Structural Integration with Ali Mischke

Making Sense of Priorities

Imagine that you and a friend are sitting atop a high wall when you lose your balance. As you start to tumble, your friend grabs hold of your arm. Now you’re hanging off the wall, your friend’s grasp the only thing between you and disaster. Your (fortunately quite strong) friend starts to pull you up, which puts painful strain on your shoulder.

What do you do? And in this moment, how much do you care about the shoulder pain?

The Logical Answer

You try anything you can think of to help your friend save you. You might grab hold of their arm to double your contact with safety, reach for the edge of the wall with your free hand, or feel around with your feet for a foothold or traction on the wall. When the emergency is over, you feel eternally grateful to your friend for saving your life.

An Alternate Answer

You try to pull away. You call out to your friend, “Let go! You’re hurting my shoulder!When the moment is over, you feel confused and angry. You might never feel completely safe around this person again.

Sounds ridiculous, no? Talk about losing sight of your priorities.

Now shift the circumstances: you are standing on safe ground and your friend reaches for your hand. For no apparent reason, your friend jerks you across the room, hurting your shoulder in the process. In this context, doesn’t the Alternate Answer above start to make sense?

Selecting the appropriate response depends not just on the details of your current situation (is my friend saving me from danger?) but more importantly on your being aware of that situation.

Where Are We Going with This?

Most clients come to my office because of either pain or movement limitations, and they often express anger at the compromised body part: “That’s my bad hip,” “My shoulder is killing me!” or “Can’t you just cut it off?” are some of the more common publishable refrains.

If we believe the body part is causing us pain without reason, those expressions make sense. However, we are often missing important details of the situation unfolding in our bodies. When we uncover those hidden details, we learn the body is doing important work. Often, the key to resolving dysfunction and pain becomes obvious.

Seeing the Forest for the Trees

A not-uncommon recent example: a client came to me with pain in the front of her left hip, reporting that it always felt tight. As she walked, I noticed she wasn’t getting full extension in her hip.

The pattern continued both up- and down-stream: her low back was stuck in extension (lordosis) and she couldn’t fully flex her ankle.

The “logical answer” might be to help lengthen her hip flexors and the muscles in her calf. Had I done so, she might have felt better after our session, but then gotten frustrated when everything tightened up again only a few hours later. No matter how much this client stretched, she would not have found lasting comfort. Believe me, I know this one. In the early days of my practice, I had a cameo in that unfortunate movie a couple of times.

On deeper inspection, I noticed that my client’s colon was adhered to her iliac fascia, the fascia lining the inside of the hip bone and its surrounding structures. With gentle separation of the colon from the iliac fascia (which took a few minutes at the most), the client’s hip had full function, as did her ankle. Weeks later, the freedom remained and the pain had not recurred.

Understanding the Body’s Priorities

When it comes to self-preservation, your body has a clear set of priorities. Organs come first, then nerves and blood vessels. Muscles and joints are relatively low on the list. This makes sense: you can live indefinitely with a hip that doesn’t fully extend. However, if the hip has full mobility and yanks on the colon, the femoral artery, or the femoral nerve with every step, you are likely to get into trouble.

Suddenly, the “stuck” hip that seemed like such a problem child is revealed as a hero. Thank you, dear Hip, for locking things down to keep my organs safe even when it caused you pain, you smart, fearless model of anatomic perfection.

Too far? Maybe. But how would life change if we thought about our bodies in that way? What would it be like to communicate with your body with skill and compassion? To understand the full breadth of reality and address root problems rather than battling with your body over the resulting symptoms? And what if we practiced this skill when we’re not hanging off a wall, but before there’s an emergency?

A Bouncy House and the Secret to Happiness

Over Memorial Day weekend, my neighbor threw herself a 30th birthday party (Happy birthday, Brooke!). There was a BBQ and a gathering of friends, but the real highlight of the party was a Bouncy House. And before you reread that first sentence, the answer is yes — I did say 30th birthday.

