summarize "Her iPhone video told a sorry tale, as you can see from the “before” photo
on the left (see figure 13): As I loaded my hips and sank down, I
automatically shifted my entire body to the right. I look like I’m about to
topple over. My problem, as these photos make painfully clear, was that I
lacked stability. It even hurts to look at it now, because it reminds me of the
thousands of atrocious, strain-inducing squats I’d committed in this awkward
position.
I was not even aware that I was doing this, but I was likely compensating
for various injuries and weaknesses that I had accumulated over the years.
This is how it works, as I would learn: We try to cheat or work around our
existing injuries and limitations and end up creating new problems. This
rightward tilt may even explain my back injury when I was only in my
twenties; even at that point, I had already been lifting heavy weights for years.
Fixing the situation turned out to be a nine-month process, but it ultimately
straightened me out, as you can see in the “after” photo on the right. It
required retraining not only my body but my brain.
—
Both Beth and Michael Stromsness, a trainer with whom I’d worked in
California and who had introduced me to Beth, were familiar with something
I had never heard of called DNS. Short for dynamic neuromuscular
stabilization, DNS sounds complicated, but it is based on the simplest, most
natural movements we make: the way we moved when we were babies.
The theory behind DNS is that the sequence of movements that young
children undergo on their way to learning how to walk is not random or
accidental but part of a program of neuromuscular development that is
essential to our ability to move correctly. As we go through this sequence of
motions, our brain learns how to control our body and develop ideal patterns
of movement.
DNS originated with a group of Czech neurologists who were working
with young children with cerebral palsy in a hospital in Prague in the 1960s.
They noticed that because of their illness, these kids did not go through the
normal infant stages of rolling, crawling, and so forth. Thus they had
movement problems throughout their lives. But when the children with
cerebral palsy were put through a “training” program consisting of a certain
sequence of movements, replicating the usual stages of learning to crawl, sit
up, and eventually stand, their symptoms improved and they were better able
to control their motions as they matured. The researchers realized that as we
grow up, most healthy people actually go through an opposite process—we
lose these natural, healthy, almost ingrained movement patterns.
Thus my youngest son, Ayrton, can execute a perfect ass-to-grass squat,
dropping his little butt down practically to the ground, bending sharply at the
knees yet remaining totally balanced and powerful. It’s just a perfect hiphinge, and it blows my mind every time. He is an absolute master. Yet when I
attempted the same movement, I ended up tilted over in the ridiculous halfcanted position in the “before” photo, one hip pointed down at the ground,
my shoulders askew, my feet rolled outward. My toddler can squat, but
apparently I couldn’t.
And neither could my fourteen-year-old daughter, Olivia (before Beth got
to work on her, too). Flexible as Gumby, skinny but whip-strong, she should
be able to squat just as well as, if not better than, her youngest brother. But
she couldn’t, because even at her young age she had already spent two-thirds
of her life in school, mostly sitting in chairs. The ideal movement patterns
that she learned as an infant and toddler were erased before she was able to
develop the hip stability needed to squat properly. If she spends the next
thirty, forty, or fifty years primarily sitting in chairs, as is likely, then she’ll be
in the same boat as many of my patients, and myself as well: we have
essentially forgotten how to move our bodies.
Most adults can’t squat correctly, even without any added weight. The
only way many of us can come close to matching a toddler’s form is to lie on
our backs, as Michael Stromsness demonstrated with me in one of our early
sessions. Then it becomes much easier to raise our knees into a perfect squat
position, with the correct degree of curvature throughout the spine from the
base of the skull to the tailbone. This tells us that range of motion per se is
not what’s stopping most adults from squatting well; it’s that when the average
adult is under a load, even as little as their own bodyweight, the job of
stabilizing his or her own torso becomes too much.
The point of DNS is to retrain our bodies—and our brains—in those
patterns of perfect movement that we learned as little kids. As Michael
Rintala, a leading American practitioner of DNS, puts it, “DNS beautifully
integrates with all the good work you are already doing—it’s like a software
upgrade for anything you are doing.”
