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Archives For November 30, 1999

PROVE IT! Part 2 (Why I’m not bothered by ‘Back Pain Myths’)

December 7, 2013 — Leave a comment
courtesy of encyclopaedia.wikia.com

courtesy of encyclopaedia.wikia.com

I recently wrote a post which was in response to a review of “Becoming A Supple Leopard” by Kelly Starrett. The reviewer took issue with both the lack of reference to scientific studies within the book, and Starrett’s failure to refer to current pain science (by looking only at postural/structural/biomechanical causes of pain). The same theme cropped up in an article called “Back Pain Myths: Posture, Core Strength, Bulging Discs” from the website ‘Better Movement‘.

“Back Pain Myths” states that the majority of physical therapy and corrective exercise done in the USA is based on incorrect assumptions, and concludes a consideration of the evidence for each ‘myth’ as follows: “..there is little evidence to support the idea that we can explain pain in reference to posture or that we can cure pain by trying to change posture..”; “…if a large percentage of pain free people have bulging discs, then how likely is it that a bulging disc is the cause of your back pain?”; and “..the current evidence states that there is nothing magic about core strength as means to prevent or reduce back pain…”. It is not surprising that some might take this as an attack on their practice.

There is no doubt that pain is a very complex subject, and that, especially in the case of chronic pain, the sensation of pain may not be caused by an injury, postural fault, or structural defect. It seems to be clear too that there are many people who have a disc bulge (or several disc bulges), without any symptoms at all. If nothing else this would seem to be good grounds not to rush into a surgical procedure if you are diagnosed with a disc problem. I can’t argue that Todd Hargrove (the author at Better Movement) doesn’t make some legitimate points – it is always good to have our beliefs and assumptions challenged – and we shouldn’t fall into the trap of letting popular wisdom become dogma.

A typical example of the ‘Back Pain Myths’ content is reference to various studies that fail to show any link between poor posture and pain (and it is interesting to read that other studies show a stronger correlation between back pain and stress levels, job satisfaction, exercise etc). Hargrove does refer to a study that seems to suggest a link between poor posture and pain, but hastens to remind us that: “it is important to remember the rule that correlation does not equal causation“. I like this mantra and am inclined to repeat it quite often myself. However, it is perhaps also worth mentioning that non-correlation does not equal non-causation – if a study fails to find a link between one thing and another it does not mean that there is none (I think that this idea is more normally expressed as: absence of evidence does not equal evidence of absence).

Again, we’d be foolish to pretend that someone’s pain isn’t an intricate tapestry, but I’m not inclined to feel that the foundation of the way that I work is being critically undermined by articles such as this. Dysfunction, poor movement patterns and stabilising strategies may not cause someone pain now, but they may cause tissue damage that could result in pain at a later date, or have a knock-on effect on a nearby structure that may become the cause of pain. I know, there’s a lot of ‘may’s in that last sentence, and I believe that’s partly because it’s very difficult to conduct meaningful studies on humans. That is to say, it is probably impossible to account for every variable between study subjects (even if we were to be able to treat humans as we treat beagles, chimps etc.), so we cannot expect any studies of pain triggers, or potential treatments to do better than show some correlation – and we know the rule about that.

I believe that the majority of studies that have been conducted would seem to indicate that exercise of nearly any kind (shall we just say ‘movement’?) is helpful for back pain sufferers, and one kind of movement doesn’t seem to be better than another. I don’t think it matters that we cannot prove the efficacy of a movement discipline, if the result is that people increase their awareness of their own bodies and thereby move and position themselves in a ‘better’ way than they were previously able to. Another thing that would be very hard to study is how the sense of empowerment from a movement practice might impact someone emotionally or psychologically, and thereby have an effect on pain sensation. Failure to prove these things does not make us charlatans.

To return to ‘Back Pain Myths’, I have to acknowledge that Hargrove’s article finishes with questions: “why do these approaches seem to work; how can so many people be wrong; and if these aren’t the true sources of pain, then what is?” So, despite the lack of science, he acknowledges that ‘these approaches’ (from the article we must assume that he refers to making postural improvements, surgery, and core stability training) seem to work. Interesting… Reading further, Hargrove turns out to be a fan of Eyal Lederman, who wrote a famous/infamous article entitled “The Myth of Core Stability” which, for me, speaks volumes about his outlook. You can easily find “The Myth of Core Stability” with a search of the internet if you wish (I tried to include a link but each time I tried to open a page I got an automatic download and, trust me, I’ve more copies of this article than I need). Lederman does an, apparently, able job of rubbishing the notion that there is such a thing as core stability, provided you accept that he fails to actually define what ‘core stability’ is, and doesn’t include an explanatory quote from any of the practitioners whose work/theories he questions. (I’m no lover of the term ‘core stability’, and I suspect this is true of most Pilates teachers. At the same time, I can’t fault anyone for trying to understand and explain how our brain controls our muscles and movement. I’m inclined to think that they are engaged in trying to find explanations for things that Joseph Pilates, for example, recognised as being true without the need or equipment to figure out why.) Lederman’s article is full of scholarly references, and he undermines the theories of those he calls ‘CS practitioners’ by means of those references to conflicting evidence. That SCIENCE trump card again. (One of those studies, at least, involved methods of testing trunk stability hilariously far removed from a ‘real-life’ situation).

Hargrove is a Rolfer and Feldenkrais practitioner. Lederman is an Osteopath. I do not wish to disparage any of these practices, but/and I’ve found it very difficult to track down any proof for their efficacy, or superiority to other practices, on PubMed, or any other websites. Yes, pain is undoubtedly a complex subject, and it is a very good idea for anyone working with people in acute or chronic pain to be aware of current theory. We cannot overlook the psychological/emotional component to, particularly, chronic pain. A very recent experience of mine (anecdotal, sorry) seemed to show that helping someone to understand how to effectively stabilise their midline (core, if you wish) had a positive impact on their confidence, and sense of self-worth, which had been seriously undermined by back pain. Yes, it only ‘seemed’ to help – I cannot prove it, and I don’t suppose the person in question would feel the need to have proof.

