Physical rehabilitation is an important part of medicine. When I was on the stroke team on my Neurology clerkship, the main goal of our team (after we identified and localized the stroke) was to make sure our patients were medically cleared so they could go to rehab (The second I wrote that I heard the Amy Winehouse song “Rehab” in my head- I’m sorry if I’m responsible for putting this earworm in your head too!).
Physical rehabilitation was also a significant portion of patient care on my surgical trauma clerkship. Indeed, one of the tasks of the med students was to do “PT rounds”, in which we tracked down our patients’ charts (yes, our hospital still uses paper charts) and checked for progress in their therapy. This became quite time consuming when our list grew to 40 patients, including 1 on almost every floor of the hospital! Each afternoon, as we tracked down charts, we would pore over the PT/OT (Physical therapy/Occupational therapy) notes. This was challenging not only because of the almost illegible handwriting of some of the therapists, but also because of the litany of abbreviations and symbols that they utilize (though with time, their interpretation became much easier). Over the weeks we would track the range of motion of our patients’ various joints, and the relative amount of assistance needed to go from lying to sitting and from sitting to standing. We would see how far they could walk (and with what type of assistance) and how many stairs they could climb up and down. The process- both the types of movements done and the assistance that is provided- is very delineated and mechanistic.
Meanwhile, in a seemingly totally different world…
Last weekend I attended a MovNat one-day workshop in Central Park. I’ve been aware of MovNat for a while now (I can’t remember my original introduction, but the name, and the general concept of ‘natural human movement’, is definitely something I came across as part of my journey in evolutionary health and wellness), but it’s something I’ve been interested in for a while, and I was enthusiastic to attend the workshop.
For those that are not familiar, MovNat is a concept of fitness based on the full range of natural human movements. It is the pursuit of fitness based on “man in the wild” not “man in the zoo”.
Through the day, we talked about and practiced 7 of the 13 MovNat movement skills. People do some interesting things in Central Park, but we definitely drew interesting looks as we explored different ways of walking, running, balancing, jumping, crawling, climbing, and lifting (the remaining 5 skills of swimming, carrying, throwing, catching, striking, and grappling were left for another day…). Many of the movements we explored were familiar, if not as things that we do on a regular basis now, then perhaps more reminiscent of a day outside as a child. Running around barefoot, tumbling in the grass, trying to nimbly walk along curbs and park benches: these skills weren’t exactly new, they were just things we needed to rediscover.
Throughout the day, the emphasis for these movements was not one of rigorous perfection, but more one of practice and experimentation. Through a variety of positions and movements, we explored our balance and flexibility, all with a focus of being mindful, both of our body and mind, and also of the environment around us. Through this practice, one could recognize the efficiency of natural movement and the (at least to me) instinctive nature of basic human movements.
As I mentioned above, many of the things we explored were not really “new”, but instead were a reawakening of movements and skills of childhood. It is great to watch a child play and realize that (at least to my rather untrained eye) they have great form in almost everything they do. Watch a child squat, pick up a rock, and play with it. Watch them as they stand up, carry, and run around with it- they don’t have to be taught how to do these movements correctly, they learn it through a process of trial and error- figuring out how do it as efficiently as possible.
Rediscovering these movements, with the help of guidance and tips from an instructor, is (at least from my take) what MovNat is all about (at least for the basic skills of balancing, walking, running, and lifting… I’d be a bit concerned if I was impressed with the grappling skills of a small child!).
So where does rehabilitation tie into all this?
As I mentioned above, the process by which people receive physical therapy in our medical system is (at least from my experience) rather rigid and mechanized. Could the instinctive and practical elements of a “natural movement” regime (such as MovNat) offer a new approach to rehabilitation?
MovNat has gained respect from many in the fitness world and beyond. Indeed the founder of MovNat, Erwan Le Corre, has given a talk on the subject at NASA. The emphasis I have seen thus far has been of general fitness and wellbeing for “normal” humans as well as athletes, but could a return to “natural human movements” be an appropriate approach to rehab? Would it help those who have lost their knowledge of how to move like a human, such as those who have suffered a stroke or a traumatic brain injury? When someone has well-and-truly forgotten how to move like a human (versus those of us who might just need to dust off those skills from childhood), can rebuilding this knowledge from an evolutionary and adaptive approach bring more success than a purely mechanistic approach? And what of those who are recovering from a long period of convalescence? Would a program that focused on the evolutionary “natural” movement of humans have greater success at returning appropriate balance and strength?
I definitely don’t have any solid answers, but it’s an interesting idea to ponder…