When I go and see my personal trainer (also an exercise physiologist), or my physiotherapist, or my podiatrist, I inevitably end up apologising for and explaining my body, and how it’s put together.
These people have been treating me for a while, and it’s also literally their job to observe how I move. They know how my body is put together. Their job is to help me move more efficiently, with less pain.
I really don’t have to awkwardly, anxiously explain that my single-leg squat is super wobbly because my right leg has quite noticeable internal rotation and the leg is permanently twisted because years of bad motor habits mean that the bone and muscle have just grown that way. It isn’t possible to correct it – merely compensate for it.
So many exercises look awful when I do them, because my leg rotates inwards. I wobble. My back arches and hyperextends unless I’m looking in a mirror (or having a really good proprioception day. I do have those. They’re amazing, and everything feels easy).
I don’t have to feel awkward and anxious, but I often do.
I keep falling into this trap.
If I do these exercises, my body will move properly.
If I keep working at it, it will work as it is supposed to.
Everything will come together as it should.
I only recently caught myself doing this, and realised how incredibly misguided this thought pattern is. I can’t blame this on my support team – they never speak to me like this or imply that they’re trying to change my body. At some point or other, every one of them has made it clear that the goal is to try and get to the point where my body can do what I need it to do, in the most efficient and least painful way that it can, given that it has a few quirks.
I’ve been unconsciously thinking (up until recently) that there’s one perfect way for my body to move and function, some ideal system that I can get closer and closer to, like the Platonic bone structure and muscle activity that will mean I’m effectively not hypermobile anymore.
Not only will that never happen, but it doesn’t even make sense to think that way.
I have multiple chronic illnesses, and treating them results in conflict between the affected systems.
Core muscle activation is an excellent example.
Strengthening core muscles is a crucial part of managing Ehlers-Danlos / Hypermobility Syndrome. This is the area where most people are a bit weak, leading to back problems and other joint overcompensations – and for bendy people, it’s much, much worse. The collagen connecting our vertebrae is just as stretchy and unstable as the rest of the collagen in our bodies and we are terribly prone to our spines moving in ways that they just aren’t supposed to (not in terms of a Platonic ideal, but in terms of load bearing function).
I also have Crohn’s Disease, and visceral hyperalgesia stemming from that Crohn’s. Hyperalgesia means “too much pain” – basically, my intestines think they’re in pain all the time, even when there’s not necessarily a proximal cause. They’ve become sensitised to pain signals because of the long term effect of the Crohn’s.
My intestines are either inflamed most of the time, or they think they’re inflamed and behave accordingly (massive oversimplification, but work with me here).
It is not recommended that you compress your core if you have Crohn’s Disease, because it will hurt like a motherfucker, and also if you have visceral hyperalgesia, that will feed the sensitisation occurring in that region.
Whenever you tighten your abdominal muscles, particularly the deeper set that wraps around your spine, you are compressing your core.
So. Whenever I try to prevent back pain, I facilitate stomach pain. Whenever I slack off on core compression to ease the pressure on my stomach, I move so awkwardly and the angle of force on my joints is such that I get back pain, hip pain and so on, and simply moving is very tiring because the whole system is just incredibly inefficient in a mechanical sense.
(I’m aware that I’m implying here that I’m fainting away from constant agony. That’s absolutely not the case! My abdominal pain is very well managed these days, and I get plenty of low-level warnings from my joints before it gets unmanageable, so I have time to get my backside into gear and start working out properly – or take a break, if that’s what is needed. It’s really not that bad. I’m just trying to highlight the conflict between the two systems)
This also happens regarding my low blood pressure. I’m supposed to wear compression garments to help with the fact that the large blood vessels in my abdomen are just a bit crap (again, due to those gosh darned stretchy proteins). Compression helps blood move back up my body from my legs, up to my heart and brain when otherwise I’d just end up with exhaustion, light-headedness and brain fog.
Mind you – and you’ve probably figured out the catch – as stated above, deliberately compressing your abdomen when you have inflammatory bowel disease can be uncomfortable. It can also hurt like a motherfucker.
So. I pace myself with the compression garments.
The human body (actually, any complex multicellular organism) is a marvel of interconnected systems and patterns. We marvel at it all the time, in awe of how the hip bone connects to the thigh bone and the thigh bone connects to the shin bone, and it’s led to a bit of a hippy-dippy idea that all these systems will strive to work in harmony with one another, if only we can find that one perfect piece of health advice.
Unfortunately, that’s bullshit.
Body parts do what body parts do, physically, in response to chemical changes and application of force. It’s physics. My spine doesn’t give a crap about my intestinal tract, and my small bowel has no sodding interest in the pain in my hips.
What is right and appropriate for one system is a stupid idea and maybe actively harmful for another.
I could feel defeated by this. I could feel that I’m just fucked coming and going. I could use it as a cover to give up, to say “Well, damned if you do and damned if you don’t, so I don’t even care anymore.” And to be honest, I don’t know that I’d judge anyone else for that response. It’s fair, and it’s human.
Instead, I had this realisation, and I found it empowering.
Because, if that’s true – if there isn’t an answer that will untwist my leg and support my spine and heal my small intestine – then here’s no perfectly healthy, functional body. There’s no perfect ideal in which every part of me will work without rubbing up against the world in some difficult way. There’s no one secret plan to make all the systems work together. You just do the best you can, and work with the systems you can. Your body will do what it can in response to stimulus that it gets from the outside world, or from internal systems; and a lot of that’s not up to you.
What you can do is try to make some of it a little smoother, a little more manageable, a little less painful and awkward.
And suddenly: that little bit that I can do feels even more significant. It’s not one small step on the road to perfection: it’s me exerting some level of control over a difficult situation and experiencing victories that are, relative to what is possible, pretty damn magnificent.
You know what, it takes the fucking pressure off.
I can stop trying – however unconsciously – to make my body normal and just make it work.