The Body Genius

02.23.2005 | Hannah Meyers | Science | 3 Comments
“Hey, do I look normal?” These poor drunk teenagers, walking home through Park Slope. It’s late, they’ve had one too many, and the tactile signals they pick up through their feet, send to their muscles using electrical signals and finally communicate to their central nervous system just aren’t coming through clearly. The brain can’t tell if the feet are hitting the ground in a regular gait, and the best that it can do is to generate speech, however slurred, asking for confirmation: Dude, am I walking right?” Thinking about walking is not always sufficient to get one’s body moving. Sometimes it takes the help of a trained professional.

I say this from experience, having had to relearn to walk after reconstructive knee surgeries. While I publicly claim it was a cosmetic “knee job”, I actually had misaligned kneecaps (patellae), which needed to be stabilized by arthroscopic surgery. Basically, what the surgery did was to lengthen the lateral ligaments and shorten the medial ligaments of both my knees. As well as bringing my kneecaps into better position, this also stabilized them and reduced subluxation — excessive and harmful movement of the patella.

Directly after surgery, my knees were roughly the color, size and shape of eggplants. My muscles were in severe shock and had atrophied to the point where they could not function. The communication between the neurons in my muscles was interrupted; the shock had disabled normal function. A man with a funny white gown had used state-of-the-art tools to shorten and lengthen various ligaments and change the distance between the bones and the muscles that comprise my knee joints. So I could sit up in bed, look at my legs, and tell them to move — but they wouldn’t.

All of a sudden I became aware that I was a much more complicated piece of machinery than I had previously had cause to appreciate. On a cellular level, the procedure had disrupted the communication between my central and peripheral nervous systems, meaning my brain could no longer tell my legs what to do, nor could my legs fill my brain in on what was going on down there. I had to relearn how to transmit signals back and forth between my brain and my muscles, and how to use the “pulley and lever” system that guides the mechanics of human movement. Most importantly, however, I had to deal with the emotional disturbance that comes from having a part of the body completely rebuilt.

To relearn how to walk, I spent a long time in physical therapists’ offices doing reps on stationary bikes. First, PTs give you electric stimulation, sending signals into your muscle cells to get them to contract and expand. They send these signals into your skin through a goopy jelly that make any self-respecting person feel uncomfortable and vaguely disreputable. Once the muscles have been buzzed, they are set to work. I had to slip my ankle into stirrups (again, uncomfortable and a bit disreputable) and lift weights up and down. After zillions of reps on my stationary bike, my knees would hurt as badly as before they’d been reconstructed. And I had the uneasy sense that PTs have no idea what they’re doing.

After months of frightening setbacks that made me doubt whether I would ever learn to walk again or be free of pain, I started working with Native Texan Cherlyn Smith, the Associate Artistic Director and a performing member of the Isadora Duncan Dance Company Dance Foundation/Lori Belilove & Company, whose years of professional dance have given her a profound understanding of how the body moves and functions. PTs exercise muscles; Cherlyn solves problems, helping each person who comes to her — most all of whom find her through word of mouth — figure out how best of be rid of the pain and infirmities that plague them. Her clients have awarded her with the nickname the Genius.

Many like myself come to the Genius after an accident or a surgery, but others find her after years of chronic pain. She calls these injury by event and injury by attrition. An event is a sudden occurrence, like a fall. But the difference is less obvious than it seems, she explains: “Often what appears to be an event is actually attrition. For example, take someone who makes the bed, throws the covers, and her back goes out. Nothing ever goes out from one movement. Picture a pencil going to the edge of a desk and one day it falls. It didn’t suddenly fall; it was working toward the tipping point for a long time.”

When I came to her, I found an entirely different approach than that employed by the PTs. She addressed my problem on three levels: cellular, mechanical, and emotional, and was aware of how these levels intersected. She was able to communicate what she knew to me, in terms I could understand.
To find the pain, she explained to me in a recent conversation, “The most important thing is to watch them walk; observe as they stand, sit. Normal motions. Sometimes if I think that they’re amending or being too careful with their movements and it’s not how they really move, I’ll ask for a glass of water, follow them to the kitchen, watch how they reach for the glass and spy on them. That will tell them more than anything else… With knee or lower leg issues, I’ll lie on the ground and watch them walk with my eyes at foot level, which can tell me more than I can observe while standing.”

After watching me move, Cherlyn fixed upon the minute points at which things weren’t going right, where my muscles were failing to work together to accomplish a motion. This approach differed markedly from that in physical therapy, where the focus was on one muscle at a time, not on the interaction between several muscles, which is of course how we all walk, lift things, sit, stand, or do pretty much anything else.

