By Mark McGrath
In writing a short introduction to the below feedback, I need to be careful to contextualise the role of Convention, while at the same time, informing you of Possibilities beyond this Way of Looking.
If I Injure my Musculo-Skeletal System in a way that compromises my ability to Rehabilitate the injury without surgical intervention, then that is my Logical and Only plausible next step.
Post-Surgery, the Surgeon and other Professionals who deal with Acute rehabilitation protocols are Key to the best possible Healing and Post-Surgery Management.
However, once the Healing process is established, and the Joint is capable of being Loaded, we need to be aware of the Global Body.
The Protocols established by Rehabilitation Professionals will be necessary, but not sufficient for Long -Term ‘Functional Ideal’ over the Years and Decades post major surgery.
This is because the compensatory mechanisms that are an inevitable outcome of any major injury, establish themselves invisibly, as we begin to move and weight-bear in our Rehabilitation.
For example, the Support phase of stepping is a closed chain contraction, that involves the information travelling from the Support Extremity to the Spine, and from the Spine to the Stepping Extremity. If the CNS detects Insufficiency in this Closed Chain recruitment, it will by-pass the ‘Painful Line’ of Movement, creating a non-preferred Movement Compensation.
In an ACL Reconstruction, this will nearly always be a Frontal Plane ‘Lean Strategy’ on the affected side. This will remain the ‘Automated Pattern’ until the Brain receives Afferent Information to the contrary.
Professionals, such as myself are interested in how you organise the ‘Central Aspects of Control.’ This is exhibited in your Standing Posture, and the array of Tests that can be done to assess the Nature of your Insufficiency. This Ability is already an Integrated Way of Looking because the Nature of the Looking is Asking;
- What aspects of your Functioning are Dominating your Experience, to the Detriment of evenness?
- What aspects of your Functioning are Absent? (These 2 Observations are inter-related)
- How do these Dominances/Insufficiencies self-organise as you perform increasingly Complex tasks such as Standing, Squat, Forward fold, Plank Push-Up, Single Leg Stance and Ultimately your Gait Mechanism.
Once this Presentation is Clear, and there is Agreement between Observation and Felt Sense, we can get to work in re-establishing ‘Functional Ideal.’
The below feedback outlines the possibility of what can happen, when we begin to ignore the messaging from the Body, Brain and CNS. The Feedback is from a Friend and Client who is very sensitive to the changes in her body.
I am sharing the Feedback to Inform about a Post-Conventional Approach, not to diminish the Importance of Convention, Protocols and Progressive Management of Serious Injury. My goal is to have you consider the Comprehensivity of your Rehabilitation, and to Contemplate the Ramifications through a Life-Span.
Excuse my few poor words to describe the revelation I have had over the last few weeks but I wanted to share it with you and in doing so, say thank you.
The last few weeks have brought into sharp focus the distinct difference between your approach to finding ideal movement vs current practice.
In my current stage of recovery from my knee reconstruction I had hit the proverbial wall. I was following the “expert” prescribed solution for someone in my position, essentially “get yourself a physiotherapist and join a gym”. Their advice, assessment of my function and treatment has been centred around my affected knee and its condition/appearance relative to my other knee/hamstring. I was vulnerable enough to assume they knew more than I (could sense within) about my body. It took me two weeks to admit to myself that this approach seemed to be doing more harm than good – my right calf was tight and overworking, my QL was screaming, my left hip was starting to pinch and grab. In general I felt that in loading my right knee, quad & hamstring (to meet their requirements to regain strength) my overall function and ability to move with ease and congruency was actually deteriorating rather than improving.
I had been working with you on those concepts for three years and making significant progress, feeling the best that I have ever been. Yet being vulnerable post injury, I mistakenly thought I had to put that work on hold to listen to those “experts” who could rehabilitate my knee. In doing so I couldn’t see that the reason I wasn’t progressing was because I was getting further away from moving ideally and it was exacerbating old injuries and pain.
I am very glad that I made the decision to see you at that time. It awakened the realisation that seeking ideal is the solution, not only to rehabilitation in the short term but to ensuring I move well in future without long term compensations.
It’s only been a few short weeks since then and I know I’m back on the right path. I feel better inside and out. I have a more global approach to my rehabilitation and I’m back enjoying this ongoing journey of learning that my body (and mind) are capable of more efficient, easier and far better performance and function. Thank you.