If people may be being routinely harmed by a practice then there is clear reason to question it. Does this mean that an unproven movement practice should be avoided, or that it is invalid? Er, NO.

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Pilates, from the ground up?

November 1, 2013 — Leave a comment

71064I have heard Kelly Starrett describing functional movement as ‘a wave of contraction from core to extremity’. This seems to fit very well with the theory of local and global muscles. The idea that we need to stabilise our spine prior to loading/moving is embedded in Pilates. It is easy, too, to find ‘scholarly articles’ on the internet (Paul Hodges, to name one author) exploring this idea, and correlating poor stabilisation in anticipation of movement with lumbar disfunction and injury.

It all seems very logical, but could it be flawed? Things seen in a lab may not have a strong relationship to ‘real life’. The fact that turmeric added to cancer cells in a Petri dish has a measurable negative effect on those cells, does not equate to consumption of turmeric ‘killing’ cancer cells in a living body. Similarly, the research that supports the concept of an anticipatory, local muscle stabilisation strategy may struggle to replicate real life situations, simply because it’s hard to measure a lot of human activity whilst accounting for variables. I imagine it’s really hard to wire someone up to any kind of measuring device and gain significant data if they’re engaged in anything other than fairly pedestrian activity. One of the challenges to the straightforward ‘centre-to-periphery’ concept that I’ve had is its failure to take into account the influence of part of our body coming into contact with the ground, or some other surface. That contact will send feedback to our brains, perhaps triggering further stabilisation strategies, for further anticipated movement or force through the joints. Therefore, the periphery is triggering the action at the centre. Where does that leave our ‘wave of contraction’? Is it blown out of the water, or can it be salvaged?

In the last couple of weeks I met two people who, separately, caused me to start to ruminate on this. One was explaining that her strategy for getting from sitting on the floor to standing was the way it was (alarming, I thought) because she had issues with both her foot and her knee. She was endeavouring to find stability in her foot, and then her knee – working from periphery to centre – on the basis that she needed to have a stable foundation of foot-to-ground before she could stabilise more proximally. It kind of makes sense – you can’t stand a vase on a wobble-board. The other instance was someone who, to my eyes, clearly had habitually internally rotated femurs and matching externally rotated tibias, and was talking about the orthotics that her podiatrist had recommended/prescribed. The podiatrist was apparently relatively disinterested in what was going on at this person’s pelvis (i.e. hip joints) because the thing that needed dealing with was her point of contact with the ground. It felt like a mini-epidemic of periphery to centre thinking. And again, there is a certain logic to this – the lady in question had knee pain. Every time she planted her foot on the ground her inability to stabilise her foot caused an inappropriate load at her knee joint, ergo: stabilise the foot with orthotics.

I should perhaps acknowledge at this point that I’m not at all a fan of orthotics. I can see that they may be a stepping stone toward getting someone’s joints into better positions, but they aren’t a substitute for actually sorting out alignment and strength issues that can have a lasting effect. I’ve worked with too many people who have orthotics for life (i.e.. someone in their 60s who’s had orthotics since their 40s). It seems akin, to me, to putting someone in a neck brace as a long term solution for poor control of their head position.

So, do we have compelling evidence to support an argument that stability actually works from the periphery to the centre (and then back out again)? I don’t think so. In both cases the idea is that a stable point of load, or contact with the ground, is more significant than a stable trunk. I can only assume that the idea is that in that case the trunk will take care of itself. I’ve used the workshop “Pilates Made Simple” to explore the idea that there are three basic demands of any Pilates exercise (that, of course, relate directly to real life) – these are: Stabilising your spine/trunk while moving your extremities; sequentially articulating your spine; and transferring load from your extremities to your centre. The latter is the one that I’m most interested in here – it seems to me to be fundamental to what we teach in Pilates, to functional movement, joint health, longevity etc.

In order to transfer load from your foot to your centre (core, if you like) you need to have control over all the joints in between. If there is a ‘break’ in that chain of force transfer then the load gets absorbed by the more distal joints. This is easy to see in people doing all fours exercises who are not able to effectively stabilise their shoulder blades against their ribcage and consequently feel the load most in their wrists and elbows. (When training I learned that, if a client was injured, Pilates always worked away from the problem – Kelly Starrett talks about “upstream” and “downstream” implications of poor positioning/control. I think the ‘fix’ for an elbow problem will more often than not be found at the shoulder than the wrist – proximal, not distal.) In the medially rotated femur/laterally rotated tibia/orthotic scenario, the orthotics may wedge the foot into a better shape but this won’t transfer into improved hippo control. However, working on laterally rotating at the hip joint whilst maintaining a straight foot (please try this yourself) will have a significant effect on foot activity. This is (for me, at least) very challenging to achieve in open chain exercises, but working on closed chain exercises on Pilates apparatus and standing work in mat classes, seem to really help to manage knee/ankle/foot alignment in open chain exercises.

The short version of all of the above: Yes, feedback from our periphery is instrumental in establishing positions, but we cannot effectively create stability and control from the periphery to the centre, it HAS to work the other way.

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Who’s Health?

October 10, 2013 — Leave a comment
image courtesy of healthcare.com

image courtesy of healthcare.com

When Joseph Pilates wrote “Your Health” in 1934 the world was a different place from the one we know now (or, at least, the Western world was). The majority of people would have lived less sedentary lives. Whilst work for many was physically hard, it appears that lines between work and leisure were much less blurred than they are now (e-mail, anyone?) Industrial food giants were largely a twinkle in the eye of their founders and real food, as opposed to food products, would have been the standard. Wheat looked very little like the Frankenstein’s monster of a grain that it is now, and CAFOs (‘concentrated animal feeding operations’) were a couple of decades away. Ancel Keys wouldn’t succeed in demonising saturated fat for another 25-30 years (and, in the absence of CAFOs, animal fat would have been less potentially sinister anyway).

