Breaking the Mould: Time to let go

Recently I’ve been introduced to some really interesting ideas on pain and movement, as well as advancing my practice from a critical thinking approach – to begin to challenge deeply held ideas and thoughts.

A little while ago I wrote about the need to do away with the ‘ideal posture’ and ‘posture bias’. Since then I’ve delved further into this line of thinking and come across some more interesting thoughts – perhaps my own training has created a bias in itself. A sort of training bias.

“No matter how much we may think we have an accurate sense of our practice, we are stymied by the fact that we are using our own interpretive filters to become aware of our own interpretive filters! This is the pedagogic equivalent of a dog trying to catch its own tail, or of trying to see the back of your head while looking in the bathroom mirror. To some extent, we are all prisoners trapped within the perceptual frameworks that determine how we view our experiences. A self-confirming cycle often develops whereby our uncritically accepted assumptions shape clinical actions which then serve only to confirm the truth of those assumptions.”  | Clinical Reasoning in the Health Professions, 3rd Edition, 2008

So did the process in becoming a qualified Pilates teacher hold within it certain biases? Are the training courses perpetuating certain ‘truths’ and in doing so failing to challenge themselves, or worse yet, teach their trainees outdated information?

A leading Pilates educator here in Australia, Raphael Bender, raised an interesting question recently in a blog post (read it here) – should Pilates teachers be taught how to think critically, have better communication skills and listening skills rather than learn anatomy?

Basically, should we be wasting time/energy worrying about the anatomy or should we instead be learning how to think, talk and listen better? Has the presence of anatomy lessons in a Pilates course created a training bias and lead to an overemphasis of its importance? It’s a fascinating idea and his points are quite valid. I myself am quite guilty of geeking out over the anatomy and getting lost down a rabbit hole of biology. I’ve had a chance to chat to quite a few of my own students this last week or so about the idea and the overwhelming consensus was they wouldn’t go to a teacher who didn’t have good knowledge of human anatomy. When pressed on why the answers tend to be grouped into two camps:

Group 1:  If an instructor knows the anatomy they know how to do Pilates exercises correctly using the right muscles so I won’t get injured.

It has been shown that it is pretty much impossible for a teacher to know whether or not individual muscles are ‘active’ or ‘switched on’ in a movement and that every body has a slightly different way of moving, a slightly different sequence of activating muscles to perform a movement. We make basic guesses, informed by personal biases and experiences with other students – but that’s about it. I want your legs muscles to work in leg movements and your arms to work in arm movements. It will not help you any better in your Pilates practice to know you need to work multifidus 20% more to improve your posture (oh look! Don’t I know stuff! Check out the brain on Dan!). Like how can you even measure that in a Pilates studio?  And quite frankly trying to activate a muscle in isolation is a path to madness, frustrating both teacher and student. Joseph Pilates didn’t seem to be a fan of it either:

“Accordingly, since we are living in this Modern Age we must of necessity devote more time and more thought to the important matter of acquiring physical fitness. This does not necessarily imply that we must devote ourselves only to the mere development of this or that pet set of muscles, but rather more rationally to the uniform development of our bodies as a whole” | Return to Life with Contrology. Joseph H. Pilates

Group 2: If an instructor knows the anatomy they will know how to handle my particular thing (injury, condition/disease) and can tailor the movement for my body.

This one has more merit but I think there are certainly ways around it. Firstly I recognise some people come to Pilates with some pretty scary injuries and problems. But I think that idea really shows what is going on and highlights just how fearful we are of movement. How prevalent the idea of incorrect movement/posture will cause an injury. There are some guidelines to follow, for sure, but they don’t require any specific great depth of knowledge of human anatomy. For non-acute musculoskeletal pain you need to:

A) Reassure – basically talk with and reassure student that it’s going to be ok; and

B) Advise to stay active – keep moving! That’s pretty much it.

