Salvatore Vuono
Remember when your parents taught you how to crawl? And to walk? And to reach your arm out to grab something? Actually, you don’t…but not because your memory is failing you. You don’t remember because it never happened. I mean, you did those things, but you were never actually taught to do those things. You didn’t have to be. They came to you instinctively by way of pre-programmed movement patterns called engrams that are encoded in your brain.
Put simply, engrams are like innate computer programs for movement, the neurological blueprints for complex actions. They dictate which muscles will be used, in which order and to what degree. Reaching may not strike you as a particularly complex action—you do it without a thought– but the reality is that it requires a highly coordinated activation of numerous joints and muscles from your toes to your fingers, all carried out with remarkable precision. Shoulder, elbow, wrist, and finger movements have to be synchronized to reach out just the right distance at just the right level, with a steady limb that adjusts to objects of variable shapes and weights, and balance has to be maintained despite the constantly changing center of mass to boot. Crawling is even more complex. And walking?? Forget about it! With all that entails, your head might explode if you had to consciously think about how to take every step. Luckily, engrams allow us the luxury of running on autopilot…literally.
But the real reason to know about engrams is this: like actual computer programs, they are prone to glitches. Mishaps result most commonly from acute injuries or chronically poor body mechanics. Spraining an ankle or fracturing a leg disrupts the body’s walking engram. Being sedentary at a desk for 8 hours a day, 5 days a week causes key muscles like your glutes (buttocks) to shut off due to chronic disuse, which interferes with multiple engrams. Such software snafus force your body to resort to Plan B, relying on second-choice muscles to get the job done. Those substitutions put you on a path of dysfunction and pain, seemingly unrelated to the original injury or problem (e.g. back pain a year after an ankle sprain).
That is why rehabbing an injury like an ankle sprain is about much more than relieving the pain, restoring strength, and making sure you can walk from point A to point B. It is about making sure you can perform those activities correctly, i.e. according to original engrams. It’s not enough to restore individual components of function without also restoring the neurological connections that make them all work together properly. That is what will minimize the chance of re-injury, and only then is the rehab complete. [This, by the way, is why people who merely “walk it off” and don’t follow through with the necessary rehab find themselves suffering recurrent ankle sprains.] The goal is to rehab entire movement patterns (walking), not single muscles (calves) or isolated movements (ankle flexion).
