Why Some Injuries Never Heal
So, your knee or hip or back or neck or shoulder is limited or stiff or painful. This ranges in severity from “I can’t move or exercise, or travel like I used to,” all the way to “it’s getting harder to bend or reach, or to walk without effort, as fast as I used to, for as long as I used to.”
Drugs, manipulation, physical therapy may have provided some short-term relief, but not long term improvement. Surgery may have been recommended or already completed to repair or replace the joint, the disk or fuse the vertebra.
Sometimes there may be no history of trauma to that particular area. So, what is the cause of these chronic, ongoing problems? Aging? Obesity? Arthritis? If these were the primary root causes, all seniors would eventually require joint replacements or spinal fusions. And why do so many younger, healthy, exercising, non-overweight people need them as well?
The answer lies in the result of years of an imbalanced workload in the body.
Chronically contracted, or under used muscles, all exert abnormal compression on the bones. These habitual, but dysfunctional forces cause joints to move in ways that damage the bones and surrounding soft tissue, resulting in inflammation and deterioration of cartilage and bone. Compromised soft tissue makes tendons and ligaments more vulnerable to shredding or tearing, as in ACL, rotator cuff and elbow injuries.
What causes muscles to be chronically contracted? The most obvious answer is injury, the normal “life-events” that happen to all of us. But what if there’s no history of injury in that specific area?
After broken bones, sprained ankles, car accidents, sports injuries or falls, we press ourselves to return to function as soon as possible, although there are areas that do not yet move efficiently. Beliefs about “pushing through” and “not good enough” sometimes play a role in our disregard of self-care. Financial vulnerability and our dependents’ needs might convince us we can’t “afford” the downtime.
In the urgency to “get better faster” and return to our responsibilities sooner, we abnormally shift the workload to other muscles and joints not evolved for those functions. These neighboring or counterbalancing muscles are required to work harder in order to perform, eventually causing problems in new areas.
These compensations become habitual and operate “invisibly” beneath our awareness.
Additionally, many of us unconsciously favor one leg over the other or over work one shoulder all because of long-forgotten childhood injuries. We may habitually hold our neck a certain way because of a recent or old fear response. Our posture and movement patterns in the workplace, playing sports or at home get hardwired in. Seniors rising from a chair can break a hip because of weaker bone density in one femur, developed over years of less weight bearing on that leg.
A restriction in your neck, back, ankle, sacrum or rib may be very subtle. It may not hurt, or even get your attention, but that area is still out of function, not doing its share of the work. So other joints, especially the weight bearing ones, are overworked, moving in ways for which they were never designed. These new, abnormally loaded areas deteriorate after years under this increased workload. They become symptomatic, painful, inﬂamed — damaged.
Emotional trauma and its lasting effects create skeletal and muscular imbalances as well. A habitually rounded spine and contracted belly or a tightened neck and jaw are ways we hold our bodies. We breathe differently when we are feeling safe versus when we are feeling threatened. Think back on how you felt when you saw a disaster on the news. Probably your shoulders and chest tightened — your breath got shallow. These changes in how we use our bodies under real or perceived threat have been happening all our lives. The intensity of our patterns of response to threat accumulates. We hold our shoulders next to our ears without even realizing it! Our diaphragm’s movement is limited and our breathing labored because our rib muscles are held tight as if we feel threatened, even though it may be just past memory. All of these compensations, from injury or stress, become habitual and operate “invisibly” beneath our awareness, causing pain in seemingly unrelated areas.
You can blunt the pain with drugs. But this just prolongs the problem. Pain-masking medications do not address the underlying dysfunction.
You can fuse spinal vertebrae, but this creates a greater demand for movement above or below the area that is now fused and “locked down.” This imbalance eventually damages a new, now overworked area.
A hip joint replacement on one side may eventually put abnormal strain on the opposite side. Range of motion and loading ability become limited due to compromised ligaments, tendons and muscle. Furthermore, the habitual patterns of movement responsible for the initial deterioration of the joint have not been changed.
All three of these solutions reduce the clarity of the incoming sensory data delivered to our brain during weight bearing and other movements. We lose some of the complex interplay between ongoing motion and stability. We may over correct when losing our balance and fall the opposite way.
There are many instances where surgery is the best choice. However, in the rehabilitation stage, if old compensatory patterns remain unchanged, overwork in some areas continues. Wear patterns begin anew. These factors may result in an eventual need for a second hip replacement or deterioration on the other side.
With all of these approaches, that often provide symptom relief, no progress has been made in providing a long-term solution for living in a comfortable body.
So now the good news. There is an efﬁcient and easy way to rebalance your body’s joint workload. This redistribution can be learned using neuroplasticity (the brain’s ability to learn and change from a new stimulus). Whether before tissues and joints become so compromised that they require surgery, or to enhance your good results after surgery and upgrade your recovery, your treatment and rehabilitation should include not only short-term relief but also a return to greater function and long-term prevention of new damage.
This alternative, or addition to, traditional rehabilitation, is non-invasive and very effective. The brain can choose new patterns of movement through exposure to novel information via the sensorimotor system. However, ﬁrst, habitual movement patterns must be brought back into awareness, to avoid superimposing new ways of moving on top of the old, faulty ones, which would create a future of conflicting instructions to our brain. At the same time, those thoughts, feelings, and solutions from childhood, that have inﬂuenced these holding patterns in our body, can be freed to come into our awareness, and be updated into adult perceptions and new choices.
This kind of neurological learning, is created from self-observed incoming kinesthetic sensations, that arise from small, exploratory, non-habitual movements, that awaken our nervous system's spontaneous mechanisms wired in through evolution and our early developmental movements. This occurs during instructed ﬂoor work and individual table sessions from a practitioner.
The nervous system‘s prime mission, aside from ensuring our physical survival, is seeking economy of effort. It is hungry for novel sensory data. But in order to truly upgrade habitual movement patterns, your nervous system needs to be reminded of previous, more efﬁcient and balanced movement in a way that gets its attention, using the unique language it understands – small, slow, differentiated, sensory-motor input.
Dr. Moshe Feldenkrais, the genius with whom I originally trained, said this about healing,
“Until we know what we do now, we can not choose to do otherwise.”
“It is not a question of ﬁnding and ﬁxing the afflicted area. It is a question of first upgrading the intention that will execute the action.” (so first we pay attention to upgrade the intention! H.G.)
Functional movement heals.
With the release of habitual patterns created from physical compensations, injured areas are no longer constantly stressed by excess or imbalanced workloads. With the release of habitual patterns created from the emotional solutions of childhood and the needs of survival, your adult nervous system has no need to reinstate them. This frees the body’s innate ability to repair and heal, bring effortless motion, absence of pain, and the joy of movement back into your daily life.
Written by Harriet Goslins 38 yr Feldenkrais Practitioner® / IA® / Founder -Cortical Field Reeducation®
with Melissa Krikorian MPT / CFR Practitioner® and Trainer