Jun 14, 2020 30 min read Health

Playing with Movement by Todd Hargrove - Summary and Book Notes

This is a summary of a great Tree Book. Tree books are books that lay out a framework of ideas. Here Hargrove explores physical health and performance from a complexity science perspective.

Review -- Playing With Movement by Todd Hargrove

Teaching Complexity Science is hard. Showing a workable path towards physical fitness, also hard.

Todd Hargrove has managed to do both in a single book.

Playing With Movement shows us how to think about our body as a complex system, without burying us in complicated jargon. It covers exercise as play, systems thinking, complexity science, mobility, pain, and more.

It's refreshing to read a health & fitness book that's both well cited and nuanced. I really enjoyed reading this book, and if you frequent this site, I think you would too.

Highly recommend.

I highly recommend for people who:

think that being healthy means forcing yourself to exercise
think of the body as a collection of parts
are suffering from pain and want to understand the mechanisms better (see a doctor!)
want to learn about complexity science in a non-intimidating way
want to make exercise more fun!

Skip this book if you:

already have a solid understanding of the Biopsychosocial model
are satisfied with your current exercise regimen

Buy Playing With Movement on Amazon

Main Ideas from Playing With Movement

Health is a complex problem, with many interconnected aspects.
Play is often the best approach to solving complex problems (like your health).
Understanding some basic complexity science can help us understand our own bodies.
Physical wellness is developed by stress, but too much is harmful
The environment has a bigger effect on your behavior than we think
Structural tissue damage is very poorly correlated with pain
To treat pain, do everything you can to let your body know it’s strong, safe, resilient, and capable.

Book Notes: Playing With Movement

The following are rough notes I took while reading. These are mostly paraphrased or quoted directly from the book. I've rearranged some ideas from their original book order to better fit themes.

Play is a natural behavior that evolved to help animals solve complex problems in the face of uncertainty. If you want to get better at a sport, find a sustainable exercise program, or even get out of pain, you will need to play with movement.

[The mainstream view] stems from a reductive mindset that views the body as a machine to be “fixed,” as opposed to an organic self-organizing system that adapts and learns.

Chapter 1: Movement Health

The difficulty in defining health is that it is complex. If it was an object, it would be multi-dimensional, with many different sides - musculoskeletal, cognitive, emotional, cardiovascular, etc.

Biopsychosocial model, developed by George Engel in 1977.

if a problem has multiple causes, there are more ways to resolve it.

This suggests a treatment approach that is personalized, exploratory, flexible, and, importantly, does not necessarily require expert assistance.

THE MANY DIMENSIONS OF MOVEMENT HEALTH

STRUCTURE

In our culture, physical structure tends to be overrated.

FITNESS

Fitness means preparedness to do physical work. It is to some extent “specific,” meaning that being fit to perform one kind of task,

You can develop well-rounded fitness with a relatively playful approach — one that is fun, favors variety, and avoids repetitive specialization. However, if you want to reach an elite level of fitness in any area, you will need to do some hard work and specialize,

RECOVERY

The optimal learning environment combines elements of intense focus with unstructured exploration. A playful attitude is one that strikes an appropriate balance between challenge and recovery.

SKILL

Some movement skills are more or less essential components of movement health. Postural balance, walking, running, squatting, climbing, reaching, jumping and landing are all fundamental.

In general, fundamental movement skills are easily developed through playful methods, while more complex and specific skills usually require some work.

PERCEPTION

Movement skill is almost inseparable from accurate perception about the position of the body in relation to the environment. Thus, learning movement skill is very much about developing perceptual abilities.

ENVIRONMENT

Our movement behavior is affected by the presence of “affordances,” features of the environment that “invite” us to move in certain ways. Green fields, hiking trails, playgrounds and dance floors all encourage us to get moving. Other environments tell us to stop moving and sit still: a town with wide streets and no sidewalks; a neighborhood without parks or green spaces; a job that requires constant typing; a living space with couches all pointed at the TV.

Movement always has a social dimension, and this is easily overlooked

PSYCHOLOGICAL

Movements have an emotional aspect — they feel good, or bad, and this makes us want to repeat them or avoid them.

Play is associated with a psychological state that gets you motivated to move, and to perform well while moving.

A MODEL FOR MOVEMENT HEALTH

The different dimensions overlap and do not establish distinct categories.

the different dimensions are not about dividing a complex whole into some neat little boxes, but providing different perspectives to look at it.

there is no hierarchical relationship between the different factors. It’s a network, where all the relationships are mutually supportive, like strands of a spider web.

most of our attention tends toward objectively measurable and conspicuously visible factors like structure or fitness. And we ignore the more subjective concepts related to psychology and perception.

play is a good way to restore emphasis to some of the overlooked areas and promote multi-dimensional movement health.

Chapter 2: Play

All intelligent animals play, and the more intelligent the animal, the more it plays.

the cheetah cubs play because it’s an effective form of “training” for the hard job of being an adult cheetah.

