Monday 27 February 2012

Some thoughts on injury

I recently watched a documentary featuring a conversation between the great former racing driver, Stirling Moss, and Richard Hammond, one of the presenters of BBC One's "Top Gear".

The reason for getting these two together was because of an experience they had in common: they had both crashed a car at high speed and been on the edge of death. Many of you will remember hearing the report a year or so ago that an experiment for Top Gear in a 200+ mile an hour car had gone horribly wrong and that Richard Hammond was in a coma. You may not remember so well the crash that landed Stirling Moss in hospital in a life threatening condition back in 1962.

The men's conversation was emotive and almost painfully honest - I would highly recommend that you seek it out on iplayer or youtube. They both talked with candour about their crashes but also about their journeys since then; about how they've coped with new thought processes, feelings and getting back into a car.

One thing in particular that struck me and started me thinking was something that Stirling Moss said. You may or may not know that he chose to end his racing career after his crash, despite having seemingly to have fully recovered. His explanation for his retirement went something like this: "When I drove before the crash, it was through pure instinct. I didn't need to think about it, I just did it. After the crash, I was still able to drive fast but I found that I was consciously having to process what I was doing. My driving became calculated rather than instinctive and it just didn't feel right" (paraphrasing).

This rung so true with me, having worked with numerous injured clients. This is exactly how they move - they think about their movement first and then control their body with their brain. Sometimes, simple movements such as walking become brain teasers as back, knee and hip pain cause them to over-think something that before their injury was natural.

In Stirling Moss's case, the reason for his over-mindfulness in a car was probably -understandably - fear of death. For most of my clients, there are several fear factors: pain, immobility and the idea that a wrong move might create more damage. Again, this is understandable but unfortunately this fear can also be detrimental. An injured individual quickly learns which movements are uncomfortable and begin to find ways around them. If their knee hurts, they avoid bending it, so if something is on the floor that needs picking up, they'll bend their backs instead. This can fairly swiftly lead to back now, their knees and backs are suffering so even more work is given to other areas of the body.

So, what's the answer? Ignore the pain? No. It's there for a reason. BUT, if it hurts to bend your knee, you shouldn't avoid all movement of the joint. The goal is to maintain and gradually increase movement but within your comfort zone. This gradually helps to restore mobility but also confidence.

Movement systems such as Feldenkrais and mine and David's own movement therapy aim to restore natural movement. The word "restore" is correct. During early child development, movement comes naturally as children play: running, jumping, rolling, play-fighting. Somewhere in early adulthood and beyond, movement becomes unnatural, as it's no longer the "done" thing to roll around on the floor, run really fast or spin around like an aeroplane for no reason. The brain imposes restrictions due to societal "rules". Throw in a few injuries - sometimes through trauma or sometimes as a direct result of moving unnaturally - and movement becomes even more distorted. It can come to feel as though you're not fitting quite right in your body and so your brain tries to figure out how to combat this, which often just makes things worse!

Instinct rarely comes into the equation at this point because it's been lost. This is often the spiralling pattern that creates recurring injury. Perhaps this is why many runners give up running.

Perhaps this is why barefoot running has become recognised as the secret of injury reversal. Connecting with ground helps your body's interconnected parts talk to each other in the same language again. And because there's no way you can do too much too soon, you stay in that "comfort zone" area which breeds patience and confidence. It diplaces the fear too - you're focused on keeping off the sharp stones which leaves your knee to find its own natural way of working.

One thing that Stirling Moss would also have grappled with would have been the element of competition. That pressure to win that comes with any high level competition. Runners often put pressure on themselves but barefoot running can help disperse this competitive element and lead to a more relaxed attitude towards running. Stirling Moss certainly still drives, but for the love of driving and cars rather than with the goal of winning a competition.

Of course, it's better to avoid injury altogether. I often refer to the martial arts and I will do so again here, for the training philosophy of true martial arts has not changed in thousands of years and has not changed for one simple reason: it works. One of the many pieces of wise advice given to David during his long years of martial arts practice was this: you should learn your art so well that you no longer need to think about how to do it. In fact, your goal is almost to forget what you've learned. The way you maintain your skill level is through practice - and not through practising harder and harder kicks and punches, but by routinely going through the basics. I remember Michael King years ago during my first Pilates certification course telling us about the benefits of returning to a complete beginner's class every so often rather than always striving for bigger and better. Build and maintain a strong foundation and the world of the injury-free is yours!

So, the message here is to not stop moving when you're injured but stay within your comfort zone so that it slowly expands again to restore you back to health. Many of Stirling Moss's peers claimed that he made a premature decision to give up racing - maybe if he'd started again with the basics and without any pressure, he'd have found that instinctive driving talent again.

Who knows?