We flung ourselves around for hours. Games spontaneously arose: who could touch the ceiling? Who had the longest broad jump? Could we somersault and stick the landing? Land in an L-sit, and then bounce back up to our feet? We chased each other, Duck Duck Goose style. We learned that you bounce highest when you’re exactly out of phase with another jumper (you’re down when they’re up). It was glorious.

Just like being a kid again? Perhaps better, because as adults we had the experience of having left that place and returned with new eyes. Amidst the joy of being fully present in our bodies, tucked in with the warmth of connecting to others without agenda, we felt an upwelling of gratitude, an appreciation for how precious was the experience.

When did you stop playing?

If your answer is “I haven’t,” then congratulations! You’re in the minority, and in my opinion you’re doing it right.

Many of us believe that we as we grow up, play is supposed to be replaced by work. We take on responsibilities, and life becomes serious business. But what would it look like if our definition of healthy adulthood included making time for such moments of playful abandon? As playwright George Bernard Shaw put it, “We don’t stop playing because we grow old; we grow old because we stop playing.”

Is work in fact the opposite of play? Notable play researcher Dr. Stuart Brown (and how is that for a great job title?) argues that the opposite of play is not work; it’s depression. With 1 in 4 or 5 women and 1 in 8 to 10 men experiencing major depression in their lifetime, perhaps making space for play should be a public health priority.

If you’ve ever loved your work (and I do hope you have), then you’ve experienced what creativity pioneer Mihaly Csikszentmihalyi calls the flow state: moments of complete absorption in your task. In the flow state, challenges are met with appropriate levels of skill; if we were thinking about it, we’d notice a sense of mastery. Yet the point is that we’re not thinking about it – in the flow state, the ego falls away, time falls away, and “every action, movement, and thought follows inevitably from the previous one, like playing jazz.” According to Csikszentmihalyi, flow state is essential to happiness. As humans, we not only like but also need to solve problems and to immerse ourselves fully in our experiences.

In the above definition, flow requires us to possess the skills necessary to meet the challenges ahead. When our skills are lacking, we feel anxiety rather than flow. So how do we gain the requisite skills? Through play.

Learning through play: or, seals have it figured out

If you know me or have read my bio, you know I volunteer at the New England Aquarium and conduct behavioral research with the seals and sea lions. On alternate Tuesdays, I spend a lot of time watching Northern Fur Seals and recording notes about their behavior. Given that the colony contains a number of juveniles, I spend a lot of time watching baby animals play (tough job, I know).

We used to have two young males, Flaherty and Leu, now living together in balmy Seattle. Visitors would come by and see them “jousting,” or posturing at each other with open mouths and gruff noises known as chuffs, and would ask if they were fighting. Nope, not fighting – just playing.

As adult males in the wild during mating season, Flaherty and Leu would choose a prime piece of real estate and defend their territory against competing males. Any females in the area would be theirs for breeding. It’s not exactly a feminist bedtime story, but I don’t make the rules. Stick with me here.

If a male waits until he’s old enough to breed to learn how to defend his territory, it’s likely to go badly for him – read: serious injury, and certainly no passing on of the genes. So, as a juvenile, he and his friends play Breeding Ground. They wrestle, they tumble, they posture, they cede power back and forth – all in a friendly environment with mom watching to be sure nothing gets too far out of control. By the time a male fur seal is old enough to breed, he’s gained mastery over the necessary skills (or else he’s learned that it’s not a good idea for him to challenge the dominant males).

Across the animal kingdom, humans included, individuals learn to function as adults and learn to relate to each other through play.

Play vs. practice

So what is play exactly, and how is it different from practicing? Practice is intentional – we repeat particular drills or exercises with the specific goal of improving. In contrast, play is unstructured, creative, driven only by curiosity and moment-by-moment desire. Though we do get better at the skills we perform during play, any sense of purpose takes a distant backseat to the simple pleasure of the play itself.

