How Hanna Somatics Helps Me Move Well Despite Labral Hip Tears

It’s time for an update.

Several years ago I wrote several blog posts about hip pain, labral tear surgery and how to help alleviate hip pain – not as a quick fix, but for the long term. Since then I’ve had countless emails from readers asking advice about hip pain and labral tears: which exercises are best for it, can Hanna  Somatics really help and advice on whether to have labral tear surgery or not.hips

So where do I stand now that I’ve had labral tears for several years, a very active schedule and haven’t had surgery?

I’m moving really well. I feel strong, I am still quite flexible and I know how to honor my limits to keep myself out of pain. You see, I am a poor candidate for surgery (I also have osteoarthritis in my hips from years of dance training and injuries), so there has only ever been only one clear choice for me: to incorporate the exercises, concepts and principles of Hanna Somatics into my daily life. This includes awareness of my emotional responses to stress, my postural habits and my daily movement habits.

That means that I have had to walk the talk and be the example of what Hanna Somatics can teach people: to become self-aware, self-monitoring, and self-correcting in their movement and muscular control. I know which activities help me and which ones don’t and I know that if I “push on through” because I want to be competitive, and I ignore how my body is feeling, I will be sore for a few days afterwards.

I was diagnosed with labral tears after recovering from a skiing accident, which resulted in an ACL tear. As a Somatic Educator, I knew that my tears were the cumulative result of years of Sensory Motor Amnesia as well as minor, but very important, imbalances in the center of my body. For some people labral tears occur suddenly due to an accident or over time due to overuse; baseball players, martial artists and dancers are athletes who frequently suffer from labral tears, all due to repetitive movements.

The Trauma Reflex contributes to labral hip tears

If you have a labral hip tear, you’ve probably had an accident, injury, surgery, or performed repetitive IMG_3857actions – all of which evokes a sudden and powerful reflex called the Trauma Reflex. The brain, the command center of the muscles, loses its ability to contract and lengthen the muscles of the waist and trunk voluntarily and equally. You find yourself slightly tilted to one side, the pelvis twisted and leg length  a bit  uneven. Your gait changes and smooth walking or running becomes a thing of the past.

Here is what I have advised my readers:

If you have a labral tear and decide to have surgery, the surgery won’t fix the muscular imbalance that you undoubtedly have in the center of your body. Only you and your brain can do that through sensory motor retraining. Then, once the tear is fixed, it’s important to restore full muscle function, balance and coordination through Clinical Somatics sessions and daily Somatic Exercises.If you don’t, you just may experience continued tightness in that hip, or aches and pains in other areas of the body due to compensation.

If your goal is to avoid a hip replacement (or put it off indefinitely), which is possible if the structure in your hip socket is damaged, then the smartest thing you could do is to get the muscles which attach into and move the hip socket to release and relax. This is what I have done. Reduce excess muscle tension and free up your movement. This will take the pressure off the injured area and help you regain freedom of movement.

No matter what you decide, improved somatic awareness and control is what will change the course of your recovery from one of pain and limited movement to one of greater movement and self-control.

So what does my daily practice look like? There are so many Somatic Exercises to learn and choose from, yet some are what I call the “non-negotiables.” All this in my next blog post…

 

The Top Three Myths About Hip Pain

Myth #1 – Your hip pain is due to arthritis

Sometimes hip pain is due to severe arthritis and very often it’s not.

When you go to a doctor with hip pain their job is to give you a diagnosis because this is what most people want. Unless you are given an X-ray, which proves beyond a shadow of a doubt that you have arthritis, the doctor has no way of knowing whether your pain is due to arthritis. I was once told that due to my age, I had arthritis. The doctor insisted he was right, when in fact, he wasn’t. Arthritis is often a “garbage pail diagnosis.” You quite possibly have tight muscles that are in a state of Sensory Motor Amnesia.

And sometimes you can have arthritis but be moving well with no pain.

Myth #2 – Your hips are weak

It’s time to retire this myth in particular. Those coming to me with hip pain have very little movement in the center of their bodies. Their hips don’t sway, their gait isn’t smooth and fluid. The problem is not weakness. It’s tightness.

