Male Announcer: You’re listening to From Pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.
Welcome and welcome back. I’m so glad that you’re here because today is part one of a two-part series on reducing and eradicating neck pain. And with this particular episode, I want to talk about two of our key tools in our toolkit. One is called granular movement and the other is called increasing complexity, and how I utilize these two tools in supporting clientele in reducing and resolving neck pain.
And I’m going to highlight these tools first and then share how I use these tools in an actual case scenario with a client who had neck pain and they saw everybody. With a client who had persistent neck pain, they had seen a whole lot of professionals. They had had some gains but couldn’t make the gains sustain.
So to begin with, what are these two tools, granular movement and increasing complexity? So this idea of granular movement is an idea that I’ve spoken about on previous episodes and on my other social channels. And it’s an initial foundational concept that I work with all of my clientele when I’m starting the process of helping them to reduce and eradicate physical pain.
Now a big piece of this and a big influence of this is where my background lies. And I have a BSC in kinesiology. I’ve utilized therapeutic applications of biomechanics and kinesiology right from the start of my career, which is now at 30 years of helping people to reduce and eradicate physical pain.
What I saw early on in my career is that when people were having trouble doing the more complicated movements in yoga, if I could break those movements down to their small component parts, the base component parts that made up the bigger movement and improve those base component parts, they were able to get to the more complicated or more complex movement a lot faster, with a lot more ease, with a lot more motor control and coordination.
I took that idea then as I saw more people with pain reducing and eradicating their physical pain very quickly. What I saw is that people who have physical pain also have compensatory patterns that when resolved, their pain goes down.
Now someone might say, but Susi, everybody has compensation patterns. Exactly. And for those people who have persistence and issues around their physical pain, what I have noticed with the people who come to see me is that when they reduce their compensation patterns, they see a proportional decrease in their physical pain.
It’s not about having to get rid of compensation patterns. No, not at all. It’s about reducing the compensation patterns, improving their overall mechanics, improving their control and coordination overall. The reason why in part this works well, and there are many, many reasons, but one is that for a lot of rehabilitation that people have gone through in all the myriad of places that rehabilitation occurs, there often tends to be a focus on doing these exercises to strengthen.
There’s often this correlation between if you have pain, there is weakness there. So then there’s exercises to grow core, to build strength, but there’s not really a look at how this person is actually moving. And as I’ve said before, in the world of movement, we all know that compensation patterns exist, but not as many people actually look at them from this perspective of how we actually reduce them.
And the health professionals who I’ve had conversations with about this will say, well, everyone compensates. That’s just normal. Mm-hmm. And you’re saying it’s normal for us to try and use our jaw to do a hip exercise and that’s going to be helpful? Or it’s normal to hold your breath while doing a hip exercise, that’s normal? Yes, it’s normal. Society, it’s normal. Lots of people do it, but is it normal functioning of the body?
And where my point here is that if we continue to hone the habits of using other parts of the body to kick in for the actual body part that should be moving better, how are we going to make progress? If you add core work and strength on top of those poor movement patterns, how on earth are you going to improve motor control and coordination?
Now, some of you might be listening and saying, well, but how does that relate to getting out of the pain? Well, what I have seen is when people reduce their compensatory patterns, they have better functioning overall. So that like if we use the hip/jaw connection again here is that if someone doesn’t have very great function of their hip and they’re over utilizing their jaw, like they’re straining through their jaw in order to get that hip to move, if they quiet that jaw down, what will often happen is they’ll recognize more clearly that that leg bone is not moving as well in their hip socket as they thought.
They can now tune into how that actual joint is functioning or not, and then go about making changes in that joint while the jaw is more relaxed. So now the jaw is not trying to kick in as the superhero to try and make the hip move. We actually work with the area that is not moving well and get it to retrain to move the way it’s meant to move.
So now there’s less tension and effort from this distal part of our body trying to support and help out, way less energy usage, the nervous system can calm down. There’s more curiosity present, so we’re more in a parasympathetic space. Things down regulate, interoception improves, proprioception improves. Those are all factors that lead to what I have seen, more and more people reduce and eradicate physical pain.
And I’ve seen this consistently over these 30 years of helping people to reduce and eradicate pain. In fact, when I was first starting playing around with this idea, which I had sort of stumbled upon, I had countless PTs tell me, you know, Susi, you shouldn’t be telling people that they can get rid of pain. You need to be telling them that they have to manage pain. Pain doesn’t go away.