What about more complex problems or conditions? I would make sure the student has been cleared to do exercise by their primary health care specialist (physiotherapist, oncologist, haematologist, gynecologist etc.) who may have their own guidelines for the Pilates Teacher to follow. That’s it.

It seems to me the real reason Pilates Teachers need to know anatomy is not to be able to teach Pilates but so that their students have confidence in what they are being taught is not going to hurt them, because of a perception that someone who knows anatomy must know how to move or modify movement. That confidence breeds trust, reduces fear and from there, movement happens. This perception seems to be difficult to shake. Raphael’s question doesn’t mean knowing anatomy hinders a Pilates Teacher – it’s the application of that knowledge that is probably more important. Not being so precious about ‘knowledge’ and being prepared to accept new ideas.

So do Pilates Teachers need a solid grounding in anatomy to teach Pilates? Maybe not. Would it be better if Pilates Teachers were better trained at critical thinking, communicating and listening?  Absolutely. Why? Because it would help qualify thinking Pilates teachers, who are able to process new information and resist the urge to propagate misleading ideas or methods like some sort of malicious thought virus, such as Text Neck.

If you don’t know about this apparently the act of looking down at a screen will set up your day to be the worst in existence – you will end up suffering from Text Neck. The theory is that by looking down at your phone or other mobile device and interacting with it (or even passively viewing it) will cause your posture to change and therefore cause pain, discomfort and the end of all time. It is said the weight of the head puts increasing levels of ‘stress’ on the structures of the neck the further we look down and that by keeping it there for hour after hour will cause trauma, pain and change our posture to one that is not ‘good’. It sounds kind of plausible right? But let’s look more critically at it. Where did this Text Neck problem originally come from?

Would it change your thoughts about this emerging worldwide catastrophe if you knew that the term was coined by an allied health practitioner around the same time he set up the Text Neck Institute to treat the ‘condition’? Usually, those spouting off about it also have click-bait advice on how to avoid Text Neck or the ‘Best 6 Exercises to fix Text Neck’. I’ll save you some time and possibly money – move your head.

Look, this is simply not a Thing. The ridiculous promotion of Text Neck being an actual health concern would be laughable if it wasn’t another example of over-egging a simple concern to play on people’s fear of hurting themselves. The idea that our species evolved to stay totally upright in an ‘ideal posture’ is ludicrous. We don’t have eyes that move too far – we actually have to move our head around to look at things. Book neck wasn’t a thing.  Spear-making neck wasn’t a thing.  Basket weaving neck wasn’t a thing. Why-oh-why has this disaster befallen our species that we can’t look down at something for a couple of hours without ruining our spine. How changeable do you think the tissues are in the neck? And if you are so insistent that they can be changed to the ‘bad’ wouldn’t they be just as easily changed to the ‘good’ too?  Why wouldn’t the weight of the head actually help strengthen the muscles of the neck?

This is a prime example of failing to think critically about the information presented as ‘facts’. It preys on the thought that a held posture will cause damage, injury and pain.  And it keeps feeding the thought in the general public that doing something, not in an ‘ideal’ way will cause an injury. And it sort of makes sense. I break my arm it hurts. I stub my toe it hurts.  Therefore I try not to break my arm or stub my toe. I avoid movements that may lead to that because, well it hurts if I get it wrong and why would I want to do that? This snowballs into the idea that there are some ‘bad’ movements or dangerous movements that will definitely cause pain or injury. Now overlay that idea a lens of personal bias formed from past experience, a mixture of belief and training and now you’ve got a real recipe for disaster, or at the very least ineffectual practice.

Instead of catastrophising every action, pre-loading our students with fear and generally making them scared of doing simple tasks we should instead be giving them freedom to take back their birthright – give them permission to move.

“You shouldn’t have to think about movement in order to move.” Nick Hannah, PT
Interview on Pilates Unfiltered May 17, 2018 – Listen here for full e

Just move.

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