The list of health related differences could probably go on for a while. In short, I suspect that it was a little easier for people to be responsible for their health then than it is now.

What of it? Well, a couple of years ago I was at the house of a client who had a business associate visiting (both American). There was an American news channel on the television, with a discussion of Obama’s universal healthcare policy underway. My two companions were clearly of a Republican persuasion, and vigorously opposed to this socialist notion. As a European I found it utterly bizarre that anyone could be opposed to something that I have taken for granted for my whole life.

I’ve lived and worked in the US, and experienced the surprise of being asked for my credit card details, in the ER, whilst trying to staunch the bleeding from a sizeable wound. I’ve also seen people of apparently limited means handing over large sums of cash in the pharmacy for their monthly prescriptions. How could this be reasonable?

More recently I’ve started to question my knee-jerk position on universal healthcare. I suspect that the Republicans mentioned above are opposed to the idea for financial reasons – I don’t know the details (apparently the ‘Obamacare’ bill runs to more than a thousand pages, so perhaps no one does) but I can imagine that there are potentially lost profits somewhere in the system. There’s little prospect of me profiting from privatised health care, beyond teaching Pilates, so I’m not concerned by that. What I am uncertain about is the degree to which our system allows us to imagine that, collectively, GPs; surgeons; nurses; physiotherapists; pharmacists etc. are responsible for <strong>our</strong> health. We can afford to fail to take care of ourselves, and make poor choices, because there’s a broad safety net of health professionals that are obliged to try to fix us. Clearly not a good recipe for personal responsibility. If we all knew that there would be financial consequences for the poor lifestyle choices that we make wouldn’t we be much more likely to make better choices?

The problem is that the ship of personal responsibility, in this regard, sailed a long time ago. Even if this isn’t you, I bet you know plenty of people who will seek a pill for any ailment, take antibiotics for a cough/cold, or go to their osteopath/chiropractor/physio to get ‘fixed’ if something hurts. If you’re a Pilates teacher I’d be amazed if you have not been asked for a remedy to some physical ill.

And here’s the real problem – we’ve been encouraged to think like this, by both governments and the corporations that ‘help’ them to form policy. Who knows why the food pyramid looks the way it does? Was it the work of a well-meaning but scientifically illiterate committee of politicians, or was it hatched in the subterranean lair of an evil food corporation executive? Probably somewhere in between, but it doesn’t matter anymore. Their work is done and the great majority of us ‘know’, beyond doubt, what healthy eating looks like. We also know that several episodes per week of 30 minutes of moderate intensity exercise are what we need to manage our weight and keep our cardiovascular system in top condition. (This probably requires a post of its own, but don’t we also know that it’s natural for a baby to vomit much of its food…?)

Governments try to protect us from the evils of tobacco, and, to a lesser degree, alcohol, and we justify huge rates of duty because these lifestyle choices place an extra burden on public healthcare. If you manufacture cigarettes you may not advertise your products, because we know all about the health risks associated with your product. However, we enjoy no such protection from the promotional efforts of the corporations, some of whose products purport to be healthy. Nestlé are free to advertise breakfast cereal made with ‘healthy whole grains’, Tropicana are equally free to advertise orange juice, which has the same sugar load as Coca Cola (who, of course, enjoy the same freedom to promote their wares). The list could go on and on – margarine proven to lower cholesterol, sweetened drinks to improve your gut health etc etc.

In these circumstances the odds seem so heavily stacked against us that personal responsibility is hardly an option. Informed choices are only as useful as the information they’re founded on. If governments and corporate giants collude to mislead us, a two-headed monster of misinformation, doing our best can easily become a recipe for ill-health. In these circumstances it seems more than ever that providing universal healthcare is an obligation. If your body were a high performance car, you’d be careful about the fuel you put in, you’d put air in tyres if they looked a little squishy. Perhaps you’d clean it often, and you probably wouldn’t park it where the risk of damage or vandalism was high. In short, you’d probably follow the manufacturers recommendations to keep it in good, if not great condition. This analogy stumbles a little in that our bodies don’t come with a manufacturers warranty, and companion handbook. However, the two-headed monster above has purported to provide one for us. ‘You break it, you pay for it’ seems like a generally appropriate maxim, and could be well applied to healthcare – you abuse and damage your body, you pay to sort it out. However, if you’ve followed the manufacturer’s instructions faithfully, surely it’s their problem?

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What does fit weigh?

September 28, 2013 — Leave a comment

3_seca-760_ecru_white_detailMy urge to write often seems related to the me coming across two colliding ideas, or if not colliding, at least divergent ideas. In this case, I’ve recently started reading the excellent “The Paleo Coach” by Jason Seib, and also seen snippets/chunks of the series “The Men Who Made Us Thin” on the BBC, written and presented by Jacques Peretti.

Peretti’s TV series offers up some extraordinary insight, my favourite moment being when the former CFO of Weight Watchers in the United States almost gleefully pronounces that the company he spent 20 years working for was a good business model because their product didn’t work, but kept people coming back and paying for more. It was if, instead of being interviewed by a journalist, he was making a secret presentation to potential investors.

Overall, the series seems to be a sincere attempt to uncover why so many people are becoming obese, and what solutions, if any, are effective. Peretti points out a number of misleading generalisations, but makes plenty of his own in the process. The most striking thing for me in all that I saw was this comment: “Personally I think people should stop worrying about their weight and focus on being healthy and happy, at any size.” This seems to me to highlight the degree to which our thinking about health has been torn away from any grounding in evolutionary biology, and outright bizarre. If your brain and body are under the impression that your situation is so stressful, or that a time of famine is imminent, and that you need ample stores of fat, is there any possibility that you are healthy?

