Moving in Three Dimensions

All movement occurs in some combination of the three dimensions. This includes the sagittal plane, frontal plane, and transverse plane.

Movement in the sagittal plane, which involves flexion and extension of the body, is the most common movement that is trained, and tends to be the most familiar in our daily lives. Sagittal plane movements include squatting, walking, climbing stairs, bicep curls, and interacting with objects that are in front of us.

Sagittal Plane

---

Frontal plane movements relate to lateral, or side to side movements, and may include side stepping, side bending, and lateral arm or leg raises.

Frontal Plane

---

The transverse plane is the third dimension of movement, and includes rotational movements such as turning the spine from left to right, or rotating the hips or shoulders in or out.

Traverse Plane

Movements in the sagittal plane tend to be overemphasized in people's lives, whereas the latter two planes of movements may be more unfamiliar.

We must be able to move with agility and efficiency in all three dimensions in order to respond to the unpredictable demands of daily life without strain. Limiting movement to only one dimensions can put more stress on particular tissues of the body, which can contribute to pain and pathology, particularly of our joints. For example, walking has the potential to be very beneficial for our whole bodies, but the way we walk can also contribute to excessive strain on certain joints. If we only ever walked on flat, invariable terrain (think concrete or a treadmill), and tend to keep our spines very rigid while we walk, this would limit our movement to primarily the sagittal plane. This may put extra stress on certain regions of our weight-bearing joints, particularly our hips and knees.

If we can vary the way we walk as well as the terrain we walk on, we can move in all three dimensions which will spread the movement over a greater area of our bodies. Imagine adding a little “dance” to your walk by allowing the pelvis to glide from side to side with each step, as well as allowing the arms to swing and the chest to turn. This will allow the body to move more fluidly by including side-bending and rotational movements in our gait. Combine this with regularly walking on different terrains (e.g. inclines/declines, twists and turns, grass, dirt, stones, etc.), and we will stimulate our bodies in constantly varying ways to minimize repetitive strain on isolated areas.

As part of a comprehensive treatment plan, your Wellness Station therapist will ensure your program includes balanced movements in all three dimensions. It is our mission to address the root of issues, rather than treating symptoms, an unfortunate tendency that is often found in more traditional therapeutic approaches. We strive to see the bigger picture, and will help you develop strategies to bring greater balance and ease into all dimensions of life.  

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Working with One’s Body, Not on the Body

A friend of mine came to spend a few days with my wife and myself, and because she had some issues with her hips and low back, she participated in three Feldenkrais method lessons with me. From her home in another state, she had been receiving traditional physical therapy for this condition with only minimal improvement.

This is the feedback she offered a few days after leaving and returning home-

“Paul, I wanted to share a few things I've noticed. It's been quite eye-opening and comforting to do everything as gently as possible; everyday things like going up and down stairs, sitting down and getting up. I'm angling my legs on stairs and it is such a relief, it's so much easier. I'm keeping the therapy movements easy, no strain and that feels wonderful too. These adjustments are also helpful mentally, as I feel that I am treating myself well and not pushing myself at all. I thought you might be interested in this feedback.”

At the Wellness Station, we provide our patients with Feldenkrais and yoga-inspired movement lessons. Moving with less strain on tissues and joints provides much more comfort and pleasure in all activities of daily living, recreational sports and work requirements. These lessons emphasize moving with ease, whether the movements are considered easy or very challenging. We refer to that which we teach our patients as lessons, not exercises, because in the words of Moshe Feldenkrais,

”When you know what you’re doing, you can do what you want.”

What's the Deal with Stretching?

We have all heard a lot about stretching. Some people swear by it as a practice that will prevent injury, restore flexibility and range of motion, and improve performance. Others consider it to be a superfluous practice that lacks therapeutic benefits and could actually lead to harm. The truth likely lies somewhere in between. To determine whether stretching would be a beneficial practice in one's life, it is necessary to clarify a few important points.

First of all, what even is stretching?

Stretching is an umbrella term that can be divided into several categories.

Passive stretching:
The use of an external force, such as the weight of one’s own body, an object, or a force from another person to deliberately lengthen a muscle. This type of stretching is targeted at a very specific muscle, such as the hamstring, and the stretch may be held for any length of time, such as 30 seconds.

