a proposal to include bodymind integration in physical rehabilitation
I have been questioning whether a strengthening approach is always the most appropriate means towards rehabilitating physical injuries or, for grappling with resolving pain. Of course, nothing is ever always the best approach, however, I have never personally been aware of a physical therapy process that didn’t eventually include strengthening as at least part of its protocol.
Muscle-work does have undeniable benefits. Toning muscle tissue is vitalizing for the entire human organism. Healthy muscle tone assists the movement of lymphatic fluid, an important immune function that rids the body of toxins. Healthy muscles also aid in the process of blood circulation and therefore tissue oxygenation, creating conditions for a healthy heart. Regular weight training is said to prevent osteoporosis. Yes to all of this. Muscles are great. This article is not meant to discredit muscle-targeted strength building across the board. I rather mean to shine a light on the nature of muscle, on a cultural overvaluation of strength and on the truth that muscles do not act alone, and perhaps they, and we, could use some more support.
I have personally found it intriguing to explore through embodied consciousness, that the muscles, powerhouses of movement which lever bones through space, do not organize their own activity. They carry out movement, but they do not generate the impetus for it. Desire does not live in muscle bellies. One of my teachers, Bonnie Bainbridge Cohen, writes
“…movement comes from the muscles…[alignment comes from the bones]…We’re used to using our muscles to make the alignment when it is really the bones’ awareness of themselves that will bring the alignment. Embryologically, the bones create the architecture of the alignment and the muscles come in later, once the architecture is almost finished, to create movement. When the bones don’t recognize themselves, when the structure is unaware of itself, the muscles come in as a compensatory pattern to create alignment.”
In private practice, I use Zero Balancing to manually address the health and quality of clients’ bone tissue and to assess the functionality of their bony relationships through the ligaments and arthrokinematics (joint motion). Even through gentle touch, working with bone, the deepest, densest tissue of the body, is a means of allowing all body systems, including muscles, organs and fascia, to come into optimal alignment. In my own experiences with physical therapy, my own and my clients, addressing the skeleton through Zero Balancing has been an essential factor in resolving all sorts of physical complaints. In fact, many of the people who come to see me and other Zero Balancing practitioners are those whose issues have not been relieved or resolved by more traditional therapeutic approaches. Another reason for this, aside from the focus on the skeleton, may be Zero Balancing’s holistic approach. A client presenting with tendinitis of the knee for example, will have sessions designed to improve the condition of and alleviate the symptoms of their knee, but in Zero Balancing, the knee will always be evaluated and balanced within the context of the entire skeleton. All joint articulations will be considered in terms of how they are functioning and relating to what is occurring at the knee.
As practitioners, meeting a client at the depth of bone, and via their whole skeleton, we circumnavigate the mechanistic ideology of isolated muscle compartments. We sink deeper into the body and we work with its interconnected wholeness. The unearthing and engagement of causative factors, beyond addressing the presenting symptomatology, arises frequently. For clients, enhancing their skeletal awareness and having the experience of bony touch has the added impact of opening doors to neuromuscular reprogramming for more functional skeletal support. Furthermore, with doors open, nervous system inclinations towards reactivity, protection, receptivity and adaptability also show up on the table to be worked with.
This brings me to my next point. What if a person’s chief complaint isn’t caused by a structural imbalance or muscle weakness at all? Bonnie Bainbridge-Cohen’s BodyMind Centering research points out that in some cases,
“Weakness, inflexibility and lack of coordination are…not due to structural or muscular problems but caused by a lack of process. When that process is actualized we experience strength, flexibility and ease in our movement and our mind.”
