Practical Science on Movement and Pain

Movement Relativism?

320px-Berlin_marathon_spitzengruppe_3There is a lot of much needed skepticism on the internets these days in regard to the idea that we can diagnose movement “dysfunction” and prescribe movement “correction.” A lot of this debate centers on the FMS and other systemic approaches to improving quality of movement. I think a lot of this discussion is useful and productive.

I also think that the level of skepticism sometimes goes too far, veering into what I call “movement relativism” – the idea that one movement will work just as well as another for a given purpose, or that we don’t have the slightest idea how to tell whether one way of moving is better than another.

Of course, most skeptics would not go this far. And, don’t get me wrong, I like the skeptical position, and have written posts from that perspective here and here. Some of the major points from these posts and elsewhere are that:

  • assessment of movement dysfunction is tough: it can unreliable, invalid, or fail to distinguish between defense and defect
  • everyone is different: what is correct for one person may be incorrect for another
  • movement is never simple and context matters: the right movement pattern in one context is wrong in another
  • speaking in terms of dysfunction can create fear movement
  • the body is “wise”: it is very good at optimizing “natural” movements like running, walking, breathing and postural control, especially when it is provided with sufficient challenge, variety and repetition. For example, many elite runners have never received technical instruction.

Despite the validity of these points, I think the skeptical view goes too far when it is expressed in statements like:

“We don’t know what movements are right.”

Or:

“There is no right way to move.”

In fact, some of my favorite bloggers like Greg Lehman have used similar language. Now this is a semantic point for sure because I think Greg and I are probably in almost complete agreement on all the substantive issues here. I also think Greg is one of the best sources of information on how much evidence we really have about our ability to assess dysfunctions and make useful corrections. That being said, semantics matter to me (hey I used to be a lawyer.) So here is why I don’t like to hear “we don’t know how people should move” or “there is no right way to move.”

These phrases sound (a little!) like what I call “movement relativism” –  the idea that one way of moving is just as good as another for a given purpose or person. Or they sound like “movement agnosticism” – the idea that we don’t have any idea at all about how people should move.

Although we definitely need to be humble about our knowledge of human movement, its not like we know nothing. We know quite a bit, even if some of it is pretty obvious. For example, we can be sure that it is less stressful and faster to run on our feet than our hands. This is of course an absurd example, but there’s a latin phrase called reductio ad absurdum which, when placed in italics, gives me the solemn right to use absurd examples to illustrate a point. The point is that not all movements are created equal in their safety and efficiency, and we certainly have at least some ideas about what movements work better than others.

People with the highest levels of function have a lot in common in the way they move. For example, even though runners will always have some individual differences in their gaits, a group of elite runners will show less variance than novices. As Tolstoy said: “Happy families are all alike: every unhappy family is unhappy in its own way.” This is true to some extent about happy movers – they share certain essential qualities in common. Measuring these qualities objectively might be difficult, as discussed in some of the recent criticisms of the FMS made by Stu McGill and others. But that doesn’t mean these qualities don’t exist.

I live near a lake in Seattle which attracts a lot of novice runners for some reason. If you have taken a walk around Greenlake, you will notice some serious diversity in running style. To be frank, you will see some straight up bizarre shit sometimes. Not that there’s anything wrong with that.

On the other hand, if you watch a group of elite runners, there is much more uniformity. Everyone is pretty much doing the same thing, because even though there are a million ways to run slow, there’s only a few ways to run fast. Sure if you watch a slow mo video of Haile Gebreselassie, you can find little flaws or peculiarities. He has a surprising amount of pronation, and does a funny thing with his left arm.

But for the most part he is adhering to a very strict formula for running success. He may not have learned how to run this way from a coach, and maybe technical instruction would not have helped him much. But watching the smoothness of his gait should leave no doubt that there are right and wrong ways to run, and that guys like Haile are doing something right. Similarly, watching the average runner at Greenlake will make it equally clear that most people have some serious room for improvement!

