An Entirely New Class of Therapeutic Exercises

Most therapeutic exercises used to treat lingering pain from postural stress fall into one of two classes. * strengthening exercises * stretching exercises Another, new class exists, however: * somatic exercises Somatic exercises improve awareness of movement, control of movement, and coordination. While they belong to a different category than strengthening or stretching, somatic exercises accomplish what therapists ordinarily seek through strengthening and/or stretching exercises: both greater strength and greater suppleness. STRENGTHENING and STRETCHING - BRIEF INSIGHT Let's take a quick look at what's behind strengthening and stretching as therapeutic exercise strategies. Strengthening The most common way of looking at pain and injury tends to describe any chronic condition that involves pain or dysfunction as the result of "weakness": weak back, weak bladder, weak eyes. This term, "weakness," lacks descriptive power, however. First off, people commonly confuse strength with control. Generally, if people have poor control of a muscle or movement, they describe themselves (and others describe them) as "weak". While a person may have a deficiency of strength, the idea that a muscle is weak and needs strengthening misses the point: Usually, the problem lies not with the muscle, but with the person's ability to control it. That kind of control develops through a process involving movement and the brain's ability to learn to control movement. It's not a muscle problem; it's a brain problem, and not even (except for certain medical conditions), a problem of the muscle, but a problem of the brain -- a developmental (i.e., learning) problem -- learning to control muscles and movement. Half of strength is muscle bulk, and the other half is control. People get their greatest strength when their muscles work in coordination. Witness the wind-up of the baseball pitcher; he doesn't throw "with his arm"; he throws with his whole body. Secondly, weakness is rarely the issue. Usually, the muscles involved are not weak; they are fatigued from being tight all the time -- or they are being inhibited by the brain as their opposing muscles contract. The fatigue and/or inhibition feel like weakness. In other words, to describe such muscles as weak doesn't illuminate the cause of the situation. What's needed is for the muscle(s) to relax so they can be refreshed by rest, or their opponents/antagonists brought to rest so the brain-inhibition (reciprocal inhibition) ends; strengthening efforts are unnecessary; muscles regain their strength immediately. Basic control of muscles is a developmental issue. Sometimes (often), people are awkward or they're truly weak because they never developed the ability to move well in certain ways. Look at handwriting as an obvious example; handwriting is a product of movement ("fine motor control"); people acquire good handwriting through learning and practice. That example applies to many kinds of movements: people may develop "gross motor control" but not "fine motor control", or they may not have any decent degree of control of certain kinds of movement because they never learned it; or they may have lost control from injury, not from damage, but from disruption of control caused only by the shock of injury or pain and its memory imprint on movement, which shows up as protective guarding reflexes outside ordinary control. The term, "workaround", applies here: When a muscle is inhibited or in contracture, the brain does a "workaround," recruiting other muscles (less suited) to do the movement of the inhibited or contracted muscle. As we know, workarounds are inefficient. A gross motor control (gross movement) problem is quickly and easily remedied by such methods as weight training -- but weight training goes only so far because only gross motor control results from weight training, not finely graded coordination. The side-effect of weight training may be muscles that are too tight (musclebound) because what strength training teaches is contraction, not relaxation, missing half the control-pattern. Finally, the pain. When muscles are too tight for too long, they inflict compression stresses on neighboring joints (including intervertebral/spinal joints). Muscles in that state have a chronic "burn", another contributor to chronic pain. It's not weakness that causes the pain, but overactivity of muscles. Recognizing that fact, therapists may prescribe the alte ative to strengthening: stretching. Stretching The very fact that therapists employ stretching amounts to an acknowledgement of the obvious: the person lacks the ability to relax muscles to allow them to lengthen. Since a person should be able to relax at will, it's a control problem, again. So, stretching involves either actions of the therapist upon the patient or actions of the patient that involve muscles other than the ones needing to lengthen to force those muscles to lengthen. The control problem remains and does not change until the patient learns to control the tension and movement of the shortened muscles, themselves. Because the brain controls muscle length and tone, efforts to stretch muscles forcibly by whatever method -- active isolated stretching, yoga, traction -- miss the mark: the brain's habitual patterns of control develop through movement conditioning, which involves the full range from full strength through to complete relaxation, not through stretching actions. The proof is in the results people experience. SOMATIC EXERCISES Somatic exercises may be categorized as "functional exercises" -- but of a special sort: generalized functional exercises -- foundational exercises that support and enhance all other exercise regimens. Somatic exercises recognize that muscular conditioning results from three things: * awareness of movement * basic control of muscle tension * coordination Awareness of Movement Before you can control it, you have to feel it. We guide our actions (such as typing or pushing the button of a doorbell) by feel. We walk by feel; we're not always watching our feet (unless we have mobility problems). Basic Control of Muscle Tension By that, I mean the ability to regulate how much strength (i.e., how much muscle tension) we apply to any movement. Precise movement requires precise control. Precise power requires precise control. To have that control, we need two things: (1) basic sensory awareness of movement, and (2) the ability to activate and to relax muscles at will. Coordination Awareness and basic control are not enough. In the balancing act of life, it's how everything works together that determines the outcome. The same is true of muscles and movement. Again, witness the baseball pitcher. Coordination incorporates many muscles and movements into a single integrated action with such good regulation of strength and timing that we get the intended movement. It's strength (well regulated) and timing. Awareness, Control, Coordination Somatic exercises use movements to create sensations that the brain can learn and recognize as familiar and associated with a particular muscle and movement. That's the "awareness" part. With repetition of somatic exercises, one develops the ability to regulate the gradual build-up and decrease of muscle-power in a movement. That's the "control" part. With incorporation of smaller movement elements into larger movement elements, done at first slowly and then more quickly, first of individual muscles (and movement elements) and then of multiple muscles (and movement elements), somatic exercises develop coordination. That, of course, is the coordination part. Strength and Length -- Plus Coordination With these three elements, somatic exercises develop both high strength and the ability to decrease exertion all the way to full, soft, flaccid rest, true rest, solving both the problems otherwise addressed by strengthening and stretching exercises. Because somatic exercises train the brain (the master-control center of the muscular system), they are sufficient to free a person from reflexive, protective muscular guarding tensions that have outlived their usefulness and cause pain so that (s)he returns to a free, strong and supple state. Somatic exercises are a new class of therapeutic exercise that accomplishes and goes beyond the results ordinarily sought through the more common forms of therapeutic exercise: strengthening and stretching.