track and field

STOP YOUTH SPORTS INJURIES: What Every Parent Needs To Know

Posted on by PEAL

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‘The gravitational field of the earth is easily the most potent physical influence in any human life. When human energy field and gravity are at war, needless to say gravity wins every time. It may be a man’s friend and reinforce his activity; it may be his bitter enemy and drag him to physical destruction.”

Ida P. Rolf, Ph.D.
You just bought a new Lexus. You decide to teach your kid how to drive. You both get into the car, with him or her behind the wheel. You pull out of the driveway, and then you instruct your child to “smash into the nearest wall!” Imagine how dumbfounded your teenager would be. But you explain, “Hey, since crashes could be a part of your driving experience, I think we better go out and teach you how to crash more effectively.” Obviously, this seems like a ludicrous idea and somewhat over-the-top. Why not just improve the driver’s skill behind the wheel and lessen the chance for collision, or even avoid the situation completely?
It has been well-documented that a surprising number of injuries that befall athletes are of the non-contact variety. Without the impetus of a strike or blow to the body, athletes are continually suffering a host of repetitive and overuse trauma. These injuries can be as subtle as musculoskeletal aches and pains, and as debilitating as ACL tears. With so many young athletes affected by this epidemic, the predicament of how to keep your child injury-free remains elusive to most people.
The problem is simple: athletes don’t move properly. They don’t sprint correctly, jog correctly, throw correctly, jump correctly, lift correctly, condition correctly nor change directions correctly. If they did, they wouldn’t get hurt. A lot of well-intentioned coaches, therapists, physicians and researchers have attempted to combat this problem with a seemingly logical approach to prehabilitation and general preparedness. However, by reducing this issue into either isolated factors (“get stronger”, “stretch more”), specific culprits (the core, non-firing muscles), or research-supported protocol (foam rolling, dynamic warm-up), the actual reason why-kids-get-hurt has been misconstrued. Lost in the reductionist dogma so prevalent today, is that all movement is a consequence of interrrelated actions. These actions, done poorly, and deeply rooted in athletes’ understanding of how to move themselves or an object from Point A to Point B, is the genesis of non-contacts sports injuries.
There has been conjecture, based on scientific data, that most significant injuries happen to athletes while they are decelerating; specifically, absorbing forces when landing from a jump or while changing directions rapidly i.e. cutting. A belief in this premise leads to the conclusion that learning to decelerate perfectly is the answer. Which is why the prevailing formula pushes towards the idea that the more we get accustomed to forceful impact, the more resilient our bodies will be. Unfortunately, consistent exposure to high velocity force, has a deleterious, not adaptive effect. This is akin to our “drivers learning how to crash better” example. Thinking that the body can be trained to overcome forceful tension and pressure is a mistake often conveyed from examination room to gym floor to playing field. Cars don’t survive crashes. Neither do we.
I see this far too frequently. We make athletes lift more, run harder and compete incessantly weekend after weekend believing that this is way to athletic prowess. And when they get nicked up, the advice is simple and straightforward: just rest up for a bit then repeat – with even more vigor. Because if that much didn’t stop the injury from happening, then that much more surely will. We are not designed to generate or consume heavy doses of external force. We are designed to attenuate and channel these forces to boost our speed, strength and performance. What matters most is our finesse and efficiency when interacting with our environment, not our muscular efforts. The objective is to redirect the accelerated, rotational forces of movement – not to try to stop or overcome them. Moving energy is a flow, not resistance and loading.
Most of my athletes never sustain these commonplace injuries. I don’t have clients waiting for surgery. If I do, it’s because they haven’t been compliant or followed protocol, or left the program too early. Athletes aren’t injured because of gender, genetics, bad luck, strength imbalances, inflexibility, fatigue or overuse. These are symptoms, not determinants. The keys are in your hands. Make better choices and drive well.
PEAL
America’s #1 Sports Performance Coach & Gait Analyst

The Question of Variability: Runblogger and Burfoot and Biology, Oh My!

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I recently read, and was dumbfounded by, two of Pete Larson’s (anatomy and exercise physiology professor at Saint Anselm College in Manchester, NH) companion internet posts – last year’s “On Running Form, Variability in Elites and What This Means to You (And Me)” and his recent blog, “On Human Variability, Running Shoes, and Running Form: The Importance of an Individualized Approach.” The gist of Larson’s (aka Runblogger) argument, woven into the subtext of both articles, is thus: although he tends “to agree that there is probably an optimal way for a human to run,“ due to the anatomical variability inherent in the human species, he doubts that a “single perfect running form” could be applied to “every human who runs.”

