This is my arm.

It was some years ago, at about 7.30 in the morning, that I witnessed a beautiful occurrence, beautiful to me at least. I was with a client in a park in Oxford – Bury Knowle Park. It was the first of a bout of sessions with the client to help them with rehabilitation of a spinal issue and of their right shoulder.

The park is relaxed and quiet at that time. It was spring and on this particular day the sky was a bright clear blue. The early morning carried with it the last chill of winter and a freshness that invited you to look forward to summer.

From 7-7.30am we had worked on gait and spinal alignment. At 7.30am we moved on to their right shoulder. The shoulder was subject to an old injury. This, combined with the spinal issue, meant that their right shoulder was rounded forward about two inches (five centimetres). Such a shift in alignment made press-ups difficult and unbalanced. The left arm and shoulder took most of the load which is transferred into the spine as a rotational load. In such circumstances shoulder rehabilitation is important because, if unaddressed, the misalignment would serve to anchor the spinal problems.

I watched them perform several press-ups against a wall, and two shoulder joint movements: raising their arm forwards with movement at the shoulder joint, then raising their arm sideways, again at the shoulder joint. If you only looked at the forward movement you’d have thought all was reasonably well. The sideways movement, in contrast, was limited. They seemed to want to move their body to help out by hollowing ans twisting their lower back.

I understood what was happening and immediately set to implementing the corrective actions. Firstly we released tension from the front of the shoulder area. This is to reduce the amount that the shoulder was held rounded forwards. Releasing allowed their shoulder blade to be in a better relationship with the ribs which means it could act as a better foundation for shoulder joint movement. This more aligned position would need to be strengthened by applying shoulder joint movements with the shoulder blade staying in place. From experience I knew I would need to help stabilise the shoulder blade. I did so and invited them to repeat the first of the two shoulder joint movements they had just performed – to lift the arm forwards moving at the shoulder joint.

I am usually very specific about instructions because the words are the language of the mind – pedantic even! In this case the response was so clean and clear, that it was transparently not what I had asked for. This is what was beautiful.

With the improved alignment of their shoulder blade, which I was helping to hold in place, I had asked them to raise their arm forwards at the shoulder joint. Instead of going forwards the arm smoothly lifted sideways. It was ninety degrees away from their desired and instructed movement.

What made it even more beautiful was that they weren’t looking at their arm, so I invited them to look and their face was a picture of incredulity. They had sent a message to their arm to lift forwards and, unknown to them it had lifted sideways!

They lowered their arm back to rest and looked at me as though I were some magician as though that would be a better solution than their not knowing how to move their own arm.

How could this happen? They had known exactly what was desired as they had understood the instruction not moments before and successfully complied with it. They were fit in mind and had a sporting background which usually helps with body awareness, and movement instruction.

Before explaining I asked them to have another go. I held their shoulder blade in place once more and asked them to lift their arm forwards. A look of concentration mixed with disbelief coloured their face. They stopped breathing, too, as they sought to perform the movement. Such signs spoke of just how much harder it was to perform a movement they had thought they could already do without thought. Pin performing the desired movement the range they achieved, instead of being over ninety degrees, was closer to half that. After four such repetitions they were fatigued and lowered their arm.

Again they looked to me for an explanation, as you might expect. I explained, putting their mind at rest.

One of the topics that fascinates me is how much we don’t notice about our behaviour, and that someone can instruct their body to do one thing and it does something else.

In this case the explanation feels a bit like explaining a joke, sort of disappointingly mundane. If you don’t want to spoil the magic skip to the asterisk!

The explanation is as follows: with the shoulder rounded forward the muscles that would usually lift the arm forwards are now in a position to lift the arm but across the chest, so not forwards. The muscles that are in a position to lift the arm forwards are actually on the side of the shoulder joint. After a short while these muscles on the side of the shoulder joint become the ones that respond to the message: ‘lift the arm forwards’. It’s a re-labelling of the muscle functions. As part of the same shift re-labelling occurs for lifting the arm sideways too. The muscles on the back of the shoulder start to do that job, even though they are ill-equipped to do so.

When I had released the front of the client’s shoulder and drawn their shoulder unit back to a better alignment I had not changed the neural connections. Their instruction to lift the arm forwards was still going to the muscle on the side of their shoulder joint so the arm lifted sideways. They did not notice because the muscles they had trained were still doing responding as they had been trained to do, to the words: ‘lift the arm forwards’. Only when I asked them to look did their mind realise there was a problem, yet it couldn’t work out what because there were no alarms during the process telling them something was wrong. The muscles responded just as they had been trained to do so, but the arm was in the wrong place!

That they were shocked is because they had believed that in asking their body to perform a seemingly simple action it had not done so and gave no feedback, until they looked at the arm, that it was in the wrong place.