When muscles learn to stay tight (due to stress reflexes), they lose their full function. They can no longer contract and release fully as a healthy muscle should. Muscles in a state of Sensory Motor Amnesia (SMA) have lost their physiological ability to release.  They are far from weak; they are, in fact, so strong that they cannot relax!

Doctors frequently pescribe physical therapy due to “weak muscles.” Strengthening muscles that are in a state of SMA only makes them worse, as I discuss in this post about Tiger Woods.

Myth #3 – Surgery is the only option for hip pain

The medical profession looks at tight hip joints and sees a structural problem. Somatic Educators look at tight hip joints and see a functional problem. Doctors don’t look at movement and patterns; they focus on separate body parts in an effort to “fix” them. Somatic Educators look for “what’s not moving” when someone walks and teaches them to improve sensory motor control of the muscles in order  to create more release in the center. This can create space and more movement in the joints. Most one-sided hip pain is due to an habituated Trauma Reflex; this reflex also causes an imbalance in the somatic center, altering one’s gait and ability to maintain proper balance.

Long term muscle function can result in structural damage, however. Labral tears, osteoarthritis can result from decades of muscle dysfunction. Isn’t it be a good idea to learn to take back control of your muscle function and coordination, your balance and your ability to sense and move yourself before jumping into surgery?

In this video I share a wonderful variation of the Side Bend, one of the most important and helpful Somatic Exercises you could ever do for hip joint pain. Try and see how it feels.

Click here for my Pain-Free Legs and Hips DVD, which has plenty of helpful Somatic Exercises to help you release, relax and control the muscles that move your legs and hips.

 

 

 

Top 3 Myths about Neck Pain

I’ve worked with a lot of people with neck pain, some so severe that they had to go on disability. In the past  Tiger Woods dropped out of a golf tournament due to neck pain – a bulging disc. He said, “I can deal with the pain, but once it locked up I couldn’t go back or come through…” While adamant that his neck pain had nothing whatsoever to do with his car accident, as I wrote in this post, Tiger has a bad case of Sensory Motor Amnesia.

Here are three myths about neck pain to consider:

Myth #1: Neck pain is all about the neck muscles

Thomas Hanna once said, “a stiff neck is a stiff body.” Muscle tightness in the neck is only a part of a larger IMG_3845muscular pattern of contraction closer to the center of the body. The vertebrae that comprise what we think of as “the neck” are only 7 vertebrae of 24 that comprise the spinal column. There are several layers of strong paravertebral muscles on both sides of the spine that extend from the tailbone all the way up into the base of the skull. If the muscles on the back of the body – from neck to pelvis – are tight, the neck will be affected. This kind of “Green Light Reflex” posture creates pain in the back of the neck and into the base of the skull.

If the front of the body is hunched and slumped, the neck will be affected as well; this “Red Light Reflex” posture draws the head forward, which causes the muscles that move the neck and balance the head to contract strongly to maintain balance.

Simply addressing the neck muscles will not solve the problem – for the long term. The body moves as a system, not a jumble of individual parts. Relaxing the back and front of the body can result in a more relaxed and pain-free neck.

Myth #2: Neck problems come with old age

The older we are, the more opportunities our muscles have had to learn to stay tight, “frozen,” and contracted. This is how Sensory Motor Amnesia develops. It occurs due to accidents, injuries, surgeries, repetitive use, and emotional stress.  If that state of habitually contracted muscles progresses over the years, it will appear that the neck problem is a result of age, when in fact, it is the result of muscular dysfunction left unchecked. There is no substantive evidence to prove that age itself has anything to do with neck problems. There is, however, substantive evidence that a lack of movement can result in tighter muscles and restricted movement. This can happen at any age, especially in today’s technological world.

