Implementing the concept of mirror neurons into an exercise setting

Posted on January 5, 2014

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From Wikipedia:

“A mirror neuron is a neuron that fires both when an animal acts and when the animal observes the same action performed by another.”

If I drink a beer neuron X fires. If neuron X also fires when I watch someone else drink a beer, X is a mirror neuron.

In the neuroscience world, mirror neurons are all the rage. You name it, and people have come up with a possible application. Speech therapy, autism, empathy, evolution, the list is extensive. However, it doesn’t take much scrolling to get to the section in Wikipedia titled, “Doubts concerning mirror neurons.”

“According to scientists such as Hickok, Pascolo, and Dinstein, it is not clear whether mirror neurons really form a distinct class of cells (as opposed to an occasional phenomenon seen in cells that have other functions), and whether mirror activity is a distinct type of response or simply an artifact of an overall facilitation of the motor system.”

Perhaps neuron X fires when I drink a beer and when I watch someone drink a beer, but maybe that’s 5% of what X does. Maybe X also spends 95% of its time on cell communication. Rather than call X a mirror neuron, it’d be more appropriate to say X is a “Communicative cell which also has mirroring properties.”

What you find is much of the media, and the scientists, purporting mirror neuron applications are making a lot of unsubstantiated claims.

First, the majority of mirror neuron research has been done on monkeys, not humans.

Second, there’s zero evidence for some of the touted benefits. Scientists have claimed mirror neurons are what help us understand actions. In regards to autism, perhaps a lack of mirror neurons, or a dysfunction in them, is part of the ailment? Say someone makes a gesture at you. According the theory, your mirror neurons for that gesture fire, causing you to understand what that person is doing. Issues with your mirror neurons = issues understanding. And what’s a hallmark of autistics? Trouble understanding social cues.

Greg Hickok of UC Irvine has a lengthy, head spinning, evisceration of the idea mirror neurons provide action understanding hereFortunately, he has some lighter reading on this topic in his blog tooAn easy refutation for mirror neurons providing understanding is using the condition Apraxia. From the National Institute of Health:

Apraxia is a disorder of the brain and nervous system in which a person is unable to perform tasks or movements when asked, even though:

  • The request or command is understood
  • They are willing to perform the task
  • The muscles needed to perform the task work properly
  • The task may have already been learned

So, Apraxia is a condition in which the person is unable to perform a task despite being able to understand the task. They have neurons which fire when it comes to understanding the task, but not when it comes to completing the task. If the mirror neuron theory of action understanding help up, this would be impossible. As the same neurons which understand the task are supposed to be the same neurons which complete the task.

A simpler example: Your dog can understand when you throw a ball for them to fetch; they know to chase it. Yet, your dog can’t throw a ball like you can. The dog has neurons to understand your action of throwing, but these are not the same neurons which help it throw a ball, because for the dog, those neurons don’t exist.

When it comes to action understanding, something else, a lot of something else, is responsible besides mirror neurons.

It seems easy enough until you realize neuroscientists have spent over a decade arguing about this. Now, I’m no neuroscience expert, but with all the people I’ve trained through the years, I know a little bit about how people understand and learn actions.

I feel like anyone who has coached people move in any capacity gets the following: Someone doesn’t merely watch a task then understand it, at least not without prior experience with that task. They watch it; maybe gain some understanding, then perform it; maybe gain some understanding, then get feedback, gain some more understanding, and so on.

Say you’re in the gym and someone is learning a new exercise. Does anyone expect this person to watch the new exercise then fully understand it? Where you demonstrate it for them, then are so confident they understand things, you walk away knowing they’ll have good form? Of course not. You demonstrate it, they do it, you give them feedback, and so on.

This seems to be a big part of how we grow up and comprehend the world. I wrote about this in my post on Dr. Drew’s book, The Mirror EffectThe idea is as we grow up our parents, or whomever is around us a lot, provides a great deal of our understanding of well, practically everything.

If a kid is in pain, how does he or she even know what pain is? Sure, there’s some innate component, but think about it. A kid is running around, trips and bumps his head. He gets up, looks around, and overreacting mom comes rushing over freaking out “OH MY GOD ARE YOU OK?!” The baby learns based off what they see; what’s mirrored to them.

In other words: kid bumps his head, mom demonstrates what happened is a painful event, kid tries being in pain (they cry), mom gives feedback (“I know, I know, that must of hurt”).

Watch what happens in the following video. Notice when mom isn’t giving predictable responses -many of which have been learned at this point, the baby freaks out:

This is a long way of endorsing how trainers, therapists, teachers, whatever, should be showing how to do something before asking someone else to do it. When it comes to learning, visuals seem to be how we learn best. It’s better to show what smiling is than to only ask someone to smile…It’s better to show what a lunge is than to only ask someone to lunge.

So, mirror neurons aren’t why we understand tasks. What do they do then? In fact, do these things even exist?

