“Thou art of the Jungle and not of the Jungle.”  (Part 1 of 2) - R Kipling, The Jungle Book

A few winters ago I hit a rough patch.  There was tremendous stress and uncertainty in several crucial areas of my life, and it manifested as physical tension and agitation.  I got home late from clinic one night and could feel the rock on my chest that was the anxiety I carried at that time.  I headed out for some air and exercise.  I put on two layers of thermals, hat and gloves and speed-walked uphill through the VT cold and dark to a playground a mile away. 

I was doing a short circuit of calisthenics when the rings and monkey bars caught my eye.  I grabbed the rings for the first time in years and could feel my body fight the first full body distraction, a short hang.  I hopped back up again and could feel my arms, shoulder blades, and torso settle into the hang, and the apprehension passed.  The third time I hopped up I started to swing a little, and I could feel the day roll off me and the calm come. 

The change in my mood and affect was striking.  Walking home I felt light and happy.  The next day my upper back and hips felt different - loose and comfortable. I was standing more upright.  I was less irritable and anxious in general.  I knew I had found something I needed, and I went back to the rings and bars every other day for weeks.  I am over 40, and I know in a very real way that I need to ease slowly into things I haven’t done in a while– especially in the cold!  I worked up to traversing the bars with a steady and relaxed reciprocal swing and progressed to the rings.  The motions became more fluid, less muscular and more inertial.  And it always made me feel calm.

I spoke to a colleague about this experience, and she said her autistic child would hang from monkey bars to calm down.  She used it as a strategy to diffuse his meltdowns.  I thought that was really interesting and went online to see if anyone else had anything to say about it.  I found first- and second-hand accounts of kids on the spectrum using suspension and swinging to achieve calm, focus, and an overall down-regulation from over-stimulation.  I hunted on PubMed to see if anyone had directly studied the effects of suspension and swinging on stress, anxiety, and sympathetic tone and struck out keyword after keyword.  This led to looking at the question indirectly and reading in disciplines I do not usually frequent.  Another friend with a child on the spectrum asked me if I would put together what I found, and this piece is a culmination of that line of inquiry. 

Brachiation

Brachiation is defined as a form of locomotion that involves swinging from tree limb to tree limb using the upper limbs and alternately supporting the body under each forelimb.  I want to discuss brachiation from two vantage points.  The first is more speculative due to a paucity of information in the literature – the neurophysiological aspects. This is the vantage point I am exploring in this blog today. 

The second vantage point addresses the mechanical aspects of brachiation, and how it pertains to structure and function of the evolving and devolving human form.  That vantage point will be explored in next week’s blog post. 

This is a thinking-out-loud piece about possible implications of movement that go beyond getting from one place to another.  It is a geeky piece of brain candy that is not meant as a treatment recommendation for people on the spectrum. Nervous systems, and the stimuli that speak to them, vary like snowflakes. 

Neurophysiological Considerations of Brachiation

A Polish group, Szot et al, performed a six month case study with an autistic child that included intense aquatic and gymnasium exercise, activities chosen for their high proprioceptive input value.  The group noted that “increased kinetic activity resulted in … a new status of functional balance characterized by smaller sensitivity in reacting to unfavourable stimuli” in the child.  This group proposed a mechanism of action that included a feedback loop between receptors receiving external stimuli from intense movements and process centers in the cortex.  More recent work in the study of autism has gone down a similar pathway and has focused on studying an apparent disruption of global integration between the processing of information from interoceptors and exteroceptors (Noel et al).  Hatfield et al discuss interoception as the perception of physiological feedback from the body.  Groups have recently shown interoception to be associated with cognitive, emotional, and affective functions, and this logically led to this avenue of inquiry in autistic people.  Studies addressing a deficiency in perception of bodily feedback and the reduced capacity to integrate the information are ongoing. 

