Learning How to Fall. It Begins in Your Head.

The fear of falling is one of the most basic anxieties anyone can experience.  

For some people, if they walk on a trail by the edge of a cliff, they cannot look down from a height without feeling a little dizzy.  Sometimes people even freeze in their movement because the fear of another step near the edge will lead to a fall. This fear can even follow us while we sleep, as you know if you’ve ever dreamt of flying and woken up with a start at the moment of sudden descent or landing.

This fear of falling can carry over into our day-to-day lives, when we walk on uneven pavement, or even think about having to walk in the dark.  

Most people try to prevent themselves from falling by stiffening their hips and the muscles of their back in such a way as to pull themselves away from the ground.  But let me suggest another way to approach the movement.

Instead of crashing to the ground, imagine that in the moment of descent, you knew that you could trust your body to land safely and softly—without bruises or broken bones.

If you feel like you are going to fall, the safest thing is to learn how to do so.  If you stiffen the muscles of your back and hips, you are more likely to hit the ground harder.  

It would be helpful to anyone who feels afraid of falling to practice getting down to the floor and up again as a mind-body exercise. One of the best strategies would be to learn over time to move to the ground as quickly as possible so you have control of your landing.

By practicing going down to the ground, you will eventually be able to move faster.

In learning how to fall, you’ll learn to move as fast as gravity.

The first step to master these physical concepts is a simple thought experiment that asks you to imagine (rather than perform) movement.

Without actually moving, imagine going down and up from the floor. The next time you imagine going down, go all the way down to lying on your back. Not only will this imagined movement melt your old habits, but it will also enable you to create new movements by expanding your embodied imagination and adding new neurons to your brain.

Next bring your imagination to the physical movement: move from standing to the floor and back to standing as you saw yourself doing it in your mind. You might even find that it’s good exercise to go down to the floor and onto your back, then return to standing—something you could practice every day. Feel free to invent your own variations, as long as how you do them is clear to you.

Try going at various speeds so that you can go up and down from the floor without bumping. Feel how smooth the movement can be and how light you can make your return to standing.

Imagine if photographs were taken of you getting down to the floor and returning or coming up from the floor to standing and then returning to the floor.  If your movement was controlled, a viewer would not be able to distinguish from any given direction you are going because your movement, if controlled, would be completely reversible.

Once you’ve mastered each step, you can then speed it up as quickly as you want.  Then, starting on the floor and getting up, you’ll learn to reverse the trajectory perfectly when going back down to the floor.  This principle of reversibility in movement will help you control your body if you go at high speed.

This up and down movement is very stimulating to the inner ear, and sometimes we need to take time to adjust to that. When you increase your speed, you might find yourself getting dizzy. If so, simply rest sitting in the chair for a while. Eventually the exercise will strengthen your vestibular system and improve your balance. You’ll find yourself becoming less concerned about approaching and leaving the floor.

And your future, falling self, with thank you. If you find yourself in sudden descent (tripping over a tree root, or a uneven sidewalk), you’ll have the body/muscle memory that will help you avoid panic and move through your fall.

By learning how to fall in this way, you can overcome basic anxieties and lessen the chance of  injury with your new smooth landing.

Upper and lower back pain: What you don’t know will hurt you

Difficulties with our backs can lead to a variety of problems—including pain in the upper and lower back, the sacro-iliac joint, and even the neck, as well as loss of work, large medical bills, and distress at not being able to live life in a comfortable way.  

The major contributors to back pain? Stress, poor posture, and a lack of body awareness.

Many years ago, I developed and conducted a back pain program for the University of California.  What I learned was that very few people sensed their back, how it moved, and how they used their back to do almost any activity.  In other words, there was a low level or even a completely absent sense of their back.  It’s as if pain was the only signal that provided the information that they even had a back.  

This lack of back awareness is understandable.  Most of us can easily see the front of ourselves and we might find it quite easy to touch the front or even the sides of our body with our hands.  We are naturally more aware of the front of our bodies.  But it’s difficult to see our back (barring eyes in the back of our heads) and for most people, not so easy to touch our back.  

What this means is that it’s difficult to notice when our muscles are overworking to simply sit or stand—or for many people, even to lie down.  I’ve seen this firsthand as a large number of people that I work with report waking up with back pain in the morning after a night that should have been rejuvenating their muscles.  

Over the decades, many exercises for the treatment of back pain have gone in and out of style.  Some decades ago, it was very fashionable in the world of medicine and physical therapy to promote the use of something called Williams’ Flexion Exercises (this involved folding the front of your body).  That worked for a small number of people, but for most people, it didn’t, and for some people, it worsened their condition.  Later the opposite idea took hold with McKenzie Extension Exercises (these involved bending backwards to wake up the back muscles and activate them more).  These exercises met with similar results: they worked for some people and they made some people worse.

The key insight: How we perform exercises is more critical than which ones we do.

No exercise, trendy or not, will be useful if you can’t feel what you are doing. Imagine you were told to walk in order to strengthen your back. You can walk around like you do everyday, but that won't improve the condition of your back; it will just strengthen your old habits of arranging your body in painful ways.  But if you sense what your back or body might be communicating-- "I'm holding my breath anticipating pain with each step" or "I'm not swinging my arms"-- you can begin to adjust the way you organize your body to move. You need to be attuned to the sensory information from your muscles and your joints, in exercise and in daily life.