So is there a right way to move? For a given person, functional goal and context … of course! For my body, and my goals, and my injuries, and my physiological state, there are right and wrong movement solutions to motor problems. Sure there might be a couple solutions that basically tie for first place, but there is a very obvious hierarchy among the different options.

Are there any actual movement relativists out there that would deny this? Maybe not, but just in case any show up, we’ll know what names to call them.

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16 Responses to Movement Relativism?

  1. Eric Kruger says:

    I think it is important to keep in mind the idea of constraints. A run around Greenlake does not place many constraints on the runner (i.e it is an open task). A run in an elite race is very constrained (be the fastest). Other sports i.e. powerlifting etc have very constrained goals and others are more open i.e. soccer and basketball. I think this is key in understanding the role of movement abudance and inter-individual variance to movement.

    Eric

  2. Ben says:

    I believe that quote is Tolstoy, not Dostoyevsky. Keep up the great blog, it really gives me a different perspective on movement and analysis of it.

  3. stacy says:

    Thanks Todd, as always, great post. This reminds me of how we adpated as a group after many sophisticated floor puzzles through a four year Feldenkrais training. It appeared that we emerged into very strong similarities in movement. I love talking to people that know way more than I about dynamic movement systems to appreciate this better. I agree strongly on your points, and where I go with this is helping my clients find the flow of their own movement, starting with gait, or their unique signature with walking. Thus allowing them to address what needs to emerge from within. Then, we can roll up our sleeves to create contexts for them to delve deeper into understanding their own dynamic movement better to improve, and reduce fragmenting body parts. Look forward to other comments on this.

  4. Todd Hargrove says:

    Hi Eric,

    Good point about constraints. That is what I was referring to a little bit in the paragraph about the body being wise: “it is very good at optimizing “natural” movements like running, walking, breathing and postural control, especially when it is provided with sufficient challenge, variety and repetition. For example, many elite runners have never received technical instruction.” In other words, good movement pattern emerge naturally when the proper constraints encourage them.

    Hi Stacy,

    I wish I made more careful observations in the changes in movement over four years. I can imagine some changes but would love to see before and afters. One interesting trend was that at least 2 or three middle aged women dropped 20-30 pounds without trying to lose weight. And I think the biggest changes I saw in myself were emotional regulation type changes as well.

  5. Mike reoch says:

    Great article again Todd. I’m with Eric that we should be aware of the constraints. Often, we talk about “correct movement” but when we look deeper some actually mean energy efficient, some are addressing pain relief/behaviour and some are addressing speed. Not all are the same thing.

  6. Mike reoch says:

    I should add adapting movement for injury prevention is not necessarily the same as adapting for pain prevention or energy expenditure.

  7. Greg Lehman says:

    Hi Todd,

    I agree with everything here. I never mean to come off as movement-nihilist. I think some of your quotes “there is no right way to move” probably came from Twitter. Damn Twitter! It loses all my subtlety.

    A few points though:

    When you suggest that there are common traits among elite performers and that there are better ways to move than others (e.g. its better to walk on your feet than your hands) I can’t disagree. There are definitely things that we don’t want to do and those that we should do when we run.

    So yes, I can definitely tell you it is better to run straight ahead, run on your feet, don’t run with your eyes closed, don’t run with your feet 2 feet apart, don’t run with your legs fully extended always, don’t wave your arms over your head when you run and don’t leap up in the air as high as you can when you take each stride. There, no more movement relativism.

    And for the most part humans figure out those things on their own.

    But we don’t debate the big obvious things. We debate the little stuff. And this is where I contend we have some difficulties in deciding what is optimal. So, I am still pretty comfortable in saying that we aren’t the best at determining when and in whom that dynamic knee valgus is really a bad thing and when it is just a variant. I’m open to correcting it in a number of situations (e.g teenage girls landing during drop jumps) but I am also open to it not being something we always avoid and perhaps even being a movement that we train to tolerate. I am also pretty comfortable in seeing an explosive athlete doing the clean and jerk and keeping a neutral spine during the movement. Neutral spine there is good but do I need to keep the same pattern when I tie my shoe?