To support his viewpoint, Larson leans on his biological knowledge of beak differentiation in Galapagos finches and blood vessel branching characteristics in cats to drive home his point about the biomechanically-varied footstrike in elite Boston marathoners. In the former case, he hypothesizes that “variation is normal…[it] serves as the raw material upon which natural selection can act in the process of evolution”, and has recently concluded, as humans “we also exhibit anatomical and physiological variability just like any other species does.”

It does make sense. The evolutionary mechanism of adaptation is obviously necessary for animal species survival. In humans, this morphing of anatomical characteristics is how we got up on two feet in the first place. Without change (nontropy), permanent existence is unlikely. All biological systems are in a constant interaction with their immediate environment – the flux of this relationship creating the breeding ground for alterations in structure and behavior. But, the “myth of variability” can be intrinsically seen when looking beyond these mutations of physical attributes, shifts of integration necessary to sustain compatibility with nature. Scientists, like Larsen, are reductionists who study these changes in vitro, becoming lost in the minutiae of things like finch beak/feline arterial differential data without a clear understanding of how specific genealogical traits relate to the principles that guide us – if at all. Their concepts about movement lack dimension. Why do we all run differently? What effects do observable variants like abnormalities, impingements or impairments have on our ability to run well?

On planet earth, these general rules will always apply: Life is movement, movement exists in a gravitationally-driven field and without gravity movement wouldn’t exist the way we know it. From birth, our motor development hinges on this delicate interaction: the desire to move and the fear associated with this movement. When first walking, babies literally “let go”, quickly stepping or shuffling from one safe hold (couch, table, mother’s leg) to another. This leap of faith, this temporary loss of balance is a must – yet also the price of freedom. As I watch and coach running daily, it fascinates me how far we’ve come from these innate beginnings.

Originally, we play with the possibilities of what our bodies can do. We begin to see the limitless potential of movement. Then something happens. We fall and hurt ourselves. We become more aware of how others move. Almost subconsciously, we begin to build walls to “protect ourselves.” We stop running with abandon. Although cursed with a higher level of consciousness than animals, we often fail to choose the proper posture for our movement. This “free will” of choice is what makes humans unique in the animal kingdom, but can limit us as well. As Dr. Nicholas Romanov explained, “the bee has an innate instinct to build the beehive with perfect construction. At this point, the bee’s ‘creativity’ is ended, illustrating that instincts are very restricted …Human progress starts, where instincts end and goes beyond this point.” We can run better. Instead we become movement victims, choosing our running style by copying from someone who copied it from someone else and so on, until we’re running with no quality. Instincts fall prey to imitation.

Not so with animals. Percy Cerruty, renown Australian running coach (of Olympic gold medal miler Herb Elliot) observed that “amongst other things I learnt from the study of the racehorse was that they all moved exactly similarly: that a silhouette of one going fast fitted exactly into a silhouette of another – extent of leg-throw – movement of legs – head and neck angles and relationships – all identical. Whether heavily built or lightly, long in the legs or not so long, tall or short.” So, if we accept that all species of animals move similarly (or the whole domain of animals, birds, insects and fish according to Aristotelian thought), it would suggest that evolution is really about changing the variables to match the situation as a subplot to finding the most suitable way to get from Point A to Point B.

 

To argue, like Larson does, that the varying heights, weights, gender and physiologic make-up of runners allows for an idiosyncratic approach to (running) movement, disavows the physical presence of gravity and our need to take advantage of it. “The gravitational field of the earth is easily the most potent physical influence in any human life. When human energy field and gravity are at war, needless to say gravity wins every time. It may be a man’s friend and reinforce his activity; it may be his bitter enemy and drag him to physical destruction,” stated Structural Integrationist Dr. Ida Rolf. Humans are systems within systems, that consume, expend and channel energy. As varied as we are (color, shape and size), we all have the same basic framework, abide by the same rules.

