“Do you think it’s connected?” Marley asked curiously. Although she had come in for low back pain, Marley had just told me about some lingering knee pain, shoulder pain, and neck pain. “Oh! And sometimes my back hurts between the shoulder blades!” she added, scrunching her arm awkwardly to try to point behind her back.
Whether you have knee pain, shoulder pain, or neck pain — or all of them and more — there are a few root patterns that lurk behind nearly ALL of the different impairments we see. It's rare that multiple pain areas are unrelated (the exception would be if someone came in with low back pain, leg pain, and a rabid-looking Chihuahua latched onto their leg in a death grip. That person’s back pain and leg pain would be unrelated, well, unless a second Chihuahua was hidden beneath their shirt…).
This is good news! It means you don’t always need to see different specialists for every different thing wrong with you. Modern Western medicine was founded on the philosophy of reductionism, which basically seeks to solve problems by isolating them rather than connecting them. Reductionism was initially useful in developing vaccines for specific pathogens but later failed to successfully address modern ailments like chronic pain. When you understand how to change your alignment, you can often solve numerous problems at once.
How are most symptoms related? It all has to do with the asymmetries present in every human being. The two major sources of asymmetry in the human design are the internal organs and the hemispheres of the brain. Think about the last time you sang the national anthem or said the pledge. You put your right hand over your left chest because that is where your heart is! And it’s not just the heart; most of our internal organs are asymmetrical, including the liver, lungs, stomach, and digestive tracts. These organs have different shapes, weights, and connections to the rest of the body. In the brain, the left hemisphere tends to be better at analytical and precision tasks, while the right hemisphere is better at creativity and artistic functions. Since the hemispheres control the motor function of the opposite half of the body, muscles on the right side of the body tend to be more controlled and dominant than the left (this is why most people are right-handed).
Before we say anything else, it is important to point out that this asymmetry is a good thing! It allows us a greater variety of skills and allows us to adapt to many different environments and activities. Much like a car needs to be able to turn right and left, our asymmetries allow us to navigate life’s many roads. But what happens when we lose the ability to turn one direction? They say two wrongs don’t make a right… but will three lefts?
Over the course of our life, we face many stressful, demanding situations. As children, we are more flexible in our approach to problem solving and will try many different methods of accomplishing the same task. The older we get, the more we tend to utilize only the path of least resistance. As crazy as it sounds, the way we pattern our movement on a day-to-day basis becomes so dominant that it is the functional equivalent of making three lefts to turn right! Not only is it inefficient, it causes uneven wear on our bodies in a predictable pattern.
Indeed, it is this very pattern that is behind nearly every impairment and pain problem that our clients face (besides the occasional rabid Chihuahua, of course). And it is correcting this pattern that leads to extraordinary outcomes compared to many traditional medical approaches. The solution is to restore a childlike flexibility in approaching different movement tasks; it is restoring the freedom to choose left and right, up and down, forward and back in any combination, at any time.
So, what is the pattern? And how do you correct it? The simplest explanation requires a basic concept of the rib cage and the pelvis. Think of them as two ovals stacked on top of each other. They should be able to rotate, side-bend, and tilt forward and backwards without losing orientation to a neutral center point. The “rib cage oval” positions itself primarily based upon breathing patterns and abdominal activation. The “pelvis oval” positions itself primarily based upon activation in the pelvic floor muscles and weight-bearing patterns (how the body centers weight over the feet). When breathing is stressed, anxious, or in any way chronically labored, the rib oval tends to tilt backwards, flaring in the front. Correcting its alignment has to do with stress management, diaphragmatic breathing, and activation of the side abdominal walls. Similarly, when digestion of food is chronically upset and when weight bearing occurs more towards the front of the foot and legs (or worse, when weight bearing occurs mostly on the tailbone due to excessive sitting), the pelvis tilts forward. Correcting its alignment has to do with improved nutrition and learning how to access muscles on the back of the legs and pelvis when standing and moving.
There is also a second, left-and-right dimension at play. This has to do with dominance of activity in the arms and legs, such as always writing with the right hand or always kicking a soccer ball with the left foot. It also has to do with the neurological and anatomical asymmetries. For example, the positional opposition of the heart on the left and the liver on the right predisposes the rib cage to greater flare on the left than the right. Finding and practicing left and right neutral requires a keen understanding of one’s body and a lifelong practice of strengthening the less dominant patterns. In a perfect world, this would happen automatically and intuitively, but in our current, stress-filled, desk-bound world, it requires training and intention. However, these practices can be as simple as keeping the right shoulder elevated and retracted (farther back) when using a pencil or computer mouse rather than depressed and protracted (more forward). It can be as simple as standing more on the left foot than the right and keeping the left foot on the ground longer than the right when walking.
If any of you are Spiderman fans, you might remember Uncle Ben’s famous line, “With great power comes great responsibility.” Our asymmetries give us an incredible superpower: adaptation. Think of all the incredible and diverse activities humans are able to practice — from sewing to swing dancing, from cooking to climbing, from writing calligraphy to running marathons. But in order to do all of these things without over-using certain parts of our bodies and making them vulnerable to chronic injury, we must attain alignment.