Cunningham Technique - Exercise on Six: Investigation of Movement Adaptation to Pain (Image Recordings)

 Cunningham Technique - Exercise on Six: Investigation of Movement Adaptation to Pain (Image Recordings)

    As discussed in my previous blog post "Practical Investigation of Movement Patterns and How they Change Reacting to Chronic Pain" I have compared my movement when performing Exercise on Six in pain and pain-free conditions. Most of the days I do suffer from intense lower back pain, but sometimes it either disappears for a few hours or I use painkillers to manage it. For my research, I have mostly used painkillers in order to recognise the difference. I do acknowledge that the difference seen in the images provided below may be due to different factors besides chronic pain such as the amount of rest time my muscles had before, the mindfulness and anticipation of how my body will adapt to pain, and the readiness of my body's structure to perform the exercise. However, I have tried to document these changes as genuinely as I could, without exaggerating or underperforming any of the positions. I have documented the exercise in a continuous video that I have stopped and extracted to provide parts of it in still images. I do also want to mention that the pain adaptation movement not only happens when the body is in pain, but it has a long-term effect on how the body functions that cause imbalances in its structures. With that in mind, I have been consciously correcting myself when in class to try to even out my body without certain muscles compensating, yet still, I have managed to capture some of the changes in movement which I believe is due to the adaptation to pain.

To present the differences in movement I am using images from two different videos. The first one is me performing the movement sequence with pain and the second one is pain-free. I have also drawn red lines on the images to better visualise the discussed changes in the structure of the body.

Figure 1. 

    Looking at these two images (Figure 1) of me performing the very first movement of the exercise sequence I can already notice a few nuances. I can see that in the first image, which was taken from a video where I performed the exercise in pain, my right foot is opening up to the side that my torso is rotating towards. The left heel is slightly peeling off the floor, indicating that I am shifting my weight from both feet to the right one to facilitate a larger twist in my thoracic and lumbar spine. I also have noticed that I did open up my right knee to the right side in comparison to my pain-free image where my hips and feet stayed square and parallel. Even though these images are not shot directly from the side, which allows a slight play in perspective, I do notice a bigger twist in my thoracic and cervical spine as well as the chest. Being pain-free allowed a bigger amplitude of the rotation.

Figure 2 & 3

    In figures 2 and 3, I notice similar changes as previously discussed in figure 1, such as the foot opening to the side of the rotation in the image of the movement performed in pain as well as the chest being generally more open and expanded when pain-free. In this specific comparison, there is also a visible dip of the upper body (when in pain) compared to the expansion and correct alignment in the pain-free position. This again could be a compensation for my lumbar spine not having as big of a rotation as desired therefore there is a larger twist in the arms and upper body than the middle section of the torso in order to achieve the wished position and to protect the lower back by limiting the movement.

Figure 4

    Figure 3 is perhaps the most visibly obvious example of adaptation I have discovered. It is also very familiar to me as I have received a correction on this previously in my training, but never considered it to be connected to pain, rather I thought that it is a habit of mine to exaggerate the arch of the back using my pelvis because of the lack of flexibility in my middle back. In the first two images, it is visible how my pelvis is being pushed forward past my midline when arching the back. My knees, pelvis, and torso are all beyond my midline as well as the end of my feet. In the pain-free image, the arch happens mostly in the upper and middle back but doesn't sink into the lumbar spine, therefore the pelvis is not being pushed forward as drastically. It is not that visible in the images, but looking at the video footage when comparing these two positions I can notice a better articulation of the vertebras when arching the back in the pain-free video in comparison to the stiffened movement of almost pushing my pelvis forward in one lot and then arching the back without much articulation in the movement executed with pain.

Figures 5 & 6

    In figures 4 and 5, I perform the same exercise on the left and right sides. In the first image looking from the back, I can again recognize the sinking in the lumbar spine in the arch and the lack of articulation and amplitude of the upper back twist. My pelvis is again slightly pushed forward. Looking at the image of movement performed without pain to the right side, I notice a visibly improved range of the twist in the upper and the middle back compared to the restricted twist of the image above.

Figure 7

    In these images, there is a visible shift of the pelvis made to achieve a further arch to the back. Different from the previously discussed figure 3, the arch in the body happens in the lumbar spine area, with a straight spine rather than a curved one. It is visible how in the first image of the exercise performed while feeling pain, my knees go forward past my toes without the increase of the bend in the knees. My knees, pelvis, and torso are again moved forward to create an arch, while in the pain-free image, I notice how clearly the bend is happening only where my torso meets the pelvis, and my back is peeling off the midline, rather than passing it.