Are mirror neurons real?

As I mentioned, an issue with the mirror neuron world is the majority of the research has been on monkeys. There is research on humans though. Here are some papers that have helped me wrap my head around this:

Notice the titles and the dates. In 2008 mirror neurons were found in humans. In April 2009 we found no evidence for them. Then a few months later we found evidence for them. And I’m only picking a few studies.

On top of this, these studies are insanely hard reads. This is partly because it is high level stuff, and partly because academics of this sort like to write in the manner of, “SPEAK ENGLISH!!!”

Because of the above, in combination with my remedial knowledge of this stuff, I’m not going to delve into these studies. Here are some major points:

-One of the confounding issues is which area of the brain is looked at. Not all studies look in the same area. “Why don’t they all look at the entire brain to simplify this?” Apparently, when you look at only one area you get a much better idea of what’s going on than when you look at multiple areas. Some scientists have different hunches as to where the mirror neurons lay. So, that’s one reason they decide to direct their research in certain brain areas. There’s a race to find these things and each scientist thinks they have the fastest route.

-Not all studies assess the same movements. From a different paper, What we currently know about mirror neurons:  

“Mirror neurons were originally defined as neurons which ‘‘discharged both during monkey’s active movements and when the monkey observed meaningful hand movements made by the experimenter.” Thus, the key characteristics of mirror neurons are that their activity is modulated both by action execution and action observation, and that this activity shows a degree of action specificity.”

The last part is the most important. In order for mirror neurons to fire, specific actions have to happen. This is what the researchers call “Goal oriented actions.” Think the difference between reaching for a piece of food and randomly moving the arms. The first is goal oriented; the second is not. Mirror neurons fire in the former; they don’t for the latter.

-The last study, which found mirror neurons, seems to be the best out of the group. They used goal directed actions and they looked in a place where it makes sense mirror neurons would be.

Let’s bring back the criticism quote from the beginning:

“According to scientists such as Hickok, Pascolo, and Dinstein, it is not clear whether mirror neurons really form a distinct class of cells (as opposed to an occasional phenomenon seen in cells that have other functions), and whether mirror activity is a distinct type of response or simply an artifact of an overall facilitation of the motor system.”

This still holds. What the studies show is cells appear to have the ability to mirror, but we don’t know if there are neurons whose sole function is to do this. For our purposes, does this even matter? If there is a mechanism for mirroring; there is real world application to be had.

Some understanding of why the brain is doing this can help with our application.

What do mirror neurons really do?

Remember, Hickok has been one of main critics of the role of mirror neurons, BUT, he believes they exist. His criticism is aimed at what other scientists have proposed their role to be. Therefore (from his blog),

“I’d like to propose the idea mirror neurons take sensory input for a motor purpose.

Can we learn something from the behavior of dogs? If you’ve played fetch with a dog you may have noticed that it quickly learns to anticipate the consequences of throwing actions. For example, it is not hard to fool a naive dog who plays a lot of fetch with a fake throw. Even though the ball isn’t flying through the air the dog may nonetheless take off in chase.

Presumably, the animal has learned to recognize throwing actions. This is interesting because dogs can’t throw and so can’t have throwing mirror neurons. This is also interesting because somehow the action observation, throwing, is triggering an action execution, chasing, in the dog. This tells us that and action observation-execution sensory-motor circuit exists in the animal.

There may even be “chase” cells in the dog’s motor cortex that fire both during action observation and action execution.

Put more succinctly in a paper from him- (Mis)understanding mirror neurons:

“Observed actions can serve as important inputs to action selection, including but not necessarily limited to, mirror actions. “

As a dog, you have a mirror system for certain movements. Your owner throws a ball, your mirror system fires, reflecting the throwing motion, which signals you to chase after the ball. The sensory input is you seeing the throw, the motor response is you chasing the ball. Sensory input => Motor response.

If you’re a human though: You still have a mirror system for certain movements; you watch someone throw a ball, your mirror system fires, reflecting the throwing motion, which can possibly signal you to also throw a ball. 

If you’re a dog, your brain can mirror the action, your body cannot. If you’re a human, your brain can mirror the action, and so you can your body. If you’re a dog, you can’t form a motor response which mirrors the sensory input. You have the neurons to mirror a throwing a motion; you don’t have the neurons to respond with a throwing motion. If you’re a human, you do.

What’s crucial here, I believe, is it appears if you are able to generate a motor response that mirrors the sensory input, the brain circuitry is the same. This is referred to as producing the same neural substrate.

For example, you watch someone throw a ball, your brain fires in the “throw a ball” manner, producing the “throw a ball” neural substrate. Whether you watch someone throw a ball or throw a ball yourself, this neural substrate is the same. So, watching someone throw a ball can help you throw a ball as the brain is practicing the same circuitry. Whether your own body moves or not, your brain is practicing the movement. If you’re a dog, this isn’t true. But we’re not worried about dogs.