Zoo animals often become sick or stressed in unnatural conditions. The modern world is in some ways a zoo for humans

PLAY IS INTRINSICALLY MOTIVATING

Play isn’t serving some larger purpose, it’s an end in itself.

Does a Labrador retriever need willpower to chase a ball? No, that is exactly what it wants to do.

Play is not about doing things that are immature, frivolous, or trivial. It is about getting absorbed in an activity that is intrinsically motivating.

an enjoyable five-mile run done in 40 minutes will promote movement health better than the same exact run that is boring, meaningless and stressful.

PLAY IS NOT TOO STRESSFUL

Play, almost by definition, never compromises the recovery dimension of movement health.

If losing makes you feel ashamed, depressed or stressed, you are probably not playing anymore.

PLAY IS EXPLORATORY

Play has a curious attitude and favors exploration over following a map.

Patrick Bateson believes that play evolved as a way to help animals avoid “false endpoints”— solutions that are workable but not optimal.

PLAY IS CREATIVE

PLAY IS TINKERING

PLAY INVOLVES RISK

Play is a way to test the efficiency of different movements, and also their safety.

Fear is the enemy, and playing with risk is a way to learn to master it. Further, handling a risky situation builds confidence, and a sense of self-efficacy.

perception of threat is at the root of many undesirable conditions in the body.

CAN HUMANS PLAY LIKE CHEETAHS?

In the modern world, following our instincts and doing what comes “naturally” doesn’t work as well. Kids who follow their play instinct might end up spending more time with video games than tree climbing.

the reality of our modern life is that most of us will need to work at physical activity to some extent —use discipline, conscious planning, and willpower to get moving.

Chapter 3: Complexity

Reductionism means trying to understand a large system by “reducing” it to a collection of smaller parts, and then analyzing them separately.

there is nothing fallacious about reductionist thinking, or dividing wholes into parts. However, this strategy may be less useful as applied to a complex system

First, it’s not easy to divide complex wholes into parts, because their boundaries are fuzzy.

complex systems have too many parts (or interactions between them) to measure.

with complex problems, more data does not necessarily lead to better understanding.

Complexity science tries to identify big picture patterns that are invisible from a reductionist perspective. This is done by turning attention away from the specific parts in a system, and towards the patterns of interaction between them.

EMERGENCE

A defining quality of a complex system is the presence of “emergent” properties, which are collective behaviors by the whole system that cannot be found at the level of the parts.

The big picture on human bodies is that they are like ant colonies....They have no idea they are part of some larger plan to form an intelligent body. And yet somehow their interactions do exactly that. We are not machines but ecologies.

NESTING: SUBSYSTEMS AND SUPERSYSTEMS

Most complex adaptive systems are “nested” in this way — they are composed of subsystems, which have their own subsystems, and so forth.

Each level of analysis may provide unique insights. Advocates of complexity science argue that mainstream medicine has spent too much time at the lower levels, where phenomena are more easily quantified, and not enough at the higher levels, where the interesting events are more qualitative and subjective.

ADAPTIVITY

Complex adaptive systems have goals and the means to achieve them.

to understand a complex adaptive system, you need to know its history.

NON-LINEARITY

Complex systems are non-linear, meaning their behavior is irregular. For example, the system might have a massive response to a minor stimulus, or little to no response

Getting better is not a smooth, upward progression, but a jagged line of improvements, coupled with set-backs.

FEEDBACK LOOPS

The dynamic behavior of a complex system is driven by connectivity between its different parts. One common pattern of connection is a feedback loop

Feedback loops can be negative or positive. Negative feedback promotes stable behavior.

Many of the physiological conditions that are required to remain alive — bodyweight, temperature, heart rate, oxygen level — are regulated by negative feedback loops.

In the body, positive feedback loops implement the response to physical emergencies.

What if the negative feedback loops don’t kick in properly, and the injured area remains stuck in a positive feedback loop? For example, pain prevents movement, which prevents healing, which prevents movement, which reduces fitness, which prevents movement. Playing with movement is a way to escape this loop.

VARIABILITY

Complex systems display extreme variability, meaning they are able to assume a near infinite number of different states

when an organism gets locked into an excessively repetitive pattern, that can be a sign of dysregulation.

The benefit of variable movement is having more ways to get the same job done.

ATTRACTORS

Which decision gets made? The answer is uncertain, but some outcomes are more statistically likely than others.** An attractor is a state of organization to which a system will tend to gravitate, as a matter of probability.

We can think of attractors as habits, predispositions, or tendencies.

someone may have a habit of being sedentary because as soon as they start a new exercise program, they get negative feedback, such as fatigue, boredom or pain. We could represent any ingrained habit as a ball sitting in a deep and narrow well.

SELF-ORGANIZATION

Complex systems are attracted to states of order, even though there is no central plan.

To move well, you don’t need to be told the right way to move, to think about the right way to move, or even have any conscious idea about the right way to move. The role of the conscious mind is mostly limited to directing intention and attention

Trying to impose strict top-down control over movement (e.g., by consciously bracing the core or firing the glutes) is unlikely to improve organization and may even make it worse.