In this quote, Bonnie is referring to the fulfillment of developmental movement processes and implying that we can embody these processes as a means of healing and integration at any stage of our lives. The fulfillment of process as therapy leads towards a more dimensional definition of strength. Strength not only as brute force, but strength as having options, nuance, and the capacity for appropriate modulation. The ability to surrender weight onto a supporting bone for example, is not strength per se, but it is an element that is required in order for the musculoskeletal system to sustain its intricate and never ceasing balancing act. Might we rename the capacity for surrender as an aspect of strength? Or identify surrendering, or yielding, as a means of locating and resourcing more support and honor that process as a potentially potent aspect of rehabilitation? Futhermore, in light of embodying process as a means of optimizing the body’s feeling and function, does the word rehabilitate need to be revisited altogether? We don’t necessarily want to repeat the old if there is room for improvement. So instead we recapitulate, we regrow, we learn, we discover, we evolve.
Up to now, the anatomy studied from textbooks has been inherently hierarchical. Historically, we’ve learned about the human body from cadaver dissections, the study of lifeless tissue. This standpoint has grown approaches to strengthening such as “leg day” at the gym, as if the entire rest of the body isn’t intimately connected with and supporting the actions of the legs. The fact is, every small adjustment to the alive human form requires micro-shifts throughtout the entire organism for maintaining balance. Our bodies are listening. They are adaptive and present. Why not apply process as a continual gathering and integration of new, diverse information about the exquisitely interconnected web of systems that keep us alive and moving? Process for each person individually and process for the collective body of wisdom that we use to heal.
As a practitioner, seeing the body and its processes, enables me to provide a space in which a person’s whole experience can be explored and relevant as their bodies’ uniquely strategized survival tactics. As I bear witness to their processes I can consider the body as a community of living systems that support each other rather than a collection of compartmentalized, mechanistic parts that require independent improvements. It is a nonjudgmental witnessing. As a client, embodiment is a process of expanding self-awareness. Being seen and accepted in this process, or in general, can be transformational for people. And engaging more of themselves in processes is not only restorative, it is empowering. You know that popular factoid that people only use 10% of their brains? Well guess what? Embodiment as a process, knowing via direct self-experience, trying things on, FEELING them, all of this will actually get that percentage higher! Embodiment process is a means of becoming more you.
Okay, so now we’re bone deep in, we’re embodying developmental processes to engage more of our whole selves, and just to throw a cherry on top, I’d like to add a third and final layer to this complex onion. Bodymind integration.
A favorite quote of mine by Mabel Elsworth Todd says that “For every thought supported by feeling, there is a muscle change…emotion constantly finds expression in bodily position.” Further supporting this theory, from Amy Matthews in a BodyMind Centering class earlier this year,
“Movement and mind co-create each other. Mind does not exist in the absence of movement. If you change your idea of something your tissues will change. If your tissues/movement patterns change, your thoughts/ideas will respond.”
It turns out that in the absence of desire, movement or shall I say, coherent, integrated movement, does not develop. What happens is, I need to eat to survive (desire) so I begin to suckle (movement). There is something I want to see, therefore I launch the struggle of lifting and turning my heavy, heavy head. There is something farther afield, I am drawn to push myself up. I really want to touch that colorful object, and so I reach out, and on and on.
If desire is such an integral component of human ontogenetic movement development, why do we not involve it in the process of rehabilitating movement patterns that have gone awry?
Bringing feeling, desire, and intention into the scope of rehabilitative practice can provide people with a sense of bodymind integration; a physical wholeness and agency which is inclusive of but beyond mere symptomatic relief. So, how can we do this?