    Hope you’re well,

    Greg

  8. Todd Hargrove says:

    Hi Greg,

    Thanks for the comment. Yes and I agree with everything you said here. Funny I almost used the phrase “movement nihilist” as well. And I almost pointed out that my problem with your language is probably due to your (over) use of Twitter. For the life of me I can’t understand why you spend so much time in conversation on Twitter! I try to follow along because I want to hear what you have to say but I can hardly understand any of it!

  9. Matt says:

    Don’t be dissing the blue bird Todd… it’s thanks to Twitter I discover great minds like yours and Greg’s!
    Top piece and a great reminder that ‘wrong’ and ‘right’ generally lie on a circle, not at either ends of a line. Still waiting for a guy who runs on his hands to chip in though…

    • Todd Hargrove says:

      Ha! Thanks Matt! Actually I love the blue bird for getting wind of great papers from either you or Neuromanter or Greg. But following the conversation is brutal! Take it to FB you guys!

  10. John says:

    The opposite of “movement relativism” would be “movement absolutism.” How many times have we read or been taught that certain movements are right, only to learn that they later are shown to be injurious. The crunch is a classic example. The knee extension machine is another that comes to mind.

    Each methodology will have its own ideal, even if its the ideal is “not having an ideal.” Dr. Feldenkrais said something to the effect that, during an ATM, the students’ movements tend to become more uniform because their human nervous systems begin to find similar organizational patterns. This would support Todd Hargrove ‘s post. As an aside, I always enjoy his posts.

    What’s missing from the screening concept is, a person’s relationship to the movement. Do they find it enjoyable, useful, meaningful and congruent with their self image? I wonder how many of those Green Lake joggers actually enjoy the jogging or are doing it because “it’s healthy?” And then we have the issue of correctives verses learning. How meaningful is corrective movement when the “how it feels, and, how does it fit into the self image” questions are not addressed? Perhaps this, in part gives rise to “movement relativism.”

  11. Kevin Maggs says:

    This entire post could get ugly very quickly so I will try and keep it brief. Using the example of knee valgus, we need to qualify when it is abnormal and when it is expected. For example, femoral anteversion, external tibial torsion, reduced ankle dorsiflexion, forefoot varus and poor motor control in the hip musculature are all causes of knee valgus. “Fixing” a patient’s knee valgus could create more problems if there osseous structure is causing the knee valgus. On the other hand, I would argue that in the absence an osseous structure being the cause, the clinician should pursue therapy/movement retraining to correct the dynamic valgus, whether it is improving ankle dorsiflexion or improving motor control in the hip. The question of “why” should always be asked when an “abnormal” finding is present during a movement screen. Unfortunately, I think most people doing movement screens don’t have the knowledge or the desire to tease out the “why” answer when performing a movement screen. In my opinion, this is where most of the discussion breaks down between people who blindly follow abnormalities in a movement screen and people who are “movement-nihilists”.
    Of course, then the question becomes – how much is too much? Is a 10° knee valgus too much? No? How about 15°? 20°?…25°? What if they have a 25° femoral anteversion that is contributing, how much knee valgus is allowed then?

  12. Kevin Maggs says:

    Okay, I dictated that last comment, so when it says “there osseous structure” it should have said “their”. Yes, I understand the difference 

  13. Chris says:

    I don’t know …aren’t we over-analyzing movements too much? Aren’t we taking away the fun of simply running or moving and enjoying it per se? I see these shows on TV that reveal all the tricks behind seemingly incredible magic and I ask myself … why are they taking the magic out of magic ? It’s like telling kids there’s no Santa Claus and tearing down the magic of Christmas.

    • Todd Hargrove says:

      Hi Chris,

      I am definitely not a fan of over analysis or taking away the fun of movement. But I think the world of reality is far more amazing, awe-inspiring and wondrous than the lies we tell ourselves – like Santa Claus exists. Many people who “simply run” or move and try to enjoy it end up getting hurt as a result. There is no magic or Santa Claus to fix that – we need people who analyze movement.

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