When I think of interoceptors and exteroceptors, two things come to mind immediately.  Fascia and skin.  When I think of fascia, I think of full body movements charged with spring and recoil.  Enter brachiation.  Suspending a body from a single upper limb utilizes long stretches of mysofascial continuum simultaneously.  Looking at hanging from a single upper limb from a muscular standpoint, attention immediately lands on latissiumus dorsi.  Recent work demonstrates that the latissimus is functionally and structurally attached to the opposite glutes (Calvalhais et al) and lower limb (Vleeming et al) through the thoracolumbar fascia.  The arm is linked to this same continuum of tissue when the limb is overhead (Myers) creating one long chain.  The latissimus has been described as essential to shoulder and pelvic stability, both of which are essential to diaphragmatic action and breathing.  The fascia is full of receptors and contains 10x as many interoceptors as other tissues of the body.  Those receptors are hard-wired into the nervous system influencing its capacity to set global and local tone throughout the myofascial continuum. 

The diaphragm is also full of interoceptors, and the breath is tied to systemic neuroendocrine regulation and systemic allostasis, the processes by which the body responds to stressors in order to regain homeostasis.  The mechanisms of systemic allostasis includes the HPA axis (hypothalamic-pituitary-adrenal axis, a neuroendocrine system that regulates stress, mood, emotions, and body processes), pain perception, and executive functioning (McEwen). 

While the literature does not have a lot of information pertaining to brachiation and suspension precisely, it does speak to the effects of similar stimuli from different types of manual therapy that utilize joint distraction, tissue shear, vibration, touch, and pressure and their effects on receptors that elicit peripheral, spinal, and supraspinal changes (Bialosky et al).  Past work involving joint mobilizations has shown that distraction, rotation, and cyclical motions provide calming stimuli to the nervous system.  Activation of mechanoreceptors in joint capsules, muscle, and the skin bombard the nervous system with input that has been shown to abate nociception, or threat, and to decrease muscle guarding. 

Zoological literature on arboreal locomotion reveals true brachiators utilize pendular movements that continually exchange potential and kinetic energy for optimal efficiency (Michilsens et al).  This would appear to be descriptive of the tension and recoil of fascial chains in action.  Brachiation is basically full body cyclical and rotational distraction with loading and unloading of myofascial continuums.  It is a movement full of the nervous system’s favorite things.

All of this boils down to the potential capacity for brachiation to be a robust stimulus to both the nervous and neuroendocrine systems.   Perhaps this proprioceptive bombardment and its subsequent physiological adjustments could produce a very centering, calming, and organizing down-regulation of a body subjected to stressful circumstances. 

This train of thought suggests that applications of different types of movement patterns may have implications that go well beyond the ways that we generally think of them in terms of transportation and manipulation of our environment. Different types of movement patterns may have utility in effecting positive changes to global tone, sense of well-being, mood, and behavior.

Moving Well Matters

A cardiologist in Brazil, DS Araujo, observed that he had patients who could run on the treadmill and ride the bike with ease but found it difficult to put on their socks and to tie their shoes.  This made him wonder about the importance of musculoskeletal health and the ability to move well in determining longevity.  He devised a simple screening test called the Sit and Rise Test (SRT) that involves transitioning from standing, to sitting cross-legged on the floor, and back to standing again utilizing minimal points of support (i.e. putting down a hand, knee, etc).

Together with his colleagues, he tested 2002 people ages 50-80 then followed up with them in 6.5 years.  The test proved to be a strong predictor of mortality from all causes. 159 people died, and subjects who scored low on the test were observed to be 6.5 times more likely to die in that time period than those who scored high.  Each point increase in a person’s test score was linked to a 21% reduction in their risk of death from all causes.  Ability to sit and rise from the floor as a predictor of all-cause mortality; Brito et al; Eur J Prev Cardiology 2014.

The Sit and Rise Test may not look like much to the casual observer, but from a technical standpoint it provides an excellent, small scope snapshot of some fundamental elements of musculoskeletal health.  It demands full functional mobility in the ankles, knees and hips, sufficient strength to lower and raise the body, and full-body core stability/motor control to organize the body and hold it all together as the center of gravity shifts forward and back again.  There is a lot going on here!  If any of these elements is missing, the SRT becomes very difficult very quickly, and it is easy to see a body compensate and strain to complete the task. 

