Bibles and Bodies

Some people know the body chapter and verse. They’ll quote it for you any chance they get.

“My neck’s sore.”

“That right? You mean the SCM – your sternoclediomastoid? Or you talkin’ your traps or scalenes? Scalene posterior, I bet. Origin’s C4-C6, inserts down there on your second rib.”

I recognize that patter.

Once, I went to meet up with a piano player who gigged in a local church band. By accident, I stumbled into a Baptist congregation when I was meant to meet him at a non-denominational one.  Before leaving, I got to experience the preacher in action, calling out passages from the Gospels and from the Hebrew scriptures like an auctioneer collects bids. It was entertaining on some level. I wasn’t buying his theology but I was impressed by his dexterity.

I remembered what a friend once observed: “naming something’s not the same as knowing it.”

Rattling off chapter and verse – whether the text is one’s body, the Yoga Sutras or the Gospel of Matthew – is a skill. Whether it’s a laudable skill or not is in the eye of the beholder/memorizer.  I’m not saying you can’t learn from people who have this skill – I certainly have – but for me, I hope I don’t become a body-parts patterer.

The people I like working with are ‘open book’ teachers/learners. They don’t have all the answers memorized in their head but they have processes they rely on to search them out.  If they had it their way, all tests/quizes would be open book ones.

T.K.V. Desikachar seemed to be a teacher like that.

At a conference in Rhinebeck years ago, he asked a participant to explore something “simple” – like whether it felt easier to exhale on a forward bend or inhale during it.

Duh.  Those of us watching knew what the answer was going to be (exhale). How could Mr. Desikachar, heir to the great viniyoga tradition, not know this?

And yet, when the practitioner reported, “Exhale,” he seemed genuinely surprised.  He commented that others had reported similarly in the past and thanked her for her observations and for investigating that for herself.

Since meeting Mr. Desikachar, I’ve met other “world-renowned” researchers and educators. In the days leading up to my visits with some of them, I had anxiety-plagued nightmares, afraid of being called out for what I didn’t know.

When I actually met them, it was incredibly disarming and actually endearing to hear them admit, time and time again, “I don’t know.”

Of course, I’ve also experienced times when an “I don’t know,” offered up by an “expert” is completely unsatisfactory.

“You don’t know? How could you not know? It says so right here in the book that…”

“The” book on knee rehabilitation. “The” Bible. “The” Body. “The” protocol. As if there’s “one.” As if they’re not all texts, all with authors, all with points of view that are open to interpretation and debate. (Which, by the way, is not the same thing as saying “it’s all good” because multiple perspectives does not always mean there are multiple truths. There are many ways to represent 2 + 2 = 4 but that’s not going to make 2 + 2 = 5 any day soon.)

As much as I appreciate the open book learners/teachers I’ve met in my life, I know I still rely too much on my ‘get the right answer’ muscles (perhaps I’m not the only one who does that).  I always appreciate it when someone gives me permission to rest them.

A few weeks ago, I was co-teaching a workshop on pelvic floor biomechanics with a physical therapist friend. We included a slide that quoted a leading medical textbook which admitted that much was not known about what the pelvic floor muscles did, despite all the time and energy spent studying them. Everyone laughed. And then picked up their pencils to take notes on what little we had to offer them.

Finally, my colleague, a therapist for almost thirty years and one of the most skilled I have come across, observed:

“Don’t worry about memorizing this stuff.  I don’t remember it half the time myself.”

“For real?”

“Yeah, just know where to look for it and you’ll be fine.”

Amen, brother.

What Happens in the Pelvis, Doesn’t Stay in the Pelvis

Recently I had the opportunity to lead a workshop on pelvic floor biomechanics with my good friend and physical therapist, Greg Hullstrung.

In my 17 years of teaching, I’ve had the good fortune to collaborate with physical therapists who specialize in pelvic floor dysfunction and study with some of the top movement educators in the country and I’ve learned that there’s a lot about the pelvic floor muscles that’s up for discussion.

