When we think of a mirror, the following associations scan through our minds:
- Something we don’t want to see (blemishes, how tired we look, crazy hair, food in our beard)
- Classic film prop for revealing something unpleasant (lurking murderer, face from sordid past, etc)
- Bloomin’ expensive
Even in a metaphorical sense, it has negative connotations:
- Facing up to unpalatable parts of our character
- Spooky mantras that lead to lifelong curses
- Bad luck if shattered (not just because of the cost)
The classic line of ‘Does my bum look big in this?’ invariably conjures up a domestic scene on the brink of upset as a lady twists herself around uncertainly in front of a full length mirror.
But I am here to persuade you that despite all that, a mirror is a GOOD thing, a wonderful thing, an invaluable tool and invariably your friend.
To persuade you gently, I’ll begin at a point hopefully remote from your direct experience. Stroke sufferers can benefit hugely from ‘mirror therapy’ when one limb simply won’t follow instructions. Fascinatingly, it has been shown that allowing the brain to see the activities of a functioning hand reflected in a mirror (therefore looking like the affected hand but actually obscuring it) stimulates the part of the brain that controls the unmoving hand. It’s a way in that is fairly new, but creating wonderful achievements for those who in the past may have been left disabled and hopeless of any return of function.
The QI team demonstrates another example of how the brain can misconstrue what it sees and adopts it as a new part of the body, and the effects,felt within minutes, have huge implications for all sorts of physical therapy, such as prosthetic rehab and posture correction.
Getting a new hand - QI
Just a few minutes people-watching on a park bench can reveal a huge range of walking styles that the body has developed through life in a quest to find the most efficient method of locomotion. The wide variety is due to the body taking into account the restraints our unique activities and previous traumas have placed on it. Even though the telling signs might be small (such as a slight change in the angle of the knee, as in the picture above) they can point to a whole chain of bad habits that will compromise performance and may risk injury. Physios spend many hours improving on these learned patterns, and the battle is always to counter the deeply ingrained muscle activations built over years with the relatively few hours that they have to train.
Gait retraining, therefore, needs to be just as repetitive as our bad habits, increasingly challenging, and with as much feedback for the patient as possible. This approach actually reorganises the cortex of the brain, whereas strength training does not. And how can we best give this feedback? By the simplest, most accessible of household objects: The Mirror.
Gaining this immediate feedback can be done with almost any area of difficult movement or dysfunction in the body, and therefore applies to everyone out there. Often I can bring people’s attention to rotations or mis-algnments in their own bodies, simply by pointing it out to them in the clinic mirror. I remember casually musing to a schoolfriend (before I became a physio – and more tactful!) that he ‘had always walked funny’ and he was genuinely shocked to observe his own rocking tip-toe walk in a video. These are not cruel tactics on my part, but an essential first step in helping people understand what they are up against, why their shoulder pain just won’t go away, or why their neck pain is related to their rotated hips.
Facing themselves in the mirror can actually have quite a profound effect. So many people (myself included) are sensitive to our ‘faults’ being pointed out, and many of us are completely unaware of how we move. I encourage patients to do their exercises in a mirror so they can practice, self-critique (not criticise) and most importantly, see their own improvement. At the very least, I give prompts for them to remember (keep your knee over your toe, etc) so the brain can feel this, see this, and start to build new, better patterns of movement. This really is key to long lasting change for your body – just an hour in the therapy room is not going to cut it. The mirror can serve as your therapist at home, in the gym, in the shop window.
Self-management is a core principle of Arcadia Physiotherapy. Self-talk is also a hugely important theme in pain and recovery. Do you shy away from the mirror, afraid of what it will show you? Do you criticise yourself internally, and even out loud? Too often we look for the bad and not the good. For a fascinating read on the history of this and how to turn yours around read this. Accurate self-perception and positive self regard has been shown to aid recovery times and improve overall well-being. So the next time you pass one, perhaps try looking yourself in the eye as you would a friend, not a rival, and tell yourself that you’re in it together – mind and body – to make lasting change for the better.