‘Decrypting’ the Body: Dominik Koch on C- section scars, Barefoot shoes and Stretching

Hi everyone,

I have recently been working with Dominik Koch, of Decrypt Bodywork on some aspects of my personal movement that I haven’t been able to figure out to this point, and boy, did I go to the right guy! I’ve been really taken aback and humbled by his knowledge and so I wanted to try to give my readers an idea of what he does.

Little did I know that a cesarean section scar from 7 years ago was hindering the movement of my pelvis, nor was I aware that an old knee injury was preventing my left foot from moving well. I was busy stretching and rolling my feet on balls, wearing my trendy barefoot shoes, confident that I would eventually make my bunion disappear, and my chronically bent at the knee legs straighten, except in all that time (about 4 years) the bunion hasn’t disappeared, and my legs are still chronically bent, meaning my quads are always working incredibly hard in standing and in gait. I feel for the first time in a long time that through this exploration with Dominik, I might ‘decrypt’ the puzzle that is my body, my unique and beautifully imperfect body.

And so for any of you that this resonates with, I invite you to take a look at his website here: Decrypt Bodywork, and you can also find him on his Instagram page here and his Facebook page here. He offers a wealth of free videos and resources on his social media to get you started “setting your body free, making it flexible and strong by providing a long term solution that works.”

An Introduction to Dominik’s work (taken from his website)

I have a history. A history of chronic neck and shoulder pain. I was used to waking up in pain and going to bed in pain. Without finding relief from of others, I had pretty much given up. When I was at my worst, I woke up unable to feel and move my left arm… Here I was again, looking for help from others that kept giving me the same stretches, the same massages and the same useless advice about posture.

That’s when I decided to figure this out on my own. I had no other choice…I went on a journey to learn. Learning to read, to listen to and to understand my own body. To connect with it and to experience it, its movement and why my neck had been bad for so many years.

Eventually, I began to understand that the answer to my neck and shoulder problems was in my left foot…This may sound crazy, but if the foundation is not right, the building on top will be wonky, right?

When I came across Gary Ward’s book  “What the foot” I was finally able to piece everything that I had learned into a global picture. My attempts to find new movement in my left foot and leg is what solved neck pain that had been there for most of my life. I will be forever grateful for his work and for giving me back a life without pain. Read more here.

Listen to Dominik’s story and his thoughts on preventing injury on this WeMove podcast episode here.

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Bare Soled Conversation

1. Could you tell me a little about the focus of your work?

I help people move and feel better by finding the missing links that are holding their body back. These are the parts of their body that have been overlooked, ignored or untreated in the past, but which their body is still moving around in an attempt to ‘be safe’. The majority of people that come to me “have tried everything” for their persistent pain, limitations, or recurring injuries. It very quickly becomes clear that no one has ever asked why a particular structure is overworked or restricted, and what its greater role is in a person’s movement and life. The parts that hurt are often simply our body’s solution to working around something that isn’t playing alongWhen we find those missing pieces we can offer alternatives that make lasting change possible. Gary Ward’s ‘Anatomy in Motion’ helps us in this process.

2. In your view, how can a cesarean section scar impact the movement of the body?

Any scar in the body, not just from a c-section is a potentially vulnerable area for our system: If I do not want to risk re-opening the wound, I can do that by avoiding any stretch that goes through the area. This is what will allow the tissues to heal and bind together again, so I definitely want to do that for a certain amount of time.

The amazing thing is that it just happens – I don’t even have to think about it. This is because my organism is self-organising and it instantaneously and constantly chooses movements that it knows keep us (and the area of a scar) ‘safe’, ultimately allowing it to heal.

Joint motions are what put our tissues under stretch and load – we need this loading of tissues in order to move. In the case of a c-section scar, which obviously goes very deep, the body may avoid movements around the pelvis and spine that would otherwise ‘pull’ on the scar. We could say that our organism seems to adopt new patterns in order to protect itself. These patterns however often go unnoticed and before we know it they may become our body’s default way of moving, even long after tissues have healed.

If I am now subconsciously avoiding a certain joint motion, it will affect how evenly or unevenly I distribute work and load across my body’s joints and tissues, potentially leading to problems and restrictions around those areas. 

3. What are some steps to take to reduce this impact?

Give it some time and allow it to heal. Then just become aware of lower body movement and areas that your body may be avoiding. Gently offer the body a way to access those parts again, to show your brain that these areas can now be stretched again. 

