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Injury Prevention

Awareness Is The First Step

Think back to your first car.  Whether it was brand new or older than you, it likely felt special maybe even unique.  Skip forward 2 months and suddenly it seems like you car’s model and color is far more prevalent than you remember before owning it. Once you recognize it, you can’t help but notice it everywhere you go.


I had a similar experience when learning about the body, specifically abnormalities in posture and gait (walking pattern).  What I thought was unique–a leg externally rotated (toes point out instead of straight)–now stands out to me everywhere I go, and I myself am guilty of it.


Before I was aware of this abnormal stance I harbored, I had chronic knee pain that would mysteriously come and go. Although the body is complex, a fundamental reason why this way of standing and walking causes knee pain is alignment, or the amount of time to absorb force. 


The Breakdown

First, your toes like to face the same direction as your knee, and your knee the same direction as your hip’s boney protrusion (ASIS). Therefore, if the toes are pointing out to the side of your body like a penguin, your knee then has to decide whether to point in the direction of the toes or the direction of the hip and becomes unhappy. 

Second, let’s say your foot is twelve inches in length from heel to big toe. This means when you walk, your body ideally has 12″ of ground over which to pass and absorb forces. Now, imagine your right foot is pointed perpendicular to your left, creating an L shape with your feet (extreme, I know).  The amount of time your body has to absorb forces on the right foot is drastically shorter than on the left; it would be the length of your heel–approximately 4 inches–instead of your entire foot.  

With only a third of the contact length to pass over and absorb forces, the body has to make compensations, which can cause problems long-term. Imagine, if one day only a third of your office showed up for work.  You would likely have to take on extra work to accomplish the daily goals and functions of the office.  If this trend continued for a few months, likely you’d be stressed out at minimum, utilizing all of your energy and stamina to accomplish the bare minimum requirements for the work you’ve become responsible for completing.  A year into this trend of 3 times the responsibility and no increase in pay, you’d be burnt out at best.  


The same is true for the body.  When our alignment is skewed, other muscles and joints pick up tasks that don’t belong to them.  After a while they begin to complain (ache, cramp, make cracking noises, etc), and if we do nothing to alleviate this pain, we’re blazing a trail to burnout (chronic pain, injury, joint replacement, etc).


When it comes to injury prevention, the first step is awareness. I tell my students that they’ll go through 3 phases during their time in school.  The first phase: everything hurts–awareness.  The second phase: I am the cause of my own pain–walking with an externally rotated limb.  The final phase: I have the most control over my pain–I am responsible for making changes.  


This final concept is the single greatest factor in determining how much a client will recover and prevent future injury.  If I see someone for 1 hr a week, that leaves them with 167 hrs where they must assume responsibility for the way they move and load their body. 


The awareness becomes a tool for controlling pain. Yes, my toes still get caught looking to the sidelines instead of straight ahead–though now it’s more of a glance than a stare down. However, I now know what to focus on at the first onset of pain, changing my foot position.


When I learn something else that my body is doing with poor form, I get excited because now I know what to look for when I have pain.  Again awareness is the first step to preventing pain and injury. So I’d like to leave you with an awareness a former student of mine, Vera, gave me.  


You’re probably holding your pencil wrong. See the picture above? There’s an exceptional amount of tension in that hand, and the grip is reminiscent of a child who has poor motor skills (as we all do when we first begin coloring/writing).  Instead of a death grip that causes white spots on our skin due to restricted blood flow, the pencil should be held loosely at an acute angle (not straight up and down) with movement and formation of letters coming from the shoulder not the fingertips. 


An awareness for next time your hand begins to cramp while writing, try to release your grip (no one’s coming to steal your pencil) and allow blood to circulate through the hand.

Take care,

Janelle