It’s widely accepted that being fat is unhealthy, yet it seems that the opposite extreme has become the definition of healthy. There is no middle ground – Fat is bad, ergo skinny is good. When skinny is patently unattainable (not to mention ‘unhealthy’) the response is to celebrate being too fat, as in “I’m happy the way I am.” There may be a case to say that, in some sections of the UK media, the pressure to be happy the way you are is nearly as great as the pressure to look like someone else a good deal smaller than you. The idea of being fat and fit is bound up somewhere in all of this. For Peretti, the fact that two obese women, who had some previous experience, could keep going in an aerobics class longer than he could was a sign that fat and fit are not mutually exclusive. Overall, the message seemed to be that nothing is truly effective in combating obesity long term – dieting doesn’t work, exercising doesn’t work, surgical intervention doesn’t work etc. Not great news for the concerned viewer who really wants to change themselves.

Then I picked up Jason Seib’s book, and was delighted. Having ‘Paleo’ in the title means I know he’s going to be talking about an ‘ancestral’ model for living now. In other words, taking the physical activity and nutrition of our ancestors as a template for how to live now. This is another way of saying that he uses evolutionary biology as the basis for his assertions about health and fitness (more of ‘health and fitness’ anon).

It fits that our concerns about our size and weight are related to how other people perceive us, or how attractive we are. Using that evolutionary model, we are wired to propagate our own genes, and mix them with other genes that are going to be resilient, robust etc. From that perspective, what attracts us to others is their appearance of health – “Does this person have what it takes to survive and flourish, and produce children that will do the same, in this adversarial world?” Just as excessive body fat won’t signal a promising mate, nor will being very skinny. In other words, as life has become easier and easier, we have developed some twisted ideas about what the roots of attraction are.

Seib argues that people who begin a diet, or programme of exercise, with aesthetic goals are largely bound to fail. That said, it’s not unreasonable to have a goal of fitting into clothes that you wore a couple of years back, or to want a smaller waist circumference, BUT weight per se is a red herring. You might change your body composition significantly, effectively exchanging stored fat for muscle mass, and not lose much weight. The whole notion of ‘losing weight’ is misguided in fact. Bathroom scales tell us next to nothing about how healthy we are. I know someone who has recently succeeded in losing weight, and I’m certain that, as well as shedding some body fat, she has also lost muscle mass. Did anyone’s health ever improve as they got weaker?

As an aside, Seib refers to research that indicates that yo-yo dieters become more efficient at storing body fat. In other words, if you get into a cycle of dieting to lose weight, and then regaining that weight, then you are likely to become progressively fatter. I can’t articulate how or why, but this is surely a natural response of the human body to the stress of deprivation and signalling the need for storing greater energy reserves.

The solution of “The Paleo Coach” is to have a goal of health, rather than a number that you read on the scale. If you take the necessary steps to be as healthy as possible then aesthetic goals will be achieved as a by-product – again, we’ve evolved to find the appearance of robust health desirable. This brings me back to the ‘health and fitness’ point. Under the heading of “What is fitness?” the CrossFit Training Guide (yes, CrossFit, again) contains this line: “We have observed that nearly every measurable value of health can be placed on a continuum that ranges from sickness to wellness to fitness.” This is to say, health and fitness are not separate – fitness is the optimum state of health. If we accept this idea then the notion of “happy and healthy at any size” is exposed as a nonsense.

Bathroom scales can tell you how heavy you are, they cannot tell you how healthy you are (I know there are some that purport to measure body fat but since one such scale told me that I was borderline morbidly obese I doubt their accuracy). Unless you’re wanting to go on, say, a theme park ride with a weight limitation, or wondering if the lift can cope with one more body in it, what you weigh is of minimal significance – your fitness will take care of your weight.

Oh, and don’t settle for wellness (“How are you?” “Oh, fair to middling.”) – is that really going to be good enough for you?

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Dear Colleagues (An Open Letter)

August 25, 2013 — 3 Comments

Dear Pilates Teaching Colleagues

UnknownHaving browsed through Peter Fiasca’s book “Discovering Pure Classical Pilates” a couple of years back, I was slightly embarrassed for him. The excessive use of bold type to underline key points concerning heretical misinterpretations of Pilates, and the somewhat polemical subheadings (“The Great Decline: Derivative Styles of the Traditional Method”), smacked of someone losing their marbles.

I’m beginning to have sympathy with his position (perhaps I am losing my marbles), though our viewpoints differ a little. I’m not fanatical about teaching only ‘classical’ Pilates repertoire but I’m with him when he says “Pilates is not physical therapy”. If not losing my marbles then at least I’m becoming less temperate with regard to the realm of Pilates teaching. Sure, we all have different backgrounds, different influences, loves, hates etc. but I’m writing this to ask if we can agree on a few basics.

Such as:

Pilates is not magic, it’s a system that facilitates teaching good movement.

Pilates is therapy only in as much as movement is therapy.

We teach, clients do – in other words, we don’t do Pilates to our clients.

If our clients believe that they can only do Pilates in our presence we have failed.

We don’t work on our clients problems, they do that.

What clients do in their classes is based on what they need, and what they want. If they ask “What do you want me to do next?”, we’ve given them the wrong impression.

Unless we have medical qualifications, we do not diagnose, or treat.

It’s not our job to determine which specific muscles are culpable in, say, an asymmetry (so it’s not appropriate to be saying, for example “Your left obliques are weaker then your right”).

We have the chance to ‘set the bar’ of what’s possible for our clients, and we should set it high.

We have the tools to help people to be better – if there’s no sign of that happening over time then we should be directing them elsewhere.

We should be practicing what we teach – all the time.

We should be taught by another teacher, regularly.