Ironically the alarms arose when they sought to get the proper muscles to work. These muscles were relatively unused and didn’t respond to the request for their proper function: ‘lift the arm forwards’ because there was very little neural connection to them. They were not trained to respond. In fact the mind was saying: ‘it can’t be them because they are not doing what we want, and even what they’re doing is so effortful it must be wrong. I am not this weak! I have also seen my arm lift forward so this has to be wrong.’

With discipline and practice the client was able, over several weeks, to develop the desired neural connection and to strengthen the relevant muscles, which included stabilising the shoulder blade so that they didn’t need help from someone like me. They could proudly lift their arm forwards, sideways, and backwards at the shoulder joint using the muscles that had evolved to do so. As a result there was no reinforcement of the spinal issue and they felt more connected with themselves!

* I see examples of this and similar patterns of behaviour all the time. This example is the cleanest and most beautiful example of us not noticing or understanding how our mind and body are working.

Two others that are related serve to illustrate just how disconnected we can become from ourselves. The first is a client who was rehabilitating from a broken upper left arm. The break was about three to four inches [seven to ten centimetres] from the top of the arm. This is a common point of fracture when people fall.

On this occasion it was a lovely sunny morning and I had just finished teaching a class. People were chatting and the client, who knew them well, came in to ask for some advice and also to ask when she could return to the class. We agreed to have thirty minutes work on her left arm and shoulder once people had gone. The next fifteen minutes were people catching up with her, and asking how she was. She confidently said everything was going well and she hoped to be back soon.

She had been through the healthcare system and had had a couple of physio sessions. She was diligently practising the exercises she’d been given, bar one which she didn’t get on with.

I wanted to see how she was moving and to see what she had been doing. She took out the pamphlet she been given with its half a dozen exercises and started at the first one – lifting the arm forwards at the shoulder joint.

I know you may be thinking is this going to be a re-iteration of the prior example. No. This is more intriguing.

There were two black and white illustrations for this exercise. They showed the start point and the ideal end point. The start point was a man with an upright spine and his right arm hanging by his side. The second was the same upright posture and the arm lifted up toward the ear. I say ideal as this movement is not possible for lots of people most of whom have not injured their arm or shoulder. I should also point out that the diagram wasn’t clear on the path the arm should take. The instructions were also not specific although the implication was to lift the arm forwards.

On a minor point the man was emotionless whereas I like the idea of them smiling throughout.

I asked her to demonstrate how the exercise was going, and frankly I was shocked. It was beautifully strange, and totally understandable.

What happened was that her upper body tensed far more than was needed and, with a lot of effort, she leaned over to the right. Her left arm tensed too, right to the finger tips. She stopped when her left hand was higher than her head. She smiled and returned to the start position and said that the exercise was going well.

At this point I should point out that each of these examples are of people who are in their right mind, educated and who held down positions of responsibility.

I asked her to start the movement again, stop a little bit from the end and describe what she felt she was doing. She did so, returned to the start and said she was getting her hand above her head as the diagram showed. I pointed out, politely, that the diagram showed no movement in the spine, whereas she was leaning to her right. She agreed she was leaning ‘a little bit’.

To help her realise what was going on I stabilised her spine so that she couldn’t lean. She sought to lift her arm and very little happened other than her body going into high tension whilst she became increasingly frustrated. She turned to me and said that I was stopping her from moving her shoulder. I pointed out that her arm was free to move at the shoulder joint and that I was constraining her from leaning her body. So she tried it again. I pointed out that the movement she’d been training was for her spine to give the impression of lifting her arm and that the shoulder joint was moving barely a few degrees whilst getting ever tighter. The tightness was then acting to reinforce the limitation.

She sagged in a semblance of defeat. The wind had been taken out of her sails – all that effort and now she realised that she had not been doing the exercise at all. Thankfully she has enough gumption that I can be relatively blunt about what’s happening, and that is true for all my clients. It means we can move on and into correction swiftly.

We worked on correcting the issues around the shoulder and she returned to class the following week. I invited her to do so so that I could prompt and encourage her to free the shoulder joint and retrain it sooner rather than leave it as it was. She’s making great progress.

Why did she end up leaning? Why was she not noticing what was happening at her shoulder joint which was the focus for the rehabilitation?

The mind seeks an outcome. In this case, with very little post-trauma shoulder joint movement and the two images her mind, she had inferred the outcome from her interpretation of the second image. This outcome, to her, was to ‘get the hand higher than the head’. She couldn’t do it by movement at the shoulder joint and so her brain had found an alternate solution – to bend in the spine.

The goal of ‘getting the hand higher than the head’ is totally different from ‘moving the arm at the shoulder joint’.