—
My own software was in serious need of an upgrade.
The details of my own journey are too involved to lay out at length here,
but in the rest of this chapter I will try to explain at least some of the basic
principles that underlie stability training. These may seem a bit strange at
first, and if you came to this chapter expecting a high-powered workout
program, you may be disappointed. That is part of the point: in my practice,
we don’t like to push much strength training, including many of the
assessments I’ve discussed, such as dead hangs and weighted step-ups, until
we have established some modicum of stability. We don’t think it’s worth the
risk. Just as in engineering, it’s worth the extra time to build a solid
foundation, even if it delays the project a few months.
A quick caveat: while strength training and aerobic conditioning are
relatively straightforward, everyone has very different issues with regard to
stability. Thus, it’s impossible to give a one-size-fits-all prescription for
everyone. My goal in the rest of this chapter is to give you some basic
concepts to think about and try out, to help you learn and understand how
your own body interacts with the world—which, in the end, is what stability
is really about. If you’d like to know more after you’ve read this chapter, I
suggest visiting the websites for DNS (www.rehabps.com) and the Postural
Restoration Institute (PRI) (www.posturalrestoration.com), the two leading
exponents of what I’m talking about here. Stability is an integral part of my
training program. Twice a week, I spend an hour doing dedicated stability
training, based on the principles of DNS, PRI, and other practices, with ten
to fifteen minutes per day on the other days.
—
Stability training begins at the most basic level, with the breath.
Breathing is about much more than simple gas exchange or even
cardiorespiratory fitness. We exhale and inhale more than twenty thousand
times per day, and the way in which we do so has tremendous influence on
how we move our body, and even our mental state. How we breathe, as Beth
puts it, is who we are.
The link between the body, the mind, and the breath is not new to anyone
who has done more than a few Pilates or yoga classes or practiced meditation.
In these practices, the breath is our anchor, our touchstone, our timekeeper. It
both reflects our mental state and affects it. If our breathing is off, it can
disrupt our mental equilibrium, creating anxiety and apprehension; but
anxiety can also worsen any breathing issues we might have. This is because
deep, steady breathing activates the calming parasympathetic nervous system,
while rapid or ragged breathing triggers its opposite, the sympathetic nervous
system, part of the fight-or-flight response.
Yet breathing is also important to stability and movement, and even to
strength. Poor or disordered breathing can affect our motor control and make
us susceptible to injury, studies have found. In one experiment, researchers
found that combining a breathing challenge (reducing the amount of oxygen
available to study subjects) with a weight challenge reduced the subjects’
ability to stabilize their spine. In real-world terms, this means that someone
who is breathing hard (and poorly) while shoveling snow is putting themselves
at increased risk of a back injury.
It’s extremely subtle, but the way in which someone breathes gives
tremendous insight to how they move their body and, more importantly, how
they stabilize their movements. We run our patients through a series of
respiration and movement tests to get the full picture of their respiration
strategy and how it relates to their strength and stability issues.
One simple test that we ask of everyone, early on, looks like this: lie on
your back, with one hand on your belly and the other on your chest, and just
breathe normally, without putting any effort or thought into it. Notice which
hand is rising and falling—is it the one on your chest, or your belly, or both
(or neither)? Some people tend to flare their ribs and expand the chest on the
inhale, while the belly is flat or even goes down. This creates tightness in the
upper body and midline, and if the ribs stay flared, it’s difficult to achieve a
full exhalation. Others breathe primarily “into” the belly, which tilts the pelvis
forward. Still others are compressed, meaning they have difficulty moving air
in and out altogether, because they cannot expand the rib cage with each
inhalation.
Beth identifies three types of breathing styles and associated phenotypes,
which she jokingly calls “Mr. Stay Puft,” the “Sad Guy,” and the “Yogini”—
each corresponding to a different set of stability strategies:"