Active stretching:
The use of the strength of one’s own opposing muscle groups to lengthen a muscle and hold for a set duration. This looks similar to a passive stretch but requires more muscular work. Active stretches are common in yoga, and may include postures such as a lunge, an active pigeon pose, or a downward dog.

Dynamic stretching:
A form of active stretching in which one uses their own strength to move muscles through a range of motion. Dynamic stretching involves taking an active stretch as a foundation and adding movement rather than statically holding a posture. This is a good practice for warming up the full body prior to athletic activity, and may include movements such as arm circles, bringing knees to the chest, lunge variations, trunk rotation, etc.

PNF stretching:
PNF stands for proprioceptive neuromuscular facilitation. PNF stretching involves alternating cycles of contracting and releasing specific muscle groups with varying levels of force throughout the range of motion of a particular joint.  This form of stretching is often utilized in physical therapy, but it can be done alone as well. For example, if the intention is to stretch one’s chest muscles by placing the right hand on a doorway and then turning the body to the left, this stretch can incorporate PNF techniques by alternating between gently pressing the hand into the doorway, and then relaxing. Or, the hand can be lifted away from the doorway to engage the antagonist muscles (mid-back, scapular, and posterior deltoid muscles). These techniques can be combined with the breath to allow the nervous system to reset levels of neuromuscular tone, as well as build awareness of how to engage various muscle groups.

In addition to what type of stretching one is performing, the benefits or detriments of the stretching routine also depend on various other factors. This includes the intention of the stretcher, the efficiency of movement, the state of the nervous system, injuries and pathologies present, and the comprehensiveness of the stretching program (e.g. only stretching one muscle group while neglecting all other muscles is not a well-balanced practice). Clearly, stretching is not good or bad, harmful or helpful. It depends on all of the above factors and more.

The type of stretching that tends to be the least beneficial and the most detrimental is passive stretching. This type of stretching involves statically pulling on an isolated muscle group with the hopes of becoming more flexible. The benefits of this practice depend on the intention as well as the technique. If one's goal is to yank and pull on their muscle until it gets longer, good luck! Our nervous system has a mechanism that will actually tighten muscles more if it senses overstretching.

On the other hand, those of us who are already hyperflexible or may have a connective tissue disorder such as Ehler's Danlos syndrome, overstretching can actually damage the muscle and joint over time, as the tissues may stretch past the point of no return and become unable to support the body in a functional way. Passive stretching is not necessarily a bad thing- if performed gently with careful attention to sensation and the breath, this practice can be helpful for calming the nervous system, deepening mind-body connection, and improving flexibility over time. However, there are more effective ways to achieve these goals.

The other three types of stretching (active, dynamic, PNF) are more useful tools for improving functional movement. If one’s stretching practice is primarily passive, try to incorporate active, dynamic, and PNF techniques into the routine. These practices improve injury resistance by priming us for movement, and deepen our kinesthetic awareness by teaching us more about our unique neuromuscular patterns of tension and weakness.

Check out this article for more information about PNF stretching and how to begin incorporating this technique

To learn how to apply these techniques through a holistic lens to relieve pain or discomfort in any area of the body, consult your Wellness Station physical therapist.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Body Scans Can Help You!

Body scans are a very helpful tool that apply mindfulness meditation to the physical sensations of the body. This is an excellent practice for improving mind-body connection, calming the nervous system, and training our mind's ability to bring attention to pleasant, unpleasant, and neutral sensations without judgment.

Improving mind-body connection:

Body scans can improve mind-body connection (aka kinesthetic awareness) simply by bringing attention to various body parts. When focusing attention to an area, we are strengthening neurological connections that regulate the bidirectional flow of information between the brain and the body part. We can also start to recognize patterns of where we hold tension in our body, where we have more difficulty relating to, and where we can more easily focus attention. This can translate to becoming more aware of certain body areas, which can help us improve our self-image and efficiency of movement. As our body is our home for the entirety of our lives, it is useful to get to know your anatomy from the inside out!