 

In the “On Human Variability” article, Larson gets bogged-down on “footwear options, genetics, dietary habits and history of past physical activity” as signs that we are nothing like our barefoot running ancestors, who were seemingly able to run all day while playing or “persistence hunting.” Yes, we are far-removed from indigenous populations like the Tarahumara or Hadzabe. They have a distinct running style worthy of emulation. Why? Because they fearlessly run on their own terms (often, fast and far) without the need of doctor visits – and for the majority of us this belies possibility. Ultimately then, the myth of variability, defined in our excuses for running poorly and hurt, are the mistakes we make in simple execution.

Currently, researchers are scratching their heads while trying to establish a running paradigm by ascertaining its symptoms. In a recent New York Times article, Dr. Steef Bredeweg of the University Medical Center Groningen, Netherlands, in reference to how best to train novices and prevent injuries said, “we don’t know what is the right thing to do.” A closer look reveals that without a measuring stick regarding human running form, chaos persists (note how many of you have or suffer from running-related injuries) as design fails to correlate with function.

Larson is even at a loss, while interpreting the article “Effects of Shoe Cushioning Upon Ground Reaction Forces in Running.” (Clarke et al., International Journal of Sports Medicine, 1983). In the end, the randomness of the “impact force vs. shoe design” data seems to have left him exasperated. He figuratively throws up his hands, re-emphasizing that “that runners are variable, and we each have different needs on an individual level.” True, all runners have different needs, but they all have the same necessities. Footstrike pattern, shoe selection and aerobic capacity may be varying but efficient movement is not. Despite how you land, getting the body in right position to move forward is non-negotiable.

 

 

Unbelievably, Larson (and journalists like Runner’s World magazine editor-at-large and former Boston Marathon winner Amby Burfoot, who reasoned “it’s hard to turn running-form theories into physics, which depends on universal laws” Really?), cannot connect the dots. Shoe design, genetics, psychology, anthropometrics and physiological limits are easy targets for scientific analysis, providing a smoke-screen which unexpectantly clouds the study of human locomotion. Brilliantly presented by Mabel E. Todd in the 1937 book “The Thinking Body”, her observation, though in opposition to Larson’s views, plays as one of the beat ad hoc definitions of running mechanics I’ve ever read: [a] “pattern…of many small parts moving definite distances in space, in a scheme perfectly timed, and with the exact amount of effort necessary to support the individual weights and to cover the time-space movement.”

When Larson shows still images of the top five finishers in the 2010 Boston Marathon – Robert Cheruiyot (the eventual winner), Tekeste Kebede (2nd place), Meb Keflezighi (5th place), and Ryan Hall (4th place) – the irony is significant. Choosing a “standardized moment in the gait cycle” to compare these runners preposterously contradicts his insistence on stride variability. Why not show them all a few frames later, when they all demonstrate the position where bodyweight balance is poised on the fulcrum of the ball of the foot? We all must go through this position [see all photos]. Knowing that proper establishment of body mass on the ground is essential, the quibbling over footstrike variance is a non-sequitur. Why argue about footstrike (or arm carriage, or body orientation for that matter), rather than acknowledge the common errors in timing and anticipation of ground contact?

 

 

The greatest obstacle facing the modern runner (and modern running performance) is the inability to fix his or her relationship with gravity. The creation of the variability myth enables the self-serving ego of the runner and the business of running research. There are costs for our individuality. Just because we see differences doesn’t mean they should exist. I help athletes reinterpret their perception of movement and become more conscious with their running. Larson, like so many others in the field (Burfoot, Ian Hunter, Alberto Salazar, Steve Magness), can’t comprehend that variability predicts a conceptual void.

Instead of providing the American running community with cohesive answers, they skirt the issue with misinformation and unanswerable questions regarding training, diet and footwear. Variability is all about what decisions we make before and after our bodies reach the tipping point. Instead of defending the heel-striking of three-time U.S. Olympian Abdi Abdirahman (as Burfoot does in the addendum to Larson’s “On Running Form” piece), when will we realize the important question is “How much better can we be?” The answer is simply articulated by Dr. Rolf: “When the body gets working appropriately, the forces of gravity can flow through.”

LSD or Speed?

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Last weekend I had the opportunity to be a part of the 2011 edition of the Wineglass Marathon. Thanks to Sheila Sutton (assistant race director), I was invited to present a couple of lectures during my stay in Corning, NY, and otherwise mingle with the few thousand runners in attendance. There was a two-day (Friday and Saturday) expo held inside the Corning Community YMCA where the runners, vendors and race staff congregated for the usual pre-race/last-minute frenzy.