If someone is concerned about an old c-section scar, first of all, we need to be clear on whether this is actually an issue, rather than guessing or just assuming that it is. It may not be an issue for the person at all. But once we have assessed that it is, in fact, impacting movement, it’s the same principle: How can I show my body that re-introducing these specific joint motions, thereby inducing a stretch and load through the area is not only safe but in fact beneficial? Of course, we would also want to introduce shortening as well, in order to give the tissue its full range back. 

A nice gentle way to start would be to sit on a chair and let the pelvis tilt forward and back – around a centred point (if viewed from the side). Most people will pull the pelvis up into the lower back (i.e. move the axis of rotation back and up), actually offloading the area of the scar. As a mini-assessment: If that is the case, try touching the scar while doing the movement – does it change how you are able to roll ‘around’ the centre axis?

4. Do you find there is an emotional element to holding tension due to scar tissue, especially at the pelvic area due to the birth of a baby?

For some people that is true. People say ‘trauma lives in the body’ and it is something that I regularly see. But I would not go as far as saying that every scar holds emotions. Sometimes it’s simply the realisation that things have changed due to an event (birth, injury, etc.) that brings on a moment of reflection.

5. Do you see a correlation between pregnancy and diastasis recti?

I think it is first of all useful to try and understand the mechanisms behind diastasis recti. As most people will know, it is an ‘opening’ of the linea alba – the line of fibrous tissue between the ‘six-pack’ muscle. In my opinion, this opening can happen because of ‘excess’ movement in that one direction. With diastasis recti, movement and the resulting stretch/load often seems to be ‘channeled’ through that small area rather than being evenly distributed.

Pregnancy, of course, creates a bias towards this lengthening through the front, but there is probably more to it. We see men as well as women who haven’t had babies with diastasis recti after all. (Learned behaviour when growing up and genetics would start another conversation, but that would go beyond the scope of this answer 🙂 )

In my mind, when I see ribs that like to flare, oblique muscles that don’t work much (no or little rotation/lateral flexion available), and a pelvis that doesn’t move freely, then diastasis recti may just be the result of that. Could that have been there before pregnancy though and pregnancy just exaggerated it?

6. Can wearing barefoot shoes help with restoring movement?

Barefoot shoes help to connect with your feet – definitely! I occasionally wear barefoot shoes because I like the feeling. They can help someone become aware of their feet, and maybe even to strengthen them. But if a joint in the foot is not moving when we assess a foot, then it is also not going to move in a barefoot shoe (it’s what’s written on the tin!). If there is an injury history on that foot, the body will still move around it, no matter what shoe is on the foot until we show it that it can do otherwise.

Likewise, if movement in a foot is restricted because of something else higher up, then barefoot shoes probably won’t bring that particular movement back. For example, the position and available movement at my ribcage and pelvis affect what happens down at my foot (and vice versa). If I tuck my pelvis, it leads to a different pressure distribution in my feet compared to an anterior tilt – the 33 joints in each foot have to adapt to the change above. But if I am unable to move my pelvis, my foot probably won’t change – because it doesn’t have to. At the end of the day, it is about my body’s mass management…Once we understand that, we can explore alternatives to re-organise it.

7. Will stretching in general help?

I would ask, “help with what?” 🙂 What is the intention behind a stretch? Does it make you feel better? Does it make you feel relaxed, help you calm down, unwind? Then stretch! Do what you enjoy!

When it comes to pain and injury, however, more often than not stretching can be counterproductive if we are not clear on what we are stretching and why. Generally, we all want to stretch muscles that feel ‘tight’. But what is tight really? If we don’t think about our body for a second: if a t-shirt is too ‘tight’, everyone would agree that the fibres of that t-shirt are stretched because I have gained a few kilos during lockdown. A ‘tight’ rope is taut because it is being pulled on from both ends. Weirdly, when it comes to our body we think of muscle ‘knots’ and contracted muscles but often the opposite can be true. Our brain just doesn’t have a way to tell us the difference.

People’s hamstrings often feel tight because they are already stretched long all the time, unable to offload and to shorten. If I am clear on the state of a muscle, then I can make a decision on whether it needs stretching or actually shortening in order to take pressure off, if that is what I want to achieve.

8. Any other advice, you think might be useful for c section mamas?

Don’t worry! Enjoy your family 🙂 

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