COMPLEX VS COMPLICATED PROBLEMS

Complicated problems have many interrelated parts, but each can potentially be controlled with extreme precision in a top-down manner, provided you have sufficient expertise.

Complex problems are different, because expertise isn’t necessary or sufficient for success.

When qualified experts have major disagreements over the basics of how to solve a problem, it is most likely complex [see, all of nutrition science].

In most cases, expertise will probably help, but will not provide a quantum leap over common sense, individual experimentation, and a strong intention to succeed. Although complicated problems always require expert knowledge, solutions to complex problems might be deceivingly simple.

a controlling mindset may limit the freedom an organic system needs to self-organize.

Because we cannot acquire full knowledge over complex systems, we need to remain humble in our interventions, acting more like a gardener cultivating growth, and less like a craftsman shaping an object.

“We can’t fix complex problems, but we can dance with them.”

CONSTRAINTS

A constraint is defined as a feature of the system or its environment that limits the states the system can assume.

I think of constraints as like the banks of a river, channeling all the dynamism of the water into a definite shape. The water still has tremendous freedom to move, but within limits.

Self-organizing systems perform best when they are given freedom within appropriate limits, as opposed to being told exactly what to do.

When changes happen through command, they may be more fragile and impermanent, subject to falling apart as soon as discipline wavers.

You can think of any effort to improve your movement health as being about playing with the constraints around which your body self-organizes.

Chapter 4: Stress and Adaptation

Over time, repeated bouts of good stress will make you more healthy, sane and attractive.

Over time, or even in an instant if the stress is extreme (e.g., a really bad musical), these events can overwhelm the system, or slowly deplete vital resources, leaving you weaker and less adaptable.

A particular form of stress might be good for one person and bad for another.

STRESS AND PHYSICAL CHALLENGE

When the emergency is over, the body will shift out of “fight or flight” and into “rest and digest.”

Stress is not just for emergencies — you need just a touch to walk up the stairs or get out of bed in the morning.

Thus, a healthy stress response system is constantly adjusting its level of activation or relaxation.

When balance is disturbed, the body may become attracted to a more protective state, making it harder to sleep, relax or enjoy life.

EMOTIONAL STRESS

in social animals, and especially humans, emotional challenges also activate the stress response, even if they do not involve an immediate physical threat.

GENERAL ADAPTATION SYNDROME

Selye’s ideas have been significantly modified since they were developed, but the basic framework remains highly influential,

OVERLOAD

A stressor will cause an adaptation only if it exceeds a certain threshold of intensity and frequency.

your body has been adapting to movement stress your whole life. Therefore, your current level of fitness and coordination is a reflection of what your body “thinks” is an optimal solution to life’s physical challenges.

Stress doesn’t cause adaptation until the stress is over and recovery begins.

you can’t adapt if you don’t recover. Nor can you learn. The process of learning new skills starts during focused practice, but is consolidated in downtime like sleep and daydreaming.

DIMINISHING RETURNS

training has diminishing returns. The better you get, the harder you have to work to get better still.

At the novice stage, just showing up is 80% of the battle, and if you do that, the adaptations will come easily.

One of the practical messages of this book is that you should pick as much low-hanging movement health fruit as possible. Another is that play is often sufficient to pick that fruit with a minimum of effort.

elite performance requires a lot of work, and just playing around won’t get the job done. However, because of the importance of minimizing unnecessary emotional stress, the workload should include as many elements of play as reasonably possible.

SPECIFICITY

We adapt to the specific challenges we encounter, not challenges in general.

But many other adaptations have far less “carryover” to other activities than you might imagine.

REVERSIBILITY

Fitness adaptations have a “use it or lose it” nature. When the stress that creates them is removed, the adaptations slowly fade.

muscles seem to retain some “memory” of their prior level of strength and endurance, making it easier for them to recover their past abilities after they are lost

Memories related to motor skills are far more permanent. Even after decades of neglect, we don’t forget how to ride a bike.

INDIVIDUALITY

there are many other reasons that people adapt to stress differently, and this should be considered the rule rather than the exception.

SLEEP AND STRESS

Sleep helps fight the negative effects of excess stress, and excess stress makes it hard to sleep.

Sleep deprivation denies these benefits and is therefore one of the most potent stressors that can be applied to the human body.

There is a strong association between insomnia and chronic pain.

STRESS AND PERCEPTION

One of the complexities of stress is that it depends on perception.

The emotional regions of the brain are the first to detect a threat, so stress is heavily affected by mood.

STRESS AND SPORT

The role of subjective perception in the stress response has major implications for how we train to promote movement health or sport performance. It means that we must consider psychological factors, not just objective variables like sets and reps.

PERIODIZATION

Trainers like John Kiely are skeptical about the ability of [periodization] to forecast ahead of time exactly what kinds of physical stress will best promote an athlete’s fitness on a given day. There are simply too many random variables involved, such as sleep, injury, recovery, and motivation.

