The field of Western physical therapy (PT) and to be more specific, how it evolved to look at and organize movement, is fundamantally different than Eastern dynamic integrated movement systems such as Yoga, Qigong, Feldenkrais and Tai Chi. Where Western movement has its origin in a system build on individual muscles, planes and axis which evolved through evidence based practice, Eastern movement has a older and more diverse history with links to Chinese and Japanese battlefields as well as ancient healing techniques. Looking at them superficially, the two systems seem worlds apart, which might even be the case in most part. However, when we use these differences to our advantage and pick the best of both worlds, we can unify them in a new model that improves our understanding of movement and forms a new and superior model for treating musculoskeletal pain.
“Do not deny the classical approach, simply as a reaction, or you will have created another pattern and trapped yourself there.”
― Bruce Lee, Tao of Jeet Kune Do
Western “Cut it Up, and Put it Back Together”
The origin of Western movement can be traced back to the period of The Renaissance, where we started to dissect the human body, creating an inventory and topographical map of its individual components. Organizing these components in a framework comprised of origins, insertions, planes and axes, bony landmarks and anatomical topographic directions, it formed the database on which we’ve modelled our understanding of human movement. This can be compared to an ‘inside out’ or ‘reverse engineering’ approach which can be very helpful to understand individual components in a systems, but might fail to explain how these parts form the unifying whole.
There is a well-known story of ‘the blind man and an elephant’, that depicts the (possible) drawback of this approach perfectly. Here, a group of blind men heard that a strange animal, called an elephant, had been brought to the town, but none of them were aware of its shape and form. Confident by their abilities on describing an object by touch, they sought out the animal. The first man who grabbed the trunk described it as being a “snake like creature”. Another man who touched a leg said it to be a pillar, like “a thick tree-trunk”. Yet another placed his hand on the side, calling it “a wall”. The same, incorrect characterization of the elephant were made by the man who felt the tusk and tail. All man failed to sketch an accurate portrait of the animal, as did the Western approach of explaining the grand design of human motion.
By cutting up the human form, identifying and describing the parts within, they tried to simplify this complex system of interconnecting structures, but by doing so, they lost sight of the harmonious whole. Thereby, most researchers who write about how movement should be organized, have little to none personal experience in advanced movement skills like Yoga, Qigong or Tai Chi. It’s like asking a person to compose Beethoven’s ‘Fur Elise’, by only explaining the concept of notes, chords, meter (rhythm) and the staff. He might come far, but to capture the soul, overall architecture as well as minute details within, is in a different league all together.
The Western approach can be very powerful and innovative though, as it brought mankind to the moon and created modern civilization. It’s phenomenal in creating complex mechanics and can be very helpful in understanding the structure and parts of things, such as our brain, by creation of the MRI. But, as with any mechanism or mathamatical formula, it’s only effective when used correctly.
Eastern “Let Nature Decide”
For the origin story of Eastern movement, we have to travel a lot further back in time, some say to 5000BE as a Qigong stance is found on pottery from that age, whilst others will argue 3000BC, dating it from a clay tablet with a yoga post found in India. The precise date is of non-importance for this post, but seek for yourself if you want to pinpoint the exact time and place in space. Eastern movement is comprised of numerous systems including: Yoga, Qigong,Tai Chi (Chuan) as well as numerous Martial Arts and can be traced back to ancient Inda, Japan and China, to name a few. They were created to be healing techniques as others evolved from the battlefield with some to be a combination of both.
I’m definitely no scholar in the origin-story of these movement systems, only having basic knowledge by looking at its evolution in Western medicine and self-interest in the topic. To simplify, we can divide Eastern movement into two sub-groups; movement originating from the battlefield or ‘Martial Arts’; movement with a medical and spiritual purpose such as Qigong.
The evolution of Martial Arts is based on one simple rule: efficiency. Looking up the meaning of ‘efficiency’ the Cambridge dictionary it states; “The good use of time and energy in a way that does not waste any”; “The difference between the amount of energy that is put into a machine in the form of fuel, effort, etc. and the amount that comes out of it in the form of movement”. Surviving life in general and especially fighting for your life during wartime, is all about being efficient. You’ll have the highest statistical odds of survival when you develop the most efficient way of slaying your opponent, for this, you’d needed to become a ‘master of movement’. In this state no enery is lavishly wasted, with every move being executed with purpose and deathly precision. Enter the Martial Art schools, which formed ‘hot spots’ of movement innovation, by trying to outmanoeuver the enemy and later, rivalling schools. This brought a revolution to these Eastern movement systems and today, we can reap the benefits.
