I had a job to do today to screw a hook on an internal door in my cottage. There is a bench in front of the door which is part of how I move around indoors (see blog post ‘The Heart of the Home’) . I thought maybe I could sit on the bench, but needed to be higher. I could have found something to put on top of the bench to sit on, but with nothing to hand I decided to try doing the job in high kneeling.
High kneeling is a position that has been possible for many years, right from the early days of injury, although it has never been a functional position. I used to have little quality to the trunk in general, even less in the lumbar region, virtually none in the pelvis and a definite disconnection at the lumbar sacral junction. Even sitting used to involve propping my body on top of collapsed pelvic structure, so the more demanding position of high kneeling was nothing but propping myself up. My lifeless pelvis would tilt drastically forwards resulting in severe flexion of the lumbar spine and discomfort in the weakness (disconnection) at the lumbar sacral junction. It would take all my effort with both arms just to hold myself there.
This type of structural weakness, with tilted pelvis and arched back, is common in many people with varying disabilities and is also notable in a significant portion of the able bodied population, to a lesser degree. I caught the news the other day where a disabled child had undergone a miracle operation (so to speak) to enable him to walk for the first time in his life. He was wobbling along using crutches with the arching of his back so severe that it was painful to watch. Having never been on his feet the kid thought it was great, although in reality he had simply swapped one struggle for another that was potentially even harder. It was only the use of crutches that kept him on his feet and the importance of ensuring there is sufficient underlying structure to support the bodily position cannot be over emphasised. It is often the case with disabled people that they attain to positions and actions that are beyond the structural capacity of their bodies; mainly through endeavour to live life, the best they can, but also through a desire to push beyond their boundaries.
My work in bio-mechanics has led me to expand the boundaries, through improving structural capacity, rather than to seek to push beyond them, although I am guilty at times of exceeding those boundaries and screwing the hook on the door, in high kneeling, is one such example. What surprised me this time, though, was the involvement of the sacrum. I’ve never known that feeling before, nor such capability. I wasn’t sure it would work, but found I could use my left elbow, against the door, to hold myself up and still use my left hand to hold the screw, while using the screwdriver with my right. With new structural capacity in the sacrum the right side of my body held well and only the weaker left side wanted to collapse.
I have been improving my body for years and for a long time now the sacrum has played a functional role in sitting. Now for the first time it is strong enough to begin playing a functional role in the more demanding position of high kneeling. I have every reason to believe I will continue to improve, while finding new strengths never ceases to amaze me.
Spinalroots 