The one thing every good plan has in common is gradually progressing the level of stress, while making sure the kind of stress is varied.

it may be that the exact order and specifics of the training variations are less important than the fact that they exist.

Changes in training prevent boredom and staleness and inject some randomness into a system that needs a bit of chaos to drive creativity.

PLAYING WITH STRESS

The stress vulnerability model uses the metaphor of a bucket.

If your bucket continues to overflow, your resilience will start to suffer. The size of the bucket will effectively become smaller, meaning that you have less adaptive capacity.

When back pain suddenly shows up, we are tempted to blame it on the last minor stressor that affected it, such as a soft bed in a hotel. This is like blaming your bankruptcy on the last latte you bought before your account finally went into the red.

Each person has their own bucket size, a unique set of stressors to fill it, and a particular sensitivity to each stressor.

The goal is to slowly grow the size of your bucket over time, so that you increase your resilience and general function.

Chapter 5: Fitness

Asking who is “fittest” is roughly analogous to asking who is the most physically “prepared.” It begs the question: prepared for what?

PHYSICAL ACTIVITY IS INCREDIBLY GOOD FOR YOU

Physical activity is now considered one of the “big four” lifestyle factors (along with smoking, nutrition and drug abuse) that have major effects on health.

regular exercise can prevent dementia, type 2 diabetes, some cancers, depression, heart disease and other common serious conditions — reducing the risk of each by at least 30%.

General exercise, meaning whatever exercise you enjoy, is an effective treatment for low back pain.

PHYSICAL ACTIVITY AS A KEY CONSTRAINT ON HEALTH

How does physical activity work to improve so many different systems in the body?

Part of the explanation is that humans, and indeed all animals, are fundamentally in the business of producing movements.

From a Darwinian perspective, nothing else really matters. Movement is always the end goal, and is therefore directly connected to every system of importance in the body.

Physical activity is therefore a key constraint that organizes the body, keeping it attracted to states of order that are healthy and functional. Without this constraint in place, the system tends towards entropy and chaos

LOW-HANGING FRUITS

With exercise, working to improve a weakness would probably have more general benefit than improving a strength.

the courage to try something new without fear of failure. A playful attitude toward movement is one that doesn’t worry too much about the embarrassments of doing something you’re not good at.

VARIABILITY OF PHYSICAL ACTIVITY

Good athletic coaches make sure to vary the training stimulus.

PLAYING WITH FITNESS

If you want to “play” with fitness as a way to improve general health, here are some “rules of the game” to keep in mind. Have as much fun as possible within these basic constraints:

Aim for at least half an hour and up to two hours of physical activity almost every day.
Movement should be varied in terms of volume, intensity and type. Most activity can be fairly light. Walking is the most natural and beneficial movement for human beings.
Occasionally include some high intensity work that significantly challenges your strength, power, and/or capacity to sustain high energy output for a short period of time. Climbing, running and resistance training are logical choices.
Include movements that challenge coordination, balance, and range of motion.
Move around a lot at a slow easy pace.
Frequently move with some urgency or pick up something heavy.
Every once in a while, move like your life depends on it.

Do something that you enjoy doing and feels meaningful, even if it doesn’t check every box in the guidelines.

Chapter 6: Environment

The modern environment for humans is a bit of a zoo

we build our own cages, so we have a pretty good idea of how to keep them enriched. Of course, not everyone has the resources for as much enrichment as they might like. And even when we do, we don’t always make the healthiest choices about what kinds of enrichments to purchase.

Social and environmental variables are key constraints on movement. They help set the conditions that either reward or punish us for being active or sedentary.

part of what makes an enriched environment is the way we perceive it, and this is something we can change.

THE CONTEXT FOR MOVEMENT

My oldest daughter never did very much biking when she was in elementary school. If you asked her why, she would have said that biking is not one of her interests, or that she is just not the kind of person who likes to bike. In other words, she would have explained her biking behavior in reference to her internal psychological state. But this theory would not explain why, a few years ago on a camping trip, she spent almost all day biking for several days, seemingly enjoying every minute. She was on her bike within ten minutes of waking, and then on and off until ten minutes before going to bed. Why the sudden change? Did she have a transformative experience? Was she suddenly convinced that biking is actually a fun thing to do? No! Because as soon as she got home, she went right back to not riding her bike. The only thing that really changed on the camping trip was the environment.

Ecological psychology emphasizes the importance of context. The main premise is that humans are fully “embedded” in their environments, and therefore we can’t understand them very well in the abstract.

We tend to underestimate the effect of the environment on our behavior, perhaps because we overestimate our self-control and agency.

It’s not always about the activity itself, but the social environment.

You can go against the environmental grain if you are determined, but there is less friction in life when you go with it.

NATURAL ENVIRONMENTS

People like exercising outdoors better than indoors.

One reason for this difference may be that movement through an outdoor environment provides sensory feedback that you are actually getting somewhere, which is the whole point of movement in the first place.