Oh, and perhaps most importantly, strong is not a dirty word.

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My Primal moment

August 21, 2013 — Leave a comment

The story that follows is nothing compared to the stories of hundreds of thousands of people who have experienced danger, disaster, war etc. That said, it felt like I learned something useful about myself, and it also felt as though it justified the changes I’ve made to my lifestyle in the last couple of years.

Here goes:

IMG_1388

The view, on a good day…

I was recently on holiday in Southern France with my wife’s family. We were staying in a house that is about 350m above sea level, on the side of a hill (mountain?) that is 1050m above sea level. There’s a rough but easy to follow path from the house to the peak, and 3 of us set off to the top one afternoon.

Clouds had been building up, and after only 5 minutes or so we could hear a sound like a strong wind through the trees, that turned out to be a wall of monsoon-like rain coming toward us. Prudently we turned back, but set off once again after the rain had passed, only 10 minutes or so later.

Around the point that we had previously turned back, all 3 of us wearing shoes, shorts and nothing else, passed a family coming down the path, wrapped up in waterproof jackets and looking miserable. I’d be lying if I said we didn’t feel amused by the contrast between our party and theirs, though that was tempered by discovering some of the hailstones that had fallen earlier, probably on that poor family.

IMG_1399

My brother-in-law has spent many summers exploring the area so, when he suggested deviating from the main path to make a more circular than out-and-back journey, we had no doubts about the idea. This is a beautiful part of the world, there are stunning views to admire, and on this morning there was the chance to see the impact of heavy rain on the landscape, some paths still being mini rivers.

Around the time that the sky was turning particularly blue-grey, it was acknowledged that we had missed our uphill path, though on the hillside what appears to be a path can quickly disappear into the undergrowth. The solution was to simply head upwards, negotiating the vegetation in the way. So far, so undramatic. When the rain started we experimented with sheltering under trees and scrutinising the pallor and movement of the clouds, confident of a break in the rain. It didn’t come, so we decided that being on the move was better, and carried on uphill. It had already crossed my mind that I wasn’t feeling the need to hold F (my brother-in-law) responsible for our predicament -weird.

It seems counterintuitive but the vegetation became denser the higher we got, and the way (not path – definitely no path) got steeper. Did I mention the rain was unrelenting? So the purchase on mud/stones/roots was increasingly tricky. I’d had my favourite eggs, bacon and avocado breakfast, and was feeling energetic and strong. P, the youngest of our party, is what I might (in a judgemental moment) call a ‘sugar-burner’ – bread and jam for breakfast. He’s young, and was raised that way, so the choices he makes are more habit than real choice. Anyway, P was beginning to shiver, and the novelty of our situation had evidently worn off. (I later discovered that, in the conditions, his shoes were disintegrating from the inside out, so his crappy breakfast may not have been entirely to blame for his mood).

F was regularly assuring us that we were nearing the top so, of course, it felt as though we weren’t. Amazingly, the rain became more intense and we decided to try to shelter again. This was when I had my ‘epiphany’. Squatting under a tree, with hail cutting through the leaves of our ‘shelter’, and with rain water running into parts of my body that even a shower won’t always get to, I was amazed at how I felt. Again, I wasn’t blaming anyone else, and in years gone by I know I would have been angry with F for leading us to this point. I was reminded of scenes from ‘Platoon’ when the grunts are sitting in the jungle drenched under the incessant rain (yes, I do know that we were in no danger of being shot at). I wasn’t cold (daily cold showers paying off?), instead feeling incredibly resilient. I was a bit concerned about P, whose shivering was intensifying, but at the same time I knew that I was strong enough to carry him to safety if I had to. Our situation was ludicrous and, again to my surprise, I wasn’t at all dispirited.

Deciding once more that we were better off on the move we set off for the ridge, where the vegetation disappears. There is a track running the length of the ridge which was a river a few inches deep at this point. Our way back meant following the track a little more up hill before meeting the path back down to the house. We jogged our way to the top of that path, and then sped up on the descent. Now the rain eased. The path is rough, alternating from stones to gravel, clay to chalk, and with roots here and there to add spice. Once running it was hard to stop, and I have rarely felt as invigorated as I did then – concentrating hard on each footing and feeling agile and powerful. Some 4 hours after we set off we arrived back at the house with, for me at least, a feeling of triumph.

Again, I’m well aware that this isn’t a tale that involves much peril, or endurance, and we all came out of the experience unscathed. Nonetheless, it felt to me that 2 years of ‘primal lifestyle’ had made me better able to cope with adversity. I’m better nourished; stronger; more resilient; my immune system is stronger; and, perhaps most importantly, I’m aware of how empowering it is to, instead of blaming someone else, own responsibility for my actions and any resulting predicament.

Thanks for reading.

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Better Than God?

June 5, 2013 — Leave a comment

Most people, if you stopped them in the street to talk about nutrition, would probably know that butter and saturated fat are bad for you. They may well also know that those fats will raise your cholesterol level, and that high cholesterol can kill people. They may well also have some ideas about what constitute healthy fats. After all, this information has been very well disseminated by governments, medical professionals, news media, and producers of healthy fat and cholesterol lowering products.

I know how easy it is to make butter. I made some once when I was overzealous in my cream-whipping, trying to impress someone. Margarine, or Benecol (“Benecol is a range of foods that contain a unique patented ingredient, Plant Stanol Ester, that is proven to lower cholesterol. Benecol is available in a variety of delicious products including yogurts, yogurt drinks and spreads.”) is a different story – I’ve no idea where to start, so I looked it up, and apparently making margarine goes something like this:

It appears that olive oil is also relatively simple to extract from an olive. Certainly the process is mechanised these days, but it’s easy to find instructions for the home enthusiast, requiring nothing more complicated than millstones… It’s also pretty easy to render lard – animal fat, heat, a pan, a jar and some cheesecloth are all that’s required.

