilates or yoga gurus, exercise does not lengthen muscles to give you the “long graceful shape of a dancer.” Think about it – to make a muscle longer you would have to pull apart the bones where the muscle endpoints attach.

And to make your muscles bigger, high rep light weights won’t cut it. If you can do more than thirty reps of a particular exercise, you probably aren’t using enough resistance to increase the size of the working muscles. I have seen many magazine articles illustrating muscle “sculpting” exercises with a weight no heavier than a purse.

The unspoken rational for low weight/high rep exercise is that it will make the muscle look more defined by reducing fat around the muscle. This is the fallacy of spot reduction, which is impossible as described below.

The myth of spot reduction

Weight loss occurs as a result of a caloric deficit – expending more energy than you take in. Assuming a deficit exists, fat will be burned all over the body – not just in the specific local area where the exercise was done to help create the deficit. In other words, no matter how many arm curls you do, this won’t lead to any more fat loss around the arms than any other exercise that burns a similar amount of calories.

Muscles look defined simply because there is not that much fat around them. Increasing muscle definition is a simple consequence of losing fat all over, not doing magical exercises in the areas where you want definition. Therefore, if you lose enough weight, you will have a six pack regardless of whether you have ever done a crunch in your life. And all the crunches in the world will not reveal even a one pack if your body fat percentage never drops below the required level.

So next time you open a fitness magazine, notice how many times you see these myths exemplified. Then throw the magazine in the trash.

One day last summer at the playground with my five year old, I was watching kids effortlessly land jumps off various structures. I decided that landing a jump is a very fundamental movement skill that I had neglected and could stand to improve.

The reason I had avoided this movement for a while is that it makes my knees a little tender and sore. Landing a jump requires absorbing a lot of force at the knee. My common experience is that a lot of aggressive changes of direction from either landing a jump or cutting in sports can make my knees feel a little stiff and sore. It’s not a big deal, just enough to feel it a little when climbing stairs and training the day after.

So when I approached this movement I decided to be very careful, grade my exposure, and try brushing up on my skills in the absence of any major forces or stresses. To do that, I started with just dropping into a squat quickly as opposed to jumping.

I also changed my technique. I noticed that the kids at the playground usually land jumps with the trunk angled forward as opposed to vertical, which increases the work at the hip muscles, and brings the hands closer to the ground where they can absorb some of the force. All this takes pressure off the knees.

So on each landing, I made sure to slap the ground with my hands to absorb some force, even on the tiniest jumps where I didn’t really need it. It felt a little floppy and uncontrolled, and I looked just like my one year old when she was falling forward onto her hands about 400 times per day while learning to walk.

But it worked. This removed a lot of pressure from the knees, and felt really good. I started increasing the height and intensity of the jumps, and within minutes I was comfortably landing jump from heights I hadn’t jumped from in at least ten years. With no knee tenderness at all.

Within another few minutes I had completely forgotten about the idea of taking it easy and was jumping all over the place with foolish abandon, not paying any attention to my knees at all. At the end of the session, the dumb part of my brain thought I was immortal, and the uptight worrying part thought my knees would pay the price for a day or two.

Later that day, I noticed something interesting. As I was climbing stairs, I noticed that my knees felt better not worse. They felt stronger and springier. I decided to test them a little with some sporting cuts and they felt better there too. I actually felt younger and stronger. Why was that?

Here is my explanation.

Obviously not enough time had passed for the structure of the knee to have changed at all. Warming up is not really a good explanation either, because I do not get the same effect from warming the knees thoroughly by other means. In fact, all the work with the knee musculature should have made them weaker not stronger and maybe even a little inflamed.

Maybe I changed my motor control patterns at the knee, making it more efficient? Possible, but I’m not convinced. I do all sorts of coordination work at the knee and it is very beneficial, but has never resulted in this type of feeling.

I think what happened is that the training session didn’t so much teach my brain new movement skills, but convinced it that certain movements were safe to do.

