Monday, September 7, 2015

Creative Solutions for Creating Balance from Asymmetry

Guest Post By Daragh Crowley

What the heck was Daragh having me do here? Read to the bottom to find out!

Try standing on one leg and doing a squat without shifting your pelvis or rotating. Tricky, right?

Now stand on both legs, activate your pelvic floor, squeeze your glutes on both sides, and tighten your lower abdominals. Then lift one foot, and try the squat again. Better?

On the first go-round, maybe, maybe not. But with practice, an optimally aligned single-leg squat is certainly within most of our grasps.

The thing is, if you're an amputee like Travis, you don't have the luxury of standing on both legs while engaging your pelvic floor, glutes, and abs. You see, Travis was born without a femur in his left leg. Although he ambulates well with the aid of an above-knee prosthesis, he doesn’t have the benefit of feedback from two feet touching the ground.

As a consequence, Travis relies heavily on his right hip for stability and has limited neuromuscular control over the left side of his pelvis. He exhibits severe weakness in structures like the glutes and hip rotators, which work dynamically to align the pelvis in a neutral, balanced position.

So far, I’ve worked with Travis on two occasions. During our first session, which Travis chronicled on his blog here, we discovered that his soft tissue restrictions extend all the way down his “good leg." In fact, we found that the sliding tissues of his lower leg and foot really weren’t sliding at all -- or at least not in a way that allowed him to utilize them to their full potential.

In my practice, I’ve come to find that restrictions at the foot prove particularly problematic. Our feet are our primary point of contact with the world. They support our entire structure and inform our posture globally. If we have restricted tissue and limited articulation in our feet, we wind up with bad connections through the rest of the body -- akin to static on a telephone line.

Tissue restrictions at the foot mean the postures we’re assuming are based on bad -- or at least only partial -- information. Sub-optimal alignment of the foot then cascades up the chain through the knees, hips, pelvis, and so on, causing us to make poorly informed decisions about how to position our body in space. It's like trying to balance when drunk. Restoring the tissues of the feet so they’re supple and sliding freely allows for better feedback and, consequently, a greater connection to the ground beneath us.

For this reason, during our first meeting we worked exclusively on Travis’s intact foot and lower leg. By the end, we were able to change the quality of the tissue from hard to the touch to soft and supple; the distinctions of the individual muscles became clear. For Travis, this meant greater sensation and ease of movement as well as the ability to perform a single-leg squat with optimal positioning and an integrated, optimal transition from start to finish.

We recently got together for round two to continue to explore the complex issue of Travis’s pelvic imbalance. Because he doesn’t have a regular feedback mechanism on his left side, Travis’s neuromuscular connection to that side of his hip complex is extremely weak. To compound this issue, soft tissue restrictions have built up in his hip flexors and low back in response to his imbalanced movement patterns.

With my hands and elbows, I worked to free up the most dense restrictions. We also made use of a foam roller and some “superfriend” applied pressure (me pushing down on his leg while on the roller) to free up the soft tissue of his right lower leg.

Once we’d gotten better sliding of the tissue, we tried out a “hack” to create a feedback loop for his left side. We took a monster band, shortened it with a knot, and hooked it around his shoulder and the inside of his short leg. In a tall-kneeing position, the resistance of the band pulled upward on his left hip. To up the ante, we had him raise his arms overhead (see video above) and later even added a light kettlebell.

The band effectively provided a feedback point for him to connect his mind to. Immediately, Travis was able to “find his left hip” in a way he’d never felt before and, consequently, bring his pelvis into balance. Pretty damn cool if you ask me.

About the Author

Daragh Crowley is the owner of Mobility Continuum, an integrated mobility and movement therapy practice in Philadelphia, DC, and NYC. Be sure to follow him on Facebook and contact him there with any questions.

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