In between lectures I did some gait analyses (notably with new client Jennifer Brower-McNutt, former 2004 Olympic Trials marathon participant) and answered running-related questions. Jen, and another of my athletes (John Weiner, 49, who ended up finishing 4th overall) were running the 1/2M, so I bundled-up early Sunday morning and headed towards the starting line at Campbell-Savona School. Just prior to the race start, many of the runners lined the school’s hallways (it had started to rain outside), going through the usual stretching and idle chatter routine. Typical of runners, in between calf and quad stretches plus keeping-myself-warm bouncing, was the predictable query posed to anyone within earshot: Am I prepared?

The question was always answered with positive reinforcement (“you’ll be fine!”) – and even more so when the questioner assured the listener that “I got my miles in.” It’s as if those five magical words were the key elixir to surviving any test of human stamina. Having those miles under one’s belt, although seemingly effective, has yet to guarantee any type of success regardless of the distance run. In fact, despite the folklore that “you gotta get that 20-miler in” pre-marathon, how many of you, or people you know, have suffered in that final 10k regardless of their “long run” preparation.

So, if endurance doesn’t give you endurance, what the hell does??? In a leap of faith few are willing to accept, it may sound illogical at first but is truly at the heart of maximizing your running potential: Speed is the foundation of endurance. I first learned this concept from my friend and mentor Dr. Nicholas Romanov (Pose Method) and have witnessed it’s veracity with my own athletes and clients. The adage of “building your endurance through long, slow distance (LSD)” to give you the physiological base to tackle endurance challenges is misleading. Coaches from Arthur Lydiard to Bill Bowerman have stressed, in one form or another, the necessity of optimizing one’s aerobic capacity. Perhaps because of the prevalence of the “jogging” culture, which has led to a boon of recreational runners, or the narrowly-scoped obsession of the scientific community with the physiological effects of prolonged exercise, the concept of running better is all about heart and lung capacity. Unfortunately, all LSD gives you – with a modicum of aerobic benefit – is the ability to move slowly over periods of time while exposing yourself to fatigue, bonking and injury. If our aerobic reservoirs were the linchpin, then why doesn’t someone like Lance Armstrong, whose aerobic engine is legendary, run the fastest marathon times? You may argue that cycling requires different muscles or skills than running, which would point to something else at issue here: technique.

With good technique comes speed, and with speed the potential to endure. Remember, the fundamental requirement is how precisely a runner can interact with the forces available (gravity, ground reaction, muscular stretch-reflex), visible in how effectively he or she can remove their foot from the ground. The kinesthetic awareness that allows the body to move forward hinges on the understanding that there is an exact time-frame for economy – one that is beyond the amount of oxygen consumed per kilogram of bodyweight per minute. The less time you can spend on the ground, the less taxing it is to the muscular system and the less oxygen needed to fuel stressed-out muscles. Humans are built to survive (i.e. slog through marathons), but at great cost. Speed, in the true sense, is that proper combination of skill/effort/awareness/precision you’ll never find while running slowly for slow’s sake (although I want to point out that jogging can be treated as more skill development for improving one’s running technique).

Great distance runners can perform at a sub-5:00 pace, mile after mile. Yet, even Ryan Hall (after Sunday’s 2:08/5th place performance in the Chicago Marathon), commented that he needed to improve his “turnover” and drop his 1/2 marathon time to solidify his Trials and Olympic chances. The idea of strengthening one’s ability to accelerate in shorter intervals succeeds on many levels, physically and emotionally.

The belief that speed cannot be trained year-round is a falsehood. Much research has proven the positive cardiovascular results from repeated interval training. The blueprint is the knowledge of what intervals will bring out your best? How many? How often? With proper interval work and ample recovery, the lessons learned during speed training pay dividends for elite and recreational runners alike. Which leads us to the ultimate question: how fast can you be?

Running Economy

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In his recent post “Running Economy: Overrated and Misunderstood” (Running_Economy.pdf), Steve Magness, exercise scientist and newest addition to the Nike Oregon Project team, bemoans the “sad state of a lot of physiology research out there”  which has streamlined exceptional running performance into a neatly tied package of  running economy (RE), maximal ventilatory intake (VO2max) and lactate metabolism threshold (LT). To him, these physiological markers are informative yet underwhelming. “There are no easy variables that can tell us how good of a runner you are or can be.” Really? So, what methods can we use to predict and evaluate running performance? How then, do we address the most cogent underlying question of What makes a great distance runner?