Pain (and weakness) at a joint results from the brain’s opinion that the joint needs to be protected. There was something about my training session that convinced my brain that my knees were not as old as they thought they were, that they didn’t need as much protection as they were currently getting. So it gave me a longer leash to play with. This is why each training session should always send a little good news to the brain about the state of the body.

What do you think? Have you ever experienced something similar? What kind of news is your exercise sending your brain?

Let me know in the comments.

Here are the details:

What

The classes are designed to improve coordination of the spine and ribs. In that regard, each lesson will focus on a basic movement of the trunk, such as flexion, extension, rotation, side flexion, etc. These are the fundamental building blocks upon which all our movements are built. Thus, if you get better at any of these basic movements, you will improve all the other movements which are built on this foundation, which is to say everything you do physically.

If you want to know what an ATM lesson is like, you can do some free samples here.

When

Classes will be held Tuesdays evenings from 5:30 pm to 7:00 pm, from January 31 through February 28.

Where

Classes will be held at Room 36 on the second floor of the brick building of the Phinney Ridge Community Center at 6615 Dayton Ave. N, Seattle.

Please note that the community center has two buildings – a blue building at street level on Phinney, and a brick building down the hill with its own parking lot. You want to go to the brick building. Directions to the brick building are here.

Cost

The cost is $10 per class or $8 per class if you want to pay for all five in advance. The classes build on a common theme but each can be done separately.

To sign up

Just show up. But space is limited, so if you want to make sure there is space, contact me here.

Some stats

About a year ago, Better Movement averaged about 4,500 page views per month. It looks like the year will end with an average of about 16,000 page views per month.

There are now more than 1,000 subscribers of various kinds and my Facebook page went from non-existent to 330 fans in the last six months.

Overall, I’m pleased with the progress.

Products

In July 2011 I released my first product, an e-book along with four Feldenkrais lessons called Better Core Movement. I’ve received a lot of positive feedback which is very nice to hear. In the next six months I hope to finish two new similar products: Better Movement for the Hips and Better Movement for the Shoulders.

Social Life

The most exciting thing about 2011 was getting to interact with several other excellent blogs and sources of online info.

In April, Mark Sisson of Mark’s Daily Apple listed Better Movement as one of 18 Underrated Blogs You Should Be Reading. That was quite an honor, because MDA is one of the top fitness/health blogs in the world. And, I was in very good company – all the other blogs on the list are really top notch.

Paul Ingraham of SaveYourself did a few excellent guest posts, and I did some mediocre posts at his site. Paul is one of the best sources of evidence based information on the internet concerning treatment of musculoskeletal pain.

Chris Highcock at Conditioning Research did several posts pointing to my articles. Chris’ blog was just deservedly named one of the top ten best by Outside magazine.

I also got to do a guest post at the Perfect Health Diet blog, run by Paul Jaminet. This was especially pleasing because I am a huge fan of Paul’s writing and ideas.

Diane Jacobs was kind enough to reference many of my posts at her amazingly useful Facebook page: Neuroscience and Pain Science for Manual Physical Therapists.

Finally, I was privileged to interact with many intelligent, well informed people in the comments section of this blog and on Facebook and other places. Thanks everyone for your contributions.

Plans for 2012

My main goal with this blog is to be part of helping to affect a paradigm shift in the manual therapy and fitness world away from treating the body like a mindless piece of meat and towards an approach that is more consistent with what we know from evolutionary biology, neuroscience and pain science. This shift is a long time coming and has many years to go, but I see lots of progress in the last year or two. Check out my blogroll to find the sites that I think are at the forefront in this regard.

It’s exciting and meaningful to be part of a community that is passing around useful information and generating new ideas through research, experimentation, debate, and just plain old shootin’ the shit. I look forward to more of the same next year.

Happy New Year, good luck with your movement in 2012, and thanks for reading and sharing!

Simply unbelievable. I posted another video of the same guy here.