Patient (aged 13): “Doctor, I have sore Achilles’ tendons”
Doctor: “You have severs disease”
Patient: “How long do I have to live?
This case of severs disease was a simple matter of two non-plantarflexing calcaneous bones. Why would they not plantarflex? Because of a non-symptomatic subluxation of C3, which had shifted forward, making it impossible for the patient to get a healthy extension of his thoracic spine or flexion of his cervical spine. Turns out falling off the see-saw age 3 wasn’t as innocuous as it first seemed….
The disease is not the discomfort in the heels. The disease is the prevalent pandemic of therapists and medics who choose to label symptoms rather than understand them, who choose to treat the pain rather than get underneath it…
It seems to me that there is a consistent theme showing up, one I have become very much aware of. The therapists, from all disciplines, who rise to the top of their game all seem to have a few things in common: primarily they think about the bigger picture, have experienced at some point in their working life that what they were taught or what the scientific papers suggest is not a whole truth when it comes to working with the human body and that there is more to working with the human body than meets the eye…. or hand….:
The therapist of the future is not satisfied with a simple outcome for their client. They know deep down that to rub a sore shoulder, treat a knee problem or offer an external ‘crutch’ may not actually be providing a solution for the patient. These are therapists who care about the end game. Not about managing the symptoms, or keeping them at bay but about understanding the essence of the problem. When it started? Where it came from? What you were doing at the time? What was happening in your life at that time? What happened before that that may have triggered it? They take histories and analyse them like a detective, somewhere they know somehow that a smack on the head age 3 has lead to your Achilles’ tendon problem that provides a persistent complaint today.
The therapist of the future is interested in patterns and is guided by rather than absorbed by the problem. They also choose to investigate patterns over taught procedures knowing that one will lead to a different solution than the other. Pattern observation always leads to a clearer understanding of how ‘stuff’ is redistributed through the closed chain system of the human body. Patterns give us insights to our movement behaviours, relationships between one muscle and another far removed from itself, gait patterns that quickly become habitual and repeated step after step, recognised by the bodybrain as necessary for survival. Muscle chains à la Myers, acupuncture and eastern meridians, simple (and complex) movement pattern work, determinations of gait, exploration of the nervous system and it’s intricate nature are all examples of ways to visualise and start to ‘see’ patterns prevalent in the human body and on show in your patients. The patterns you witness are the patterns that define the way your body has chosen to tackle it’s external environment given the structures in place. It’s motor control at it’s highest level. Your patterns put your problems on show. The modern therapist sees and feels them…
The therapist of the future is not distracted by where the pain presents itself but recognises that both pain and trigger points could be holding the system together; their interest and fascination of patterns will lead them to an awareness of whether the pain is a problem, or if the pain is an outcome of a musculoskeletal adaptation elsewhere in the body. When a compromised body is being held together by soft tissue that becomes irritated, there is a need NOT to release the point of pain (via trigger point or foam roller for example) but to understand what that point of pain is working so hard for. Using patterns and looking at the whole picture, as well as understanding the system at large will lead to making appropriate changes that no longer require the body to hang on for dear life and allow the point of pain to dissipate as the system slowly reorganises toward a pain free and thriving state.
Let the body do the healing
The therapist of the future has an intuitive sense that healing takes place in the patient and not via the therapist. The body has all the conditions in place to heal itself (from anything) providing the over-riding parameters of the ‘condition’ no longer remain in place. Imagine a world where patients bought into this concept too, became less reliant on the therapist and more interested in how they managed to get into this situation. Imagine if they came into clinic and declared not that their knee hurts but that something in their system has changed and the outcome is the symptom they feel, and they asked you to investigate with a thorough history, an observation of their patterns (both physical and non-physical) and help them to understand the alarming downgrade in their system. Your response: “Of course, it would be my pleasure. Of course the first thing to be aware of is that the symptoms you feel are merely signals guiding us toward the original cause of your problem… So let’s be grateful for them hey?”
Swing both ways
The therapist of the future is not tied to the couch or a single modality, they use plinths as well as the gym floor, they explore manually as well as analyse movement and willingly observe open and closed chain mechanics in a bid to see which one carries more dominance; they piece the mechanical influences together through advanced understanding of whole body gait and interview the body to discover it’s motor control preferences and watch how the joint system and muscle system talk to each other to determine optimal patterns for every day use. No matter what their background and training they know that there is an emotional complexity to all of this that when understood can be invited to let go and witness the change ripple through the human body… This therapist definitely sits on both sides of the coin.
The therapist of the future is motivated by results and outcome and chooses to recognise that strange and powerful things happen when you leave the sphere of scientific understanding. They choose their own experience over what science suggests is ‘right’ and has even acknowledged that the scientific way often doesn’t lend itself to a useful outcome. The modern therapist (therapist of the future) is a wildcat, not born of strict rules and an education that points to a deep isolated understanding of the parts of the human body but is free to understand anatomy at the deepest level and yet observe it as a whole and integrated unit not separate from the issues of the mind so prevalent in our histories and the modern world we struggle about in.
The therapist of the future sits on a higher level, not of knowledge but of appreciation of the whole, is able to work on a plane that filters down to every tiny part of the anatomy. A thought can influence your physical properties and most probably does as the repetitive patterns of your mind run wild causing havoc in your body. A simple modification to a joint that sets a phase of movement up for success and is then directly experienced as an organised movement pattern is sufficient to ripple through the motor control centre and change the way you walk. The way you walk influences every segment of bone and every square millimetre of soft tissue. As muscles come to balance and walking patterns become optimal, the human body begins to thrive in a new space, taking on new breath, new thought, new blood flow, new neurological appreciation of itself and it’s talents. Can your body change your thoughts? Can your thoughts change your body? Perhaps only if the patterns – the influencers – that override the programming of all that are challenged to adapt to serve the system at large. That’s when patients no longer need to return week after week but have their own healing placed in their own hands. Patients of the future no longer rely on the therapist as a fixer and begin to take ownership of their bodies once again.
As our understanding of the human body races towards a new edge, as therapists from a variety of modalities come together, as personal trainers, no less, freely learn the skills to cause influential shifts in the structures of the human body. It should be clear for all to see that the therapy world as we know it is subject to change. No more labelling, no more abandonment onto schemes of pain management, no more surgical interventions without true cause of the problem bing uncovered first. Do I share a pipe dream or a vision of the future? I believe the latter as I am lucky enough to be one therapist, amongst many, who’s work and experience firmly has his sights set on making this a reality for the many.
The therapist of the future thinks clearly, thinks big, embraces patterns and complex challenges and takes every action possible to get underneath their clients signals to guide them towards a happier healthier future where there is always hope and always a solution.
Gary Ward © 2014