The awesome Luke (with pet pooch Bob. Yeah, I know, CUTE LEVELS OFF THE CHART!)

I am so excited to launch the inaugural Expert's Chat feature on the Mad To Live Blog where I hand over the reins to an expert, someone who is somewhat shakin' things up in their specific field, somebody who is something of a renegade, with a new approach, a new outlook or/and a highly effective hypethesis or ethos that they can share with you and I.

First up, we have Luke Worthington. Luke recently grabbed my attention when he suggested some pretty out-there therapy I hadn't heard of to resolve some ongoing uper body/shoulder pain/leg pain (head to toe basically. Doh.) I've been dealing with. Luke has a lifetime of experience in international and elite level sport. Having been a two national athletics champion, he went on to pursue a successful career in rugby, playing for Premiership team Harlequins among others, and is a former world endurance rowing record holder. Over the past 20 years Luke has worked in the UK, USA, and Russia, gathering experience of working with and alongside some of the World's leading athletes, coaches, and medical professionals(note: this is a man who knows his sh*t.)

Spending some sessions chomping on sticks, blowing through my mouth and squeezing balloons between my knees to cognitively re-set my body and elimminate pain, his progressive approach to pain management, PRI, is, in layman's terms, a way of making sure you can use your body to do more of the sports you love without it breaking down on you. He is the only person outside of the USA qualified to do this and is basically the yoda of pain management. Here he introduces us to PRI, and how it is relevant for action sports. Action sports afficionados are normally well versed in pain & this is a man with an approach that can totally shake up common conceptions about pain management. Check it out, and find out how it can help you.

PRI FOR ACTION SPORTS

Firstly a massive thank you to the astoundingly awesome Sophie Everard for allowing me to write this piece for her blog. Injury management is very much my ‘thing’ - having spent many years smashing up my (and other peoples) body on a weekly basis, I have, over the past 15 years or so gone through a paradigm shift in the way I approach physical preparation for both myself, and the athletes that I work with.

One of the very first conversations that I had with Sophie was around how she may be able to manage a little shoulder niggle that had come about from many hours of surfing, boxing, and generally being a total badass.

The purpose of this piece is not just to share the techniques we used in that session, but also to help to spread the word to the wider action sports community about how to bulletproof their bodies and keep them doing the things they love for longer.

A LITTLE BIT ABOUT MY APPROACH

Injury management, rehab, prehab, corrective exercise (<--- insert whatever fitness industry buzzword you like) professionals, have come to the fore quite significantly in recent years as we have sought to narrow the gap between clinicians, and coaches, and I would very much consider myself to be part of this movement.

This group of professionals, although striving for the same end goal, have typically fallen into two camps with very distinct ideology: the autobots and the decepticons : mobility guys, and stability guys, in other words one group focuses on stretching what is tight (your yogis can probably sit here too), the other strengthening what is weak. Both of these approaches are ‘right’, but in my opinion there is a more important question: which is WHY is something tight or weak? To answer that question we need to consider position and posture. So the answer to the am I a mobility or a stability guy is neither – I am an alignment guy. That is not to say that my approach is the ONLY one, far from it, but it works, and for reasons I will come on to, I believe it to be specifically appropriate for the actions sports community.

WHAT IS POSTURE

‘Stand up straight’, ‘chest up shoulders back’ are common phrases we’ve all heard thrown around to improve posture or exercise technique. However, the more we learn about the body, the more we appreciate that posture is more complex than simple body alignment – posture is a highly integrated co coordination of multiple systems that the brain arranges to control our centre of mass against gravity – phew, if that sounds like a mouthful its because it is! Another way to look at this is that we should consider posture as the relative position of the body at any one period of time, not a static ‘snapshot’ of position but rather a dynamic state neuro reflexively regulated as our body orients itself with whatever task is at hand. i.e., when something shifts one way, somewhere something else in the kinetic chain must shift the other way. Think of it as a gigantic living game of Jenga.

Environmental, psychological, and positional factors all have an influence on movement patterns that affect our posture. These patterns reflect our ability to breathe, rest and rotate symetrically with both the left and right hand hemispheres of our structure.

