When Movement Patterns Lead To Pain

In my last post, I discussed the utility of movement patterns and how they help us navigate our lives. Today we’re going to talk about the dark side of movement patterns… when they lead to pain. I say that in jest because really there are no such things as good or bad ways to move. Movement is simply a solution to a problem. We figure this out as babies. If something captured our interest from across the room, we figured out how to crawl or scoot or roll over to get to that object. Babies try a variety of strategies to move and continually refine them until they figure out what works best within their ability level. There are no good or bad solutions, simply ones that are more or less effective. To some degree, we continue to do that throughout our entire lives. We move using patterns we’ve developed, very often from long ago, to accomplish a goal or solve a problem. We are only compelled to change these patterns when they no longer serve us. Either they no longer solve the problem at hand, or they create strain on certain tissues causing irritation, inflammation, and eventually, pain. Rather than thinking about patterns that lead to pain as “bad” or “wrong” I prefer to frame them as a formerly brilliant solution to a problem that has outlasted its usefulness. This respects the service that pattern provided and helps my patients to engage in less self-blame about their physical situation.

Our bodies are designed to facilitate survival, not perfection. We create patterns based on 3 factors, ease of movement, the familiarity of movement, and perceived safety of movement. We do not create them for perfect biomechanical efficiency. Let’s look at these one by one. Our body and brain is designed to conserve energy. Therefore, we will only move in ways that are easy for us. If I have developed a stiff joint or tight muscle and it is difficult for me to move in a certain direction, I will develop a movement pattern around that stiffness just to conserve energy. We tend to move in paths of least resistance. This is the reason that in my movement retraining sessions I urge people to avoid the temptation of engaging in large effortful movements and rather try to train themselves to move smaller but with greater ease.

Familiarity of movement is very important in the creating and persistence of movement patterns. We continually do what is familiar to us because it is much simpler than figuring out something new. So if we can accomplish a goal by using an old pattern we will do it, even if a new pattern might be more biomechanically efficient. It is much less work for the brain to fire the neurons in a way that it has before rather than invent a new pathway. This is known as Hebb’s rule and was discovered by Donald Olding Hebb, a neuropsychologist, way back in the 1940s. In retraining sessions, I encourage people to move in new ways that defy old patterns in an effort for the brain to create a new pathway. Over time and with repetition this new pathway will become familiar and integrated into everyday movements.

Finally, there is perceived safety of movement. As previously stated, we are designed for survival and our body and brain are doing their best to protect us. If moving in a certain direction is unsafe or even perceived to be unsafe,  we will build patterns around protecting ourselves. I suffered 2 severe left ankle sprains one year apart in my late teens, one dismounting the parallel bars and the other playing volleyball in gym class. I was on crutches for a month and out of sports for 3. My injuries have long since healed, but I have noticed that to this day I stand in a way that protects my left ankle from rolling outward. This position tilts my hips slightly to the right and causes my left groin muscles to be overactive and my gluteal to be a little underactive on the left. While it is impossible to know that my preferences are due entirely to those old injuries, I do not believe it coincidental. I rarely have issues with day-to-day activity, but if I am doing something higher level, like downhill skiing or distance running I feel the disadvantage that pattern puts me in. On a daily basis, I intentionally work to move myself in a way that opposes that pattern to try to prevent tissue inflammation and remind my brain that this is a safe alternative to my preferred pattern. Of course, I am not so self-aware as to understand every pattern I have. No one is. Our bodies have a wisdom that is impossible to break down into individual pieces, and that we are not well served to criticize. We can however begin to recognize our tendencies and actively work to change them.

The combination of the three factors driving pattern creation can sometimes lead us to move in a manner that puts repeated stress on a few specific tissues. This is when pain just sort of emerges out of nowhere. When you think, I didn’t even do anything, why the heck am I hurting. Our bodies continually refine our patterns and that’s why most pains simply go away on their own. Often times pains can be recurring or chronic because we fall back into a painful pattern and cannot find an alternative that brings ease and satisfies the easy, familiar, and safe requirements.

Next post we will dive into the 4 phases of changing movement patterns, so look out for that!