Old Habits Die Hard

[Guest]

by Mike Napierala, PT, SCS, CSCS, FAFS

Often the idea of Physical Therapy can be oversimplified by patients and even by doctors.

Range of motion, stretching, strengthening exercises. Yes, all those are often a key part of recovery.

A recent patient, let's call her Judy, who had Total Knee Replacement surgery looked in the mirror the other day and saw a glimpse of how those old habits just don't disappear from simple stretching and strengthening drills.

Judy had lost her knee-straightening ability months before her surgery. The knee arthritis had produced a stiff, bent knee that she'd just gotten used to living with. Walking with her knee bent at 10-15 degrees just became the norm. Surgery replaced those old worn joint surfaces with new, shiny, pristine smooth ends that no longer had rough bone exposed, pain and cracking with each step. BUT, that surgery didn't replace her connective tissues or tendons and muscles.  

All the same stiffness and weaknesses AND HABITS she'd developed over the years were still there.

So when Judy finally got her knee flat on the table, "full extension," it felt like a new milestone was reached and she could move on to the next challenge. She was even able to keep that leg totally stiff and raise it off the table without bending and maintain straightness while standing on it and reaching out the opposite foot.

But then she began walking and that similar old pattern of a bent knee came back. She seemed surprised and puzzled as I had her walk past the large mirrors in the exercise area, seeing the bend that still haunted her gait in spite of what seemed like a done deal just minutes ago on the table and on the floor in standing.

Old habits die hard.

She needed help with her proprioception and motor control. Proprioception is about your body's awareness of movement and muscle activity. Motor control is about the patterning and sequencing of accomplishing movement in an effective and efficient manner.  

Remember, it's equally or more about the nervous system and those firing patterns and "habits" that our body produces after thousands and thousands of repetitions of a movement, eventually resulting in automated movement patterns. Things we do without real conscious thought.

When you have developed compensations and "bad habits" related to an injury, it often requires going beyond just some simple stretches or strengthening exercises.

That's why having expertise in biomechanics and understanding function is key to putting on our creativity hats to design exercises that help your neuromuscular system help the "old dog" in you learn a new trick!

Let us know if you or someone you care about needs help getting beyond oversimplifying your recovery process to a few simple stretching and strengthening exercises you got off the internet or saw at the gym. Finding appropriate ways to stimulate your proprioceptors and reinforce proper movement patterns is key.  

PEAK PERFORMANCE is not only who we are, it's what we want for you!