For example, she realized that my big toes were splayed out like the opposable thumbs of orangutans. Well, not quite that bad, but they were spread far enough from the rest of my toes to serve as a balancing point on their own. So she had me exercise the muscles in my big toe that run into my foot and bring the large and second toes into proximity. I did big toe exercises with rubber bands strapped around the toes to apply resistance. (It looked ridiculous).

By focusing on small motions and particular interactions of muscles, I made a lot of progress. It took three years before I no longer had to think constantly about walking in order to do it. Until then I had a series of external checks that I could do: feet turned out at the right angle (check), slight curve in back (check), shoulders in line vertically with hips and ankles (check).
“It’s like that song,” Cherlyn says: “the hip bone’s connected to the thigh bone…” When either surgery or training has changed the alignment of bones or of a joint, everything else changes. The problem she is looking for isn’t always in the spot where a client is experiencing pain.

I asked how she knows what sort of exercise to assign a person. She replied, “Sometimes instinct: just look at which way I think something needs to go.” She went on: “The body is pulleys and levers – very sophisticated ones – tied into various emotional and intellectual activities. It’s a matter of what’s too long and what’s too short, and how do you create a balance lengthening and shorting to pull the body into a better neutral posture.”

Having a clear image in your mind of an action that you want to perform genuinely helps, Cherlyn believes. Simple visualization affects muscles. Athletes are often instructed by their coaches to imagine, for instance, hitting the perfect spike over the net. (Experiments have found that adults can increase the strength in their pinky fingers and elbow flexors simply by spending time imagining working these muscles.)

As part of teaching, Cherlyn often gave me ways to visualize the movements that I was trying to do. For example she described a lamp that is too far from an outlet, and compared it to two of my bones that were not properly aligned.  Just as the light will not turn on until the plug reaches the socket, my muscle would not begin to work until the underlying bones were in the proper positions.  This image helped me grasp the change that my exercises were intended to bring about — and to achieve this goal.

The Genius has spent years considering the body and developing techniques training it. “Some are things I’ve learned and others are adaptations.  Some I pull from dance training.  And some are improvised on spot because nothing I’ve already taught is working for that person’s issues.  Necessity is the mother of invention and I play with making it right until I get it.”

And there’s more brainwork involved in how a person stands, moves, and slouches than one might expect. Ms. Smith recounts one episode in which “I had a client with a lot of back issues and a slouch movement habit. I worked with her brother, and he had the same thing. Then I saw a picture of the whole family. They were very, very Catholic — just the hiding the genitals thing. You’ll see very often in one family the same postures. A lot of is learned responses, and sometimes it’s also genetic.”

Then there are social postures: “I have a friend and colleague – she’s a movement therapist …and she works with prison populations among other things.  And there is what they refer to as Rapist Posture.” She stands, thrust her pelvis forward, and retracts her shoulders. “You see somebody coming at you like that, run away!” And emotional postures. The Genius pitches her head forward menacingly, and booms “What do you want to know?  I’m going to tell you!” Or a different sort of openness: she pulls her chest in and slumps her shoulders: “Sadness and withdrawal. Get someone to open this up (indicates chest, shoulders, neck) and she will burst into tears.”

Now when I run to catch a bus the experience of running is simultaneously odd and elating. To be executing effortlessly something that used to be barely possible and extremely painful makes me feel that reality has changed, that a miracle has occurred.  When I run, I am aware that all the parts are working underneath me, and that they are all doing this merely at my internal command: “catch that M5!”

I am a prime example of what Cherlyn knows: “Once you take that skeleton that is put together with the ligaments, and the muscles become the pulleys to the bones that are the levers; and once you now put that with a person’s life experience and psychological makeup, it’s not so simple anymore, which is what makes it so fascinating. It’s the combination of concrete and non-concrete that make it so interesting.”

Very nice article. Makes me wish I had had reconstructive knee surgery. Not really. (I mean, not really about the knee surgery, it really is a very nice article)
02.23.2005 | RMC
This is such a moving and well-written chronicle of what was clearly a traumatic yet transformative experience. It is a deep meditation on who we are and also a useful, straightforward piece of information.
02.23.2005 | Ruth Gais
I have to thank Ms. Meyers for making me wonder if I'M normal. She's enticed me, with her light touch and detailed prose, to re-evaluate my erratic and sometimes painful relationship to my neck, spine, hips and knees. Maybe I'll check in with The Genius now.
02.24.2005 | S.K.Y.

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