This isn’t a story relating directly to dancing, but it does relate to being a human, and since you’re one of those, too, I think you’ll find there’s something in this story for you.
This is a story of a lady that I feel I failed, and my six weeks working with her left me feeling frustrated and confused. In writing this I’ve managed to find some clarity, to see the big picture. That it wasn’t my failure, it was a cumulative failure.
This lady was a cyclist referred to me from physio post rehab for bilateral rotator cuff issues that she wanted to learn some exercises for to strengthen her shoulders.
I was taught that when we see the exact same injury on both sides of the body, the root of the issue may lie somewhere in the middle. Her shoulders may not be the problem. Her shoulder issues may be a symptom of something that’s been going on for much longer.
So, I thought, probably useful to check out what’s happening (or not happening) with her spine and ribcage, those guys that her shoulders are attached to.
We checked out her spine and rib motion in three planes and observed that there was some stuff definitely NOT happening through her spine, some important motions missing (well, all motions are important… You can’t change one thing without changing everything else, too).
To me, what her body was saying was clear: Her thoracic spine was locked into a flexed position- her cycling posture. When she moved her ribcage into an anterior tilt (down), it looked like it was getting pulled into a canyon, but to extend up she became locked and couldn’t move at all.
Aha, I thought. No wonder her shoulders feel gnarly, she can’t move her spine!
It should have been quite simple, but it ended up as a fight. It was more than a “can’t”, it was a “won’t”.
This lady had a team of people trying to “fix” her. A physiatrist for her back issues. A pelvic floor specialist for her pelvis issues. And another physiotherapist for her shoulders (the one who referred her to me). And all of us were saying something different.
Her pelvis and back people told her she should avoid extending her back (even though she was stuck flexed). Keep her pelvis stable and prevent movement because it was rotated. Moving was her problem, according to them.
And I humbly observed the lack of movement in her system. Her back stuck stiff, flexed, unable to extend except for one segment of her lumbar spine, and unable to flex except for a good chunk of her thoracic spine (exaggerated while she’s on her bike).
To me, movement was her solution! Get her spine moving again in the appropriate ratios. See if her pelvis and shoulders might be able to reorganize, and we’ll get closer to the truth.
But her trusted team told her not to.
They told her not to extend her back. Extension is bad. Extension will hurt you.
But there are no good and bad movements. For this lady, both extension and flexion were causing her issues, at different places, at different times, in different ratios and for different reasons, but her team decided that the solution was to completely eliminate one range of the spectrum.
And even though it didn’t hurt to explore her range of spinal motion together, even though she told me she felt like things were moving in the right direction, she told me she couldn’t do my exercises anymore, simply because her team told her they were bad.
In a conversation we had:
Me: “Did it ever cause you any discomfort while we practiced spinal motions in our sessions?”
Lady: “No. It felt fine. But they told me not to. And last week I felt great, the only time my back started to bother me was when I got on my bike”.
Me: “So, you felt good until you got into the flexed posture we’re trying to teach you how to get out of, and then you felt all your symptoms come back?”
Lady: “Yes. My physiatrist recommended that I get a steroid injection in my spine, so I’m going to do that, and I’m not supposed to do your exercises”
I am amazed.
She won’t work on extending her back, even though it takes her out of the position that causes her pain: The position on her bike that she spends hours and hours in every week.
I just couldn’t understand it. Her mind seemed as locked up as her spine…
Granted, I’m not a medical professional. I’m “just” a trainer. I’m qualified to work with movement. I can’t diagnose and prescribe. I’ve been working with her for a much shorter period of time than her team. They have information I surely don’t have. There are always more complexities than what I’m being told and presented with and I can appreciate that.
But in a complex situation, could not a simple plan of action- make spinal movement feel safe again, be of great benefit?
Medical pro says, don’t move, movement is bad, hold your body still, get this injection. All you have to do is lie on this table…
I say, movement will set you free, explore this, there’s so much potential to unlock. But it’s going to take a lot of work, patience, and practice…
And I wonder… would I have done things any differently in her position?
She made her decision with the information she had at the time, to best of her abilities. And with so many conflicting points of view, of course it’s safer to believe the people who have the power to diagnose, prescribe, and “fix”, and whom she has been working with for much longer.
And so eventually we parted ways.
In our final conversation I told her to be an advocate for her health and to always choose what was best for her, not to get lost in the noise. To take an honest appraisal of what everyone was saying to her and do what she felt was right based on what she knew, and what her body was telling her. To continue with the exercises that make her body feel better, and scrap the ones that don’t. And I told her she might consider not seeing so many people to eliminate the noise and confusion. I wished her the best with her spinal injection and to be in touch if she wanted some input in the future.
I imagine this will be the last I hear from her.
Could I have done more with her?
I explained why we were doing what we were doing, and it made sense to her. But the opinions of her trusted team held more clout than her own experience in her body.
I think that last sentence sums it up: Being unable to trust your own body over the opinions of other people telling you what is right or wrong for you to do.
It makes sense that this would happen after years of pain and many injuries, you stop tuning in with what your body is honestly experiencing as a way of just getting through the day, and you start to look to other people to tell you what is right for you. It’s no wonder she made the choice she did. I probably would have done the same. In fact, I HAVE done the same in the past.
Take away from this story what you want. I’ve learned an important lesson, and I hope this lady has, too.
For me, it was a beautiful reminder that my job goes well beyond showing people exercises and counting reps (I absolutely hate counting reps).
My role must include showing people how to tune in to their bodies, to learn to trust their bodies again, and to provide them a safe experience to explore movement.
To show them a way to develop a nurturing relationship with their bodies, not one of mistrust and loathing.
To encourage them to be brave in this exploration of movement, to be advocates for their own health, to inquire and question what people are asking them to do with their bodies, especially me (because when I have to explain, I learn, I appreciate the free education!).
And, if along the way, they get a bit stronger, move forwards from pain, enhance their quality of movement, and start to enjoy being in their bodies again, then that’s a bonus.
As dancers, this relationship with your body, one of nurturance, compassion, and trust, is essential if you want to dance sustainably, as long as you want, and at the level you desire.
If you could describe your relationship with you body in one word, what would it be?