The first step of engaging desire, is often visualization. The world’s best athletes use this strategy. Why can’t we? Ideokinesis is a strategy for doing this. From an article written by Pilates Educator, Cara Reeser,
“Ideokinesis is a process of visualizing or imaging movement… [in order] to train the nervous system to produce new neuromuscular patterns. When we imagine, or intend a movement in the body, although not actually doing the movement, we…change the habitual patterns of messages, or impulses, being sent from the brain, through the nerve passageways, to the muscles. When visualizing a movement pattern we are initiating nerve impulses along certain neurological pathways to the various muscles, and inhibiting impulses to other muscles, to bring about a desired movement. Visualizing a particular sequence of images excites the appropriate muscles to produce the desired movement. When this improved new pattern is activated during movement, stress is decreased and the new pattern promotes a more balanced alignment of skeletal parts. Regular and attentive use of this new neuromuscular pattern will allow the body to begin organizing around this change. Habitually overused and tense muscles will begin to release and gain flexibility, while flaccid underused muscles begin to develop tone and strength.” Full article here = https://www.carareeserpilates.com/wp-content/uploads/2016/03/9-LINES-OF-MOVEMENT.pdf
Studying Ideokinesis with Irene Dowd has given me a means for engaging my clients using visualization as a strategy for getting them to feel different and to find supportive neuromuscular engagement. I’ve found the most compelling means of inspiring clients to visualize images that are clear enough to effect physical change has been to cue them with feeling words and images that are tactile and that relate directly to the feelings they’ve brought into the room around their pain. Words and images that inspire qualitatively rich body sensations, body sensations that will provide the relief they so desire. The mind of the emotions expressed around the client’s injury and their experience of enduring pain and symptoms becomes uncompromisingly relevant for a precise concoction of just the right cuing. For example, encouraging someone to ‘softly float their patella into the cushion of their quadricep muscle mass’ produces an entirely different result from asking them to ‘lift their patella by activating their vastus medialis more, more, more’. Can you see how the words effect the feeling, the intention, the desire? How they might stimulate a different neuromuscular pathway of activation?
This work can easily become the arena of somatic psychology and has the potential to enter the territory of nervous system trauma responses as well. Trauma can come up in the context of safe space being provided, healing touch and listening being offered and especially when a person’s feelings around their physical wellness are validated. And when things do come up, they can be worked with via movement and touch. From an energetic perspective after all, the expression of emotion is movement while the trapping of emotion in the body is tension. All of this can be tracked and allowed to process via bodily sensation. This is the bodymind connection. The physical structure is a conduit for the movements of our minds and our emotions and it came to its dynamic architectural precision in concert with allowing their flow .Providing clients the space to clarify and therapeutically engage their emotions (desire) and intentions (mind) as a part of their physical healing process, is integrative and as a result, the shifts that occur are long-lasting. Identifying internal narratives for what they are (stories) releases people from their hold and makes room for the naming of the feelings that are interwoven with a person’s pain, injury or ailment. This process can catalyze profound shifts in self-understanding. Clearly, I buy into this. For any persisting naysayers however, I will take a moment to point out that not all physical injuries, pain or imbalances require all this digging. Sometimes you stub your toe and that’s that. Some issues, especially those that aren’t chronic long-held patterns, are more easily resolved. They are less deeply grooved into our nervous systems.
That said, if you are showing up with a chronic concern that hasn’t responded well to traditional, non-invasive therapy, or you have a gut feeling that an emotional weight is exacerbating or manifesting as a physical condition, then please consider my proposal. These are options to investigate before choosing painkillers or surgery. Why not explore what could be the key that opens the stubborn lock to you feeling better, to you feeling like a fuller, more integrated version of yourself? Why not add the above approaches to the tool-kit of strategies that are traditionally employed for physical rehabilitation, not to abandon the current approach altogether, but to supplement it with whole person wellness? Why not listen more deeply, more compassionately, more holistically so that a process of investigation is not precluded because of landing prematurely on a diagnosis?
What if we collectively consider that perhaps strength doesn’t always need to be the default desired outcome? So that if we were to peel back our muscle fibers, we would find not only the stories of strength and endurance, but also sinews that sing of vulnerability, surrender, patience, presence, qualitative nuance, interconnectedness, and pulsing, alive resilience. Are there ways in which our society at large has been hindered because of on overvaluation of strength and power not only in the individual body? How can our minds and emotions shift as we make space for all of this nuance? What if we collectively reorient towards process? What if we acknowledge the quality of the client/patient-practitioner relationship as just as important to the rehabilitation process as the prescribed actions taken? What if we validate the gathering of experiential wisdom and the understanding that not every person’s experience fits with the documented theory? What if we invite more feminine wisdom, process and research into the fold of the healthcare and medical fields and position it as the mainstay of the societal healing that is so desperately sought through the collective outcrying of our bodies in physical pain?
Photo by Gizelle Peters.