AFFORDANCES

When affordances are perceived, they “invite” certain movement patterns.

Modern environments are filled with affordances for sedentary behavior — comfy chairs, elevators, magical screens that help you explore the world with the swipe of a finger, and delicious foods within easy reach.

I often leave soccer balls, kettlebells, or resistance bands in conspicuous areas of the house.

Skateboarding and parkour developed when people started to look at urban jungles as obstacle courses. By seeing the world in a different way, they invented new forms of movement.

Different perception leads to different action. And this works in reverse as well — action changes perception. When you develop a new skill set, you see the opportunities to put it to use.

PLAYING WITH THE ENVIRONMENT

Put yourself into environments that encourage activity, especially outdoors. Enrich your indoor environment.
Develop basic literacy and appreciation for movements that can be done in any environment — walking, running, sprinting, jumping, climbing, throwing, dancing and gymnastics.
Explore movements that are well-suited to your current environment.
Find social groups that encourage you to move, and that make you feel like a valued member of the group when you do. Avoid groups that make you feel guilty, ashamed, or incompetent.
Take advantage of what the modern world has to offer.

With just a few internet searches, you can find instruction in martial arts, juggling, yoga, capoeira, soccer, kickball, gymnastics, javelin, and kayaking.

No matter how weird your interest, there is an online community of like-minded people gathering information about it, analyzing it, sharing it, and most likely getting about half of it completely wrong.

Chapter 7: Structure

The structure of the body — the muscles, bones, tendons, ligaments and connective tissues — is easily seen and measured. Because anatomy is right there ready to be MRI’d, foam-rolled, and scalpelled, people are quick to assume it’s the key piece of the movement puzzle.

However, the correlation between tissue damage and pain is far weaker than you might imagine.

On the other hand, structure is underrated in its effects on coordination. The shape of the bones helps determine what movements are most efficient and comfortable for a particular person.

STRUCTURE AND FUNCTION

We all know you need to be big to be an NFL lineman, tall to play in the NBA, and small to be a jockey. But there are more subtle ways that structure affects movement.

Muscular structure has a huge impact on movement ability.

The body’s structure adapts to mechanical stress.

DAMAGE TO STRUCTURE

If your joints feel good during and after healthy activities, the “age” of the joint is not a good reason to stop them.

Repetitive stress will make tissues stronger if they have adequate time to recover. In fact, moving too little may be as bad for joints as moving too much.

STRUCTURAL REDUNDANCY

In a machine, a local failure may cause a global catastrophe.

But living things are more robust than machines. They are built with structural redundancy, which allows them to perform the same function in many different ways.

At least nine different muscles can help flex the hip.

The same is true for almost any other basic movement in the body.

THE DISCONNECT BETWEEN STRUCTURAL DAMAGE AND PAIN

structural damage to the body does not always cause pain, and pain is not always the result of structural damage.

almost no matter where you point an MRI on a person over 30, you have a very strong chance of finding significant damage, even in places without pain.

many popular orthopedic surgeries to repair damage found on MRIs work no better than placebo.

MRIs on People Without Pain

In 1994, a study was done using MRIs to examine the backs of people without pain. It was discovered that about half had at least one bulging disc.

Another study did a ten-year follow up, looking at the extent of disc degeneration, spondylolisthesis, disc bulge and other findings. The conclusion: “Our data suggest that baseline MRI findings cannot predict future low back pain.”

new guidelines recommending against the use of MRIs in connection with recent onset back pain, which have been found to be associated with worse outcomes. The cause for this association may include increased risk of unnecessary surgery, or reduced feelings of self-efficacy and optimism about recovery.

we know that tissue damage does not necessarily result in pain. That doesn’t mean it’s irrelevant.

Many Orthopedic Surgeries Don’t Work

many popular surgeries (but not all) work no better than a placebo.

None of the above means that we should not trust orthopedic surgeons, or that surgery should never be used to treat chronic pain. Many surgeries have been proven to work, and are definitely a good idea under certain circumstances.

the medical establishment has some biases in the way it treats chronic pain. It favors treatments based on simple structural explanations for pain, and tends to ignore complex neurophysiological processes that may be more important.

STRUCTURE AND MANUAL THERAPY

Popular techniques like spinal manipulation or myofascial release are premised on the alleged ability of the therapist to make significant and meaningful changes to hard structures — bones, muscles and fascia — in just minutes, using nothing more than hands!

Although myofascial techniques have been shown to increase flexibility and reduce pain, the mechanism probably involves changing neurophysiological processes related to perception or coordination, not structure.

Bones don’t snap “in” and “out” of place

Although spinal adjustments can relieve pain and improve range of motion, the likely mechanism is once again complex and neurophysiological, not simple and structural.

Muscles don’t have “knots”

the subjective feeling of tightness is not the same as actual mechanical tightness. In fact, it is unlikely that stressed muscles become palpably tight.

skilled massage therapists are unable to palpate a client’s back and predict which areas feel tight to the client.

