REHABILITATION

Figure 8: Right leg stance phase in walking

TIP

Practise exactly the movement you want to get better at

HABIT

A habit is what comes easiest to us. It is easiest because it is what we have prac- ticed most often.

Human beings are creatures of habit in all we do. We are at our most ‘comfortable’ (or familiar) when resorting to habitual behav- iour such as training routines, favourite sitting posture when watching TV, or choice of music. These habits are stored in our subconscious, through repetition, and referring to them brings us a level of com- fort (familiarity) even though they may be harming us in the process eg. smoking.

The same applies to physical habits such as leg crossing or slouching. These are fixed, subconscious ways of using the body brought about through repetition, and although they may not be totally ‘comfort- able’ for us to perform, they are familiar, and associated with a level of personal security. After a while it will feel totally normal for one to experience discomfort, stiffness or shortening but because these movements are ‘normal’ to us we continue. Asking the person to move or sit in a bal- anced or aligned way will take them out-

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Figure 10: Enhanced view of improved foot posture compared to figure 8

side this comfort zone, and the new activ- ity will initially feel wrong, though not necessarily painful.

How do we form habits? Habit formation can be seen as the inter- section between knowledge, skill and desire (13). This applies to movement pat- terns, as movement (the skill) may be a physical response to stimulation (the desire and the knowledge). The first attempt and experience of a movement is formed in the conscious mind. When this movement is repeated over time in response to stimulation it becomes entrenched in the subconscious mind, and the movement becomes automatic. A new motor skill or habit is thus learnt.

Carr and Shepherd use this process within the motor relearning programme as an effective way to teach functional move- ment patterns (14).

Figure 9: Right leg single leg dip

Figure 11: Improved foot posture reveals extent of TFJ malalignment

Figure 12: Enhanced view of improved foot posture compared to figure 6

Can we change habits? The good news is that given the following circumstances, habits can be changed and new patterns of movement can be taught.

In order to re-educate faulty movement or posture, the individual must first become aware that what they feel they are doing is not what they are actually doing.

■ an understanding that their habitual pattern of use is detrimental to the body

■ an awareness of a positive alternative movement or posture

■ motivation to make change either from a desire to feel better, or to improve performance

■ reinforcement through repetition throughout the day, using functional activities because these are more meaningful to the brain.

POSTURE Posture can be defined as a snapshot in time of how we have moved or posi- tioned ourselves. Alexander acknowl- edged the importance of strength in what we commonly call postural muscles within the human body (15). Now described as local and global stabiliser muscles, they have been the focus of much research (16, 17). This research has shown postural muscles to display the following characteristics:

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