So, Whadda Ya Know?

There are two important questions that scientists ask when they learn something new.

The first is “What do you know?” and the second is “How do you know it?”

Let’s face it, there is really not much new under the sun, most “new” things are ones that someone has finally discovered but were there all along except no one noticed or it had been learned and forgotten by someone else. Sometimes a change in technology will let a person look in a way that finally made the phenomena evident, but the phenomena was there all along.

For example, gravity existed before Newton sat under his apple tree in the 1680’s. But he figured out mathematical relationships so the effects of gravity could be quantified and predicted. (Even though his underlying idea that gravity was instantaneous was disproved by Einstein 270 years later.) Those relationships were always there, his gift was in being able to look at what was there and see information in the data he already had, information that had always been available to anyone if they knew how to look. To this day those equations are used to do practical calculations about planetary motions and the interrelationships of objects in motion.

In our personal experiences with movement the same is true. Consider learning to walk. Gravity, the floor, and the muscular coordination to walk is all the same as it was before you walked. The world “felt” the same the day before you knew how to walk and the day after. But at some point, you figured out how to sort out all that information in a way that you could use to walk. You were not lacking for the information being available before, you did lack a discrimination of what each piece meant and how to use it to be able to walk. And as you walked more you made more discriminations of the sensations and walked even “better”.

Being able to discriminate what all the sensations we have “mean” about the world is something we all have to do to learn and grow. Along the way we all discover that we have to stop thinking about the world or some portion of it the way we use to if we want to do something new for us. We have often heard you have to give up your old ideas to do the new thing. In the case of movement, it is very hard to move in a new way if you cannot conceive of it or you are convinced you cannot do it. It’s like trying to imagine of a color you have never seen or a sound you have never heard. But unlike sight and sound, volitional movement is generated by entirely you and so the limiting factors on how we use our structure is our ideas of what it can do and how. (Yes, many of our ideas are accurate. I cannot turn my neck 180 degrees or touch my toes without bending somewhere in between my shoulders and hips. But I do not need to do those sorts of things to learn to walk on a tightwire.)

Fortunately for us, we have minds that can think about this and help us inhibit our habitual ideas about how things should be or feel as we try something new. We can visualize or internally rehearse a new movement to groove the nervous system to have a tolerance of a familiar activity feeling differently than expected. At the least we can keep our minds quiet and inhibit our initial recoil from new sensations as we do something familiar in a different manner.

So, what has all this to do with the price of tea in China? Not much. But it does have to do with changing the common perspective on manual therapy techniques that if I change the tissue the client will change and stay changed. I can have all sorts of techniques applied to my body that change my ability to move on a tissue level – loosen the fascia, the muscles, realign the joints etc., but in the end, I have to decide to be okay with feeling different. If not then I won’t use the new abilities because the tissue arrangement I had was a fine adaptation to give the sensations I was expecting or willing to tolerate and, ever efficient, my tissues will return to their previous state over time.

As practitioners then, the question is, “How can I assist my clients in changing their ideas of what movement is possible and accept how that feels?”

There are methodologies such as The Alexander Technique and the Feldenkrais Method that work to apply the rational mind to change how sensory data is assessed and used, a top down approach to the question. But for me that is not enough. After all, many of us are kinesthetic learners not rationalists. After all, I am primarily a manual therapist, I communicate with my hands and through touch much more than with words.

Is there a way to use manual therapy interventions that helps people change their ideas about how the world should feel to them or even what they feel is their own self? I want a way to work from the bottom up to provide sensory data to clients in a manner that facilitates their changing their ideas of what sensations are and mean without my biases or ideas about what is “right” to affect their process. These are important questions about how we do manual therapy. Ones that I have a few thoughts about but ones I hope others are thinking about.

It's a big idea, helping people change their internal concept of how they relate to the world outside of them in a manner that integrates with who they feel they already are. But why not think big? That’s what makes manual therapy fun and exciting.