PLAYING WITH STRUCTURE

Although adults cannot make major changes to the shape of their skeletons, they can make dramatic body transformations by adding muscle and/or losing fat.

For the most part, the best way to develop the structural adaptations that will assist your performance in a particular activity is to ... do that activity. Work at some level that you can easily tolerate, and then slowly progress over time.

Chapter 8: Mobility

Mobility means how well you move near a functional end range of motion.

When movement isn’t constrained by structure, the nervous system needs to work harder to provide control. Another cost of floppy joints is loss of efficiency and power.

PLAYING WITH MOBILITY

just climbing would keep you very mobile, even if that’s all you ever did.

You don’t need a climbing wall to use this same basic template for playing with mobility. Get into any position that is functional for a wide variety of activities — standing, squatting, all fours, lunging, sitting in various positions on the floor. Now reach a hand (or foot) to a random distant point on the floor or the air, while keeping your other points of contact with the floor. (Yes, this is basically the game of Twister.)

Our primate ancestors lived in trees and spent a lot of time reaching for tree branches in random locations. Our bodies are well-organized to serve the needs of the hands to grasp distant things, and therefore reaching tends to get the body coordinated

the body coordinates itself best when attention is directed to some external goal in the environment.

The nervous system also constrains range of motion. If it perceives threat related to a muscle lengthening, it will stiffen the muscle to protect the body.

Go as far as you can safely, establish some confidence and functionality at that range, and then try to go further next time.

Chapter 9: Posture

The purpose of good trunk and neck alignment is not to create an appearance of verticality or upstandingness to a critical observer. It is to help you efficiently and safely accomplish some physical task, such as standing, sitting, walking, running, reaching, etc. So posture should be judged by how you perform and feel, not by how you look.

optimal posture is not a single anatomical arrangement, but many. Posture needs to constantly change according to current needs for safety, function and comfort.

Your balance is therefore dynamic, not static.

While working on a computer, your attention goes to the screen in front of you, and the neck “helps” the eyes by moving the head forward, which tends to slump the chest.

The system works very well without us trying to control it. According to Nicolai Bernstein, a pioneer in the science of motor control, we should think of the postural system as we would an internal organ. It doesn’t benefit from “interference in its business.”

POSTURE AND PAIN

Bernstein’s advice is very different from what you hear from popular posture gurus and media headlines.

One common theme is that slumping is bad, and likely to cause pain in the neck, upper back or shoulders. Another concern of postural gurus is alignment of the pelvis and low back. Another popular idea is that postural asymmetry causes pain, because it stresses one side of the body.

The overwhelming majority of the research on posture and pain does not support a causal relationship.

No association between leg length inequality and back pain.
No association between neck pain and neck curvature in 107 people over the age of 45.
Teenagers with postural asymmetry, excessive thoracic curve and/or lumbar curve were no more likely to develop back pain in adulthood than peers with “better” posture.
Teenagers with slumped forward head postures didn’t have more neck pain (although they were more depressed).
No association between neck pain and “text neck” as assessed by physical therapists.
Ergonomic programs do not reduce the risk of a future onset of neck pain, but exercise reduces the risk by half.
Sitting at work is not associated with low back pain.

many studies have easily found other factors that correlate with low back pain, such as exercise, job satisfaction, educational level, stress, and smoking.

POSTURE AND CORE STRENGTH

Stability is especially important during activities that create a lot of force on the low back, including heavy lifting, or high-speed bending or rotating. However, most of life requires only minimal activation of the core musculature.

Although core exercises can reduce low back pain, they seem to work no better than many other treatments, including brisk walking, general exercise, or even exercises directed towards relaxing the core muscles, which is basically the opposite of bracing.

Bracing is energetically inefficient because it requires extra muscle work, and it limits mobility and function in certain contexts. And bracing works by compressing the joints, which may over time be a source of excess stress.

Peter O’Sullivan, a physical therapist and back pain researcher, argues that common advice to brace your core during everyday activities may be counterproductive. He often gets clients to feel better by doing less, not more work, with their abs.

PLAYING WITH POSTURE

The research on posture and core strength should not be construed to mean that posture doesn’t matter for pain or performance.

Good posture is complex, individual, dynamic and contextual. It doesn’t make sense to measure it with a plumb line, or try to improve it with one-size fits all rules. A better approach is to explore different postural options and find what works best for you.

most of us are attracted to good postural solutions through sensory feedback, and find them without any conscious effort.

fear of movement related to bending or twisting can predict excessive core bracing, reduced postural variability, and bad outcomes in chronic pain.

C.S. Holling: “Placing a system in a straitjacket of constancy can cause fragility to evolve.”

Recall that it is difficult to control complex systems directly in a top-down manner. It’s better to think in terms of changing the constraints around which they self-organize.

