I have been moving away from structuralism (focusing on structural problems and misalignment) towards a more integrative and individualized approach.  Each person is so unique, and the more I work with people as a Yoga Therapist and Yoga teacher, the more I marvel at the mystery of a human being. 

There is no formula that is going to "fix" everyone, there is no single joint, bone or muscle that is the "source of the problem".  It all depends.  Research done for the last 25 years has struggled to find much evidence that pain can be explained by structural abnormalities, or that correcting structural deviations would bring pain relief.  You might be interested in this article by Eyal Lederman, The fall of postural-structural biomechanical model in manual and physical therapies: exemplified by lower back pain.

Since everything seems to be in the eye of the beholder, I have been talking more and more about proprioceptive capacity, or our ability to sense our body.  Some of the latest research about the nervous system has been very illuminating, and apparently the health and resilience of our nervous system may play a bigger role in how well we age and how good we feel than we ever realized.  This is starting to make sense to me: I have seen many different bodies by now, some with rather noticeable structural imbalances - major scoliosis, major misalignment of hips and shoulders...  But quite a few of those people report having no pain, no discomfort and are able to move with great ease. I, myself, am far from perfect, and yet my body feels wonderful to live in. Others, meanwhile, even if there is hardly anything wrong with them, are suffering from pain, sometimes of the debilitating kind.  Why?  What is the nature of pain? 

Pain and rehabilitation science has not been very impressive - science still doesn't quite have all the answers, although some people would have you believe that they have it all figured out.  For example, only now science is discovering that tendons are incredibly complex "bio-ropes", but there is still no clear understanding of how to treat them.  Only recently science realized that fascia is an incredibly rich sensory organ that connects everything to everything else.  Many people have never heard the word fascia yet, that's how new it is!  I have a whole lengthy article, called Fascia, the New Frontier, which you may find interesting.

What is this proprioceptive capacity, or body awareness?  You may have a rough idea of where your right leg is, but can you tell the exact angle of the knee, the precise position of the thigh bone, without looking at it?  When you are moving in space, are you able to have an accurate picture in your mind of the landscape under your feet, around you?  Do you move fluidly and nimbly through space, or do you stumble often, loose your footing, bump into things?  When you lose balance, do you find it difficult to "save yourself" from falling, or are you able to quickly adjust your position in mid-air, to avoid an injury?  When you are in a yoga class, and the teacher says - straighten your back leg, are you sure yours is straight?  You wouldn't believe how many people have no idea that their back leg is not straight in Warrior I pose!

It appears that our nervous system is simply unable to perceive the very body it governs.  Sometimes the pain we perceive is not actually, really, truly there!  Have you ever considered that pain is very subjective?  Or at least, the degree of pain.  I have read somewhere recently that relaxation and rest, truly deep rest, like a regular Savasana, is just as effective at managing pain as medication and even surgery.  There have been studies done on knee pain, where "pretend surgery" and real surgery were found to have identical effects!  The power of the mind is, indeed, absolutely awesome.

And it is the mind that perceives pain, perceives its location in the body (have you heard of referral pain - pain in a completely different place?), the degree of that pain, etc.  The nervous system is how the mind communicates with the body.  What would work to stimulate this connection, to nourish it?  It appears that rehabilitating this connection can have profound effects on our state of well being.  Here are my two cents on what I believe is the most effective way to establish and hone that connection:

  • regular mind/body sessions, such as Yoga or other type of meditative exercise, where you really pay attention to what you are doing
  • slow, mindful, deliberate movements, with precise placement of limbs, fluid transitions between positions, focusing on the pleasurable sensations.  Read this article for more: Slow Movement with Awareness - Better than Exercise?
  • movements and positions that feel really, really good - providing the mind with sensory input from the body that feels nourishing.  Too often people believe that they need to overload their sensory system with aggressive, hard, draining exercise, but that only numbs the nervous system further.  I have a whole other article on this subject, called Yoga in America - the Sensory Overload
  • resting between movements, at the end of each event, to give your nervous system a chance to re-balance itself, and then resting for a while after your session, to fully integrate the experience
  • keeping the movements mid-range for the most part, repeating the same movement in that mid-range several times, and only then venturing into the comfortable end range dimension
  • all of the above done with breath awareness, supported by the breath, to keep your attention sharp on those sensations

Basically, my theory as of late (subject to change, or course, as new information comes in), is that it doesn't matter what you do, but how you do it, as well as variety of activities and keeping these activities moderate (not wearing yourself out too much), with lots of rest and relaxation.  Let's all do Yoga every day, shimmy around on Miracle Balls, take a regular walk, dance in the kitchen, garden, laugh with friends over a good meal.  A little bit of everything, and everything in moderation - that seems to be the key.  To stimulate the nervous system just enough, but not too much, avoiding jarring, painful, or extreme sensations.  There is a lot less wrong with us than we think!  Let's celebrate all that is right with us.  Who's with me?