When was the last time it was thoracic spine day at the gym?  When was the last time you worked on your end range ankle or hip mobility?  When was the last time you focused on stabilizing your thorax over your pelvis?  Many key elements of musculoskeletal health are often lost in sedentary positions working and traveling.   They are also lacking in the often sparse diversity of movement patterns that can occur in a busy city life.  And they are commongly overlooked in gym routines, workout apps, and exercise classes.  Moving well matters, and it is worth learning to address all the elements of what it takes to move well.

 

"First, Move Well. Then Move Often." - G Cook

It can look like this.  You were busy with grad school, stopped running while writing your thesis, and somehow never got back into it.  That was 5 years ago.  You have been chained to a desk ever since and have decided that you really want to do the office 5k.  So you head out for a mile run, then bump it to two the next time out because a mile has never been anything to you.  You do okay with that so the next time out you increase to the 5k distance and feel pleased with yourself.  Then you get out of bed two days later and your (insert painful part here) is killing you.  You try easing up, changing shoes, but it continues to bother you.  This has never been a problem before!  What happened?

The first rule of the Human Body is that it is inherently lazy.  It is an efficiency model, and it never does anything that it doesn’t have to do.  It will not support the muscle or mobility needed to be agile and resilient if it is not regularly asked do so.  So basically, if you don’t use it you will eventually lose it.  This creep of lost potential occurs across all systems in the body – neurological, musculoskeletal, cardiovascular, respiratory, and so forth.  From a musculoskeletal and neuromuscular standpoint, lost mobility, strength, stability, and motor patterning can happen so slowly it is hard to notice – until it hits critical mass or you try to do something that you need it for and find it lacking. 

What happened to that body that was sitting at a desk for 5 years while the markets rose, fell, and rose again?  The ankles froze up, the hamstrings and hip flexors shortened, the thoracic spine tilted forward and petrified, the shoulders rounded in, and the stabilizer musculature forgot how to work.  Muscle mass was replaced by tissue less desirable, blood supply to soft tissue dried up reducing healing capacity, gas exchange and fuel burn became inefficient, the bones in the feet and legs got softer, the cartilage and discs became less squishy, and the body found a new balance point in all this murk that it decided was its new normal.  It became a markedly different body from what it was before the grad school thesis when running a few miles was nothing to it.  It stopped moving well.

So what happens if you do not move well, and you decide you are going to move often?  Think about the tire on a car.  When the tire is in perfect alignment there is an even distribution of force and weight across its tread, and it runs for an allotted number of miles before you need a new tire.  Now think of that same tire knocked out of alignment by a car-devouring pothole.  The tire still works, but one portion of the tire is taking the brunt of the force and wearing excessively while the rest of the tire quietly sits beside it.  Everything has its breaking point, and it is not a matter of if the tire will blowout but when it will do so.  Every structure in your body is like that tire – designed to evenly distribute force and weight for its allotted mileage.  You can think of your knees, shoulders, and back in this way.  If there is not balance in the system between posture, mobility, strength, and stability something is going to end up working harder than it should and is capable of a premature blowout.  This is the mechanism behind sub-acute injuries, more commonly known as “wear and tear” injuries and “postural strains.”  You may know them by their common names: tension headaches, osteoarthritis, IT band syndrome, meniscus tears, rotator cuff pain, low back pain.  Repetition does not hurt a body – repetition with poor mechanics hurts a body.  Building structural alignment and balance is essential to a body working well.  More is not better.  Better is better. 

When it comes to caring for and improving our bodies, we need to give attention to our weak links and address all of the components of moving well before we subject ourselves to moving often.  The second rule of the human body is the body always changes in response to stimulus.  Different types of exercise and tissue work are stimuli that result in different types of changes in the body.  Improvements in the structure, function, and mechanics of the body can be achieved by giving the body what it needs in terms of stimuli to improve itself.  Regarding dose and intensity, so long as we don’t do too little and bore the body, or do too much and inadvertently knock its two front teeth out, we can gradually and progressively move it forward in a more desirable direction.  This is the basic tenant upon which rehab and training alike are built.