On the flip side, the inability to discern right vs left in those with persistent unilateral pain is well established. As is the loss of 2-point discrimination and fine motor control in acute and chronic pain states. The brain maps can and do become distorted based on various stages of disuse and loss of non-threatening stimuli. They shrink and we can’t access them as well – essentially they are blind spots on the map. Like we can’t even visualize the body regions clearly. I think this happens even in uninjured people who become neurologically locked into specific patterns of movement such as the Left AIC or PEC in PRI-nomenclature. Interestingly, when the mind wanders and attentional focus is lost even our visuospatial system loses symmetry. These asymmetries become further facilitated with each movement that produces successful completion of a task – which only serves to make the existing pattern stronger and perpetuate the blind spots. This can become an issue for those seeking improved output and performance because the brain will not allow high force output to a body region that it does not feel can safely tolerate it – like areas with blind spots. I often see this in people who are segmentally strong but poor integrators.
I mean, we see this everyday as coaches and physios. Here’s a test: pick a problematic movement or body region that you or your athlete is struggling with like a chronic ankle issue. Have them visualize the area without actually looking at it. I will typically utilize the body scan method. A body scan is a mindfulness technique used to bring attention and awareness to the body in a thorough and systematic way. Here’s a script and here’s a guided one I’ll often use – I really like how Todd Hargrove describes it in his most excellent book A Guide to Better Movement.
Have them focus on mentally tracing the outline of the affected region – is it clear? Can they picture the nuances and anatomy of the region as well as they can on the other side? Typically, the weaker and non-dominant side (usually the left side) is fuzzy in the mental eye with blind spots and inaccuracies. The lumbar spine is also often poorly visualized likely because we struggle with segmental control here as well as it’s smaller real estate in the homunculus (might this be why so many experience poor lumbopelvic control and often revert to an extension dominant patterning?).
Improving one’s awareness of the blind spots can improve attentional focus and potentially optimize motor output without inducing a maladaptive response – such as pain, anxiety, excess muscular tension. Because the brain has already “been there” and explored the region, the sensory input (whatever the mode) is likely much less threatening to the system. And it makes the outputs more efficient as found by the lead researchers in my former lab at PT school. The ability to shift attention from one body region to the other has been found to improve with practice and aids motor control by allowing the brain to recognize salient inputs for processing. Look, informational processing is what sets apart those who are robust high performers from the posers.
The bottomline is to seek out the blind spots and then gradually shrink them over time – improving performance in the process.