Vegetable oil, or seed oil is, like margarine, a different story, as this video shows. In the US they call it ‘canola’, in the UK we call it ‘rapeseed’. (You may not fancy watching the whole thing. If you do, listen out for key words such as: ‘solvent’, ‘chemical extraction process’, ‘wash with sodium hydroxide’*, ‘bleach’. You’ll be glad too to hear that they deodorise the final product…)

It’s pretty much the same process that’s outlined in the flow chart. (Clearly not instructions for making Benecol, because there’s no mention of adding those plant stanol esters….)

What, might you ask, has this got to do with God? You can say God, if you like, or you might choose Mother Nature, for the sake of this particular argument. I’m inclined to simply call her Nature. And here’s my point: someone who is very dear to me is a regular consumer of industrial food products like Benecol margarine, and also happens to be a practicing Catholic. He eats Benecol on his bread (there’s a whole other problem) because medical professionals, and advertising have told him this is what’s best for him, and because I’ve got no credentials for getting into an argument with his doctor.

I don’t practice any religion, so I’m guessing how the thinking might go. At the same time I believe that human evolution has been intimately entwined with us making use of the things that nature provides us with, just as is the case for most living things. Predatory carnivores pick their food from herds of herbivores, antelope graze, killer whales eat seals, seals eat fish (some of the really mean ones eat penguins!), many fish graze on algae etc. Technology changes many things for us – it’s very much easier for us to control fire the it used to be, we don’t need to hunt wild animals any more because we’ve learned how to corral and domesticate them. That list can go on and on. The thing is that technology tends to make life easier for us, and tends to generate revenue for the inventor and/or manufacturer. It doesn’t necessarily make us better (Yes, this was last week’s subject.) And when we’re talking about fat, we’re talking about nutrition. Say it out loud: ‘NUTRITION’ – that which nourishes us. There’s hardly anything more important than this in our lives. If we make changes to how we nourish ourselves, surely they should be based on making us better – not based on making life easier, or generating huge profits for industrial food corporations? (By the way, isn’t it weird that the same company that makes Cornetto, also makes Comfort fabric softener?)

Back to my Bencol eating, Catholic friend. Because it feels cruel, I’ve resisted saying to him: ‘God has given us all this bounty with which we can nourish ourselves. Do you really think that we can manufacture better nourishment in a factory, using enormous resources of energy, chemicals and precious water, than God has seen fit to make easily available to us?’ Again, I’d rather be talking about ‘Nature’ than ‘God’, but that’s largely irrelevant. What kind of arrogance leads us to believe that we are somehow different from any other lifeforms on the planet, and that despite millennia of successful nourishment, garnered with the assistance of  some simple hand tools, and fire, we can ‘create’ food that will do a better job of nourishing us?

Of course the real truth is that it’s probably a combination of greed and fear that leads us to the point where we believe that readily-derived-from-nature is bad, and chemically/industrially manufactured is better. However, if we can strip that away (tough, because fear is what drives capitalism so well) then perhaps we can see that it is vanity and arrogance that tricks into thinking that we (or our doctor) may know better…

Special bonus video (reward for perseverance)

*Yes, it’s caustic soda, but don’t worry, it’s of a higher grade than the oven cleaning or sink unblocking kind.

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Older is not better

May 31, 2013 — 2 Comments

There was a report in the news last week relating to research into the safest place for a baby to sleep. According to the researcher I heard interviewed, the conclusion of the study was that the safest place for a baby to sleep is ‘in it’s own environment’. This struck me as rather curious, since I’d also read recently about the almost constant contact that babies in indigenous cultures enjoy with one or other of their parents.

A couple of days later I was talking to a pregnant woman, and mentioned this, at which point she said “Older is not necessarily better”, and went on to point out that in the past many more babies died than currently do. (This is a favourite theme for anyone rejecting an ancestral model for lifestyle choices. That or, ‘no-one lived past 40’…) It wasn’t the time to be pursuing that debate, but I cycled home musing on it that night.

It’s certainly true that because humans have done something for a long time it does not follow that it’s true. There are many examples of horrific practices that, happily, we have left behind us. I’m also aware that it’s rather easy to romanticise a, perhaps, simpler time, or a simpler life. (Years ago I was on holiday with friends, one of whom was from a farming background, and with far more working class sensibilities than I can pretend to have. We were on the island of Tobago, and I was very taken with the lifestyle of the fishermen in the village that we were staying in. They positively glowed with health, and whilst they obviously had to work hard, they seemed to be quite well rewarded. I was attracted to what seemed to be a very ‘natural’ and healthy life, with a straightforward effort/reward equation, and incurred the disgust of my friend for my privileged ignorance of the realities of hard work/hand-to-mouth existence.)

So, acknowledging that I may be wearing my rose tinted specs, I’m still fascinated by the idea that populations with less of the trappings of western civilization might enjoy a closer connection to their environment than we generally do. And this connection imparts a kind of wisdom that we turned our backs on many decades ago. This is a subject that many writers seem to be delving into at the moment – Mark Sisson’s “Primal Connection” is directly related to this, and it’s a theme that Frank Forencich regularly writes about. Doubtless there are many more. Perhaps people that live in closer contact with their environment make choices for the health of their environment, rather than ease of living, as ‘civilisation’ and the industrial revolution have allowed us to do for the last century and a bit. If you know that your food and shelter is dependent on maintaining something of a symbiotic relationship between yourself and your surroundings then you are highly likely to behave in a way that preserves that relationship. The chances are that this way of living has been ingrained for centuries, so that it is interwoven with your learning, play and life in general as you grow. In other words, perhaps it’s unconscious – you know what’s important without knowing that you know. Again, this is my rose-tinted perception, reinforced by wonderful books like ‘Wild‘ by Jay Griffiths.