And I’m like, but it’s happening in the 13 classes I’m teaching a week, the 130 people who are coming through my studio space in my groups of 10. They’re reducing and eradicating their physical pain by improving their compensation patterns, reducing them and improving overall neuromuscular mechanics. So why on earth would I lie to them and say you have to manage pain?
Now thankfully, these days, we now know that pain can truly biologically reduce, thankfully. So now that kind of commentary doesn’t happen. And thank God I didn’t listen to those people way back then. So the idea here is that if we can help improve the way the body is moving, so get the hip moving the way it’s meant to move, let the jaw relax so it doesn’t have to be involved in any other of those pieces, we will see significant functional change.
To get there, we utilize granular movement. So we want to look at this component part. And you’ll often hear me say, how is the leg bone moving in the pelvis? That is the granular movement of a single joint. And just looking at that, is it moving? Is it not moving? Yes or no. And if it’s not, if we see the pelvis wanting to go, if we’re seeing the breath wanting to go, if we see the jaw wanting to go, then help your person move that leg bone in the pelvis without all those other factors involved.
So to reiterate, I’m using and I’m focusing on the segment. I’m not actually saying which muscle to use. And I’ve got a method to that madness. And that method is that most folks who are compensating aren’t able to accurately tune in interoceptively and proprioceptively to their bodies.
So for me to say to them, please use this muscle, they don’t actually really feel what that is. And they make it up, which might be another compensation pattern. So when I focus on objectively what’s moving or not moving, now they can make gains. So that’s the component part.
The adding complexity piece is then moving beyond the granular one joint movement and adding more joints to the movement. So we might be adding more like into a twist or a side bend or other parts further up the chain or down below further towards the feet, for example, if we’re working at the hips. And we start to see more and more patterns as we bring more of the kinetic chain into the movement pattern. We progressively bit by bit add complexity to the overall whole.
So now the granular movement, which we had grown awareness over, we still have the awareness of it. As we add those other pieces, we now have this whole body awareness of our movement and can really tune into what pieces are impacting what.
I think about it like an analog watch in some ways, where there’s all these gears that are working together to make the function happen in the watch. So all these gears, all these components are coming together into a whole. So then the whole does become more than the sum of the parts. But we start at the parts to make sure each of those parts, aka gears, are working well and then bring them all together into this amazing cohesive whole.
Let me tell you, when we work in this way, holy smokes, people, their awareness grows, their understanding grows, their proprioception grows. They have such fundamental awareness. They’re able to make such significant changes because so much comes into their field of awareness. They see what’s not working, they see what’s working, they see what’s missing, and they can make change.
So how does this play out in a real life example? Well, I had this client who came in and she had a lot of neck issues and a lot of health professionals had been helping her, but she hadn’t made a lot of gains. And they provided work that was really great, like I saw stuff in her notes of what she brought in about what they were providing, all really effective exercises that would work for a lot of people.
And in this case, what was happening was she was plowing through the exercises. She wasn’t aware of what she really should be tuning into, and so was doing the exercises like a to-do. And because she had been through a lot of different health professionals, she had a lot of different exercises and wasn’t really sure which ones she should be doing. And she was sort of doing a mishmash of all of them, not really aware of if any gains were being made.
And that’s a really fundamental piece here. She was not aware of what she was doing, so she was not aware of any gains that were really happening. So what she was aware of, which was the pain, and that was persisting. So we began the process by initially tuning into simple, granular movements.
And when it comes to the neck, I find one of the greatest places to explore is to simply have my hands on someone’s neck. So placing my hands in behind, like if they’re lying on their backs, and then asking them to move their leg. The reason for this is because the neck is so far from that hip joint and it really makes the point loud and clear. Because so often with persistent issues of pain in the neck, when we move any part of our body, the neck wants to get involved.
So when I choose something that is seemingly so far from the neck, and the person can feel how much they’re using their neck, the lights come on really, really quickly. It’s granular movement at its finest.
So I remember when I was working with her, we simply started with, let’s bend your legs at the knees, feet flat on the floor, a position that’s often called hook line. And now just let your right leg bone rotate out so the knee comes towards the floor. It’s a movement that I often call knee drop. And so she did that, and lo and behold, her neck kicked in.
So then I asked, can you move the other leg bone? And lo and behold, the neck kicked in. And this made a lot of sense, right? A part of her body, a weighted part of her body, her leg, was moving beyond the center line toward one side and then the other. So there needed to be some offset to balance off that load, yes, but that offset ought to have happened closer to her pelvis or in her abdomen, not her neck.
