The undoing: Biomechanical rehabilitation

It turned out the foundation of my problems was not musculoskeletal, but – as a former dancer, yogi and amateur physiologist – muscles, tendons, ligaments, fascia and dysfunctional movement patterns was where I started. I’m fascinated by the mechanics of motion in the human body. It’s all about loads, levers and the force of impact. Transference of energy. Basic physics, really. I watch anatomy videos for fun.

Our skeleton – and all the tissues that hold it together – is perfectly designed for movement, created to walk on two feet. Bones bending a bit to take loads and forces. All sorts of tiny muscles, ligaments and tendons working together for energy-efficient movement, distributing the force and dampening its impact, sometimes storing up energy to release it like a spring. It’s an incredible achievement of mechanics. Better than any bridge, building, machine, or other human-designed structure.

But we are conscious beings with individual will, and so we take it for granted and develop unconscious bad habits that deform our physical selves over time. A focus on comfort and ease makes parts of us lazy. A focus on the psyche and the intellect makes us neglect the body. Even a focus on the body can lead to imbalances and doing it wrong. The body knows how to move – in some ways, we just need to stop interfering.

Imbalanced or incorrect habitual patterns of movement developed throughout a lifetime – or in my case, muscles failing because they were swimming in waste fluid and weren’t getting good blood supply nor nerve signals – mean that we end up using the wrong part of us to do what we do, disrupting that lovely design. But we become so used to it, doing it wrong feels normal. This has a cumulative effect, perhaps causing pain and inflammation, often in another part of the body from where the problem is.

Many years ago, a physiotherapist told me how important using the feet correctly was. She was right! To walk most efficiently, weight needs to go through the feet so they can absorb and distribute the shock. The load is spread throughout bones, muscles and connective tissue first in your feet, then ankles, then legs and so on, up to the muscles in your rear end and also your core abdominal muscles.

She gave me exercises to re-establish me using my feet properly, which helped, but came way too early in the process. There was so much other stuff I had to fix first.

It’s amazing that we can actually walk without using our feet, but thanks to my un-rehabiltated broken ankle and a pelvis gunged up with fungus-lymphatic fluid, I did for years. It was like I had wooden legs below the knee, they were so inactive. And my core muscles were no good either.

So my brain instead compensated in any way it could, doing its best to get my body to move how it was being told – overusing muscles in the hips, tightening the pelvic floor, engaging shoulder, spine and neck muscles to help with stability. Until everything got so fucked it failed.

All wrong

There’s a small but important muscle called the piriformis that runs between your sacrum and the top of the femur (thigh bone). It’s part of your bottom, deep deep down under everything else. Along with other hip muscles, it rotates the femur, turning your leg and feet out, as well as abducting* when you move your leg out to the side. It helps keep your pelvis level when you walk, and is just generally a really crucial part of the pelvic structure.

If it’s too tight, the feet become turned out, messing up the excellently designed mechanics of walking. And if the feet are permanently turned out, the piriformis gets shorter (the body is so efficient, it won’t waste energy on a muscle that’s not being used). And then you’re in a little vicious circle!

A short piriformis can also compress the sciatic nerve – the nerve that makes your legs work – that runs under or sometimes through it. The gluteal nerves are there too, and the pudendal nerve that serves your whole undercarriage.

So it seems that was happening to me. I also discovered my pelvic floor muscles were unbelievably tense, blocking blood flow and nerves and god-knows-what and generally making things not work.

And!

I discovered I had no muscles in my inner thigh. They were wasted, weak…just not really there. The flesh flabby and doughy. And thinking about it, I can trace this back to when I was 8 or 10 years old. So with nothing to counteract the tension of the abductor muscles (piriformis etc), little by little over the years, out my legs turned.

And!

Like so many, I was in the terrible habit of sitting on my sacrum, tucking my pelvis underneath so the weight goes in all the wrong places. I think I had developed a ‘posterior pelvic tilt’, tucking my bum in and flattening the lumbar curve. And I had no strong glute muscles to counteract this.

Short hip muscles + no inner thigh muscles + deep core muscles not working + I don’t know what else = out of position pelvis + duck feet = not using walking muscles properly -> vicious circle.

This also has an impact on everything higher up as the body copes with loads in the wrong place, compensating by engaging other muscles that weren’t designed for that job. And then you’re an old person with joints worn out through ‘wear and tear’, but that’s only because they’ve had to endure years of misuse.

Neuromuscular rehabilitation

Basically, my entire musculoskeletal architecture had gone a bit wrong and so I’ve worked very hard to correct it. In my case, it wasn’t simply due to bad habitual movement patterns, but what I reckon was fungal overgrowth and accumulated dirty lymph shutting down some peripheral nerves. So it was a complete tangled mess, and recovery has been a lengthy, slow and difficult process!

One of the reasons it’s been so slow and I often call it a rehabilitation – sometimes it feels like learning to walk again after a nasty car crash (a 20-year car crash) – is because it’s not just about recovering physical condition, strengthening weak or damaged muscles, but it’s also about re-educating my brain.

As we know, the brain is the control centre. And if it’s getting information that something’s wrong muscularly, it stops using it, switches it off to protect that area, shortens a muscle that’s not getting used, engages something else instead. So as well as having to strengthen or lengthen muscles, and release tendons and ligaments, I needed to tell my brain that they were safe to use. Particularly in my damaged lower legs. Switch this one on, that one off.

My brain was itself affected by the toxic gunk, as was my upper spine and neck. Spinal ligaments would snap and crack and I’m sure the vertebrae would compact a bit. My spinal cord’s definitely been affected, though I couldn’t say how with any certainty, just that sometimes messages were not getting through properly.

So it’s been a process of slow re-education. Small exercises with frequent repetition to send messages to the brain to build new neural pathways. And I mean sloooooow! And with lots of re-re-learning, as so often I got busy and my brain/body reverted to its habitual patterns. Consciously changing the unconscious reactions of your body is very, very difficult.

Still, I did it in the end. Chin up!

*Abduction = moving a body part (usually a limb) out, away from the midline. Adduction = moving it in towards the midline.

Next: Toilet taboos

CHIN UP 10/14
LIST OF CHAPTERS

Image borrowed from elevation-physio.com. All rights reserved etc.

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