Calming the nervous system:

Body scans are a meditative practice that train us to bring our attention to the present moment. Rather than allowing our minds to wander with worries of the future and regrets of the past, we are practicing the ability to focus attention on sensations of the present moment. This can help shift us into a more parasympathetic state of the nervous system, which allows our bodies and minds and relax and restore. This will help to relieve stress and anxiety, as well as improve our health, well-being, and relations to ourselves and to others.

Exploring various sensations:

The intention of a body scan is to bring attention to all kinds of sensations in the body, including those from the skin, muscles, joints, and even our organ systems. These sensations may be pleasant, unpleasant, or somewhere in between. The point is not to assign judgment to an unpleasant feeling, but rather notice the sensation for what it is (e.g. pressure, tightness, ache, tingling) and to recognize what happens when we stay with it without trying to change anything. This can improve our ability to bring attention to real-time sensations through a lens of separation and objectivity, rather than letting emotions such as fear run wild when pain arises during our daily activities.

Here is an example of how to perform a "five lines" body scan:

1. Rest comfortably on the floor or bed in a position. Consider lying flat on your back with your legs extended and arms resting by your sides, or use any props to get more comfortable.

2. Begin to settle in, slow down your breath, and close your eyes.

3. The body scan will involve the five "lines" of your body: each of the four limbs, as well as the spine from the pelvis to the head.

4. Right leg: bring attention to the right side of the pelvis, sensing what part is touching the ground. Sense this space from side to side, back to front, noticing any sensations (e.g. buzzing, tingling, tickling, pressure, temperature, clothes against the skin, skin against the ground, etc). If no sensations are present, notice that too. Then let your attention slowly travel down to the hip, down the thigh, to the knee, calf, ankle, heel, arch of the foot, ball of the foot, and toes. You can then let your attention travel back up to where it came from towards the right side of the pelvis. Take as much time as you need, noticing if it is more difficult to move your attention quickly or slowly.

5. Repeat this process for the left leg. Notice differences between the two legs.

6. Right arm: bring attention to right shoulder blade in the back, collarbone in the front. Let attention travel towards the right shoulder, then upper arm, elbow, forearm, wrist, hand, all the way to the fingertips. Then travel back up in reverse.

7. Repeat this process for the left arm. Notice differences between the two arms.

8. Spine: bring attention to center of pelvis, the sacrum bone against the ground. Slowly travel the attention to the low back, feeling your abdomen in three dimensions. Notice that as you breath, the size of this area changes. Feel what part of your spine is connected to the ground, and what is not. Then slowly travel towards the mid back, rib cage, upper back, base of the neck, neck, head, face, and finally the crown of your head.

9. Rest completely, noticing what the attention is drawn to now. 
 

At The Wellness Station, we ensure that body scans are a regular part of our client's mindfulness practices. We may begin or end sessions with a guided scan, as well as create or recommend a recording for home use.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor

and The Wellness Station Team

Ehlers-Danlos Syndrome Part Two: An Almost Miraculous Improvement in Comfort and Function!

Don’t Miss Out on the first blog post about Ehlers-Danlos!

Brief Case of Patient with Ehlers-Danlos Syndrome:

Susan was 32 years old when she began her Feldenkrais inspired physical therapy sessions at the Wellness Station.  Prior therapy included three different sets of sessions of traditional physical therapy.  Susan said,  “I felt like I was being taught to move in a rigid fashion!”

Her primary concerns were-

            1: Her inability to safely manage weight bearing situation’s

            2: Bilateral lower extremity joint pain.            

She required using a railing to go up and down stairs. She could not safely manipulate up or down any steep inclines.  When climbing more than one flight of stairs, her husband often provided her with support from behind.

After three sessions, she described experiencing minimal discomfort and significantly enhanced weight-bearing confidence. By her seventh session, she was independently going down a very steep embankment to dismantle a fence on her property!          

Susan’s stated, “I now feel like my brain knows how to provide the appropriate actions for my life’s intentions!” She learned to enhance neuromuscular patterns of function for all of her spinal and weight-bearing joints similarly to someone learning all of the keys of the piano to play a tune!

Written by Paul McAndrew, PT, GCFP and The Wellness Station Team