So we were starting to see where there were some inefficient movement patterns. So then I asked her to slide one leg forward and then slide that leg back, and guess what? Her neck fired up. So then what I asked her to do is, can she only move as far as the neck doesn’t fire in both of these exercises? And lo and behold, not surprisingly, there was very little movement.
Now there could be a tendency as someone’s listening to this to say, well, why didn’t you just get her to engage her core? Yeah, I could. But what we saw happening is that her abdomen was not responding at all to the movement of her leg and the pelvis.
Now please hear me correctly. I’m not saying that the abdomen is core, not at all. But it’s the part of her body that I could see being at the top of her head. I can’t see the pelvic floor when I’m at the top of her head. I can’t see the pelvic floor even when I’m at the bottom of her feet. But it’s a place where I could tune into how her pelvis and her rib cage were relating.
And her pelvis was wanting to anteriorly tilt, it was wanting to kind of do a funky chicken when her leg bone moved in a certain distance. So simply where I played was, okay, can we first find your breath? Because the breath is fundamental to the core. It is fundamental to stability. It is fundamental to nervous system downregulation. It is fundamental to being in a parasympathetic space. It is fundamental to relaxation, all of which is fundamental to retraining movement patterns effectively.
So we began there, can you just breathe? Now she could breathe without her neck firing up, yay! So then we just played around with some soft, easy breathing. And her neck started to settle more and more and more into my hands. Her jaw started to relax, her eyes started to soften.
With a bolster under her legs next to support her legs so she wouldn’t have to work so hard to hold her legs up, I then asked her to simply move her head. So now we’re back up closer to the point and move her head left and right. And now she could settle into the movement of her neck.
You see, if I had started at just moving her neck left and right, she would have been expecting that and there could have been a whole lot of bracing. And to unravel that, that could have happened easily. But that I started at such a distant part from her neck, it really highlighted just how much she wanted to hold in her neck in order to make a movement so far away.
So then by being able to bring her back more local to the granular movement of her neck, she could then relax more. She had tuned in more. She had recognized that, oh, my neck shouldn’t be so involved in the hip. Huh. How do I help settle that? And bit by bit by bit, she was able to get there.
So she was able to find movement of her neck with an easy breath. The easier her breath, the softer her neck, the quieter her jaw, the lighter her movement, meaning smoother, which then enabled me to come back to her leg bone and hip movement. And lo and behold, she was able to find an easy breath. Her abdomen started to kick in, her pelvis was staying more quiet.
We could see more responsiveness in the lower part of her abdomen as one leg moved one direction and then came back. She could do the movement after all, before all of this, but how she was doing the movement was where the help was needed. So she was able to tune more in, settle more in, be able to be curious, fundamental factors for coming into that parasympathetic state.
And she sunk a little bit more into the floor, relaxing, more at ease. More trusting, as she put it, about how her body was responding. She could feel her body responding, her interception was improving. Where her body was in space, her sense of that was improving, her proprioceptive awareness, that was improving. All of these very simple pieces coming out of some granular movement and improving that granular movement.
So then we could start to blend these two together. Can you move your neck and your leg bone? Can you move your leg bone both out to the side, then straighten it out along the floor? Can you add complexity? By complexity, I’m adding movements together, either leg bone and hip plus the neck, or leg bone and hip out to the side and then straightening it along the floor.
That’s adding more planes of movement to the movement itself. There’s more to think about, more to do, more to track, that’s complexity. Then as the sessions went along, we were able to add more complexity, bringing in more parts of her body, and she was able to tune into all of it, bit by bit, step by step.
This is an example that highlights how, number one, where the pain is, is often not the problem. It’s certainly an indicator that something is in existence. And when we start to bring in granular movement, become curious about how parts are involved, how parts are compensating, and start to settle those out by simply recognizing the movement pattern and considering, is that what’s meant to be happening here?
When we bring it down to its granular roots, is that what’s meant to be happening at that singular joint? Is that compensation pattern really meant to be involved? And what happens if we quiet it? And as we quiet it and movement improves, what happens if we start adding more and more joints, more planes of movement, more complexity?
And consistently, time and time again, as we add more complexity, add more complexity, once those foundational patterns are sorted, we make the gains back to better movement, less pain, a whole lot faster.
If this is of interest to you, I have a neck program that you will probably love, and you can read all about it over at functionalsynergy.com/neck. I would love for you to join me.
If this episode has resonated and you’re looking to deepen this idea of getting your body back on board, of listening deeply to your symptoms, of listening to the whispers so you don’t have to hear the screams, and you’re looking for one to one support or professional training, then reach out to us at [email protected] where we can customize your learning path. That’s [email protected]. Looking forward to hearing from you.