Bodies in Space: Normally and During a Pandemic

LOW BACK PAIN: THE POTENTIAL CONTRIBUTION OF SUPRASPINAL MOTOR ...

Here’s a vocabulary word for the day: proprioception, which is a fancy way of describing the body’s awareness of its own movements and position in space. What a random thing to talk about during a pandemic. Or not.

This is a term used mostly by physical therapists. When people have a deficit in this proposed sixth sense, they can be more prone to injury because it impacts balance. Many organs play a role in proprioception, but perhaps the vestibular system is most well known. If you’ve ever had an inner-ear infection, you probably felt very off center. This gives you a sense of equilibrium and stability, and helps you plan and execute movements subconsciously in a way that will keep you in balance.

But the concept has utility outside of physical therapy. If you’ve ever wondered about clueless people in crowded spaces who don’t seem to be aware of how much space they are taking up, or who clumsily knock you around on as they walk by your aisle seat on an airplane, they probably have a deficit in proprioception. In the case of patients with trauma, a common feature is a sense of disembodiment- feeling like floating brain minimally connected with the body. This indeed is why patients with PTSD are often at higher risk for accidental injury and falls.

I myself got a total ligament tear for simply walking in flip flops a few years ago which required over a year of rehab (PSA- don’t wear flip flops, they are the devil’s tool)! It was a bit of a wake up call I needed to learn to live in my body more than I was. An interesting result of that is I learned I have TMJ from clenching my teeth (apparently during the day and night). Most of my friends who wear a night guard for this reason loathe the things. But I loved it. As I told my therapist, “the night guard lets me know where my teeth are, it is a grounding anchor.” That may sound weird to normal people, but she saw it as a good sign of learning to live embodied, and of increasing proprioception.

So back to the current global COVID crisis. There was a recent New York Times article on how people are now using their bodies to navigate with more awareness in a pandemic. How much more aware are we all now of what 6 feet means, spatially? The article describes a new choreography being learned in urban areas as people start to learn to walk just a bit further away from each other. For those of us still travelling to work (in my case, in a hospital setting), how quickly does the reflex to shake hands or pass physical objects between coworkers get rewired? How often did we unconsciously touch our face before this time?

Reminder to myself about COVID-19 | Don't Touch Your Face | Know ...

How can you increase your proprioception, not only to maintain balance but to reduce your risk of contracting COVID? Qi gong or its cousin Tai Chi are great practices for increasing overall balance and awareness. There’s also some early evidence that electro-acupuncture can help improve proprioception in joint injuries.

In terms of COVID protection, being aware of touching our face may be the best thing we can do. My brother said he’s going to have his staff of auto mechanics wear makeshift masks, if only because maybe it will help them be more aware of touching their face. Being mindful of other objects you touch a lot is also important.

How much more aware are we when we touch a doorknob or an elevator button in public spaces? When we remember to wash our hands, are we also wiping down our cell phone? The pen we have been using all day? For those of us in healthcare, we are often hyper-vigilant when we’re at work on these practices, but can forget when we enter the real world again. I went grocery shopping and realized with horror I rubbed my eyes after touching all kinds of surfaces. Since the common theme with all of this is increasing mindfulness, there’s perhaps no better way to do that than to take up a daily meditation practice.

What would Chinese Medicine have to say about all this? Perhaps not too much directly. But some concepts may connect. First, balance. Yin-Yang is a foundational principle of Chinese Medicine. One could write whole books on it, but for now, the basic concept is that health is being in balance and disease is when things are out of alignment. That resonates plenty in this time where nothing seems to be in the usual order.

Additionally, space and directions mean a lot. You’re probably familiar with feng shui, a way of orienting buildings and homes. Whereas Chinese Medicine focuses on qi or energy within the body, feng shui similarly assigns energy to space and directionality of structures. Proper feng shui balances the home in the same way proper health reflects a body in balance.

From a pathogenesis perspective, we may think of imbalance as ” excess wind” Wind is a concept representing one of six external factors of disease. It’s a bit above my pay grade, but more details can be found here. When the external wind (perhaps conceptually here an invisible virus) invades the body, sometimes, the shit hits the fan. For those nerds who are reading about mortality in COVID, it seems like a likely factor in the worse cases is a cytokine storm, in which the whole immune system just goes bananas and ultimately leads to multiple organ failure. In this case, the concept (and weather metaphor) translates perfectly.

An interesting take-home question is what happens to all of our old behaviors when this is over? Do we hug less? Does the handshake go the way of the dodo? Do we still feel sketchy about public transportation or big crowds? Do masks become as common in the West as they have been in parts of Asia? How much of the mental health difficulties of social isolation will be attributed to a marked loss in human touch? For now, we can only guess.

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