Interview with Todd Hargrove - April 2014
The following is not original material. This interview is reproduced with permission from Cinema, a former Twitter personality & blogger who left the social media world. The reproduction is intended to preserve & share Cinema's insightful interviews.
Many of you may already be familiar with Todd Hargrove’s wonderful blog http://www.bettermovement.org. He is a lawyer turned certified Feldenkrais Practitioner and certified Rolfer. You can get in touch with him through his website and via twitter @ToddHargrove. I’m very excited to have had the chance to interview him and discover his perspectives on his line of work & progression over the years. Enjoy the read!
Transitioning from lawyer to Rolfer is a unique story. Not every lawyer that experiences back pain takes the same path you took. Tell us your story.
Hi Cinema, thank you very much for having me!
Yes the jump from attorney to Rolfer is pretty unusual. I wonder if there is another one?
I enjoyed many aspects of being an attorney, but the workload and the stress were too high for me. In fact, the stress probably played a role in my developing some chronic pain.
I was very motivated to get out of pain, so I tried to learn as much as possible about it. I did PT, yoga, Pilates, corrective exercise, functional training, postural training, stretching, and eventually Z-Health, Rolfing and Feldenkrais. There were many dead ends but I eventually made a lot of progress through trial and error over a few years and went from having major problems to pretty much none at all. In the process I learned that I was fascinated with chronic pain, and that there is a lot of misinformation and confusion about it.
During the same time period, I was also getting interested in the science of performance. This was partly because I was looking for an edge in my sports – competitive squash and not-so-competitive soccer. I read books by Gray Cook, Mel Siff, Mark Verstegen, Michael Boyle, and Shirley Sahrmann. I noticed a lot of interesting connections between the study of pain and motor control.
At some point in my legal career, I noticed online that there was some sort of seminar in Seattle on low back pain. I wanted to attend, but of course I couldn’t because I was a lawyer not a PT. This was just a while after I had spent a couple days bored out of my mind at a continuing legal education seminar. It occurred to me that it might be a good idea to have the kind of job where I was actually interested in the continuing education. It was a good thought!
Are there any lessons you’ve learned from your experience as a lawyer that you apply today in life & work?
I think my legal career probably doesn’t have much effect on the way I interact with my clients, but it does have an effect on the way I interpret research and write about my thoughts.
Attorneys need to cite authority in support of their legal claims. When you review an opponent’s brief, you check their citations. You discover that quite often, the citations fail to support the claims. In fact, they sometimes support the opposite claim. Most commonly, a citation can be interpreted in many ways – there are nuances, ambiguities and subtleties as to how it applies to the facts of your case.
This experience probably gave me a sense of skepticism in how I read claims made in articles and books on manual and movement therapies. As it turns out, manual therapy authors are no more trust worthy than lawyers.
Another thing about being an attorney is that when you write, you need to always be imagining every possible way that an opponent could attack your argument. I can’t help but go through a similar mental process when I write now. I think it’s probably helpful in ensuring that what I write is defensible in some way.
What differentiates what you do from an athletic trainer, massage therapist, physical therapist, etc?
Here’s what I do to help my clients. Based on my background as a Rolfer, I do manual therapy in the nature of a deep tissue massage, as well as gentler techniques like skin stretching, or what Diane Jacobs calls DNM. I do some passive mobilizations that are informed by my Feldenkrais background. I do active movements that are sometimes like Feldenkrais awareness through movement lessons, and sometimes more like corrective exercise. I also educate my clients on pain science. And I try to be a good listener and provide empathy, support and encouragement. Whatever the case, I am always looking to provide novel, interesting and non-threatening inputs that will hopefully result in improved outputs: better body awareness, better control over movement, and less perception of threat related to movement.
Unlike a personal trainer, I don’t organize a plan for strength and conditioning, although I might let people know they need more of one or the other. I’m different from a physical therapist in that I don’t have the training to diagnose sources of pain or make specific prescriptions on that basis.
Running a business and making time for family can be difficult. How do you handle this? What measures have you taken to keep this in balance?
I have two kids, ages seven and three. They are a ton of work! My wife is a psychotherapist (one word not two or three), and we work out of the same office. When one of us is working, the other is with the kids. Pretty simple. The challenge for me is to carve out some time to read and write. So I do a lot of whining about that.
What is your perspective on the “Evidence Based” trend? What are it’s limits & benefits as you see it in your practice? (I really enjoyed your post “Is Science Your Enemy?”)
Glad you liked the post! (Not everyone did.)
I read a lot of debates about whether an evidence-based approach is superior to a science-based approach, or whether intuition, anecdote and personal experience are valid forms of evidence supporting the use of a particular technique. I think good points are made on all sides of these debates. In the end, I think manual and movement therapists should be able to give good reasons for what they do. I also think that science has already shown that many therapies either do not work, or do not work for the reasons usually offered.