Play has infinite variety, including but not limited to word play, social play, constructive play, and the type of play exhibited in the Bouncy House – body play. Defined by Stuart Brown as “a spontaneous desire to get ourselves out of gravity,” body play enables us to enjoy our bodies, to discover new patterns of movement, and to gain mastery over our physical environment. Body play boosts vitality and helps us stay physically healthy.

There is a time and a place for both practice and play, and flow state probably requires a healthy dose of both activities. In my experience, it’s generally easier for adults to acknowledge the need for and make guilt-free time for practice; hence, this ode to play.

Bringing it all together

Play staves off depression; it gives us a sense of mastery; it drives innovation; it bonds us together; and it both generates happiness and helps creates the conditions necessary for flow-induced happiness in our other activities.

So when was the last time you experienced joyful abandon? Moved for the sake of enjoying the feeling of movement? If as an adult you find yourself anxious about rather than energized by the challenges ahead, if you feel undernourished and overstressed, if you’ve forgotten what it’s like to delight in your body, perhaps you’re overdue for a play date. Alone or with others…last one to play is a rotten egg!

Let it Go

The first time I went Irish set dancing, I was a sweaty mess. After two hours of hurling myself around the dance floor, and being hurled by my also-new partner, I was exhilarated and spent.

Fast forward two years, and my partner and I happily danced through the evening, still looking and smelling fresh.

What changed in that time? Did we gain endurance? Perhaps, but that’s a minor piece of the puzzle. Did we learn to move properly? In a manner of speaking; more accurately, we learned how and what not to move.

What not to move???

Somewhere in that two years, we began to lean into each other in the spins to increase momentum. More like flying, less need to pull with our arms to drag each other around. We began to spring lightly from the balls of our feet rather than stampeding with heavy heels. Springing gave us resilience, helping propel us forward. Heavy heels had literally held us back, requiring that much more leg work to take the next step. (Try it! You’ll see what I mean.)

Week by week, we made subtle shifts, letting go of every extraneous movement until what remained was the essence of the step. And when we thought we were done, another 80-plus-year-old footwork teacher would come over from Galway and show us how much more deceptively simple it could be. It was thrilling.

Whether you take up dance, swimming, structural integration, or nearly any other physical pursuit, over time you learn elegance and efficiency. Which muscles need to move, and which can rest. How to let the principles of physics, like inertia and gravity, do the work for you. How to flow, instead of fight. We understand the need to refine our technique when dancing, or playing a sport or musical instrument. Perhaps it’s time to apply the same idea to sitting, standing, and walking.

Are your shoulders overly friendly with your ears?

In an effort to stand up straight, some clients rely on their shoulders, drawing shoulders closer in to the rib cage, and up into the territory of their ears. They come to see me with neck and upper back pain, and sometimes numbness in their hands. We soon discover they have reduced range of motion in their shoulders, and often have trouble taking a full breath, as their shoulders crowd the upper lungs.

Do shoulders have to work so that you can stand tall? On the contrary, lifting from the shoulders is a common compensation for a sleepy core. If you can release the shoulders and let the inseam of the legs and the deep stabilizing muscles from hips through spine do their job, you’ll likely stand taller, breathe easier and feel greater comfort.

As you sit to read or work, do you find the muscles of your brow tightening? Your jaw clenching?

Growing up, I could always tell when a friend of mine (let’s call her Rachel) was concentrating on her homework, because she would chew on her tongue. It was an unconscious habit; she never noticed unless someone else pointed it out.

Rachel wasn’t chewing hard enough to injure her tongue, but she was creating a habit of jaw tension associated with concentrating, thinking, stressing…and which modern urban professional doesn’t spend too much time concentrating, thinking, and/or stressing? As she entered the working world, Rachel started to grind her teeth. These days, she needs to wear a night guard to prevent tooth damage.

Chewing on her tongue may be part of Rachel’s unconscious working routine, just as my Lounge Techno Pandora station cues me that it’s time to focus. However, the muscular effort is clearly not required for effective thinking or typing. For her, as it does for many of us, jaw tension went from context-based habit to standard operating procedure. What might happen to her jaw tension, her teeth, her stress level if she could let that muscular effort go?