You may think this is rare whereas it is actually a very common problem. It is just that this client’s actions present an extreme example. In essence if you ask your body to get your hand higher than your head you either raise your arm through elbow and shoulder movement to do so, or you lower your head, or you do both. The brain senses the hand is higher than the head and is satisfied. Then the action and neural pathways between the brain and the body are reinforced until this is the way you address that request. For this client ‘lifting the arm at the shoulder joint’ becomes ‘bend your torso to the right until your hand is above your head’. The more you do it, and it may only take three repetitions to learn this, the more you reinforce the unhelpful pattern.

The third example of not knowing our body is also beautiful, not just beautiful but beautiful and funny. I should say, just to be clear, that I do help people move past these situations. I find them beautiful and interesting because if I didn’t I would find it hard to continue to do my job – for me there must be intrigue and fun at work. I also work on the basis that making light of our behaviours invites us to smile and to laugh, to relax and to willingly make a change. The issue is the issue and remaining serious can lead to retaining unhelpful tensions which impair our efforts to change. Also, it’s very hard to laugh without your core muscles working, and they are key to successful rehabilitation of most any part of your body.

The final anecdote is of a friend who attends classes and occasionally has a one-to-one session to address specific issues. We were in the middle of the first one-to-one session addressing lower back issues. One of the aspects of what I do is to look for tension patterns that seem to contribute to structural problems. His postural patterns suggested, to me, someone who sat cross-legged. When I asked about sitting cross-legged he said, quickly and definitively: “I don’t cross my legs. I never cross my legs.” I replied: “Okay, well it will be something like that. We’ll see what else arises.”

As we moved through corrective exercises nothing else came to mind. I did ask again about cross-legged behaviour and he again denied doing it. Recollecting the biblical story of Peter denying knowing Jesus three times when Jesus is arrested I thought, for surety, I would ask a third time, smiling. Again he denied crossing his legs. “I never cross my legs.” He smiled too, probably thinking I was being a bit daft, rather than unwilling to accept his assertions.

We finished the session well. He had exercises to perform to reinforce the progress made in the session. Afterwards he invited me to stay for a cup of tea, and I accepted. It was a sunny afternoon and I had no appointment until the evening. Although we rarely sit down when I pop over to see him and his family, for some reason we did on that day.

Within thirty seconds he had crossed his legs. I smiled and politely said: “That’s interesting. You are crossing your legs.” He looked down, nonplussed: “Oh, yes. I don’t do that.” In saying the words he uncrossed his legs and we carried on chatting.

Within thirty seconds he had crossed his legs again. I smiled again and politely said: “That’s very interesting. You are crossing your legs and yet you don’t do that.” He looked down, frowning: “Oh, that’s strange. I don’t do that. I never do that.” In saying the words he uncrossed his legs once more.

On the third occasion I just caught his eye and looked at his crossed legs. He uncrossed them, and put his hands on his thighs as though in a bid to notice any shift, even in an endeavour to prevent his legs from crossing, if they felt the urge to!

After having explicitly noting this behaviour three times I know, from experience, that people can become quite frustrated if you keep pointing it out, so I chose to just subtly raise an eyebrow.

They continued to cross about every thirty seconds. I would raise an eyebrow. He would look down with a variety of expressions on his face from surprise to frustration and annoyance.

After half a dozen more crossings and uncrossings his increasingly tense body relaxed and he burst out laughing: “I don't understand how this can be happening. How can I not have known this? I can’t believe it.” At which point he decided to stand feet apart so that he could not cross his legs at all. Doing so removed the behaviour and the feeling of being a fool for not knowing what his body was doing.

The issue for this client was that in crossing his legs the resulting asymmetric tension was aggravating his lower back. Doing it subconsciously meant he was unlikely to be able to correct it.

Part of the aim of the mind is to make behaviour subconscious, in effect to automate them. Life becomes easier to handle if behaviours are automated.

Such behaviours are either innate or have been trained in. They require no conscious feedback or active attention on our part. These behaviours can become so automated that we cease to notice ourselves doing them, and that’s the whole point. They require no conscious mental effort allowing our conscious mind to focus on other things. This freedom from conscious involvement means that such behaviours, whether simple or complex, can happen swiftly and consistently. Many of these behaviours are actually quite ‘large’, that is to say that they are readily noticeable, if we choose to observe, just like crossing our legs.

By bringing the subconscious action to his conscious mind my friend had the challenge, and opportunity, to re-learn how to sit. By explaining all this to his conscious mind he didn’t feel like such a fool. It’s been good to see him change. He can now sit without his legs crossing. As a result his back strength has improved, and he is feeling much the better for that.

There are many other examples of how we get into movement and behaviour patterns that don’t serve us, and yet they are so ingrained and reinforced that we may never spot or change them. Perhaps you will see something in yourself that you had never noticed before, something you can choose to change ... if you wish.