It’s been a long time since I’ve blogged. Too long.

But to put things in perspective, since my last post back in (gasp!) July, I was in Europe filming and on retreat, teaching workshops and seminars almost every weekend, putting together a book deal, and most importantly…getting a massage therapy license.

I figured since half the research I read is from the field of manual therapy – the other half being from the field of movement therapy movement-for-general-well-being (credit for that mouthful goes to YA) – I should get my hands metaphorically dirty and join the ranks of my fellow hands-on therapists.

Coming from such a strong background in biomechanics, movement, and research,  massage school was an interesting experience for me. The program I chose offered a strong option in the area of musculoskeletal injury and rehab, so it was an area in which I was competently versed. Most of the other students were quite new to all things human body related (think of your first day ever of your first 200 hour YTT) and were either pursuing a new career or entering their first career – both admirable achievements. They were all lovely people and extremely passionate and enthusiastic about learning their craft. I refer to them collectively here only to make grander statement about the education process and my full intention is to hold them up, not criticize them.

Back to musculoskeletal concerns.

One of the best components of massage school is the intensity of kinesiology training. The students got way more anatomy and joint kinematics than most yoga trainings provide.  And this got me thinking…

If yoga trainings had a greater focus on kinesiology, would that be a benefit to our community?

My answer here is not a definite yes or no.  As always, my answer is “it depends.”

And how it depends hinges on how well critical thinking is taught.

Here’s an example from massage school:  After just a few days into the program, I realized the general message of the course was to establish the root cause of most musculoskeletal ailments was tightness in that area. We spent a lot of time rubbing away tight muscles and stretching out tight joints. I’m guessing if you’re reading this, you already know how I feel about tightness. After one day of assessing tight IT bands and determining that everyone in the room seemed to have two of them, a smart-as-a-whip student asked the instructor, “so what exactly does a not tight IT band feel like?”  I wanted to fist bump her but instead did this on the inside:

via GIPHY

To be clear, I have full respect for our teacher. Teaching is the hardest gig out there. I also understand that students want to know an answer. They don’t want to hear “it depends.”

The #1 question I get when I’m leading workshops is “What is the cue for that?”

Students look crestfallen when I stumble around reaching to make some verbal sense out of what I just observed, expressed, suggested, and observed again on the student I’m working with.  I get it.  Learning the cues is what got them out there teaching successfully!

Additionally, when information is so new to the students, it is difficult as a teacher to answer questions without a lengthy detour into an entirely different course. Another perceptive massage student once asked such a complex question about stiffness which made it apparent to me that nothing short of a 16 week graduate level course in biomechanics would have sufficiently answered his question.

But all of that said, I still worry that too much anatomy training without exercises in critical thinking (or interpreting data, analyzing articles, etc.) leave students less empowered rather than more empowered.  It becomes too easy to reduce deficiencies in human movement to a single causative mechanism [1].  We’re just not that simplistic.

Please don’t interpret this to say you shouldn’t study anatomy and biomechanics. I believe you absolutely should. But know that for every solution you discover through your studies, more questions should arise.

Here are a couple examples from massage school relating to low back pain (a common topic because of its prevalence in our society) that I think would be interesting to yoga teachers:

1. We were learning the “correct” muscle recruitment order for a prone leg lift (think single leg salabasana). Using our hands we were trying to feel which muscles activated and in which order. Wondering how reliable our hands were at giving us this information, I suggested, “Wouldn’t we need an EMG and a laboratory setting to get any real data since we’re measuring milliseconds?” After that, we were taught to just feel for general muscle recruitment patterns which we I determined told us nothing at all. The rest of the group was encouraged to conclude a glute deficiency (since being human automatically predicts us to have faulty glutes and tight IT bands, right?), while I wondered how I entered this alternate universe. Later, I went back to my earlier research on the topic and found two opposing conclusions on the matter [2,3]. Imagine that!

(image via dreamstime)

2. We were learning being schooled that core stability (CS) exercises are the best way to prevent and reduce low back pain (LBP). Since this particular course focused on suggesting a few simple exercises and stretches to our clients based that would support our session work, we exhausted the topic of CS. We did a gazillion exercise (most of which resembled Pilates) that none of the students could do except for me (I was the only movement professional in the class), yet none of them had back pain in spite of their terrible core stability. Hmmm. (Anecdotal, I know, but what a great opportunity to question the system and do more research). So we looked at a book of the lumbar spine and transverse abdominus (TvA) muscle, and yup, that makes total sense! TvA supports lumbar and supported lumbar means no pain. Got it. Only we now know that CS exercises are no better than general exercise in alleviating LBP [4,5] and therefore we could have gone without humiliating the less-than-stellar movers in the class and sentencing them to the inevitable doom of LBP.

(image via dreamstime)

My point is (I know, I’m a bit rusty at blog writing) that we all have a lot to learn. And if you’ve taken the path of yoga based in kinesiology (other than yoga based in the chakra system – not knockin’ you,  just saying you get a pass when it comes to evidence based conclusions) you’re in for a bumpy ride. Things you learned once are going to be challenged. Many of you have taken my webinar a few times. Have they ever been the same?  (Say no.) I reserve the right to change my opinion as I research more. Heck, I would never write my early blogs in the same tone today – I have so much more information to add!

This is why we read real research articles in my 40 hour yoga biomechanics courses.  We discuss them at length and question if clinical relevance for our teaching practice can be deduced by the outcome of the study.

This is also why I don’t have the cue for that.

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[1] Wallden, M. (2015). “But we’re infinitely more complex than a car”: A systems approach to health and performance. Journal of Bodywork and Movement Therapies, 19(4), 697–711.

[2] Lewis, C., & Sahrmann, S. (2009). Muscle Activation and Movement Patterns during Prone Hip Extension Exercise in Women. Journal of Atheltic Training, 44(3), 238–248.

[3] Lehman, G. J., Lennon, D., Tresidder, B., Rayfield, B., & Poschar, M. (2004). Muscle recruitment patterns during the prone leg extension. BMC Musculoskeletal Disorders, 5(3), 1–5.

[4] Lederman, E. (2007). The Myth of Core Stability. CPDO Online Journal, June, 1–17.

[5] Mannion, A. F., Caporaso, F., Pulkovski, N., & Sprott, H. (2012). Spine stabilisation exercises in the treatment of chronic low back pain: A good clinical outcome is not associated with improved abdominal muscle function. European Spine Journal, 21(7), 1301–1310.