As you move through your day, scan through your body. What muscles are working that don’t need to?

The brow, the jaw, the neck are good places to start looking, but undoubtedly you’ve found your own tension hidey-holes. Take a moment to breathe. Let the tension go. Don’t try to force your body to relax (when has that ever worked?), but allow it to soften. Even just a little. You didn’t build the habit overnight, and while it would be lovely to make instant change, these things take time.

So….scan your body again. Did any tension return while you read those last few sentences? Breathe. Invite it to soften. Lather, rinse, repeat. What do you notice? Perhaps you are calmer, more comfortable. Perhaps you’re moving with a little more freedom, breathing with a little greater ease. Welcome home to your body. You might be surprised how spacious it can become.

Suffering is Optional

A key Buddhist tenet states, “Pain is inevitable; suffering is optional.”

Painful things happen in life. Unless you spend your life encased in bubble wrap and refrain from risky activities (including sitting!), you will incur some injuries. As social animals, humans are guaranteed to experience emotional pain.

What does it mean that suffering is optional?

It’s not always apparent, but we have choices about how we respond to every situation we encounter. When we don’t like something that happens, do we accept the situation? Do we perhaps find the unexpected benefit? Or do we strike out, shut down, catastrophize, regret?

Years ago, I went on a family trip. As we pulled up to our destination, the driver, who shall remain nameless, parked too close to a steep, muddy hill. We got out to check out our accommodations; when we returned, the car had careened to the bottom of the hill.

Decision time. We could have yelled at the driver, starting a fight that ruined the mood for the entire week. We could have worried the car might need repairs we couldn’t afford, or that our week would be spent taking care of the car instead of enjoying our time. There were any number of ways in which we could have decided to suffer.

Instead, we giggled. The kind of giggle that comes from the deepest part of the belly and lasts for minutes. Then, we dusted ourselves off, got behind the car and pushed. There were six of us, and it took all of our combined strength, but we got the car back up that hill. We felt powerful, highly entertained, and most importantly, bonded. We took a great picture in front of the car, and I remember that incident far more than I remember all the things that went right that week.

OK, I get it. But what does this have to do with my body?

Let’s say you injure your left shoulder. It’s going to hurt; pain is inevitable. What’s important is how you respond to that pain.

Do you stop moving the shoulder entirely, fearing more pain? If so, the body gradually builds up extra fascial strapping (think packing tape) to reinforce the immobility. Over time, you lose range of motion. Without the same range of motion in your shoulder, your neck may start to hurt. Perhaps your walking stride changes, as you stop swinging that arm.

Right now, try taking a walk without moving your left shoulder. Really do it; we’ll wait.

Did you notice the whole left side contracting? Did you feel how the hip doesn’t swing as freely as usual? Now try walking normally. Do you feel the difference?

As this theoretical shoulder injury heals, do you gradually return to trusting the shoulder? Or do you call it “my bad shoulder,” and refrain from using it as you did before? Do you take the time to smooth out your walking stride, or is it permanently altered? With the left side contracted, and the left hip not swinging as freely, perhaps you develop low back pain. Perhaps you notice you’re not as bold and confident as you used to be: your shoulder is literally holding you back.

Now your neck hurts, your low back hurts, your energy is waning, and you feel old beyond your years. You’re suffering.

What if you choose a different path?

What if as the shoulder heals, you maintain as much gentle range of motion as possible? You pay attention to how your posture and movements shift to accommodate the injury. As your shoulder begins to feel better, you consciously work to unwind those patterns. As you walk, you pay attention to your left hip, allowing it to swing as before. You relax your neck and side body. The pain passes, and you avoid suffering. Victory!

You have options.

Structural integration is about creating awareness and giving you options for how you stand and move. Not sure where your suffering began or how to unwind it? Contact me to learn more about how structural integration can help.