Power in the Hip-Time To Go Deeper

This weekend, I saw mastery. Alison Grimaldi is truly an expert on the hip, and because I knew that already, I was worried that I had talked her up too much to fellow PT friends planning to attend the class. What I had found out instead is that I had underestimated how professional and impeccable her presentation would really be.  Decades of meticulous work packaged into bite-sized material for clinicians to cherry pick when working with patients.

It was both motivating and challenging to be back in the band with former PT classmates and co-workers, processing such dense material at what felt to be 3x my normal speed of thinking. I’m not sure how I landed in a field with such sharp professionals, but sometimes I quite enjoy the good dose of humility… (sometimes).

Having been a Feldenkrais practitioner for over 10 years, it is of course, not even possible anymore for me to learn anything about the body without immediately mapping out how it integrates with thought, movement, learning, motivation and the entire kinetic chain. It’s almost like my professional physical therapy courses teach me to zoom in on what’s happening in an affected area, whereas Feldenkrais immediately zooms me out to where the physical body meets the person, the life, the story.

The brief minutes when Alison talked about isometric contractions (a muscle contraction without movement- think of pressing against a wall) was very timely. It’s an evidence-based concept that isometric exercises can function to inhibit pain, and with this knowledge, many researchers and clinicians have taken to an approach of “switching on” a deep muscular system through isometric training, “recruiting” and “activating” muscles in a way that clearly has an analgesic effect on the nervous system.   

When Dr Grimaldi spoke of isometrics in the hip, she shared with us a conversation she had with well-known pain researcher, Lorimer Moseley on the topic.  She told us that when she asked Mosley, “do you think isometrics are helping with pain because they inform the homunculus?” (In English, this translates to: “do you think that isometrics decrease pain because they create awareness to the brain?”) Moseley had similar notions, and hearing this brought me back to the conversation I had with a patient only two days before. 

I had been working on her foot in a prone position that looks much like a precursor to crawling when she asked me to explain to her what it was that I was looking for.

What a Feldenkrais practitioner looks for is not always so easy to describe, but I believe what I was looking for was also a “switching on” of sorts.  The method is not as localized as an isometric, meaning that most of the time it isn’t typically focused on one particular joint, but if an isometric contraction help inform the brain’s map, then Feldenkrais is basically instructions on how to create a love affair with one’s homunculus— a very deep dive into the mystery of one’s own self-image, and the tangible reality that influencing one’s body will influence one’s mind.

Without having more of a language to answer my patient’s question, I told her, “It’s really a feeling of aliveness that I’m looking for. From the outside, it feels similar to touching a baby or toddler.  Something responds more than muscles, reflexes or basic movement….with you, the toes start to move spontaneously. They fan and fold, like they are spontaneously responding to something.” 

Is this “activation” or perhaps “disinhibition” or “axoplasmic flow?” Most likely, yes. I think Feldenkrais might’ve said it’s an integrative process that takes place within one’s nervous system and is completely personal to them. It was important to Moshe to not interfere with what emerges naturally when a person receives the right input. 

Recently, there has been some chatter about a new article in Nature on recent developments in homunculus literature. I sent it to Alison, and am looking forward to hearing her response.  Researchers are now seeing that there is more than anatomy that makes up an integrated body schema.  The body, the mind, the person. It’s all part of the map.