Knowing What We Don’t Know

“Ideally speaking, one should describe the function of each component of the pelvic floor muscle individually; however no such information is available. Broadly, the pelvic floor muscles can be considered to have 2 important functions. They provide 1) support or “floor” to the pelvic viscera and 2) constrictor functions to the urethra, vagina and anal canal.” (V. Raizada MD, R. Mittal MD. Pelvic Floor Anatomy and Applied Physiology. Gastroenterol Clin North Am. 2008: September, 37(3); 493-vii.)

Naming the pelvic floor muscles has even proven to be tricky. While it’s agreed that the levator ani and the coccygeus muscles are the main muscles of the pelvic floor, naming the component parts of the levator ani is where the agreement breaks down (pubovisceral?, pubococcygeus?, puborectalis?, etc.)

Part of the challenge lies in the fact that the pelvic floor muscles are subtle and hard to study in living people. In cadaver studies, some of these muscles have been damaged due to pelvic floor traumas (this is especially true of some of the cadaver studies of women who gave birth).

But for movement professionals, and Yoga teachers in particular, there are 6 Key Concepts worth keeping in mind in both our own practice and as we work with our students/clients.

1. What Happens in the Pelvis, Doesn’t Stay in the Pelvis.  For starters, resist the temptation to isolate the pelvic floor from the rest of the body. The support that the pelvic floor provides (or does not) affects how the foot hits the ground, the stability of the knee, the condition of the hip, whether the low back gets chewed up, and it even impacts tension in the neck and shoulders.  Think locally but act globally.

2. It’s Not What You Know, It’s Who You Know. In life and in the body, connections matter. Look no further than the obturator internus (a decelerator of hip internal rotation, hip adduction and hip flexion and whose fascia provides an origination for the levator ani) for proof of the pelvic floor’s connection to the lower body. Who else would seem to be an influencer/influenc-ee of the pelvic floor musculature?

3. What’s In a Name? Everything. Pelvic floor or pelvic core? Christina Christie and Rich Colosi are physical therapists based out of Chicago who suggest a great way to get your head out of the pelvis: assess and train the pelvic core. The abdominal muscles are the front of the pelvic core, the paraspinals provides the back, the respiratory diaphragm provides the top and the pelvic floor is the bottom. Does that shed more light on some of the bottom-up and top-down influencers?

4. Don’t Engage Your Pelvic Floor Unless You’ve Had a Really Long Courtship. In some cultures, it’s cool for one person to tell another, “Engage So-and-So” even though no relationship has been cultivated. And hey, sometimes that works out. Just like artificially engaging your pelvic floor muscles works out sometimes. Perhaps a better strategy is to ask those muscles: what turns you on? You know what we’ll hear: actions.  So if you suspect someone’s pelvic floor isn’t turning on, don’t yell at it (engage! activate! lift!), instead, learn what movement patterns turn those muscles on and then trace their movement patterns to see whether they’re getting those motions (or not).

5. Nobody Drives in Neutral. A lot of well-intentioned energy is spent helping people ‘find neutral’ as if positioning the spine in a neutral position is the end all, be all. While it’s nice to find neutral, remember that just as nobody drives their car in neutral (they pass through it to get to other gears), nobody functions in life with a neutral spine. Over-training a ‘neutral spine’ can remove the there-by-design, anterior (forward) tilt of the pelvis. Taking away the anterior tilt of the pelvis removes the bony support that the pubic bone provides the bladder, asking the pelvic floor muscles to pick up the slack. Literally.

6. The Final Word on The Pelvic Floor/Core… There is no final word on the pelvic floor/pelvic core. For that matter, this observation would hold for much of what is ‘known’ about the human body.  So as we apply this information – and gather more – in our best efforts to be of help to the clients/students we see, it’s always helpful to keep an asterisk handy and to get comfortable saying “I don’t know” and “it depends.”

Want to go deeper? Email Al Bingham (transform@transformationzoneyoga.com) for details on the Yoga Training for Teachers with Private Clients, a series of workshops to be held in Manhattan.