Unlocking Movement Options Through Test Retest Strategies

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Transcript

Lindsey Vestal Today we're going to do something a little bit different. I'm going to walk you through an exercise to illustrate the importance of test and retest and how individualized and progressive pelvic floor muscle protocols can really influence the healing journey of our clients. Let's go. 

Intro New and seasoned OTS are finding their calling in pelvic health. After all, what's more ADL  than sex, peeing and poop? But here's the question. What does it take to become a successful, fulfilled and thriving O.T. in pelvic health? How do you go from beginner two seasons and everything in between? Those are the questions and this podcast will give you the answers. We are inspired, OTs. We are out of the box, OTs. We are pelvic health, OTs. I'm your host, Lindsey Vestal, and welcome to the OTs and Pelvic Health Podcast. 

Lindsey Vestal I want to walk you through your own movement experiment today. Because I want to get curious about how narratives inside each of our own brains influence the way we move. Sound okay? I hope so. I haven't done this before, and this is a podcast. So it's a little funny to be talking you through a movement experiment, but I think there is something really powerful about audio because it does leave open interpretation. It does leave open the fact that however you move is okay because it's more about the fact that we're going to do a test and retest to compare and remain curious about the differences. And I think audio can be a really good format for that. The next question you might have is how does this translate over to our clients? It's my belief that an individualized protocol or an individualized lack of protocol, a customized program, can really influence the healing journey of our clients. So let's try this with a test retest. So let's say we have a client who comes to us, right? And maybe this client tells us that when they squat, it hurts their knees. So we can start with establishing their baseline performance. So naturally, how are they doing that squat? Let's look at their breath. Let's look at their mechanics and even things like how do they actually initiate the squat, what part of their body moves first? And we get all of this information in more simply by observing and by asking your client how it feels while they're doing the movement. All right. We're going to do this together ourselves in a moment. We can change one variable after we establish the baseline just to continue to see how the movement progresses and how we're feeling about it. And I usually suggest picking the one variable that jumps out at you, maybe the one thing your intuition is drawn to. All right. So for this client, this client who says squatting hurts their knees, perhaps I notice that the client is holding their breath throughout the entire squat. All right. So that's the baseline. The baseline has been established for this one variable. The next thing we do is simply teach them how to do it differently and then retest with this change. So this would mean that I would actually get them to blow before they go, or to initiate an exhale before they move their body into that squat. We would do this over and over again. So they were comfortable with it. And then I would ask them to retest once they understood how it was different. I'm going to assess it versus that first performance. And I'm going to ask them, how did it feel differently? And I'm definitely going to suggest that you repeat it for consistency, right? Have them do it quite a few times. 

Lindsey Vestal You can then move on and try a different variable if the first one didn't change much. Keep going until you find the thing that moves the needle, which is basically the experience the client is having with the movement. So another experiment after the breath, one could be, okay, let's try your next squat by initiating with your bottom. I've noticed that you usually bend your knees first. Let's try moving back towards the wall with our bottom. And maybe I place them against a wall. So they got that tactile feedback of what it feels like to have their booty move back in space. Okay. And then I would ask them, how did that feel? How did that feel compared to the first time you did it before we changed anything? Okay. And I would just keep going until a variable evoked a change. Okay. I find the best learning we can do is when we do it ourselves. So are you ready to give it a go? I want you to, if appropriate. If you're not driving a car or something else like that, I invite you to get onto your feet with enough space around you that you can do a squat. And we're simply going to do a squat today. So just go ahead. While I'm talking here, do your squat a few times. Just observing how you feel. Okay. Some questions you might ask yourself is what is the ease of the movement? How does it feel for you today? You know, and just let whatever answer comes into your mind be there. This is your baseline. This is your most natural uncrewed way of doing the movement, the way you're likely to do it when you're completely on your own, not in front of another therapist or a friend. 

Lindsey Vestal All right. So what is your performance like? Are you having any symptoms? Are you feeling what are you feeling? I'm not going to put words into your mouth. What are you feeling? Notice without judgment. Just simply ask yourself, what are you experiencing with this simple movement? Notice. I said notice without judgment, because I'm also inviting you to pay attention to the narrative or the stories that might be coming up. Some common ones are reasons why we're squatting in a particular way. You know, where did that reason come from? Did we learn it at some point and we just adopted it as the way we should squat? Or maybe we've seen someone else do it a certain way and we're simply mirroring it. Maybe a health care provider told us we should squat a certain way and that's the way we're doing it. Maybe you've heard something like squatting past our toes is an ideal or squatting deep is bad for our knees or that our toes always have to be straight ahead. Maybe, just maybe, these are some of the different narratives that you've subscribed to throughout the years. That's totally okay. Just notice. Okay. Now we're going to change our squad. We're going to introduce a variable. This is the first thing that I want you to try. I want you to start the squad again in the position that's the most comfortable to you. The most natural. The most familiar. For now, I want you to try going a little bit wider. So widen that stance, bring those legs away from each other and squat a few more times. How does that feel for you? Again, just listen to your body and maybe paying attention to the narrative that comes up. Okay. Let's try our second variable. 

