If every day from the time you were two, you squatted down low to “do your business”, you would have a felt sense of the value of using those strong, stable hips to do the work of bending. For better or worse (mostly better!) we started using toilets, and we stopped squatting as part of our normal day. But getting close to the ground is necessary for so many activities, and most of us have found a faulty way to move that relies on the small back muscles more than the powerful hips.

Look at how kids play. Imagine adults you know doing the same thing. Nuh uh. Here’s why:

Adults have come up with all sorts of ways to get close to the ground that mostly take our hips out of the picture. I’m sure you’ve heard from some authority– your doctor, your mother, a well-meaning newscaster; “bend with your knees and not your back”. Well, bending forward is actually OKAY and necessary to squat down properly. The modifications that avoid squatting are not only less efficient, but they can lead to problems.

For example, if you bend down and it hurts, you may develop a fear of bending and vow to never bend forward again. But bending is part of life. Every time you sit down, stand up, or wash your hands, you bend. Fear of bending alerts your brain to possible danger and makes it more likely that the smallest twinge will be magnified.

Even non-threatening sensations such as heat, cold, or light touch may be interpreted as pain. This is called central sensitization. Further avoidance and fear of moving your back causes the homunculus- the part of your brain that creates a map of how your body moves and senses-to become “smudged”. This means your brain no longer has a clear picture of what your low back looks like or how it moves in relation to the rest of your body. This blurry picture of your back interrupts communication with your brain and makes it even harder to figure out how to move on your own. Click here to read more about smudging  

Over time, when your body moves by bending your back and not your hips, and the pattern becomes ingrained. You might want to fix this, and use your hips and back the way they were designed to be used. But it’s hard to make this switch on your own because your body has learned to move using the path of least resistance and what’s more, your brain has a fuzzy picture of your back.

All hope is not lost though! This is where your physical therapist comes in. Just as the brain makes adaptations that increase pain so you avoid movements, it can be taught to be less sensitive to those very movements. First, knowing how pain works can help. Second, you need to move. This works best by gradually introducing the motion that created the cascade of pain. As you relearn and practice movement patterns, they become habitual. Then, as your body’s capacity to control movement improves, you can do more. And, as you gain confidence, your nervous system relaxes.

These videos describe the progression and strength building we use to reinsert a healthy and natural bending motion into your daily activities. Since each person is unique, with their own imbalances and habits, it takes a skilled physical therapist to design the ideal program and progression for you.

Start in a gravity eliminated position on your hands and knees rocking back and forth.Your back is now allowed to bend slightly without the compression of gravity, as we try to improve hip mobility.

We will then progress you to controlling this movement under the effects of gravity with a sitting hip hinge and then a standing hip hinge. Once that is mastered, we would then add a load to the movement such as a deadlift, and then add asymmetrical load in that you need to control resistance in all 3 planes, as in a chopping motion.

Sitting & Standing Hip Hinge Exercises

Keep in mind – movement rehabilitation can take weeks to months. It isn’t easy to undo old patterns. But with your commitment and our help, you can return to your daily routine, moving properly, without fear or pain while bending.

So even though our modern life makes it so you don’t have to squat in the woods, learning to move the right way will help you regain strength and avoid injury.

As we said, bending is a part of life. You want to get it right. We can help. Call today to make an appointment.

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