Magness attempts to answer this question by explaining that although “it would make sense that the ‘better’ ones running form, the more efficient” that person is, someone like Alberto Salazar (who had poor mechanics) was efficient based on the current scientific nomenclature. The problem, he states, is that RE is a complex variable, and that there are “three types of efficiencies that govern how [economical] a runner is in a whole body sense” – mechanical, physiological and neural. According to Magness, “some parts of you will be very efficient while others won’t.” In this way, RE “reflects the sum of all those parts.”

There is some truth to what Magness says. In “Web of Life”, Fritjof Capra reveals that in the systems thinking view, “the essential properties of an organism, or living system, are the properties of the whole, which none of the parts have. [These properties] arise from the interactions and relationships among the parts.” By defining RE as the relationship between several types of efficiencies, Magness owns some understanding of the the parts contributing to the whole. However, states Capra, “the belief that in every complex system the behavior of the whole can be understood entirely from the properties of its part” is the central idea of the reductionist approach of modern movement science. So Magness is just as guilty as the scientists he criticizes – by reducing RE to smaller parts and missing the point that the properties (of efficiency in this case) are destroyed “when the system is dissociated, either physically or theoretically, into isolated elements.”

It was biologist Joseph Woodger in Biological Principles, 1936 (cited by Capra), among others, who emphasized that “the key characteristics of the organization of living organisms was its hierarchical nature.” In other words, there are multileveled systems within systems. In humans, every step we take displays the connectedness between balance and falling, support and motion, thought and action. Economical running form relates to our ability to interact with our gravitational environment.  Our bodies are already attuned to the slightest fluctuations. All we need to improve is a better sense of our “loss” of bodyweight when falling forward during the gait cycle.

It’s not about the body becoming more efficient “at sending the neural signals from the brain to the muscles,” as Magness argues. The brain does not determine “what muscle fiber to fire to do a certain movement.” Muscles have pre-determined functions as agonists/antagonists. It’s not our job to tell them what to do. This is handled by the precise, dense network of interactions that criss-crosses anatomical, physiological, psychological, emotional and biomechanics barriers. We are still discovering how to predict and define the potential of human performance. Capra summarizes that “all scientific concepts and theories are limited and approximate.” Science can never provide any complete and definitive understanding.”

Ritzenhein UNPLUGGED

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Dathan Ritzenhein is considered the “future of American distance running.” His career, earmarked for greatness, has followed an inconsistent trajectory. Having won championships and setting records in distances from 3,000 meters to the 1/2 marathon (for a complete bio and race results history click on the following link: http://www.usatf.org/athletes/bios/Ritzenhein_Dathan.asp), Ritzenhein has fought innumerous injuries while dedicating himself to becoming the world’s best marathoner. Frustrated by a ninth-place finish in the 2008 London Marathon (and plagued by calf pains), he left his coach of five years, Brad Hudson, and joined Alberto Salazar and the Nike Project in Oregon. (Salazar, now with cross-country coach Jerry Schumacher, is employed by Nike to oversee and coach a coterie of elite runners including Ritzenheim, Kara Goucher, Matt Tegenkamp,  Amy Yoder Begley and Alan Webb).

Ritzenhein has been most susceptible to stress reactions and fractures of his metatarsals. These issues have led to inconsistencies in his training and racing. I can remember a blurb in ESPN the Magazine (2008) describing the G-Trainer antigravity treadmill he used to accumulate “130 miles per week during his rehab.” Supposedly, an elite racer’s running form is an individual thing. Writes Jennifer Kahn, in the New Yorker piece The Perfect Stride: Can Alberto Salazar Straighten Out American Distance Running?, “Many top distance runners have idiosyncratic form, and adjusting even a minor detail of a racer’s alignment can trigger a cascade of changes: subtle shifts in knee or foot position that can make a runner vulnerable to injury.” Consequently, when Salazar “tinkered” with Ritzenhein’s form, more than one eyebrow was raised. Salazar, winner of the Boston Marathon and three-time winner of the New York equivalent, was known for an inelegant stride and, plagued by the injury bug himself, forced to retire in his prime. He first addressed Ritzenhein’s “near horizontal arm carriage”, emphasizing the fists being held higher up, in what he termed the “nipple to nipple” position. “According to Salazar, this strained the forearm, and thus, through a long chain of physiological connections, the leg muscles,” Kahn commented. After a great start under Salazar’s watchful eye (an American record in the 5,000m in Zurich and a blistering 3rd place finish in Birmingham, England for the World Half-Marathon Championships), Ritzenhein again fell prey to injuries that curtailed his 2010 NYC Marathon preparation. Here, he finished a disappointing 8th overall in a time (2:13:33), his slowest in years. Strained tendons in his left ankle caused him to pull out of the recent Bupa Great Edinburg XC Race. His preparation now is for the 2011 Virgin London Marathon.