Myth #3: Neck problems mean the neck muscles are weak and need strengthening

I addressed this issue of painful muscles being “weak muscles,” in an old post about the Top Four Myths About Back Pain. Painful, tight muscles are rarely weak; in fact, they are usually so tight that they can neither release fully, nor move efficiently. Tightly contracted muscles which lack proper blood and oxygen are painful, sore and, because they cannot fully release, feel weak. What is needed is to restore fully muscle function, so the muscles can do the two things they are meant to do: fully contract and fully release. A muscle that cannot fully relax is holding unnecessary tension. Learn to relax and control the neck, back, shoulders, and hips and move the entire body efficiently and your neck pain will probably disappear forever.

Try this easy movement in order to relax and release not only the back muscles, but the neck muscles as well. Notice the connection between the neck and the lower back:

To learn to reverse chronic muscle pain with gentle, easy Somatic Movements for the back, neck, shoulders and hips, click here for my Pain-Free Neck and Shoulders DVD.

Somatics Trainings Coming Up in 2015

Here is our updated roster of Essential Somatics® Somatics training opportunities for 2015.

Public workshops, appointments for clinical sessions with Martha and on-going classes are on my website.

Somatic Exercise Coach Trainings – Level One

Somatic Exercises can change how we live our lives, how we believe that our minds and bodies interrelate, how powerful we think we are in controlling our lives, and how responsible we should be in taking care of our total being.

          ~ Thomas Hanna, Ph.D., author of the book, Somatics

YORK, UK- March 6 – 8, 2015 – Only 1 slot left!Image 8

DOOR COUNTY, WI – March 20 – 22, 2015 – register now!

SOUTH ORANGE, NJ – March 27 – 29, 2015 – register now!

CALGARY, ALBERTA – April 16 – 18, 2015 – only 5 slots left

CARTERSVILLE, GA - May 1 – 3, 2015 - register now!

MELBOURNE (Ocean Grove,Vic.), AUSTRALIA – November 6 – 8, 2015 – register now!

ADELAIDE, SW. AUSTRALIA – December 11 – 13, 2015 – register now!

See and hear one of our new SEC coaches describing his experience.

Download a complete PDF prospectus of the training.

Somatic Exercise Coach Training – Level Two

LINDSAY, ONTARIOApril 24 – 26, 2015 – only one slot left (must have completed SEC Level One)

Hanna Somatics Retreats

HOLLYHOCK RETREAT CENTER, Cortes Island, BC – The Myth of AgingAugust 19 – 23, 2015 HollyhockBeach-3_5B872-1

Spend 5 days on beautiful Cortes Island, BC and begin to learn why people develop chronic muscle pain, inflexibility and limited movement. If you have “tried everything” for your back, neck, shoulder or hip pain, and have only experienced short term relief, come learn how to achieve long term pain relief and improved muscular function – on your own – whenever and wherever you need it. This retreat is open to the public. No previous knowledge of Hanna Somatics is required.

BALI, INDONESIA – October, 2015 – details TBA – Somatic Yoga/Hanna Somatics – this week will offer the opportunity to take Somatic Yoga classes with Jo Bentley of Soul Safari Yoga and Somatic Movement classes with Martha Peterson, CHSE

COMING UP in 2016 – Somatics Retreat in Europe

Clinical Somatic Education Professional Training Program

Learn the hands-on clinical methods of Thomas Hanna, Ph.D. to help people regain freedom of movement and eliminate sensory motor amnesia and chronic muscle pain and dysfunction.

SEMESTER ONE – November 16 – Dec. 4, 2015 – Ocean Grove, Victoria, Australia – contact Martha directly if you are interested. Acceptance requires participation in the SEC Level One training, as well as an interview and application.

Eliminating Sensory Motor Amnesia Can Bring Tiger Woods Back Into Competition

Tiger Woods is taking a leave of absence. Even he seems confused about what the real problem is. Does he need to keep changing his swing? Improve his attitude with sports psychology? Get stronger? Tiger has tried just about everything, from the best back surgeons to his trusted physical therapists and coaches, yet nothing has worked for the long term. His story is, unfortunately, all too common. He is hitting his head against the medical wall because his trusted practitioners and trainers are trying to “fix” him from the outside in, when the problem all along has been happening on the inside – within his own sensory motor system.