In other words we can move freely without restriction or compensation.

AND WHY THE HELL DO WE CARE?

So now we have gotten some biomechanics principles down – one of the key questions I expect people to be asking is why should you give a sh*t whether your hemispheres can reciprocate when all you really want to do is get out there and do what you love?

When our fundamental asymetries become too much to manage without compensation (think back to the Jenga) movement becomes restricted in as a result of improper joint and muscle position. This essentially means we will create excessive neural ‘tone’ (tension, tightness, hyperactivity, all means the same thing) in certain muscle groups and is akin to attempting to drive your car with the handbrake on.

Good posture or position should not entail constant active muscle engagement. Over engagement is a sign of compromised position – the effort it takes to stand upright against gravity should be minimal and undemanding.

WHY IS THIS RELEVANT FOR ACTION SPORTS?

Action sports, almost by definition – require you to have to be ‘in or out’ you can't, for example, half heartedly jump out of a plane!

Action sporters (if that’s not a real word then it should be) therefore, are some of the most amped, extended or permanently ‘on’ individuals I have ever come across. These guys are on their toes, eyes wide open, 100mph ready to catch a big wave, take off the end of that jump, or I don’t know, wrestle a dinosaur at a moments notice.

Is that a bad thing? Not at all – so long as we can also switch that shizzle off.

Biomechanics and psychology are mutually dependent:

* In neuroscience terms, turning things ‘off’ requires the individual to start to use more of their parasympathetic nervous system (recover, rest, and digest), turning them ‘on’ requires more sympathetic activity (run, jump, wrestle dinosaurs).

*Biomechanically when we assume an extension posture (chest up, shoulders back) we can exert more power and produce more force

Physiologically our sympathetic ganglia (the parts of our brain that stimulate the sympathetic nervous system) are not actually situated in the skull, but rather in the thoracic spine. Therefore when we are in an extension posture we will compress these ganglia, stimulate the sympathetic nervous system, and become even more extended, more stimulated and so on… fantastic if we’re in the middle of a zombie apocalypse – but marginally less fantastic if we want to sleep at nightor have our bodies move without fighting against ourselves.

Extension posture, alert, on, sympathetic nervous system dominance

Flexion posture, rest and recover, parasympathetic nervous system dominance

WHAT CAN WE DO ABOUT IT?

Fortunately quite a lot!

One of the most effective ways of down-regulating an overactive sympathetic nervous system is simply to exhale…

As simple as that sounds most of us, especially not dinosaur wrestling surf ninjas, are guilty of living in a state of permanent inhalation and never fully emptying our lungs. Exhaling fully requires us to retract our rib cage, dome our diaphragm and use our internal obliques to drive air out of the lungs – if we do all of these things there will have to be a certain amount of flexion in the thoracic spine, that means no direct stimulation of the sympathic ganglia, giving an opportunity for the parasympathetic systems to take over (this is one of the reasons smokers feel less stressed after having a ciggie – nicotine is a stimulant – it’s the neuromechanical action of blowing out the smoke that calms them down).

SO WHAT CAN WE REALLY DO ABOUT IT?

Blow up some balloons – for real. The exercise I would most recommend for action sports aficionados is to sit on the floor with knees bent in front of you, and your back about 2-3 inches away from a wall, place a balloon in your mouth, take a deep breath in and try to fill a balloon with as much air as possible whilst trying to touch the wall behind you with the back of your ribcage. Repeat this 2-3 times as close as possible to when you’re about to take part in your sport.

If you can fully exhale you can reduce sympathetic tone, shut down some over active muscle chains, reduce injury risk, improve rest and recovery, and most beautifully: permit full, unrestricted, and pain-free movement, that means being able to cut a turn both ways, switch your stance, and find that mythical ‘flow state’ that each and every one of us who enjoys action sports is really craving.

Sciencey reference for the balloon exercise to prove I’m not a weird balloon creep:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971640/

Thank you Luke, and stay tuned for our next Expert's Chat with martial arts prodigy and movement coaching renegade, Jamie Ray, and more from Luke Worthington soon!