SOME POTENTIAL CONSTRAINTS ON POSTURE

movements that require good integration of the trunk with the limbs, such as crawling, walking, running and swimming (all locomotive movements) will also tend to improve the organization of the trunk.
activities that challenge balance, like gymnastics, dance or skateboarding.
yoga, Pilates, or tai chi develop skills in maintaining a particular alignment under variable conditions.
Feldenkrais Method, which are designed to help you “remember” all sorts of subtle movements in the spine and ribs that you may be neglecting.
Posture has a psychosocial dimension. Body language sends social signals about mood and confidence.

one of the reasons you tend to slouch when you look at a computer screen is that it helps you get closer to the object of your attention. If you direct your attention to the wide world around you, to objects both far, near, up, down, left, right and even behind you, your head will naturally move into a more upright position.

Chapter 10: Skill

The Russian physiologist Nicolai Bernstein was one of the first scientists to look at physical coordination as the product of complex systems.

COORDINATION AND DEXTERITY

coordination alone is insufficient for real-world function. A further requirement is adjusting coordinative patterns to fit the particular circumstance, which is always changing.

Bernstein called this improvisatory skill “dexterity,” and recognized it as a higher level skill than mere coordination.

this top-down model could not fully account for dexterous movement, which always involves novel elements for which the brain couldn’t possibly have any prior programs.

The only common element is the intention to create the result. The intention comes from the higher levels of the brain, but the intelligence that executes this intention is widely distributed all over the body, emerging from interactions between muscles, joints, sensations, reflexes, and feedback from the environment. Through this bottom-up process of self-organization, the final motor pattern will be “soft-assembled” at the moment of execution.

skilled movement involves a kind of “motor wits,” or ability to improvise new solutions on the spot. We are more creative than we imagine. Even in situations where the environmental conditions are exactly the same on each repetition, the need for improvised variability is critical. For example, when expert blacksmiths repeatedly strike a target, they use a slightly different pathway on each swing.

LEVELS OF MOTOR CONTROL

Level one: trunk and neck control.

Level two: large multi-joint limb movements.

Arthur Lydiard, one of the most famous running coaches of all time, summarized his thoughts about running technique with the following: “Forget about form.”

Level three: targeted movements

level three perceives the relationship to the outside world. Thus, level three is where merely coordinated actions become truly dexterous

Level four: complex actions

Complex actions are sequences of movements that, when linked together, solve a motor problem.

Elite performance in these areas does not come as “naturally” as movements controlled by the lower levels. Instead, you need to put in thousands of hours of deliberate practice, and probably get some coaching as well. You also need to watch other great players and emulate what they do

one of the reasons complex skills are hard to acquire: the system is not that interested in learning skills that do not have broad application.

THE GAME IS THE TEACHER

we learn by doing, not consciously applying advice from an expert about how to move.

good coaching is about providing the athlete with “problems not solutions.” The game is the teacher. If you set up the right constraints...the systems that control movement will self-organize, and you will learn the right skills.

PERCEPTION AND ACTION

You need information to solve movement problems. We also need to move well to perceive well.

When golfers are getting ready to hit a ball, they waggle their club in some idiosyncratic manner. They aren’t rehearsing the swing, but trying to get a feel for the relationship of the hands, shoulders, hips and club.

Because perception and action work together, you can’t effectively practice a movement skill unless you simultaneously practice the related perceptual skills.

A good example is the use of agility drills, where the athlete runs around cones in rehearsed patterns...When you run around cones in choreographed patterns, the perceptual challenge is removed.

When you know exactly what movements you need to perform in advance, you aren’t challenged to improve anticipation, dexterity and balance.

Running on a treadmill at exactly the same speed, mile after mile, is a very different experience from running on a trail, where you must scan the surroundings, and make adjustments to speed, posture, and foot placement.

Similarly, resistance training with free weights or bodyweight is a different experience from applying force to machines that move along predetermined pathways.

When action stays coupled with perception, movement feels more playful, interesting, and meaningful.

THE ROLE OF ATTENTION

Perception is affected by attention, which acts like a spotlight on sensory information.

Wulf argues that internal focus “interfere[s] with automatic motor control processes that would ‘normally’ regulate the movement.” By contrast, external attention allows the body to “naturally self-organize, unconstrained by the interference caused by conscious control attempts.”39

Trying to control your movement top-down interferes with bottom-up processes that are far more intelligent.

Here’s an important caveat: this doesn’t mean we should never have internal attention during performance or practice. Internal attention may be occasionally useful with novices, and in learning complex movements with many different parts.

MOVEMENT “DYSFUNCTION” AND THE COMPLEXITY OF “CORRECTION”

According to Shirley Sahrmann, persistent pain is frequently caused by movement “impairments,” which can be identified with objective assessments, and fixed with motor education.

Similar ideas can be found in “corrective exercise,” which is concerned with using proper technique in basic exercises.

the basic premises of the corrective model are sound. But in practice, corrective methods often ignore the complexity and variability of movement, and the body’s ability to adapt to stress over time.

Movement patterns that are commonly alleged to be dysfunctional are not correlated with pain or increased injury risk;
Treatments aimed at correcting specific dysfunctions often work no better than general exercise; and
Corrective methods may create good results even when no “correction” occurs.

the benefits of coordination training for pain are probably more about playing with movement than fixing dysfunctions.

