"One Cannot Think Well, Love Well, Sleep Well, If One Has Not Dined Well." - Virginia Woolf

I was reading an article on BBC written by a genetic epidemiology professor named Dr. Tim Spector who went to live with a hunter/gatherer tribe, the Hadza, in Tanzania.  He was studying the link between what we eat and the diversity of the microbiome of our digestive system.  In the course of 3 days, Dr. Spector’s gut diversity increased 20% by eating foods outside of his daily regimen including local plant life and porcupine.  Our guts contain trillions of bacteria that are at the core of our metabolism and immune system, and a growing volume of data suggests that greater diversity of bacteria in the gut provides improved health and a lower risk of disease.  20% of trillions is a lot of bacteria!  It is clear that adding a little diversity to the good doctor's diet resulted in an impressive return in health for a short-term investment.  

So what does a diverse gut signature have to do with movement?  Multiple branches of science have shown time and again that what is good for one system in the body is often good for the others.  Cruciferous vegetables?  The research suggests they are potent anti-cancer agents, as well as conducive to heart, gut, and brain health.  Walking?  The research suggests it is important for decreasing the incidence of all-cause mortality as well as cognitive health.  A diverse gut biome is increasingly deemed necessary for optimal immune and neural health, as well as overall capacity to physically thrive.  And a diverse movement biome is increasingly recognized for optimal neuromuscular, musculoskeletal, and cognitive health. 

15 years ago, I met a man who told me that gyms were invented for people who did not own peach trees.  He had owned many acres of peach trees for over three decades.  Each day he would tend the trees and the land – harvesting, raking, planting, mulching, trimming, planning, and fertilizing.  He was always moving, and his movement varied considerably day to day.  He did not have any significant issues with pain until a year and a half after he sold his land and peach trees.  That is when I met him.  His movement biome went from robust and constant to limited and minimal.  He basically became sedentary.  His back, shoulders, and knees all became an issue from the marked decline in his physical capacity instigated by the narrowing of his movement biome.

I was at a photo and video shoot a few weeks ago, and a young creative asked me, in my professional opinion, what the best workout was.  She said is it yoga?  Running?  Lifting?  Zumba?  Biking?  Swimming?  I said yes.  She said but which one?  I said all of them.  As much variety as she could handle.  She did not appear ready for that answer.  And I thought that was odd.  When I got to thinking about it though her response was not surprising.  Watching tv and social media, one would think the gym or a phone app is the place where physical health and resilience are attained.  Much of the research the public is exposed to regarding parameters of physical activity and exercise have to do with minimal amounts of cardio or strength training one needs to do in order to achieve improvement and some curbing of disease processes.  There are often suggestions that some programs/movements are good and others bad.  Like you can attach a moral imperative to a movement pattern? 

More recently, we see in the emerging research that the thousands upon thousands of low threshold, variable repeats that occur throughout the day of an active, non-sedentary (read that sits less than 3 hours a day) person are where the underpinnings of overall physical health and capacity are achieved.  Work done by Rezende et al suggest that people who sit for more than 6 hours a day are 40% more likely to die from all cause mortality in the next 15 years than people who sit for less than 3 hours a day.  Their work further suggests that hitting the gym hard for an hour each day may not be sufficient to bridge the gap in health from a sedentary existence.  Our society seems fixated on doling out the minimums rather than the optimums.

The gym means different things to different people.  In my own experience, it is one of my favorite places and a place I have spent a great deal of time in throughout my life.  It has been a training facility, a medical facility, a temple, a meditation hall, a laboratory, a social club, an office, and a library to me.  For me it has also always been an adjunct to the work of living an active life, not something that took the place of it.  The capacity I gained there allowed me to hustle for pucks in the corner of the rink without being knocked over.  It allowed me to crash my snowboard without dying.  It allowed me to hike without knee pain, to clear my head after an argument, and to manage my stress.  It has always been a way for me to build greater resilience into my system to allow for life overall to be more healthy, fun, and robust.  It has never been a replacement for living actively.

In the long game, 3 sets of 10 twice a week do not fix 10 hours of not picking anything up every day for 15 years.  5 minutes of couch stretch each morning does not counteract 45 years of riding a desk.  3 sets of heel raises do not counterbalance walking a tenth of a mile daily and leaving your feet in foot coffins for the past 10 years.  They can help of course but are insufficient in isolation. These efforts are most effective when mixed in with a more active and variable daily movement biome.  It is the difference between thinking of movement as an intervention versus a lifestyle change.  It is the difference between looking to do the least required to see a change versus doing what it takes for things to actually be different.