Tiger Woods has Sensory Motor Amnesia.

The reason none of his treatments are working – for the long term – is because Sensory Motor Amnesia (SMA) can only be eliminated from the tiger_woods_injuries_576“inside out” – by learning, through movement, how to release and relax his muscles at the brain level. He is unaware of how he has adapted, physically, to the accidents and injuries and repetitive stresses of his life. Accidents, injuries, surgeries and repetitive movements have taught his muscles to stay contracted – never fully releasing. These adaptations of muscular holding have changed the way he moves and his once powerful and accurate golf swing has gone by the wayside. He can, however, get it back.

The brain teaches muscles how to move; that’s how elite athletes learn to move so efficiently. Tiger’s brain has taught him to contract his waist and trunk rotators in response to the constant twisting inherent in golf as well as in response to the accidents and surgeries he has experienced. This habitual pattern is called the Trauma Reflex.

Tiger can very easily get back on top in golf once he learns how to eliminate his Sensory Motor Amnesia and regain an accurate sense of himself – from the inside out. He has not only lost control of his muscular system; he’s lost control of what it feels like to be Tiger Woods. Restoring muscle function and reducing excess muscle tonus is a learning process that will not come through traditional strengthening/stretching, PT or surgery.

Sensory Motor Amnesia can only be eliminated by changing the way the brain senses and controls the muscles

His doctors and trainers don’t know what to do with him because SMA doesn’t show up on MRI’s, X-rays or blood tests. Surgery only exacerbates SMA because it creates even more compensation and adaptation in the brain/muscle connection. It doesn’t address the root cause: the fact that his muscles are sub-cortically (involuntarily) contracted all the time. His brain cannot recruit his muscles properly, nor relax them fully.

One well-known trainer recommends the following advice:

Woods must now take time to listen to his body, get off the course and fully restore his strength and mobility. Rest is not what he needs most. He needs strength. Woods must focus on strengthening his erector spinae muscles, his abdominals and obliques as secondary stabilizers, and his posterior chain for function. 

This is the the same recycled myth about muscle pain that fitness trainers have been teaching for decades: when you lose your form or experience back pain it’s because you’re weak. This couldn’t be further from the truth. In actuality, muscle pain develops because the muscles are so strong they cannot, physiologically, relax nor recruit properly. Strengthening only makes things worse.

What Tiger Woods needs is not more muscles, a bigger squat or stronger obliques. He needs to learn to relax the muscles of his back and waist muscles.

Tiger needs to learn how to pandiculate with Somatic Exercises (instead of stretch), and work with a skilled Somatic Educator in a clinical setting. He needs to de-habituate the stress reflexes he is stuck in so he can regain balance in the center of his body and move freely again. I would love to see Tiger back on top of his game and back in control of his life. With Hanna Somatics he will find that not only does his life go better, but his golf game comes right back where it used to be – and possibly even stronger than before.

Here is a sample of a good place for him to start:

How Do You Reverse Hip Pain?

Here is an old blog post, recycled and updated with free videos. It has stood the test of time.

Strengthening hip muscles doesn’t always relieve hip joint pain.

In this post about hip pain and labral tears I questioned the commonly held belief that strengthening the muscles of the hip will somehow relieve general hip joint pain when you’ve had an injury (like a labral tear).  Here’s a recap:

  1. Labral tears are generally the result of athletic injury or wear and tear over the years due to accidents. Labral tears cause instability in the hip.
  2. Instability in a joint causes muscles to contract to try and create stability.
  3. This kind of reflexive contraction to save yourself from further pain or injury or to compensate because because of an injury changes the way in which you would normally move.
  4. The muscles involved in this “Trauma Reflex” pattern must be trained to relax first before beginning any course of strengthening or exercise. Otherwise you will more deeply entrench a pattern of muscular dysfunction.

I recently read a blog written by a young woman who has struggled with hip pain (and also has a labral hip tear) for 4 years.  One extensive post had to do with her experience of dealing with hip pain. She strongly advocated hip exercises, and included links to videos of yoga stretches and repetitive Jane Fonda-esque exercises, all under the heading, “Hip Exercises Will Hurt.

