BACKSTORY: I recently gave one of my new clients the All 4 Belly Lift to do for homework.
This exercise is one I learned about from the Postural Restoration Institute, whom I highly recommend. But if you’ve been reading here for a while, you already know that (exhibit one, two, three, four, and five).
He was already familiar with the exercise and the above video I sent him, but wanted to know the difference between something like this and just doing a toe touch or sit and reach and breathing?
The All Four Belly Lift is a way to take a few degrees of freedom (a.k.a. compensation options) out of the equation. What I mean by that is being on your knees limits your ability to use your ankle to avoid expanding through your back and tucking your pelvis underneath you.
This exercise is also a way to inhibit your back side and teach your front side to turn on. Specifically, it’s really good for helping someone feel their abdominals working, helping them get all the air out, shutting of spinal extenders, and opening up the back of the hips.
A toe touch and sit and reach breathing can also accomplish these things. I like the belly lift because I think it’s easier to cue someone to keep their neck muscles off.
With the other two, you’re putting the hamstrings on a stretch. That’s fine for some, but for people who have extra flexibility in their hamstrings (most lifters, including you), they will get a lot of this motion from their hamstrings, not pull their pelvis underneath them.
For these people to get the motion of the exercise, they will tend to reverse their spinal curve. That is, their lumbar spine flexes and thoracic spine extends. If this happens, we’re actually accomplishing the opposite of what I want. See drawing below if it helps.
I know, it’s beautiful. One of my science classes last semester was in the art building, so I’m an artist now.
The same kind of thing can happen with the toe touch. One thing that the toe touch offers that the other two do not is the sensation of the feet in the ground. Being able to hold a toe touch and breath is a progression in terms of complexity, but a regression in terms of how much strength one needs to perform the exercise correctly. Most lifter types need a little bit of external load to overcome to help them feel the positions that I want them to achieve. This is why I tend to dole out more all four belly lifts than the other two variations.
They all can be effective, but there are differences to consider.
One of my goals for my non-athlete athletes (the teachers, moms, doctors) is neutrality.
But what does that even mean? What’s not neutral about me?
It’s reminds me of the intro in Van Halen’s “Hot For Teacher”. I don’t feel asymmetrical.
Asymmetry is Natural
Forgive the morbid visual, but if you cut yourself right down the middle and looked at your right and left insides, no part of your rational brain would think, “I’m a perfectly symmetrical human being.”
And what does that make you? That makes you and I part of the same Homo sapiens family. That’s it. Asymmetry isn’t weird, it’s normal. It’s necessary.
The biggest internal asymmetries that I like to point out to clients are the size of the thoracic diaphragm, the side of the liver, and side of the heart. These make us really good at standing on our right legs and breathing into our left chest wall.
And going back to Van Halen, most people I’m cuing won’t feel asymmetrical until I get them neutral. If you live a life on your right leg (hint: you do), you’d feel weird on your left leg, too! Remember the story I wrote about from that course a few weeks back?
The Origins Project
It’s impossible to say where or why or how this asymmetry has come about to be so prevalent, but I can make a guess (because that’s what the interwebz is so good for: speculation).
It makes sense to me that this asymmetry has come about from natural selection, just like, you know, everything else. The infamous Pat Davidson recently shared a quote with me that sheds some light on the topic from the point of view of a physicist.
“…right-handed DNA for all is the rule. Evolution plays an essential role in this. As only like spirals can link to make a double helix, there is no advantage if some of us had right and others left, or if we had a mix of both. It appears essential for effective procreation, that the half provided by the male matches that from the female, and the most efficient way is if they have only one and the same handedness. While this does not explain how and when the asymmetry in the amino acids of our DNA originated, evolutionary advantage aided by the vastness of time could be the cause.”
-Frank Close, “Lucifer’s Legacy”, p. 76
If you think about the beginning of life on Earth, making two sets of DNA would, at best, halve the chances of life forming. So these all-right-sided DNAs had a huge advantage in making copies of themselves.
If I go any further on origins, I’ll be stepping out of my bounds of education, so let’s shift gears. What am I examining to see whether or not you’re neutral?
