foot to core sequencing

What do feet have to do with one's core? Turns out, everything. It all starts at the feet. The most functional movement humans do is walk. If our parts are aligned and neuro-muscularly coordinated we walk and work with ease and without pain. There is a sequence to neuro-muscular firing that is essential to this coordination. Think of a string of fire crackers, each causing the next to ignite. That's efficient. If you had to keep lighting every couple fire crackers you'd get frustrated and you wouldn't get the same effects.

So here's how it works:

We must have enough inversion of the foot in order to effect external rotation of the tibia which, in turn, causes internal rotation of the femur, activates the glutes, then initiates firing of psoas, pelvic floor and respiratory diaphragm. It's a neuro-muscular firing cascade that happens from the ground to the core by virtue of our feet impacting the ground.

We also must have enough eversion of the foot, have enough ankle dorsiflexion and be able to get over our big toe in order to effect adequate propulsion. A number of compensations reveal any inadequacies—walking with feet pointed outward, rolling the feet, twisting the leg, throwing the leg to the side or picking up the foot early. Have bunions? or flat feet? They're the result of compensations.

Neuro-muscular firing initiates while we are anticipating where to place our foot, even before the step is taken. There's an unconscious planning that takes place in walking (and running), one that either serves us well or has become a pathological habit. People who have been raised shod have more foot, ankle, and leg injuries than people raised barefoot because the sensory ability of the small, intrinsic nerves of the feet have been dampened. A shod foot trying to walk is like a ear trying to hear underwater—distorted and unsure.

Getting some barefoot time in each day can re-awaken those small, intrinsic nerves, improving balance and proprioception while protecting you from injury over the long term. Many runners who change from shod to barefoot, or minimalist, get injured because they try too much too soon. It takes some time for the nerves to waken and for your body to adjust to using your muscles in new ways. Take it very slow and gradually decrease your shoe's support over time.

Check out Harvard's website on "Biomechanical Differences Between Different Foot Strikes" for more, really cool information.

Tummies & Posture

The pendulum keeps swinging back and forth between two camps. There are those who say that we should pull in our tummies to keep our abdominals strong and promote core strength and there are those who advocate for not pulling in our tummies, that we should maintain our lumbar curves. Right now we are in an era of 'let it all hang out'. Actually, the two camps are not entirely mutually exclusive, yet both are wrong.

We do want to activate our transvers abdominus throughout our day, while maintaining our lumbar curve and while allowing our tummies to move with our breath. This means pulling in our tummies slightly, about an inch, while not maintaining a rigidity to that hold. The transverse abdominus is a component of the core, which provides stabilization for functional movement and contributes to balance and proprioception. We do want to strengthen our core. But more importantly, we want to engage our core in concert with functional movement. In this way we educate our bodies in neuro-muscular coordination. A strong muscle without neuro-muscular coordination is a bully to its neighbors.

Urology as a subspecialty of neurology, a case study

"It's all about neuro-muscular coordination."

If you've taken my Bladder & Pelvic Floor Health class (whether for patients or for practitioners) you've heard me say this umpteen times. It's one of the major take-aways from the class. You've also heard me joke that "Your bladder doesn't pee, your brain does."  While this is not completely accurate, it serves to underscore an important theme: Your bladder is part of a very complicated neurological system and it operates within that system, not as an adjunct.

I have a patient whose story is an excellent representation. She had an existing bladder issue from a previous trauma when she came to my Bladder & Pelvic Floor Health class. Over time, she was healing herself with the exercises that I taught. However, she recently had a fall that caused a moderate head trauma. She didn't drive for four weeks and she was off of work for seven weeks. She found that her body prioritized the new trauma; her bladder issue, with the new stressors her body was going through, worsened. The concussion left her balance and proprioception compromised. She experiences dizzy spells. These are common neurological symptoms with trauma, and especially with head trauma.

At my Pelvic Floor & Core Workout Series she has shared with us how, in doing the slow movements and really paying attention and feeling her body, it fatigues her mind and body. She's noticed that she gets emotional with the movement and with her impatience in feeling fatigued, and that the emotion and fatigue are both signals for her to take a rest. But she's seeing improvement with these slow, intentional movements that challenge the core, coordinate proprioception and improve balance. Remember, these all contribute to and mirror the condition of each other because they are all neurologically based.

It truly is all about neuro-muscular coordination.