Maybe they will.

And if you have a hip injury that hasn’t been addressed, hip exercises will hurt your chances of ever feeling really good again.

To  her credit, the writer admitted that she still has hip pain despite the exercises and noticed that one leg seems “shorter” than the other – yet her own doctor’s advice was to strengthen her hip muscles and to “not expect much more mobility than she already had.” Despite her good intentions and obvious search for pain relief, from a Somatic Education perspective there is better advice out there than what her doctors gave her or what she is giving her readers.

Try these Somatic Exercises for hip pain relief.

When hip joints are tight, it’s because the muscles that attach into the joints have learned to stay tight. They need to be retrained, slowly and intelligently – not forcefully – to release, lengthen and move freely again.

Here are a few easy movements you can do at home to begin to release hip muscles that, when habitually contracted, contribute to chronic pain. Then I’d like to caution you against certain commonly prescribed exercises that can sometimes make hip pain worse.

Instead of stretching the muscles as you go through these movements, you will pandiculate them – contracting the muscle first, then slowly lengthening it to a full relaxation (as if you were imitating a cat or dog getting up from rest). Pandiculation is the key to re-setting muscle length and restoring sensory awareness and motor control without forceful or painful stretching.

Arch and flatten: This movement relaxes the back muscles. Tight back muscles contribute to tight hip joints.

Arch and curl: Click here for an explanation/tutorial on how to do these two movements. Arch and curl helps to relax the abdominal muscles, while the washrag allows for easier full body twisting. It relaxes the back, waist, belly and hips.

Side Bend: This movement directly addresses the “Trauma Reflex” muscles of trunk rotation that, when habitually contracted, are probably the biggest contributor to hip pain. This movement will teach you to relax, release and lengthen the waist muscles so that both sides of your waist are the same length and have the same ability to bend from side to side.

 

Lie on your right side, as shown in the photo below. Have the knees folded on top of each other at right angles to the body. Rest your left arm on the floor so that your head can rest on it. Get comfortable.

Let’s first explore the lower part of this exercise: put your top hand at your waist and, keeping the knees together, slowly lift the top foot as shown at right. Notice how the hip slides up toward the ribs as you lift the foot. Allow the hip to move as the foot lifts. The waist muscles are drawing the hip up as the foot lifts. Repeat that movement 3 times slowly. Completely release the hip and foot back to neutral.

Now let’s explore the upper part of the exercise: reach the left hand over top of the head and grab your right ear. Inhale and on the exhale, very slowly lift the head into the air. Let the waist muscles and ribs contract to bring your head up. Sense the contraction in the waist as your ribs squeeze down toward your hip. Slowly release down to neutral. Repeat this 3 time slowly.

Now, let’s put both movements together for a full pandiculation of the waist muscles. Inhale, expanding the ribs, and on the exhale lift the head, and the top foot at the same time. The ribs squeeze down as the hip slides up toward the ribs. You’re making an accordion with the waist muscles!Let the movement of the waist and hip raise the foot. Notice the contraction in the groin as well. Only go as far as is comfortable and don’t force any movement! You are retraining the muscles, and reminding them that they can move.

On the inhale, slowly lower the foot and the head down at the same time. You’re lengthening and relaxing the waist muscles as the hip rolls down to neutral and the ribs relax.  up the right hip to touch the right armpit. Lengthen the entire side of your body as you come down to neutral and completely relax as shown in the photo on the lower right. You’re beginning to gain length in the waist muscles! Repeat this movement 6 times slowly.

Roll onto your back and take a minute to notice the difference in sensation between your left side and your right side. Let your brain soak up the sensory feedback. Now roll onto the other side and repeat the side bend 6 times slowly.

Finish this series of movements with the Washrag.

Remember to do all these movements SLOWLY, GENTLY and WITH AWARENESS.