Well, as someone who works with bodies and weights, the best way I know how to attack the situation is through movement. Even though not every change is orthopedic, these changes are the most tangible to you and I.
So I do some tests. I look at the position of your lower body with an Adduction Drop Test. This will tell me a lot, but most specifically, it tells me the position of your pelvis. Can you adduct?
There are some other accessory lower body tests that I’ll do to confirm my findings because I mess up sometimes. Hip motion tells me a lot of things.
Then I do some tests to look at the position of your upper body. An Apical Expansion test is the first time I ask you to breathe for me. Can you exhale on the left side? Can you inhale on the right side?
Then I’ll confirm my findings, which I find is especially important for the Apical Expansion test because it’s hard to judge the results without tester bias. Shoulder motion tells me a lot of things.
I always look at the way your neck moves, too. This Cervical Axial Rotation test is important because your neck motion tells me a lot of things.
If I can get all of these tests cleared, you’re neutral. If you’re neutral, you can effectively move side to side. You can walk with two legs instead of a right leg and a left kickstand. You can aspire. You can create.
Based on the natural asymmetry I was talking about earlier, I’m able to make some test predictions. If all of these predictions prove correct, I would call you “classic”. A classic left AIC, right BC, right TMCC. A classic human.
Then I can give you an exercise or push on your ribs to help you get neutral.
After you get neutral (note the wording; I’m not doing it, you are), I give you some homework to make it stick. Neutrality isn’t a forever-defined state.
This reminds me of a tenured client I’ve worked with many times at IFAST. She got neutral months ago and was so proud of the progress she’s made. I imagine me watching this is what it feels like when parents see their child walk for the first time.
Then she got busy at work, started sleeping less, eating worse, not coming into the gym consistently, and getting neck problems. I was able to look at her one-on-one and found out that she’s not neutral anymore. What gives?
The state of your system is dependent on so many factors: what you see, what you hear, the exercises you’ve been doing, what has happened to you in the past, who’s around you… Any perception of threat steals your neutrality and puts you into survival mode. What happens for someone like our client in this case is she forgets what it feels like to be neutral. My job is now to remind her. But how?
For some people who aren’t too far locked into the normal, asymmetrical pattern, the task I give you might be to find your left heel a few times a day while you’re at work. This could be enough to remind your body that you have a left side that likes attention, too.
For most people, I’m going to give you some exercises to do at home and in the gym. You may have years of adaptations and compensations that we need to combat, and those tests I listed above tell me which of these we should focus on. And if you’re trying to get stronger and healthier, these exercises can help mitigate the negative effects of weight training.
Most commonly, I see a locked up pelvis on both sides because I see people who like to lift heavy things. If this is you, part of your program is going to be opening up the outlet of your pelvis. As I tell my anatomy students, this makes it so you can poop. Though this is hilarious to tell people in public, it’s not the only side-effect. Remember Bob Ross?
Then we’ll follow up with a lot of reaching activity. If the butt is closed off, so is the back. Active reaching helps make things stick better.
Then I might give you an exercise that reminds your body how to work as one whole system; an integration exercise. Moreover, I’d like this exercise to be done while standing, because you’ll be standing when you’re going about your daily life without me. I want to teach my baby birds to fly.
This pathway isn’t set in stone, it’s just a blueprint. Some people get different homework. Some people get the same homework for different reasons. Some people get the same homework for the same reasons.
That’s just a quick primer on neutrality. If you know someone at the White House, can you suggest to them that we make the first 24 hours of winter Neutrality Day? Neutral people welcome the winter because they have bodies that can deal with change.
Do you welcome winter?
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Send this article to the last person with whom you talked about neutrality.
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Phoenix is seriously 40 degrees warmer than Indianapolis and seven thousand less percentage humidity, so I was immediately caught off guard. Though I didn’t have my physical therapist friends test me right away, I’m pretty sure the unpredictable environment would have stolen my neutrality, had any remained after four and a half hours on a plane.
The problem with having specialists in so many different areas these days is that the whole problem gets neglected.