I think that it is often important to understand why a therapy works, and to explain this to the client. Many therapists don’t care why a treatment works, they only care that it does work. However, there can be unintended negative consequences when a client gets the wrong idea about why they felt better after a session.
For example, I know someone who received ART to treat his neck pain. He got good results, but came away with the idea that his pain was due to scar tissue in his anterior neck, and that the therapy was working by breaking up the scar tissue (a very implausible explanation in my opinion).
Because of this misconception, he started to go about his own program of self-help in regard to his neck pain. This involved extremely aggressive interventions to break up what he thought was scar tissue. He was causing himself a ton of pain, and was probably irritating some sensitive nerves near the anterior neck. Eventually he made the whole problem worse. This wouldn’t have happened if his ART practitioner had been more curious about why his treatments work.
This problem is magnified when the therapist not only lacks curiosity about science, but denies that science is an authoritative source of knowledge at all. This type of magical thinking is quite common in massage, and is a big problem in my opinion.
Most influential book and authors? (professionally & personally)
Here are some of my favorite authors by subject.
Manual therapy: Eyal Lederman has some good textbooks.
Motor control: On Dexterity by Nikolai Bernstein. Incredible book!
And of course, more important than all of these books put together: Game of Thrones.
While we’re on the topic, you’re in the process of writing a book! Why did you decide to write the book? And who is its audience? (You can read an excerpt of Todd’s book here: “Book Excerpt: Sensation versus Perception”)
I guess I wrote the book for the same reasons I started a blog. First, to get onto paper a lot of ideas I have running around my head. That way I don’t have to expend the mental energy to keep them organized anymore! Second, to help people with useful information. For some reason, I spend an incredible amount of time and effort thinking about pain and movement, and I think it causes me to have some insights that might help others.
Chronic pain is a huge problem. There are no easy answers on how to treat it, but we can improve our situation by eliminating the misinformation that causes confusion, anxiety and wasted resources. If someone in pain goes to seven different therapists, he might receive seven different explanations for his pain, and seven completely different treatments. And there is a good chance that the majority of these treatments will not be supported by any good science at all.
I think one common theme in this confusion is that therapists overemphasize the extent to which some alleged defect in the body is responsible for pain, and fail to appreciate the role of the nervous system. I happen to be very geeked out on pain science and neuroscience, so I’m in a good position to help remedy some of this confusion.
The book is focused on the nervous system, and is intended to be a resource for anyone who wants to move better and feel better, or help others do the same. It is especially tailored to professionals like physical therapists, massage therapists, chiropractors, personal trainers, or instructor in yoga, pilates or martial arts. But it is also written so that a person without any previous background in the subject matter can understand it.
The goal is to provide people with a concise and simple explanation of the science they need to understand pain and movement (like biomechanics, motor control, and pain science). And to boil all this down to some general principles for improving movement that will be applicable in a very broad set of contexts. The book also provides 25 movement lessons, based on the Feldenkrais Method, that represent one way to apply the principles. So it’s kind of like teaching people to fish and giving them 25 fish to get them started.
When and where will the book be available for purchase?
The book will be available for purchase on Amazon, probably by May 15.
If you could travel back in time and face yourself right after graduating college, then what advice would you give yourself?
Invest in Google and Amazon. Chicken wing consumption needs to come down.
I don’t regret going to law school at all, it was one of the best times of my life. But I do regret not getting started with my current career a little earlier. Is there a difference between these two things? It feels that way to me. If I had gotten started with this career earlier maybe I would have been more involved in strength and conditioning and sports performance.
What simple/basic ideas & concepts do you believe will help practitioners become better/stronger/wiser?
That is a good question. I’m not sure I have a very good answer, and I still have a long way to go in becoming better/stronger/wiser myself. But I think you are right that good manual therapy is based on some simple basic ideas. Here are my suggestions.
Client interaction and listening skills are important. If you are trying to treat pain, learning about pain science is important. Which technique you choose doesn’t seem to be that important, as there are many different types of techniques that get results. What seems to be important is that you execute your techniques with skill, which means practice, practice, practice. For your practice to be productive, you need to, as much as possible, use some method to get feedback as to whether the technique is actually doing what you hope it is doing. In other words, assess, correct and reassess. And of course make sure that what ever you do can be supported by evidence and solid reasoning.
How has your practice evolved since day one?
There have been some changes along the way, but looking back, it has always involved the fundamentals described above. Hopefully I execute all of these with more skill now.
I am always studying and researching and going to seminars looking for the magic bullet or the magic technique that will help everybody. But in the end, it seems that what works according to the research and my own experience is the simple stuff – educating people about pain, providing empathy and support, and pain-free novel sensory input. And getting people to move in new ways.
Todd, thank you for the power-packed interview!