We were over at a book store on the weekend and picked up a book called Incognito written by neuroscientist David Eagleman.
The gist of the book was that the majority of brain activity is largely subconscious. That the brain is continuously processing information and working algorithms to questions and problems that we have inquired about either consciously or subconsciously. A conscious example might be pondering which new computer to buy, factoring in price, model, manufacturer, specs, hard drive size, peripherals desired, etc. Over a period of minutes, hours or days you bounce around the issues until you rationalize a best decision for your needs and wallet. On the other end, a subconscious example might be learning a new motor skill in your gait pattern. For example perhaps, a pathologic pattern is the one being learned. In one case the brain may be subconsciously learning to reduce gluteus medius muscle in an attempt reduce hip joint compression forces and thus hip pain due to a degenerative joint cartilage surface (see Dr. Allen’s recent video, Applied Hip Gait Biomechanics, Sept 15). In this scenario the brain was working out the algorithm to solve for the pain. The brain is continuously subconsciously processing to solve these problems, it is always working in the background, in sleep or in a wakeful state. We have all had these epiphany moments where the solution to a problem comes to you seemingly out of the blue. However, it is not the case. The brain had been at it for some time.
Eagleman describes the conscious brain as a CEO who is handed a final product that has been worked on by hundreds of employees for weeks, those employees being the subconscious brain parts. The CEO is the last to know, they only get to see the end success of hundreds of hours of work by the employees, and they often take full credit because they are the CEO afterall. It is a long process to achieve solutions to complicated problems. Afterall, do you really think Steve Jobs made the iPad all by himself ? Some might.
Where are we going with this ?
Unconscious incompetence: you do not know the right foot has turned out during gait.
Conscious Incompetence : someone has brought it to your attention.
Conscious Competence: you find a reasonable motor pattern to turn the foot in, but you must stay conscious of this pattern for the correction to be maintained.
Unconscious Competence: eventually unknowingly achieving the foot alignment correction. Give the brain the correct information … then give it time and the correct supportive exercise and let the brain figure it out. It will bring that foot inline eventually as long as there are not other impeding factors. The key is making sure that the pattern you teach your client , or that you institute yourself, is not a compensation. That’s the hard part ! You have to know what is right before you know what is wrong. Pick the wrong pattern and you find yourself down a fork in the road that is full of potholes and problems. Don’t guess. See someone who KNOWS. We had a guy fly in to see us yesterday and this was exactly the case. Therapy has been prescribed in-part off of a video gait analysis and incorrect physical evaluation. You can’t guess at this stuff. You gotta study!
Coming directly from our temporal lobes, we are…The Gait Guys