Qigong is a perfect example of movement for medical and spiritual purpose. It’s recognized as a “standard medical technique” in China since 1989 and has established itself in the general population as a technique for preventive and curative functions as well as longevity and meditation. Its seen as a way to cultivate and balance qi or “life energy” e.g. through moving meditation, coordinating slow-flowing movement, deep rhythmic breathing, and a calm meditative state of mind.
Eastern traditional medicine has a more holistic approach to illness. There is more focus on, if I may call it that, the energetic body, with examples such as chakra’s and meridians. It sees the body as a whole where qi can be in balance or imbalanced due to a variety of influences such as nutrition, external causes e.g. dampness, dryness, wind and cold and emotions. This, of course is a very superficial description of all elements involved, but it’s enough to depict the difference between West and Eastern systems.
“The tendency of Chinese thought is to seek out dynamic functional activity rather than to look for the fixed somatic structures that perform the activities. Because of this, the Chinese have no system of anatomy comparable to that of the West.”
— Ted Kaptchuk, The Web That Has No Weaver
Best of Both Worlds
Having such a profoundly different origin and path of evolution, both worlds created their own language and rules, making it a challenge to marry the two in current models. Thereby, Western medicine is somewhat sceptical about the effectiveness of Eastern medicine, as it has a hard time verifying the claims made, through statistical analysis and clinical research, setting it aside as “pseudoscience”. This is true for both general Eastern medicine as for integrated movement systems. It’s possible that we just haven’t developed the right measuring tools yet or, we have to change our perspective on these movement systems. Either way, when we keep trying to understand everyting through set beliefs, we inhibit our ability to evolve our perception and knowledge.
Movement is hard to quantify in numbers or words and is best felt in your own body, it’s therefore difficult to have a solely scientific approach to describe the effects of movement. How the movement feels and if the individual prefers one over the other for instance, will be an objective observation and will differ from person to person. Nonetheless, we have an obligation to back our claims with scientific research to validate the underlying structure of the method. How to teach a motor skill for example, is an important part, and a widely researched topic from which we can source validation for this method.
To unify of both worlds, we need to set aside our ego and use the difference between them to our advantage, crafting a new set of glasses for the purpose of remoddeling our current understanding of movement. Through these glasses we need to answer the ‘what’ to teach and ‘how’ to teach it, where both questions have multiple layers which we can explore, but for now, we keep a general view on them, answering which movement system best reflects nature and how to build up to a functional, final movement.
What to Teach
There is no single answer to the ‘what to teach’ question as every systems has their own strengths we can exploit. Yoga for example, is a great method to learn posture and general relationships of trunk and limbs whereas Qigong and Feldenkrais are better suited towards how these relationships move together. Again, we use our plasticity and not pin ourselves down on one single system, as we didn’t discard eihter world for their belief system, but picked the best from both.
The Western build movement model, has a big flaw which makes this model less suitable for our purpose of advancing the status quo. It has adopted the model of static integration, which is a topic on its own, but by doing so, it misses some key elements of natural human movement. Static integration assumes that one bone of a joint is an unmoving structure around which the other bone moves. This differs from reality, where muscles are two way streets and will pull both bones toward each other. This is best shown in the example of the ‘core’, where the abdominals and low back extensors are held responsible for the movement and stabilisation of the pelvis. It doesn’t take in consideration that the abdominal muscles are attached to a moving ribcage, which will be pulled into flexion when the abdominals contract. This flexion needs to be counterbalanced to maintain an upright posture which can only be achieved by the back extensors, creating a co- contraction of both flexors and extensors which in turn creates a corset of the torso, inhibiting free movement. Therefor the dynamic integrated systems are better suited to the question of what we need to teach.
How to Teach
Current methods on how to teach, can vary widely between schools and teachers and science has multiple methods with varying substantiation. Most use a outside- in method, starting in the full pose from where corrections are made or looking at the end result from a movement such as the tajectory of the ball from a kick. To execute a complex movement is no easy task, considering there are a lot of joints that need to be controlled simultaneously and countless details within, where small changes can make a big difference on the overall quality of the movement. Therefore, dividing these complex poses and forms into smaller digestible sub- movements, will make it a lot easier to learn.
Here, the Western method works perfect to break down a complex movement into bite size chunks. Applying this template to integrated movement, will divide the body into its regional constituents such as hips/pelvis/low back or upper back/neck/shoulders. From this, we can create a large variety of exercises focusing on these interrelationships, which will enable an individual to learn the movement step-by-step and from the inside-out, before combining them into the final form.
It’s beneficial to have an open mind and being flexible, not afraid to change your perspective when a better suited model is presented. Don’t accept a new model submissively however, but ask the questions that will help you understand the benefits of said model. Try to find how seemingly separate systems can benefit and enhance each other, instead of defending your own camp and trying to falsify others.
“The measure of intelligence is the ability to change.”
― Albert Einstein