In contrast, industrialisation and technology have allowed us to disconnect from the natural world more and more. (Aside from the practical implications, there is a rich vein of research into how this impacts our mental/emotional state). I’m certainly not about to give up a home with central heating, but I can believe that some time amongst trees and plants nourishes me in ways that food cannot.

Perhaps as the basis of postmodern theory (which I understand, highly simplistically, to be something like; ‘reality has been replaced by symbols and simulations of reality’ – apologies to Baudrillard if I’m way off the mark) we seem to have become very good at identifying problems that we have created for ourselves through technological advances, and remedied them with more ‘technology’. MBT shoes seem to be the perfect illustration of this idea – We recognise that there’s a problem with shoes, and pavements, flat ground etc. So instead of removing our shoes, and trying to spend more time with our feet on a more natural surface, we develop shoes that move us further away from true connection to the ground, whilst trying to represent that connection. Duh.

How about ‘ergonomic’ chairs? We recognise that sitting at a desk in front of a computer screen, controlling a mouse, and typing isn’t working out to well for us. No surprises there – we’re not ‘built’ for sitting for long periods, the load on our spines increases two-fold when we go from standing to sitting. The solution is, of course, to design a chair that makes us ‘better’ at sitting. One that actually requires less muscular connection in order to remain in the same dysfuntional position.

We no longer have the innate sense that should tell us that sitting for hours at a time is a bad idea. It reminds me of a conversation I had years ago with a martial arts enthusiast (and osteopath). His theory was that Pilates is essentially the same practice as yoga, tai chi, karate, kung-fu, kendo etc., but modified for a Western sensibility. One of the crucial differences is that, in the countries from which those other movement practices originate, children would be practicing them form a young age – repeating movements over and over again. By the time that they were old enough to question why they were going through these movement patterns, they had no need to ask the question because their body had learned the answer through the action. His argument went on that people doing Pilates often need to ask, or understand intellectually why they are doing particular exercises because they have not had the opportunity to develop that innate ‘body intelligence’.

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Could this be the perfect squat?
Sorry, can’t find who to credit for this image….

A brief search on YouTube will quickly elicit plenty of video clips of toddlers doing ‘perfect’ squats, deadlifts etc. – the evidence seems fairly clear that we ‘know’ how to move well at a very young age, or at least that moving well is woven into our early development. Things seem to go wrong around the time that we start to put children in shoes, and make them sit for prolonged periods of time. Shoes and chairs are simple examples of technological advances that are creating problems for us, far beyond what surely could have been imagined when they were first conceived. Just as ‘older isn’t better’, newer is not better either. More importantly, increasing the disconnect between ourselves and our environment is a recipe for newer, perhaps more complicated problems (I’m envisioning later scenes in the excellent Pixar animated film ‘Wall-E” – if you don’t know what I’m referring to, please put this blog post down immediately and remedy the situation – I guarantee it’s way more entertaining).

So older is not necessarily better, but wisdom might trump technology. Returning to the subject that I started with, of baby’s safest sleeping place, isn’t it strange to think that a baby should have its own environment, that is separate from that of its parents? Does that occur in any other species of mammal? Is this perhaps a sign of our fundamental loss of sensitivity to our surroundings, that an adult’s sleeping space is inherently dangerous to a baby? Or have we truly figured everything out better than any of our ancestors did?

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Pilates, it’s not magic

May 11, 2013 — 11 Comments

I seem to have frequent epiphanies these days – or rather the idea that things that I ‘knew’, perhaps in the darker recesses of my mind, suddenly crystallise into sharp and sometimes powerful ideas. Simple things, such as ‘Pilates doesn’t cure back pain, good movement cures back pain.’ Of course, Pilates is an excellent vehicle for teaching good movement, and it certainly ‘fixed’ my chronic low back pain years ago. Now I recognise that it wasn’t that my various Pilates teachers waved their wands and cured me with a dose of magic – they taught me better movement (and positioning) than I was accustomed to practice at that time (God love ’em).

There’s another conversation that can be had later/elsewhere about various methods some Pilates teachers seem to have for appearing to do magic, to be filed under ‘Disempowerment’.

Another closely related epiphany that I had recently (thanks to the wisdom of Kelly Starrett finally sinking in) is that whether we are teachers of Pilates, or yoga, or salsa, or karate, or tai chi, or…almost any other movement discipline, the work is the same – teaching good movement. (Pilates called it ‘right movement’). Some of those disciplines may involve a broader scope than Pilates but, in as much as they are movement disciplines, they should be teaching good movement.

I was leaving a health club today, after teaching, when one of the PTs approached me and asked if I just teach Pilates, or if I teach yoga as well. To my surprise, when I answered “No, I don’t teach yoga.” her immediate reply was “Why?”. My internalised response was something along the lines of: “Because I’ve found a really efficacious method for teaching movement (and spent years trying to do it well), why would I want to train to teach a different method with the same purpose?” I understand that people are drawn to yoga and Pilates in ways that I am not, so no disrespect to the multi-disciplinarians out there. To me, she may as well have said “Why aren’t you a personal trainer?”, given that I think that job should be essentially the same – teaching good movement.

This is what gets me excited at the moment, the idea of helping people in my classes to move, or position themselves well. And Pilates is such a brilliant means to this end. I had another revelation today – that the Hundred is a fantastic assessment tool. It can tell you so much about someone’s awareness and competence – Is their thoracic sufficiently mobile for their head to be well positioned? Can they stabilise their scapula? Are they able to disassociate their arms from their trunk? Can they stabilise their midline under the load of their legs? Can they keep breathing while doing all of the above? And so on. All questions that relate to activities outside the class.

If I can see that someone is struggling with any of those requirements of the Hundred, what are the most effective ways that I have for helping them do better? Obviously there are many ways to skin this particular cat, and I have a question for any teachers that are reading this: Is cueing muscles the best way to help people to move well?