Instead of trying to ensure that movement conforms to one ideal stereotype, therapists should simply work on improving the shoulder’s general mobility, strength and functionality, and let the system self-organize.

trying to correct running form is unlikely to prevent injury, and will often cause runners to be slower and less efficient.

PLAYING WITH MOVEMENT SKILL: OPTIONS NOT CORRECTIONS

Another problem with the corrective model is its potential to demonize movements that are normal, healthy and useful, like heel striking or flexing the lower back in a forward bend.

We can look to corrective exercise for ideas on how to play with movement skill, remembering that the goal should be to expand our repertoire of movement solutions, not reduce them.

Chapter 11: Pain

[the feeling of having pain] is widely distributed across many different brain areas, including those related to memory, expectation, fear, goals, and movement. Thus, there is no single “pain center”in the brain, and no simple switch that can be thrown to stop it.

we can think of pain as the output of a highly sophisticated alarm system.

But the origin of some pains is more elusive. Think of all the times you have been unable to explain why some particular pain comes or goes.

pain often cannot be blamed on local tisue damage. Instead, it may be caused by something more complex — an interplay between a variety of factors, many of which relate to the pain alarm system itself.

The purpose of pain is protection

PAIN AND THE BRAIN

Many brain areas activate in parallel, including parts that are involved in sensory discrimination, emotion, fear, memory, cognition, and movement. These are collectively called the pain matrix or the neuromatrix.17

the brain is processing information related to threat, essentially asking “how dangerous is this really?” and deciding whether pain is necessary for protection. To do that, it considers all available evidence related to threat, as well the environmental, social and functional context.

The eyes are a good source of information about threat to the body, and seeing is believing.

The sense of touch (mechanoreception) also has significant effects on pain...This is why so many different touch therapies are effective short-term pain treatments, including massage, ultrasound, kinesiotape, foam rolling, or just good old-fashioned rubbing an owie. The mechanism is basically distraction.

Chronic pain is correlated with persistent negative mood, and depression seems to predict the development of chronic pain.

The way you think about your pain can change it.

Catastrophizing (which means expecting worst-case outcomes) is a risk factor for transitioning from acute to chronic pain.32

optimism and self-efficacy — the beliefs that your pain can improve and that you are the one who can improve it — are predictors of recovery.

Here’s an important caveat related to the role of the brain in pain. None of this means that pain is in your head, that pain is not real, that pain is your fault, or that you can simply think pain away with the right mindset.

A SYSTEMIC VIEW

Pain, anxiety, depression and stress-sensitivity may be specific manifestations of a general pattern of defensiveness and hyper-vigilance. There are [not many] specific treatments for these conditions that work significantly better than general health interventions like exercise, sleep, and stress reduction.

the best evidence for treating persistent pain points towards improving general health, as opposed to fixing specific “issues in the tissues.”

do everything you can to let your body know it’s strong, safe, resilient, and capable.

CENTRAL AND PERIPHERAL CONTRIBUTORS TO PAIN

Pain is more likely to involve a significant central component when the following factors are present:

There is no specific pathology that explains the location of pain.
Pain is not well-located and moves around.
Pain is poorly correlated with mechanical stress on the painful area.
Pain is correlated with emotional stress, mood, sleep, fatigue, or other symptoms.
There are multiple painful sites throughout the body.
There are other complex chronic health conditions

Fortunately, we don’t always need to know the specific mechanism to get a good result.

A relatively simple strategy of “just load it” is often an effective way to treat pain in a local area when pain is related to movement.

move through functional ranges of motion with coordination, and handle the associated loads. If it hurts to load the joints at one angle or movement pattern, find another that is less challenging.

I think of it as slowly retaking territory that has been lost.

SIMPLE MODELS FOR COMPLEX PAIN

The philosopher Alfred North Whitehead said: “The only simplicity to be trusted is the simplicity on the far side of complexity.”

pain is multi-factorial; it depends on perception; the brain is a key hub for information processing; and pain is part of a larger pattern of self-protection that also includes changes in the immune system, endocrine system and musculoskeletal system.

Complex problems, including those related to pain, are not necessarily hard problems to solve.

Complex pains are...often resolving on their own after a few weeks of common-sense self-care.

WICKED PROBLEMS

The system is behaving badly, and the bad behavior is reinforced by feedback loops that make it highly stable. Because the problem is multi-factorial, it is not clear where you should intervene in the system. Further, many interventions, especially those directed at “fixing” a single factor, can have unintended consequences, activating feedback loops that actually make the problem worse.

The efficacy of these treatments is less about specifics, and more about just perturbing the system in some way, getting it to reset to a more adaptive state.

Wicked problems can be solved. But they are not fixed with a single intervention. Positive change is slower, more organic, a process of evolution.

Have these notes influenced the way you exercise or the way you think about your movement? I'd love to hear from you!

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