ManMade - A Case Study on the making of a man

Dre Domeninchini is on a mission.  He's using himself as a Guinea pig to see if he really can become the ultimate in health, wellness, happiness and success as a man.  I met Dre at a London Real meet up last year where he expressed great interest in working with me as phase 1 one of his project.  

Dre is an unusual and interesting case.  He had a serious accident when he was 18 and he's never been quite right since. He did however, train himself up to enter a bodybuilding contest in New Zealand.  Two years ago he entered into a medical drug trial that backfired and set off horrific symptoms of his previous injuries. He hasn't been able to exercise without setting off terrible pain which was making him feel physically and mentally weak, unhealthy and hopeless. 

But he is a man of hidden fortitude - a man who decided he would turn his pain into inspiration for others.  So he created ManMade.  A YouTube video series about what he's doing to make himself the ultimate person in all areas of his life.  He chose me and Precision Movement as the first phase of his journey with exercise. And this is his story... 

(Just as an aside, I don't usually reveal the identity of patients, but as Dre is making a video series about his journey he gave permission for me to use his name and promote his story!)

 

Assessment

Dre came to me and said that he wanted to get out of pain so he could begin training again.  I asked him what he was training for and he said he wanted to have the fluidity, freedom and grace of movement of Ido Portal with the strength of Arnold Schwarzenegger.  

He walked into my studio in a great deal of pain mostly focussed around his neck and shoulder area and he said he felt most of the pain came from his mid lower back. He has good genetics as you can see from his photos below. He doesn't look weak or unstable but in his first assessment I found that his joints lacked integrity and stability. His posture was quite slouched and although I don't think it was the cause of his problems I do think it was exacerbating them.  His movement patterns were definitely not optimal and I do think they were causing further harm and recurring injuries. I knew after the assessment there was a lot I could help Dre with and so we began... 

You can see above in the left hand photo that Dre's head, shoulder and hips are forwards of the midline marker.  His mid  back curve is quite pronounced and his ribcage is slightly tilted back. The photo on the right shows his hips and torso are shifted to the left and his lift knee appears higher than the right.  On the whole these are pretty good first photos compared to what I usually see.  This just highlights that even in a body that looks well and relatively aligned, there can still be movement dysfunctions that cause and exacerbate ongoing pain.

You can see above in the left hand photo that Dre's head, shoulder and hips are forwards of the midline marker.  His mid  back curve is quite pronounced and his ribcage is slightly tilted back. The photo on the right shows his hips and torso are shifted to the left and his lift knee appears higher than the right.  On the whole these are pretty good first photos compared to what I usually see.  This just highlights that even in a body that looks well and relatively aligned, there can still be movement dysfunctions that cause and exacerbate ongoing pain.

 

Phase 1

I was keen to address Dre's ribcage alignment which is closely linked with breathing mechanics to lay a foundation for better upper body posture. I gave Dre a series of mobilisations and stretches to open up areas of tightness such as the front of his shoulders and chest.  Interestingly Dre had been doing a number of the stretches and mobilisations I gave him already but he was doing them with poor alignment so they were not helping - they were hindering his progress.  

This brings up a really important issue that I see time and time again in rehabilitation of long term pain and injury, patients are doing stretches and exercises before they come to see me but they are not doing them properly.  I cannot stress enough the importance of understanding alignment in all movements and even in stretches and mobilisations.  

"I couldn't believe the difference in the stretches and exercises I had been doing for years when KT helped me do them in the correct alignment.  She explained everything to me so I really understood what I was doing and WHY I was doing it."

One of the other main issues was to do with stability.  For me, movement has two main components - the movement and the stable part around which movement occurs.  If you think of a crane, you have the moving arm and the stable base.  All movement in the body works with this same basic principle.  However, we are all much more concerned about the movement part than the stable part!  For me, movement starts with the stability.  When you are stable, movement is freedom.  With Dre, when I asked him to do some movements all the corresponding segments would shift and move at the same time.  It took great patience and consistency of training on Dre's part to improve his stability so we could move on to more functional movements.

"A lot of the work I did was subtle and I had to really concentrate on how to make these seemingly insignificant changes.  For instance, one of the cues KT uses for a specific series of exercises is to pull the shoulders apart from each other.  It sounds so simple.  But understanding how to do that, then recreating it over and over was really challenging.  What was astounding to me was the impact it had on how the exercise felt and how I could perform it.  These little cues KT has are incredibly powerful.  It feels like I have a whole new relationship with my body and how it moves."

Changes

It took Dre an number of weeks and a real commitment to practicing every day to change the resting alignment of the ribcage and gradually everything else began to change too.  

When you begin working with a patient, the first few weeks is like peeling back the layers of an onion.  What you first discover and address can then often reveal other underlying issues.  In about week 5 Dre came in complaining of a pain all the way down the arm which he just couldn't shift.  I did some tests and gave him a nerve mobilisation which cleared up the issue within days.  

Within 5 weeks he was pain free and his body began to change - not only the alignment but the tone and definition began to show.  It was an unexpected bonus for him.  It just goes to show what good genetics and the right alignment with corrective exercise can produce!

 

Phase 2

As Dre got more stable and more aligned I challenged him with more complex exercises integrating more of the body.  The goal of rehabilitating through movement is to progress the patient as soon as they are ready.  When I first meet patients, it is common for them to tell me they are still doing the same exercises they were given 6, 9, even 12 months ago!  Exercises need to be progressed back up to full functional movement patterns as tolerated by the body.

There were sessions where Dre would slip back into his old habits so I would re-establish the new movement patterns and postures that we were working on.  It's very common to slip back into old habits because these have been the dominant programmes for so long.  Consistency and regular reminders are crucial in the early stages of successful rehabilitation and reprogramming of movement patterning.  

Dre really had to consciously think about his cues and new posture before performing each rep of each exercise in the early weeks of more complex movement patterns.  Movement and your relationship to your body begins to change when you have to think in this way.  I believe your kinaesthetic awareness begins to develop again - you begin to connect with how your body feels. Movement becomes mindful and in many ways more purposeful.

 

The Outcome

Dre was doing loaded functional movement patterns like the lunge and back row work in the last week (week 12) of working with me.  He still can't believe he's been lunging all these years without using his glutes!  We tested the movement patterns he really struggled and often resulted in re-injury before he finished and he can perform them pain free.  

He's now taking himself through a strength hypertrophy phase with his new found alignment and stability.  

He's also been busy editing the video series which I am featured in.  You can watch episode 1 HERE.

If you know someone like Dre who is suffering with ongoing pain and cannot get back into their exercise and enjoying their life because of it, then please share this article with them.  For more information about how I can help you or anyone you know who is suffering with chronic pain or injuries please visit my website or email me direct at KT@precisionmovement.co.uk and mention MANMADE for 25% of your first assessment.