Salazar has argued that for Ritzenhein to compete for the top echelon, he would need a more radical overhaul of his running form. “To compete against the best you’ve got to fix this…But there’s a risk. We may injure you.” Such absurd comments are what perpetuates this myth that there is no correct running technique. Whatever you have is God-given, argues Kip Keino, Kenyan Olympic champion. Clearly, the plethora of injuries in Ritzenhein career have pointed to some sort of biomechanical malfunction. Salazar has noted (in a Q & A piece in Runner’s World July 7, 2010) that “Gordon Valiant – the head of biomechanics for Nike – did an evaluation of Dathan and was able to find some things that are unique to Dathan with the way he runs and strikes the foot. With that (study completed), we now have some modified inserts. I wouldn’t call them orthotics – just an insert into the shoe where he has an abnormal amount of force near his third metatarsal. It seems to have alleviated his symptoms completely and we’ve retested him in the lab and shown those forces have been lessened tremendously.” In the same article, Ritzenhein admits that he “was definitely more of a heel-striker” and is “getting to his mid-foot more…”

It amazes me, when looking at the photo stills of Ritzenhein running, that Salazar, Valiant, Lance Walker (Michael Johnson’s Director of Performance) and even Ritzenhein himself (!) fail to grasp the concept of movement. As I’ve discussed in previous blogs, all movement is a result of a pivoting from a fixed point. We reference this as falling. We are propelled in running by falling forward from the axis of ball of foot when it’s connected to the ground. During this brief period of support, the Center of Mass (COM) of our bodies is allowed rotate via the vector resultant of gravitational torque. Gravity is essentially pulling us toward the earth. To avoid a complete plunge – and redirect ourselves horizontally – we must change our foot support in a timely manner. Any delay in this process (support-fall-pull-support), induces more stress on our joints and connective structures. Instead of a uniquely orchestrated confluence of gravity, ground reaction force, friction, muscle elasticity and contraction, an inefficient runner must use more effort and absorb more impact. The position of the initial footstrike is decisive for determining the stride efficiency.

From the first image of Ritzenhein (S1, moving left to right), you can see that his left foot is landing ahead of his COM. This causes the bent “K” posture you see in S1: head and chest forward, hips back (Salazar has been critical of the cant of Ritzenhein’s pelvis). It’s not until S3 that Ritzenhein achieves the falling stance (Pose Method) – prior to that he’s just “catching” his body up to the point of ground support on his left foot. Now here’s the moment of choice: Ritzenhein can either allow forward momentum to continue or he can interrupt it. He doesn’t and his body drifts vertically. In S4 you can see that he’s making the common mistake of “toeing-off,” trying to propel himself through the multi-joint extension of his ankle, knee and hips. It is misunderstood that the toe-off is necessary to create propulsive force (“sprinter’s slap” as Salazar has interpreted). Obviously, with Ritzenhein’s bodyweight ahead of the pivot point of his left foot (S3), the push-off phase in S4 redundant. Subsequently, this makes his right leg extend, right foot dorsiflex and oversupinate and left leg recover late (S5-S6). He remains a heel-striker.

The domino effect from improperly landing is rehashed over 26,000 steps in a marathon. What’s not understood in Ritzenhein’s circle of influence can be summed up by a quote I have of Dr. Nicholas Romanov’s:

Nature doesn’t care about fitness or high performance. We are equal facing gravity. It is about how much gravity we want to consume, both in time and space.  This is what develops our body and mind. Injuries occur from losing the fight with gravity.

Dathan, if you’re reading, give me a shout.