Take a moment after doing these movements to notice the sensations of your body. Lie quietly on your back. This allows your brain time to absorb the sensory feedback you have given it. This new sensory awareness results in improved motor skill and flexibility.

In my next post, I’ll discuss my own answers to the following questions about labral tears:

  1. Should they be repaired?
  2. How do you deal with the discomfort of a tear if your doctor says, “let’s just wait and see.”
  3. Are you setting yourself up to create serious structural damage to the hip joint by not repairing the structural weakness?

I welcome all feedback about the advice given in this blogpost. Do the above movements for a couple of days and let me know how it goes. If you need help, advice or guidance, please contact me!

To learn these movements at home for rapid, long term muscle pain relief, click here to buy my new, easy to follow instructional DVD.

Why Somatic Movement Classes and Clinical Sessions Work Best Together

Janet (not her real name) came to my office this week complaining of hip pain. Walking upstairs was painful and laborious. She was only in her 30’s.  She had, as she put it, “a list a mile long of things she’s tried” in her quest for pain relief.  Nothing had worked. She told me, “I’m told I have piriformis syndrome. If I could just get my right buttock to relax, I think I could finally begin to feel better.”

We did a hands-on Clinical Somatics lesson in which, she learned, very quickly, to release her tight waist muscles, ribcage and trunk rotators. She learned the “back lift” Somatic Exercise to begin to relax her tightly contracted back muscles.

Only then was she read to learn to release her gluteal muscles on her right side. In testing her range of motion, her hip and leg barely moved. I taught her to release the entire pattern of contraction that was causing her buttock to spasm: her tight buttock, abdominals and abductor muscles. Working with feedback from my hand, she contracted these muscles together, and then slowly began to lengthen the muscles. This technique is called “assisted pandiculation” – it re-sets the muscle control and length at the level of the nervous system.  Twice more she contracted, then slowly released those same muscles, until she reached her own comfortable limit, flopping her leg inward easily. What happened next took me by surprise:

She began to yell, Oh my God, oh my God! I can’t believe it! I can’t believe it!

Are you alright? Does anything hurt? I asked. She’d scared me!

No, no, no, it’s just that I finally relaxed my buttock! I’ve been saying this all along and nobody believed me! This is my eureka moment!

Janet left the office with an ability to move her hips in a way she hadn’t been able to for 8 years.

Most muscle pain problems are functional in nature, not structural

Why did this clinical Somatics session help her when years of physical therapy, trigger point therapy, massage, acupuncture and medical treatments hadn’t? Because Janet’s problem wasn’t structural; it was functional. She suffered from Sensory Motor Amnesia. Her brain had simply forgotten how to relax the muscles that had involuntarily and violently contracted many years ago in response to two traumatic accidents. Her muscles had learned to adapt, resulting in a twisted pelvis, altered gait and tight hip joint. This is called the Trauma Reflex. As Jane learned to release the entire pattern of tightness on her right side (and compensatory tightness on her other side) and improve the function of her muscles, she began to relieve her hip pain and regain muscle coordination and balance.

Janet isn’t completely out of pain. She has more to work to do to change the holding patterns she learned from her accidents as well as from long hours sitting at the computer.  In addition to a few more clinical sessions I suggested that she attend every Somatic Exercise class and workshop she can possibly can.  I give this same advice to every client I work with. While private clinical sessions are profoundly effective, attending only a few sessions is like taking a few  piano lessons and expecting to perform like Chopin or Mozart!

People often ask, “why do I need to come to class if I’m doing private sessions and feel much better?” The answer is simple: classes gives you the opportunity to learn more. Learning takes time – especially when you’re learning to change the habits of your brain. The more you learn, and the more you practice, the more you learn about yourself and your reflexive responses to stress. You learn to regain mastery over your body and movement. Eventually efficient movement will become your brain’s default mode as you become more self-monitoring, self-correcting, and self-healing. Varying your daily Somatics routine with Somatic Exercise classes and workshops and fun, functional movement makes your brain smarter and keeps you out of pain.

Click here to find a workshop, class or training near you.

Click here to purchase Martha’s Pain Relief videos.