So get up.  Get out.  Do stuff.  Lots of different types of stuff.  Sit less.  Move more.  Hit the gym.  And the stairs.  And the woods.  And the climbing wall.  Ride the train on one foot.  Hang off the monkey bars.  Watch tv on your belly.  Do your paperwork on the floor.  Learn new tasks, new sports, new skills, new instruments.  Your cognitive pathways and motor pathways run next to each other.  Let all of you improve and enjoy the benefits of engaging more fully in the world around you. 

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

“You're gonna get better or you're gonna get worse, but you're not gonna stay the same.”  - JP

Last week’s blog focused on possible neurological and neuroendocrine ramifications of brachiation, locomotion that involves swinging using the upper limbs in reciprocal fashion.  This week, I would like to look at brachiation through a more mechanical lens.  I would like to consider it from the vangtage point of structure and function in evolution and devolution of the human form.

Mechanical Considerations of Brachiation

Similarities in structure between modern day full-time brachiators (i.e. Gibbon monkeys) and present-day humans include long curved fingers, reduced thumbs, long forelimbs, freely rotating wrists, flexible shoulders, and good grasping capabilities (Jurmain et al).  Gutierrez informs us that clavicles are struts in brachiators that position the upper limb away from the body to free up global positioning and use of the limb overhead, all while increasing the limb’s strength and dexterity.  It is clear that our ancestors spent some time hanging out at height as it is written all over our bodies. 

However, there seems to be a great deal of controversy and discussion in the zoology literature regarding why and when it was that our ancestors decided to stand upright, and ultimately why they decided to stay that way.  Recent findings in the fossil record are more supportive of the notion that our more direct ancestors were not strictly arboreal folk brachiating from one limb to the next, but rather generalists who did some brachiating, did some climbing, and were quadruped in a swing through kind of way (knuckle-walking) before they were biped (a “semiterrestrial ecological generalist” for those keeping score) (Niemitz).  There is discussion of brachiation as an exaptation, or a pre-adaptation, to becoming bipedal.  An exaptation is a trait that can serve one function and come to serve another over time.  This line of thought suggests that brachiating gave us the capacity to become bipedal by promoting upright posture and situating the thorax over the pelvis with stability and control.

For better or worse, human beings are found all over the planet.  One of the features of humans that makes us so resilient is that we are not particularly well adapted to anything - we are generalists.  Therefore, we are not confined to a small temperature zone, particular climate, or single food source.  We are largely able to support ourselves with a source of water, edibles, and an appropriate oxygen percentage.  What we lack in less supportive environments we are able to make up for with the craftiness of our relatively enlarged brains and opposable thumbs.  Our great adaptability comes from our great capacity to be generalists - just like our ancestors who could get food from the trees, the side of cliffs, and eventually wade upright through marshes and shorelines, scrounge around the savannahs, and run across the plains.

The body always changes in response to stimulus, and physical activity is a boss stimulus.  Evolution never stops.  It is going on right now.  And while we are sharpening our survival knives in some areas (i.e. Uber app, SmartWool, and FreshDirect), we are actually losing capacity in others.  Physical devolution is being driven by increasingly sedentary lifestyles, screen time, and comfortable chairs.  We are shrinking to the size of the bowls we find ourselves in most frequently, and this means we are becoming more specialized and less generalized as our posture, mobility, strength, and stability cease to be sufficient to climb, hang, swing, squat, and even get off the floor. 

A deep squat is a presentation of end range hip, knee, and ankle mobility, lower extremity/torso strength, and the motor control to hold everything together. Brachiation is the presentation of end range shoulder, scapular, and thoracic spine mobility, upper quarter rotational capacity, upper extremity/torso strength, and the motor control to hold it all together through full body reciprocal motion.  One is a full body compression, and the other is a full body distraction.  Both represent the ability of the limbs to support the weight of the body.  We need them both to remain solid generalists capable of escaping oncoming trains and high water.  The exaptation capacities of brachiating – the upright posture, stable diaphragm and pelvis, elongated legs, full mobility of the upper quarters, and resilience of the myofascial continuum – are needed to keep our bodies healthy, agile, and resilient. 

It is accepted that every push demands a pull, and every straight plane motion demands a rotation.  Perhaps every compression also demands a distraction. 

“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.