Should we be Trying to Change the Way People Move?

Back when I was a squash coach, I'd have many older squash players coming to me with quite unorthodox techniques and who wanted to improve their game. It was always a challenge to figure out whether I should change their fundamental technique or work with their flaws and simply improve them in other areas. It usually depended on the ambitions of the player; if they were prepared to see a short-term drop in standard for a long-term benefit, then I could go about making big changes to their technique, otherwise there seemed no point.

In much the same way, the conventional wisdom promoted by most physiotherapists and exercise physiologists when it comes to injury prevention is not to fundamentally change posture or movement technique, but to work with their client's physical flaws and do the best they can to loosen some areas and strengthen others because I think many are - maybe justifiably - sceptical that their clients are really going to be dedicated enough to put the time in to make meaningful changes.

It isn't only this, however. There is an uncomfortable truth about the way society is these days, and that is people find it very difficult to accept criticism, say sorry, or admit flaws. I see the fitness and health industry largely placating, rather than challenging people because of this. "There's nothing wrong with you", "You're fine just the way you are". These are the mantras of the times. When it comes to long-term health, however, no, you aren't fine the way you are, and deep down you know it. The health and fitness industry make quick bucks off you all the time because you aren't willing to admit you have very fundamental problems that need to be addressed. The result is people throw money at quick fixes and fads that never work

With this in mind then, I have some disdain for the way most current physios and exercise physiologists operate. In all my years training people and working with these guys, results have seemed very thin on the ground. All I see is people with problems that get a little better for a while (usually down to simply resting the affected area), but over the long-term always deteriorate. The issues they had always came back with a vengeance or simply moved somewhere else.

Perhaps you might think the word "disdain" is too strong a word, but if there is something that really frustrates me about the world of health and fitness, it is that health professionals in the most trusted positions know next to nothing about preventing injury in the long-term. The very basis of their work is flawed and their claims to be able to prevent injury are false. People's physical problems will deteriorate with age if you don't change anything important, so you can't work with them or around them, you have to go about trying to fix them. In a game of squash, your game plateaus without fundamental changes, in your body things progressively get worse, guaranteed.

Changing the way people move is perhaps an ambitious goal, especially in an age when everyone is so busy, but it can be done and any progress towards fixing people's biomechanics is much better than just letting it slide further.

I have had many clients express incredulity at being able to change their posture and gait - at least on any permanent, unconscious basis - but I tell them that everyone has seen it in themselves and others. If your posture and gait can change with age in a bad way, surely this is the proof that there are things you can do to change your posture and gait. If things can get worse because of your daily routines, why can't they get better with different routines?

The way you stand, walk, and run is so important to a healthy, well-functioning body because it is what humans have evolved to do on a fundamental biomechanical level. Apart from our big brains and intelligence, the way we move also sets us apart from other animals and we have to respect this in training to really promote effective injury prevention.

There is a defeatist attitude to many health professionals, and a tendency to say that many people's problems are genetic, so the best they can do is stop things getting worse too quickly (but they'll get bad eventually). In this case then, how do you know that your $120 an hour exercise physiologist or physio is doing you any good? Time and time again, I come across people who have spent years going to these people and finally have realised they have seen no long-term benefit. Their problems persist, and usually get worse, but you know you're getting old, so what do you expect?

I have always been a terrible businessman because I honestly tell people what I think. Physios and Exercise Physiologists have the perfect business model; they charge exorbitant prices, which many people write-off on the taxpayer through government health programs, and they promise nothing except that if you stop going to them, things will be worse. A few operations later when things couldn't be any worse, they promise that it really could've have been. You'll just have to take their word for it, they have a piece of paper saying that they know what they are doing after all.

I'm afraid I keep running-up against this in the health and fitness and medical industry more broadly. There is precious little will or ability to test anything on a long-term basis, let alone some of the evolutionary theory based rehabilitation and prevention techniques that I have mentioned on this site. Despite the obvious biomechanical advantages of optimising your posture, this is still seen as merely theory, not promoted or practiced by medical professionals. Therefore they are not trained in it and the government does not support people who want to do it to fix their problems in this way.

I'm sorry to say that if you have long-term chronic pain, you are currently stuck with it, and the health professionals will even tell you that this is the case. The surgeon's knife is inevitable.

To illustrate this defeatist attitude, I recently came across a blog from a local exercise physiologist. He claimed to be able to help people with their injury problems because he has had many himself, and continues to do so, even claiming he will be going to have an operation again very soon. He was actually wearing continuing injury issues as a badge of honour and using it to promote himself as a wise, compassionate trainer.

Now I have no problem with this in theory. You can go to an overweight personal trainer if you want to lose weight, you can go to a injured physio if you want to prevent injury. They may actually understand things better than someone who has never had weight problems or injury issues. Where I am critical is going to a trainer who hasn't fixed their weight problem or is not on the way to fixing their weight problem. Why would you see a fat personal trainer who is getting fatter to help you lose weight, for example?

The same goes for injury prevention specialists. Why would you see someone who can't improve their own situation? Why would you ever think they can improve yours? Blaming their genes for their continued injury issues is like an overweight trainer blaming theirs for their continued weight problems. While it is obviously going to be more difficult for some people to lose weight because of their genes and more difficult for some people to avoid pain and injury because of theirs, in both cases it can be done. It is a matter of time, effort, and know-how.

Unfortunately, I rarely come across people familiar with evolutionary theory, who are diligent enough, and have enough of an open mind to really give posture and gait training a go. It is a real shame because you can improve with age instead of deteriorate, and most people these days are going to live a long time with a lot of pain, sooner or later. Why not try to fix your problems?

Well, that goes deep for many people, and perhaps many don't want to. The current orthodoxy in treating injuries, long-term, plays on this in my opinion, with a level of dishonesty and pessimism that makes me very uncomfortable. Basically they look at you in your highly compromised state and tell you that there is nothing wrong with you, you fundamentally don't have to change anything in your life, just to do a few exercises and stretches every now and then in the gym, and fork-out exorbitant amounts of money having massages and seeing the physio for regular advice.

All this is not to say that I, or other biomechanics specialists in my field can solve your problems and it is just a matter of handing over some cash to us instead. What is required is a confronting lifestyle change for many people, a hit to egos for many, and a fair amount of time and energy working on things themselves. Improving biomechanics is not easy; there may be some large sacrifices you need to make and there are many life variables at play in order to be able to make meaningful changes. There also comes with it a realisation of your shortcomings, and this can be incredibly hard on people and most simply won't admit to the scale of their problems. All I am selling is the knowledge to improve things yourself, and most of the clients that come to me may not even need more than a handful of sessions and then they can go and work on things themselves (and I give-out a lot of free information on this site, my YouTube channel and my Facebook page). As well as my resources, I also recommend checking out Thomas Myers of Anatomy Trains, and Functional Patterns. Thomas Myers explains the anatomical theory very well, and Functional Patterns have the best training system for optimising biomechanics that I am aware of.

Finally, don't expect miracles. Learning to improve posture and movement is a lifetime exploit, a bit like learning a language. You may never be the perfect biomechanical specimen of a human being, just like you may never be truly fluent in a second language. But each step of improvement along the way opens new doors. Just as each new word learned helps you communicate better, each small improvement in biomechanics helps you move and feel better. It is a long road, but it is a journey that needs to be taken and everyone has to start somewhere.

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