Steve has foot pain. He’s referred to a podiatrist who says, “We need to open up your foot.” Foot pain comes back after surgery because his flat feet are being driven from the top down: an anteriorly rotated innominate, internally rotated hip, knee valgus, and excessive pronation at the feet.
But how far can we extend connections like these?
It’s not too difficult to get from the hip to the foot. Brian Rothbart doesn’t stop there. (2008; Rothbart 2008)
Poor “teeth coming together-ness” associated with foot position. If that isn’t cool, I don’t know what is.
Rothbart looked at the foot, the hip, and the cranium and drew relationships between them all. The summary is that when you look at a person (more specifically, a young Mexican subject), their more pronated foot is associated with shorter vertical facial dimensions on the same side.
Looking at it in more detail, a pronated foot is linked with an anteriorly rotated innominate via the mechanism I mentioned above. It is also associated with an anteriorly rotated ipsilateral temporal bone (think bringing the mastoid process up and making it less palpable, a.k.a. counterclockwise rotation in the photo below). The sphenoid is pulled downward, and the maxilla is pushed upward. There we have it: short face! There’s a helpful radiograph in the article linked above.
Pelvic bones and temporal bones look pretty similar, don’t they?
He briefly mentions a fix for malocclusions. Check out the video below for an introduction to Advanced Lightwire Functionals.
The DO lady in that video mentioned using the ALF to treat people with autonomic problems. The central goal of the Postural Restoration Institute – as I understand it – is to get at the nervous system. We want the body to have sufficient variability to do what it wants to do. We don’t want to be stuck on our right leg. We don’t want to be stuck in extension. We don’t want to be sympathetically toned up. Realigning your temporal bones, innominates, and feet are just neutrality acting on the nervous system.
Consider another article from Rothbart (2011) where he describes a foot condition.
On a side note, does anyone have a problem with him naming this condition after himself?
In people with Rothbarts foot, the first ray (that is, metatarsal up through big toe) hovers over the ground even when the talus is neutral. The big toe can’t feel anything underneath it, so when walking, the foot pronates hard to “find the floor”. These videos on rearfoot varus and forefoot varus can help you picture it.
The neurophysiological model which Rothbart proposes helps explain why proprioceptive insoles can make people better. Contrary to traditional orthotics that offer support, these insoles simply give the foot something to feel. Rapid pronation every time your heel strikes the ground holds the body in a state of extension. Good input on the bottom of the foot sent up to the cerebellum helps keep the person’s system neutral.
And as we already talked about, this can help a lot of things. From feet, to hips, to teeth!
Make sure you step back and look at the whole person when you’re helping them; getting too focal traps you into the specialist mindset. Better to be the person who sees everything than the person who misses the big picture.
Rothbart, B. a. (2008). Vertical facial dimensions linked to abnormal foot motion. Journal of the American Podiatric Medical Association, 98(3), 189–96. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18487592
Rothbart, B. A. (2008). Malocclusions Linked to Abnormal Foot Motion. Positive Health Online. Retrieved from https://www.positivehealth.com/article/bodywork/malocclusions-linked-to-abnormal-foot-motion
Rothbart, B. A. (2011). Primus Metatarsus Supinatus (Rothbarts Foot): A common cause of musculoskeletal pain – Biomechanical vs Neurophysiological Model. Podiatry Review, 68(4), 16–18.
By a suggestion from Bill Hartman, I’ve started to pick up on Leon Chaitow’s blog. The most recent topic was brought to him from a recent paper by Zieman and colleagues (2009) entitled The Amygdala Is a Chemosensor that Detects Carbon Dioxide and Acidosis to Elicit Fear Behavior.
So we have overbreathing leading to anxiety, which leads to overbreathing……. a real chicken-and-egg situation that demands attention to the causes of anxiety, as well as the mechanics and causes of overbreathing, to achieve ultimate restoration of health.
Underbreathing can also lead to anxiety as well.
We can find overbreathing in those who are chronic chest breathers (don’t use their diaphragm, which is the muscle on the bottom of the picture below), have irregular breathing patterns (find themselves out of breath when talking), and other things.
Try to keep your CO2 levels in your lungs in order by slowing things down and taking slow, deep breaths with your belly. This can help you in your fight against anxiety.