A person who uses a lot of their back muscles while sitting and even more when moving may first receive signals from the back to the brain saying, “I feel tight, but I don’t hurt yet” and then “Now I hurt, but only a little ache.”  If those the messages from your back are ignored, if you don’t sense the amount of effort in your muscular use of yourself, your back will eventually signal, “Now I really hurt so badly that I am not going to let you move without pain.”

The best approach to back care is to provide as much sensory information as possible so the person can detect and change, for themselves, how much effort are they putting into their muscles when they move or rest.

Take, for example, sitting.

Electromyography (a measure of how much you are activating your muscles) has shown that some people at rest in a sitting position use only 2% of the muscle fibers in their back while others use up to 15%.  These people can go to workshops or meditation retreats for days—sometimes sitting in difficult positions, but experience no pain after a week of meditating.  Other folks drop out of these programs after the first day because of the pain in their back brought on by sitting.  

Once you start to move, there is no option but to use more of your muscles.  But how much more? or how little more do you need to accomplish your desired activity with ease?

My goal in working with people to deal with their back pain is to educate them to better sense their backs.

I’ve worked with many clients suffering from serious back problems.  I try to help clients sense whole new ways of moving while learning how to decrease effort with every movement. Rather than trying to relieve the pain, my approach has been to give them a heightened sense of the shape of their spine, the textures of their muscles, a clear feeling for how the spine is involved in movements of their body.  This may require first touching and moving the client in such a way that the person can feel the details of the shape of their back and the amount of effort their muscles habitually use.  

Very often, their back pain would disappear.  They would react with surprise at the results:  “But you didn’t do anything,” “I felt my bones and muscles so clearly,” or “I can’t figure out how the exercises you gave me would help, because they were so simple.  No hard stretching, no repetitive movements to strengthen muscles…but I feel so much better.”

I try to give another voice for the back to signal the brain with non-pain related messages like, “I feel myself more. I even feel good. I thought I needed to stretch and pull my muscles but now I know how to release excess tension because now I recognize it.”

The secret ingredient to dealing with back pain is to learn how to recognize and sense your back more thoroughly.  Without that, there’s not much you or any therapy can do on a lasting basis.

How the age of specialization may be holding you back from healing your arm, shoulder, hand, or neck

In this age of specialization, there are many hand therapists and hand therapies, many therapists who specialize with what is called the upper extremity. There are special therapies for rotator cuff injuries of the shoulder, for elbow injuries, for muscle tears, as well as therapies for the general upper extremity of your arms.

With all this specialization and detailed knowledge of how these body parts work, why is it that more people are suffering from injuries and are taking overly large doses of opiates to deal with their pains? Well, there’s a good reason. Perhaps it is the overspecialization itself, which makes it more difficult to address how the whole body operates in an action. Perhaps it is time for a more generalized approach.

You may be suffering from some of these injuries and challenges and meeting with limited relief from all the specialized therapies. My approach is to work with the body and mind as a whole, not discrete body parts with specialized but limited solutions.

I want to help you improve the functionality of your hands, arms, shoulder and neck by involving your whole body in the process and, most importantly, your brain.

Do you think it is possible to hold something in your hand and pick it up just with your upper extremities? To lift something up, the weight has to go down through not only our backs, but also our pelvis and legs. In other words, to use our arms in the real world requires the use of our whole body. If that weren’t the case, every time you picked up a frying pan, you’d simply tip forwards. For every pound you carry in front of yourself, your back and your legs have to work to stop you from falling forwards.

But the issue of having functionality from our upper extremities is bigger than simple dynamics. To fully integrate all these different areas of your body and coordinate our body to perform actions in the world, we need a brain and in fact, the complete integration of the neuro-orthopedic body.  And even more, numerous studies on grip strength show that one of the key factors that will improve or fatigue grip strength is the condition of one’s heart and blood pressure.  We can have no strength in our upper extremities without that.  

Key factors for our muscles to be able to move us and for our organs to support those movements are our brain and our skeleton.  Nothing can move without a brain and a skeleton.

Since any issues you are facing with your hands, arms, shoulders and neck involve more than just those discrete body parts, perhaps it’s time to develop a more generalized field of inquiry and how to improve the full use of all of ourselves.

A baseball pitcher with a shoulder injury will of course have limitations.  If these limitations can be addressed therapeutically, great. But what if the pitcher could learn variations in throwing the ball that would not further damage the shoulder but could actually help heal the shoulder?  For example, learning to move from the back leg to the front leg and accelerate the trunk over the standing leg reduces the need to develop so much acceleration largely in the shoulder. In which case, learning to throw a ball with a better understanding of whole body use requires a different kind of analysis of motion and a deeper understanding of what a pitcher needs to learn to use their throws to help the tissue heal.

This approach is not a new notion. There are attempts to do this by sports coaches involved in different sports from all over the world, but it does require the skill to perceive what’s needed for each individual to learn to improve.

This is the kind of evaluation, strategic approach to healing, and improved coordination that most of my clients need regardless of how local their injury feels or how locally they’ve been conditioned to compartmentalize their bodies.