The Demand for Effort
The desire to work your way out of an injury or pain situation is understandable and reasonable, but may not be the solution. Working harder is not always what gets things done, it just means more work. Patients come in all shapes, but by and large the conversation I have more often than not is that they need to slow down and do less to promote the changes they seek.
The predominant view on recovery is that is requires more time, energy and effort to get where you want to be. That if you are not moving in the direction you want to move in, then work harder. Do more. Stop getting distracted. What if slowing down, moving less, and allowing distractions to provide solutions were more useful strategies? Recovery requires energy, it requires output without a doubt. Those acts are preceded by rest and energy storage. To apply yourself you must first determine what the right problem is, then determine a course of action to find the answer to that problem. This usually is best achieved by slowing down, taking aim and then acting. The idea that it just requires blind effort and hard work is short-sighted and often times sub-optimal. Effort is important, it must be harnessed and deployed appropriately.
In practical terms I will coach clients through slow, rhythmic movements when they begin physical therapy. Not because they are not capable of moving quickly, or producing high degrees of force, but because slowness allows muscles to relax, connective tissues to expand and provide feedback to the system that promotes energy storage. Then we can focus on noticing subtle movements, sensing what it is like to move differently, and then recreating those movements and senses under varying conditions.
This may start out with low grade rolling activities on the floor, move to standing positions under body-weight, then progressing to loaded activities and eventually loaded activities with time constraints. Removing the initial perceived constraints of doing more, working harder, and expending more energy allows for the body to find the solution. The answer is always within the problem, identify the correct problem and the answer will come to the forefront.
Austin Ulrich, Physical Therapist