Lindsey Vestal Now I want you to try to squat with a bit of a narrower stance than from your original baseline squat. And just notice how that feels in your body. Notice any narratives. Did you have resistance to doing either one of these things? Did your brain start to tell you a story? Something like this isn't right. This isn't this. This is not how I normally do it. This is not the way my body is familiar. Okay. Now let's try playing around with some more variables. I want you to start with your toes out now. So come back to that natural stance, the one you started off with. But I want you just to go point your toes outward from one another. So away from one another. Your heels are going to stay where they are and your toes are going to go out away from each other and squat a few times. Notice how that feels. Notice the ease in which you drop in. Notice the depth you drop into is any other parts of your body speaking up to you. Notice. At what point in this squat does your pelvis start to tuck under you? Okay, Perfect. Let's do another variable. Come back to that original original stance, the one that's most familiar and most comfortable. And simply try pointing your toes in. So keep your heels where they are and bring your toes towards each other and squat. Now, how does that feel within your body? Paying attention to any signals, any messages your brain is sending you. Okay, let's change it up again. Now try staggering your stance a little bit. So maybe pick one of your feet. Put him in front of the other. Put the other one a little bit further behind. 

Lindsey Vestal Feel free to grab on to something around your environment, such as the back of a chair or a table. If this feels unsteady to you again, it's it's there's not judgment here. It's experimentation. It's being curious. All right. Do that a few times and we can even try loading our squad. So if you have a book near you or a water bottle, grab that. Hold it in the front, hold it in front of you or hold it by your shoulders and try squatting. Perfect. Perfect. Again. Just gathering information. What is your body telling you? All right. Let's try changing now the pattern of your squat. See if when you squat, you can have your knees come forward more than they normally might. You know, you can kind of linger them forward longer. This is also called a knee dominant squat, right? We're accentuating how much the knees are driving forward. You can also try the opposite of this. So sitting back into your squat, limiting just how much your knees translate forward. This is what I did with that mock client at the beginning of our podcast episode where I had them feel their booty on the wall behind them. Perfect. All right. Last up. If you have something handy near you, like a rolled up towel or some pillows or a yoga mat, try squatting with something underneath your heels. So you're basically elevating your heels and trying to squat. Now, how does that feel for you? How is the ease in your body? How does it feel in your knees? How does it feel in your lower back? How about your neck? All right. That's it. You did it. Thank you for experimenting with me a little bit today. This is what we kind of call test retest. 

Lindsey Vestal It's a great thing to do with your clients to start to bring up those stories and narratives that can really influence how we feel about the different ways to work within your body, right? We start to feel and see things in terms of our accessibility, right? Like you may get them to have their toes pointed in and they might say, I was told I shouldn't do it this way. And this kind of opens up that line of communication where we are able to tell our client there isn't one right way to do anything, that it doesn't necessarily mean it's a bad thing to squat with your toes pointed in. You're simply checking in with your own body, your being the detective to your own body, asking yourself, How does this novel movement feel? And the cool thing is you can potentially unlock movement options that are available for you or for your client by simply having them play, by simply trying different strategies. Perhaps they've never tried some of them because they were told it wasn't the way to do it. This opens up this line of conversation between our client and us about remaining curious and about how I define health as having options and what's better than having movement options so that we can accomplish the same tasks but different ways. Right? We can learn that there are different ways beyond just one specific way, and that can be totally okay. Now, I like to tie this back a little bit into research, which is essentially looking for patterns. So when they pull data together, right, everyone is unique and individual and there are outliers in all of the research studies that are out there. Right. And when we look into research for general trends that could be beneficial for some, we have to acknowledge that it won't be true for every human being. 

Lindsey Vestal So we can reframe and say, okay, so here, here's these outliers that we need to recognize, and there's going to be outliers in research, and that person in front of you in your office just might be an outlier. It could be beneficial for some clients to keep their knees behind, you know, not going forward during the squat, but at the same time acknowledge that's not necessarily going to be true for every individual. So checking in with your client, how does it feel for them? It's so natural, my friends, to crave recipes and rules for how to get someone better. You may feel like, you know, just tell me the answer. I want to get rid of my client's knee pain. But here's the thing. The thing that works for everyone, unfortunately, it's not necessarily going to be the best approach. For everyone. And when we have that individual variation in front of us, we can start getting more and more comfortable with leaning on the test and retest strategy that we talked about today because it leans on our clients to tap into the wisdom in their bodies and how narratives affect it all. So here it is. There are infinite ways to make changes for everyone. So much we can explore with them and invite them to explore and be curious. You know, there's not just one way to do anything. And I don't know about you, but I find this incredibly freeing. 

Outro Thanks for listening to another episode of OTs and Pelvic Health. If you haven't already, hop onto Facebook and join my group OTs for Pelvic Health, where we have thousands of OTs at all stages of their pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and posted to IG Facebook or wherever you post your stuff and be sure to tag me and let me know why you like this episode. This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic Health Podcast.