By Robyn Edge & Gilbert Magne
This article is a reflection of what I’ve been going through over the last few months about how to be a better communicator with you. It wasn’t until a few years into my career that I realized a large part of my job is to be a teacher. My job is to assess movement, evaluate injuries, construct rehab programs, and treat with manual techniques. But it’s also to motivate, communicate and teach! If I can’t communicate to you what the problem is, how to solve it and how to move better, what’s the point of all the work we are both putting in?
Perfecting how to teach is a two way street with each client. Sometimes I forget not everyone learns in the same way. I'm a fan of body awareness, trying to get people to connect their brains with their bodies experience new ways to move. But, everyone moves and understands their body and how they move. How I see your movement is different than how that movement feels for you. Teamwork!
I was listening to you, but I’m still confused.
Have you ever walked away from a therapy session, a workout class, a bootcamp, a yoga class where your therapist/instructor went on for a few minutes with well articulated instructions only to say to yourself, “Ok, so you want me to do what?”.
Have you even gotten detailed cues and you get completely confused? This is your therapist's fault for not working with you to determine how you best understand how to move.
You and I have to work together to optimize communication of what we say and what you hear. You and I use two different languages which does make it difficult to communicate from time to time.
I think, “I want this person to activate their serratus anterior as the prime stabilizer of the scapular so when they move their glenohumeral joint overhead, they are recruiting the scapular stabilizers and rotator cuff while getting appropriate scapulohumeral rhythm through full range."
Whereas you think, “I’m going to press this weight over my head.”
We have to work together to figure out how best to understand one another. What is our common vocabulary?
Have you experienced that “ah-ha” moment when you understand exactly what your therapist wants you do to? How good does that moment feel?! Proper cueing and attentional focus help achieve these moments. These moments of good communication and understanding have staying power. That’s how you best transfer the skill/movement into your everyday life as compared to leaving it at the gym. I want us to have more of these moments.
Let’s focus in...or out.
What happens when you feel like you’re not getting or receiving the message? Communication falls apart and you might feel your therapist isn’t paying attention. Or, your therapist might not be using the right cues to get the right effect.
Here's a mouthful: "Attentional focus is as a conscious effort to focus attention through explicit thoughts to execute a task with superior performance."
In simpler terms, focusing on a task to make it better. When it comes to movement, this focus can be either what is happening inside the body or outside the body.
As examples, your therapist could guide you how to do a single arm chest press:
Some studies have found external cues produce better performance with less errors than internal cues. This indicates a higher degree of automaticity and less conscious interference. This means you will have a much higher likelihood of leaving your session with a much better understanding of how to move. Not only is the movement better, the effects last longer. And isn’t that the point?!
Why does External Cuing work?
One of the theories out there believes that if we focus internally, it interfers with automatic processes of movement. Our movement is automatic and subconscious. On a day to day basis, we don't think about how to move, we do what we want to do! If we focus on an external targets, the motor system can self-organize without our brain getting in the way. This means external focus allows for a more natural or automatic movement. While internal focus seems to interrupt the movement.
External focus allows your brain/body to figure out how best to achieve the goal. Your body explores different ways to get where it you are asking it to go. Internal focus wants you to focus on one aspect of the movement at a time while at the same time remaining aware of the movement as a whole. Your brain gets overloaded and can make movement achievement more difficult. So, external cues do a better job of communicating the most important aspects of the movement.
So the question is how do we best use external focus and cues to achieve the best outcome from the movement? How do we individualize and change the cues to compliment where your ability level is with each movement? How do we make sure each movement is purposeful with maximal effectiveness for you?
The 3 D’s of External Cueing
We, as therapists, can work within 3 key features of external cues:
Cues should tell you which way the movement has to go. Using our example of the tall plank again, I could say “drive your back towards the ceiling” or “push yourself away from the ground”. In both examples the direction is the same but the frame of reference is different. This is where personal opinion comes into play. Not everyone processes these two directional references in the same way. Some prefer to push towards or push away, this is personal preference and which one helps the most.
If I asked you to push a ball away from your chest versus pushing the same ball towards a wall 20 feet from you what would you do differently? We would do them both in different ways. We can use close cues or far cues depending on what we need the movement to do. Pushing away from your chest is a close cue, whereas pushing at the wall is a far cue. Choosing which distance cue works best for you is dependent on level of experience with the task at hand. I’ve found when I teach a new skill or movement using distances closer to the body are easier to learn.
As your experience with the task improves, we can add more elements like speed and power. Ad it may be appropriate to increase the distance of focus (ie. moving towards the ceiling instead of away from your body).
Verbs are words of action. Movement is an action. Using the right verbs when describing a movement only makes sense. Words like explode, push, press, drive or accelerate can describe how the movement should be performed.
Analogies are important when describing a movement. The two together, verbs and analogies, tell you the pace and the execution of the movement. “Accelerate off the line like a jet taking off”.
Choosing visual words are much more effective than recalling abstract words or concepts. External cues that use active verbs, analogies and words that evoke images will be more memorable. So they are easier for you to apply to the movement when you’re on your own at home, in daily living or at the gym.
The Language of Movement
Effective communication is a two way street. Communication has three components:
For this to work, you have to be paying attention to what I’m saying and I have to pay attention to what you’re doing and saying in response.
Bottomline, you and I need to work together to make sure we are understanding one another. We get success when you to come in ready to give your attention to the tasks, and I am adaptable based off of your responses. This is how we will get the most out of our time together!
These ideas also apply to our previous article written about the crossover effect. This would apply if you're sidelined with an injury or you are noticing you are more in control of a movement on one side but not the other. The article on crossover effect talks about how your body can also adapt by working on the opposite side.
What are your thoughts on these ideas? Have you found yourself responding more effectively to certain kinds of cues? Have you noticed you move more better with certain therapists or instructors because of how they cue you to perform? Let us know your thoughts on these ideas and especially let us know if there are ways that we can be more effective.