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When is the mind-body connection NOT the way to go? In yoga and in physical therapy we often encourage focused attention inward and an increased ability to perceive sensation throughout the body. "Notice how your shoulder blade moves with your arm." "Can you feel your abdominals draw in before you lift your leg?" "Does your hip hike up when you take a step?" Etc, etc.... However, there are times when doing the exact opposite, shifting your attention away from the body results in better outcomes of physical function. An article in the March issue of the Journal of Sports and Orthopedic Therapy (JOSPT) highlights an example of when it's best to disconnect. The study compared athletes with functional ankle instability due to a history of sprains to those without instability. They demonstrated that those with instability had worse balance when faced with a cognitive challenge of repeating a string of numbers backwards. The control group did not show any worsening of balance when performing the same cognitive challenge. This means that those with functional ankle instability compensate by paying attention to the act of balancing and one could extrapolate that they will not be able to return to full function unless that compensation is eliminated. The authors, referring to a previous study, state that “researchers have provided evidence that instructions directing the focus of attention away from the postural control (i.e. external focus of attention), rather than toward the postural control (i.e. internal focus of attention), may be more effective in balance training.”
Because we rarely have the luxury of focusing solely on balance in our daily lives, those with functional ankle instability need to train their automatic postural responses by eliminating the compensation of attention to balance. So while doing a tree pose in a yoga class or steamboats in a PT clinic may be good places to start balance training, it probably doesn’t go far enough. If you or your client has functional ankle instability consider having them memorize a poem, do some arithmetic or some fun brain teasers the next time they are hanging out on one foot.
Lisa Minn is a licensed physical therapist and yoga enthusiast. She has been incorporating aspects of Yoga and Pilates into her physical therapy practice since 2001 and became a certified yoga instructor in 2004. Her experience ranges from working with athletes at West Point and Georgetown to instructing elderly and wheelchair-bound clients in the fundamentals of Hatha Yoga. Lisa has conducted several lectures and workshops across the US, as well as in Honduras and Peru, where she volunteered her services. She currently resides and practices in Northern California. This and other articles by Lisa can be found at The Pragmatic Yogi.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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