In William Shakespeare’s “Hamlet” the young prince is seemingly torn by the grave injustice which he perceives as his existence. So much so is he torn that he contemplates the alternative to his own existence, being of course the end of his own life.
A bit dramatic wouldn’t you say?
But such is Shakespeare, and such is the job of a playwright. To make a juxtaposition out of a molehill and wow the audience to the point of spending obscene amounts of money to see the “latest and greatest” coming soon to a theater in the round near you.
Why am I bringing this up in a health care/strength and conditioning blog?
The same holds true for much of the recent teachings of the self-proclaimed William Shakespeare’s of the lecture circuit in healthcare/s&c. But instead of holding a skull and professing to end a seemingly woeful life, they are holding a laser pointer and professing to have the secret to bullet proof this, and injury proof that.
One of the latest trends I have noticed, especially in patients with lower back and hip pain complaints, is “crawling” for the resolution of primitive reflexes.
First off, where in the brain do the primitive reflexes live? Frontal lobe? Cerebellum? Basal Ganglia? Thalmus? Mesencephalon? Brainstem?
If you do not recognize any of these regions of the brain and cannot explain what they do, then never mention the words “primitive reflex” again. You have not earned the knowledge necessary to tell a patient/client that you are fucking with their brain in any way, shape, or form.
Now back to crawling.
The crawling done in gyms and clinics around the therapeutic, and strength and conditioning world is intended to resolve a “primitive reflex”, in this case the symmetrical tonic neck reflex; flexion and extension. Now I understand that some reflexes may be present, but the ass-umption cannot be made that every Tom, Dick, and Sally can benefit from performing crawling when the test has to be performed to assess the appropriateness of the intervention. People!!! Rehab does not equal training and training does not equal rehab, unless you are a rehab professional rehabilitating someone, and them referring them to a trainer who will TRAIN them. In the adult population, the “holding on” of these reflexes can be so subtle and difficult to detect that it is virtually impossible to perform a neurological screening for this or any other “primitive reflex”. This is not the over simplicity of application afforded the FMS, and thus the over simplicity of the information gleaned from such a “screening”. This is REAL neurological dysfunction we are talking about here…nothing to fuck with, especially when you refer to cross crawling as a panacea of sorts to be included in every patients/clients exercise program.
If the STNR is so important and meaningful to “eradicate” in the vast majority of the human populous as though it were the new Ebola and worthy of its own STNR Czar, then why ignore the other players in this Shakespearean Neurodrama, for example… Moro (I believe he was a Capulet?), Asymmetric Tonic Neck Reflex, Tonic Labyrinthine Reflex (forwards and backwards), Palmar Grasp Response Reflex, Babinski (Babinski…that guy owes me money!), Spinal Galant Reflex (and his cousin from Mexico City, Spinal Perez Reflex). Why not test them all?
I suppose my point is, if you suspect a developmental lesion in one of your patients or clients, don’t try to treat them yourself if you are not very well schooled in the neurological basis of these reflexes. You may be doing more harm than good. Real and destructive harm, no joke. This isn’t foam rolling people (a topic for another post).
I know, I know, can crawling really be all that bad? Well, we developed into bipeds for a reason.
Serge Gracovetsky, PhD describes this as the “Critter Walk”, and outlines exactly what happens to the “spinal engine” during this activity in his book “The Spinal Engine”. To put it simply, the de-evolution of human, bi-pedal movement is not something to be undertaken on a whim, or because some “guru” in a seminar told you it was cool. Biasing the spine towards lateral flexion during horizontal plane movement does not a good movement prep make (does that sound like Old English?). As bipeds, our long and arduous time spent developing hip extensors (even without the benefit of such exercises as the barbell hip thrust, and the hip lift) has earned us Homo sapiens the right to walk on all two’s, and not hold us captive from an ambulatory perspective to our spinal lateral flexors during horizontal plane movements.
Is it possible that as strength coaches and rehab professionals we are making our clients/athletes less efficient in the running aspect of their athletic development?
If it aint broke, don’t fix it…and while I am on a cliché’ roll…First, do no harm.
So next time you decide to have one of your trusting flock start crawling their way towards super-duper reflex eradication…think twice. Maybe three times.
Thank You, and in the immortal words of William Shakespeare…”Where for art thow Moro”?