The organisation under which I trained is holding their AGM around the time of writing, and an internationally renowned teacher has been invited to present workshops over the weekend. One of them is apparently titled “Pilates in Clay”*, and offers the chance to sculpt muscles, in clay, onto a pvc skeleton. The description continues: “Once you have made a group of muscles, we will use the Pilates apparatus to understand how they are engaged and in what functional capacity on the reformer.”

Now, it’s probably just me, but isn’t there a significant disconnect between teaching ‘right’ movement and understanding how (which) muscles are engaged and in what functional capacity on the reformer? Perhaps I would discover that my clients left tibialis anterior is over-recruiting during the tendon stretch. Then what? Do I then devise a program of tib ant recruitment timing exercises, along with a stretching program? What would Joseph Pilates have made of this? We might be able to look wise to our clients if we can suggest to them that their serratus anterior is failing to do its job of scapula stabilising correctly, but does that help them to move better? If you know the muscle that’s working/not working, are you a better teacher?

I would argue that this is an illusion. Yes, certainly knowing muscles and their function can aid in understanding movement. And I need to be able to have a conversation with a physiotherapist, osteopath, or surgeon using anatomical language. But when it comes down to the nitty gritty of moving, my brain is simply giving instructions for one body part (or more) to move relative to another, and the muscles are just accessories. Your brain doesn’t actually know that you’ve got muscles. Poor muscle balance is a product of poor movement, not the other way around. Aside from this, focus on muscles when teaching (in addition to appearing clever) can easily disempower the client, and help to reinforce the notion that Pilates is in fact magic, to be performed on you by your teacher. Can’t differentiate between your gastroc and your soleus? Oh dear, this is worse than I thought.

After years of being excited by analysing anatomy, and trying to ‘see’ muscles working/not working in my clients, I’ve been very fortunate to stumble upon the understanding (again, hat off to Kelly Starrett – and Gray Cook, Mike Boyle, Carl Paoli etc.) that Pilates is simple. Brilliant, and simple. The fundamentals of joint positioning for transmission of force, or resistance of load, are the same for Pilates as for any other movement discipline. ‘Force’ and ‘load’ are perhaps not words commonly associated with Pilates, but this is just different written/spoken language to describe the common language of movement.

 

*This may well be a brilliant and highly instructive workshop, it’s just that the description made me feel like chewing my fingers off.

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“No Days Off”

February 15, 2013 — Leave a comment

A couple of weeks back PilatesTree.com asked via Facebook “how much self practice do you really put in?”. It’s a really interesting question to ask professional Pilates teachers, not least because we so often seem to prioritise teaching over working on ourselves. When I first started teaching I used to “do” the class that I was teaching, and it took me a while to realise that this was a really good way to develop some bad habits (never mind that my mat was not the optimum place to be teaching from all the time..).

I’ve struggled for some time with conflicting ideas around Pilates teachers’ responsibility to be aspirational figures (see ‘What should a Pilates teacher look like?‘) and, of course, what we do should be more important than how we look. If we finish teaching a class and then adopt a collapsed posture we’re doing a lousy job of reinforcing what we teach. “Do as I say, not as I do” is rarely a powerful teaching message.

One of the consistent messages of primal/paleo lifestyle authors, and indeed Kelly Starrett, my movement sensei, is that it is our responsibility as human beings to optimally express our genes – to be the best version of Homo sapiens that we possibly can be. This seems eminently reasonable to me, and also a great basis for a slightly different question from the one above: “How often should we be trying to be better?” or better yet – “How often should we be practicing being amazing?”

The answer, naturally, is ‘every day’. Hence, there are NO DAYS OFF. Practice making permanent = we become good at what we do often, which brings us back to the post-class slouching Pilates teacher. A state of fitness is not the result of a couple of hours per week of exercise. That may well form a part of fitness, but if we practice being great for 2 hours a week, and then the remaining 110 hours (assuming a generous 8 hours sleep per night) practicing being mediocre, or worse, we don’t need NASA to tell us what the outcome will be.

Typical view of living room floor (tissue paper is for the cats to play with).

Typical view of living room floor (tissue paper is for the cats to play with).

I was unusually reticent about answering the original question on PilatesTree….in part because I know that I can’t pretend to do anything resembling a Pilates class more than once a week. Preferring to answer my own question (“How often should we be practicing being amazing?”). As of this year, I do something in pursuit of being better as often as it crosses my mind, and this means at least every day. I don’t work out every day, but I try to practice something that I need to improve daily, whether that be a skill/movement, or mobility. I’m very lucky to be married to a woman who shares my passions/obsessions, and evenings in front of the TV usually involve one, or both of us rolling various body parts on sundry firm objects, or indulging in mutual ‘quad smashing’ (For a visual on how to do this to a massive weightlifter, or your loved one, click here, and remember: “Foam rolls are for children”).

Talk of my idiosyncratic home life may have me straying off the point. Here’s the thing: Yes, practice Pilates, yoga, boot camp, karate…whatever’s your poison (passion?), at least once per week AND practice being a better Homo sapiens every day. In the middle of a TV show I was watching the other night (I put my hand up here and acknowledge that I was making no effort to be better at the time), I heard the line “Clean water is a human right.” It sounded weird at the time – I think we’re often too quick to award ourselves rights (argh! Rabbit hole! Yes, ideally every living human should have access to clean water). Ethical quagmires aside, could we say that “an optimally functioning body is a basic human right”? I hope so, and if we’re agreed upon that, we have to remember that “with rights come responsibilities”.

We have the basic human responsibility to maintain our bodies in such a way that we are able to best express our genetic heritage.

In acknowledgement of the inspiration for this post, here’s Kelly Starrett. Not my favourite MobilityWOD video (and he no longer advocates icing) but maybe it can serve as a way in to the goldmine for you – he’s ALL about being better at EVERYTHING.

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