Antifragile PT: What does it mean?
Antifragility is an phrase coined by economist and philosopher Nassem Nicholas Taleb; he noted other individuals were attempting to create complex models to essentially predict the future of world economies, politics, etc. He argued (unsuccessfully, for some time) that they failed to ignore “Black Swan” events – or singular events (how often do you see a black swan?) that completely disprove or disrupt the predictive models (his analogy is you can no longer say “all swans are white” once you see the first black one, and must therefore reconsider your theory).
Antifragility grows from this – creating systems and behaviors that not only don’t fail under stress (fragile system), but actually gain from it (antifragile system). Even resilient systems only come out as they were before the stress is applied – no better, no worse.
There are examples of this in daily life – post-traumatic growth, encouraging “grit” in our children, but the most obvious example to me is exercise and the human body.
Exercise is stress. Exercise is inflammation. Exercise is pain (if you do enough of it).
Dosed correctly, this steady diet of inflammation and soreness creates positive adaptation – whether it is improved endurance, athletic performance, ability to get up off the couch, or less pain in daily life. Dosed poorly – either starting too vigorously or done insufficiently - the system starts to crack from overload OR becomes less adaptable as it is not challenged.
But lets be honest – if you’ve ever had an injury, simply walking down the stairs, sleeping, or putting on your shoes are stressors. And traditional physical therapy tends to end there – change the stressors, give you low-stress but progressive exercises, and as your pain dissipates over time, then declare you“fixed”! Back to life, right?
And that is fine for many of the individuals that walk into a typical physical therapy office. And then there are the regulars – those who need an assigned seat in the waiting room in the physical therapist’s office. The runner who trades IT band complaints for plantar fasciitis for piriformis pain; each complaint is treated as isolated conditions and the traditional physical therapy model (rest, light exercise, manage inflammation, you’re cured!) is applied.
The AntiFragile Approach
There is a different story – to me, there is a system that is unable to adapt to stress (ground reaction forces).
The question is not WHAT hurts, but WHY it hurts.
Some answers are simple (fell down, stepped on rock), but many are not. They are long standing, variable (how frustrating to not be able to even predict WHEN you might have symptoms), and tend to respond less readily to the quick fixes that work for everyone else.
This is not exclusive to runners – TMJ complaints, headaches, spinal pain, tennis elbow, tendon injuries throughout the body – all can be issues related to UNDER stress throughout daily activities and consequently failure (fragility). Or due to OVER stress simply because your baseline to system failure is different or altered for any number of reasons.
This is the difference we offer; not the exceptional manual therapy (though Jeff & Wes are two of the only fellowship-trained manual therapists in WNC), or pragmatic exercise selection, or a keen eye for movement analysis. But that we are applying these things to YOU in order to turn your problematic movement, pain, or activity choice into a positive stress that makes you bend, rather thank break.
Fragile = Weakens under stress
Resilient = Original state under stress
Anti-fragile = Gains from stress
Where do you want to be?