MVMT Physical Therapy

Good vs. Bad – The Binary Point of View

Hardly a day goes by in the clinic when a patient says either “I know my posture is bad” or “I think I’m doing this wrong”. We have such binary perceptions of our bodies – posture, physique, movement, task, technique. The desired outcome is either Yes or No, Good or Bad. How do I respond to these absolute, black-and-white statements? I ask some questions.

Am I Doing It Wrong?

How we perform a task varies from person to person. It also depends on what the desired outcome is. When evaluating a movement, we should first look at the result. Are you performing the task? Was it successful? If our task is performing a free-throw in basketball, then did you score or not? Maybe you’ve just picked up basketball as a hobby, and are practicing your shots. Perhaps that goal then is to actually hit the backboard, and not the gym wall behind it. A fair shot might be that the ball actually left your hands in the general direction of the basket. Better results mean you’re hitting the backboard more. Good throws might mean that you’re sinking the ball 6 out of 10 times. And Perfect performance would be 10 out of 10, with nothing but net.

But what about other tasks that are less obvious in their outcome – not so black and white? The long jump, running, weight lifting, yoga, running a marathon. What about walking or just standing?

The Questions

My main response from “Am I doing it wrong?” is usually “Did you perform the task?”. If we consider the task of lifting a box from the floor, did you successfully pick up the box and put it on the table? If so, then it was successful. You did it!

The next question is “Was it painful?”. No? If there was no pain during or after the task, then we’re ahead of the game. But keep in mind: dysfunctional movement isn’t always painful movement… yet. If there was pain during, or as a result of the task, then yes – you’ve done something “wrong”. Especially if that is “your pain” – that knee, back or shoulder pain that brought you to physical therapy in the first place.

The final question is “Could we improve how you did that?”. (See “dysfunctional movement”, above) The answer is almost always Yes. But since those assessments are based on each person for each task, let’s consider some other factors.

What makes something bad?

If you’ve ever seen a show from Cirque du Soleil (my favorite!), then you know that the human body is capable of amazing things. Yours is no exception. But there’s one factor that dominates many injuries – Time. We were designed to be able to bend in many directions. However, sitting in a slumped position at a computer for 8 hours every day isn’t one of those purposes. Static positioning over long periods of time puts undue stress and strain on joints and soft tissues, creates stiffness, and often leads to neck pain and low back pain. We were made to move.

Other factors that contribute to injury are: repetition, overload, overtraining, lack of mindfulness, and environmental factors. Greg Glassman, the founder of CrossFit, has said that it is often OK to sacrifice a little perfection for progress, but never at the expense of sacrificing safety. Gray Cook, the founder of the FMS & SFMA tools, opines that we as clinicians and coaches are not the Movement Police. It’s our job to help you move better – not necessarily perfectly.

Our brains executes these “trial and error” sequences as we perform tasks. As we push the boundaries and expand the margins of error in our movements, we help the brain to reorganize and our many, many systems to adjust and adapt. So where does that leave us, as movement-bound humans? Keep pushing forward, cut yourself some slack, strive for perfection, yet be OK with just moving better than before. Be mindful that movement is a spectrum.

Mark M Lusk, DPT, OCS, CFMT

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