We now have our framework for real world application.

Implementation

Think of athletes. When trying to change their technique, what do they often do? They watch film. Usually a combination of themselves to understand their flaws, along with watching whatever it is they’re trying to attain.

Say you think Roger Federer has perfect forehand technique, and your forehand technique is lacking. You may watch film of Federer to pick up on his technique. We now have an idea why this works: the mirror system. Watching his forehand technique produces a similar circuitry in your brain, as if you actually swung your racquet.

There’s another perk of learning this way- it’s less intense. As a baseball pitcher, you can’t work on your technique through actual throwing indefinitely. You can’t throw everyday, all day. You’ll overtrain, burn out, get hurt, lose strength, etc.

I wrote about this in How many sets and reps to correct muscular imbalances? I used strength and hypertrophy in that post to exemplify there is an optimal amount of volume when trying to get attain something, such as getting stronger and bigger. Go above or below this threshold and you run the risk of attenuating gains. You can’t always be “on.”

The brain however, is always on. So, using our mirror system enables us extra practice without the expense of hampering gains. We’re still using the brain, but we leave the musculoskeletal system alone.

“Isn’t this mental imagery / visualization?”

Not quite!

This is where the work of Lorimer Moseley and the NOIgroup comes in handy. They have a great resource, The Graded Motor Imagery Handbook. They talk about how different levels of imagery elicit different levels of brain activation. Visualization / motor imagery, imagining yourself doing a movement, elicits the greatest level of brain activation without actually moving.

Contrast this with observing people (mirror system), which is, they think (we don’t know for sure yet), the lowest level of brain activation.

So, compared to motor imagery, we’re activating less of the brain.

“Isn’t that bad?”

When you put things into the context of an exercise program, no. I think it’s actually good. Just like the muscles, it’s not like the brain can be on 24/7. Using observation allows us to practice at the lowest intensity level possible.

Speaking of context, let’s remember we’re using all this in the realm of teaching people how to move differently. We’re usually trying to get people out of habits that have been ingrained for a long time. In my experience, people have a very hard time initially knowing when they’re moving better. They just don’t know where there body is in space. They forget their knees are caving in, how they’re standing, their elbow positioning, whatever it is. They need constant reminder and feedback of how to move differently.

Let’s say this population uses motor imagery. Instead of squatting, they’re imagining themselves squat. How does anyone know if their form is bad? There’s no way to give them feedback. If I’m working with someone I can’t let them know their knees are caving if their knees aren’t actually moving!

This is important because we don’t want them getting better at a dysfunctional movement. And, in motor imagery, the brain is firing almost as much as if they were actually moving. You might not be able to see the dysfunction, yet they could still be practicing the dysfunction in their head.

Therefore, I believe using observation is better. Here’s how I do it:

  • In a corrective setting, from Monday – Sunday I outline what to do for people. 6 of those 7 days involves actual exercise. 3 of the 6 days are dedicated to one workout, workout “A”; the other 3 of the 6 days are dedicated to the other workout, workout “B.” This fits in line with the optimal frequency to train muscle groups for beginners.
  • One of the 7 days there is no regular exercise. Instead, I have the person focus on their activities of daily living. They’re going to be moving during the day; let’s do it well.  I also have them watch videos of the proper form of certain exercises, and I have them observe other people’s movement dysfunctions which are similar to theirs.

Let me use a recent example; someone with a common issue. Alex is someone presenting with knee pain. His femurs tend to rotate inwards too much, and his lower leg tends to rotate outwards too much. His knees turn in too much; his feet turn out too much.

On Monday, Thursday and Saturday, he has various exercises aimed at working on this. On Tuesday, Friday and Sunday, he also has various exercises working on this, but these 3 days of exercise are different than Monday, Thursday and Saturday. This way we’re not working the exact same muscles and movements more than 3 days per week.

On Wednesdays, when there is no prescribed exercise, Alex works on his ADLs (he also does this the rest of the week), which are aimed at his movement dysfunction.

Next, he watches some of his prescribed exercises to further ingrain proper form. He might watch the ones which have been the hardest for him to nail down, the ones I think have most benefit, or the ones which tend to give him pain. This way he gets to watch people do a movement which may give him pain, in a pain free manner.

Finally, he watches other people throughout the day. Observing others who 1) Have the same issue and 2) Don’t have the same issue. Paying close attention to the differences between these groups. Now his observation has a goal. It’s not random people watching; it’s people watching with a specific focus. The idea being he wants to “mirror” the better movement and learn to avoid the improper. He takes his sensory input -watching good and bad movement at the lower body, and uses that to form a motor response -his own good movement of the lower body.

This way, 7 days per week, Alex is working on moving better. Whether it’s through actually moving better throughout the day, specific exercises, watching other people, all week he’s doing it.

As you can see, I’m only prescribing this with people one day per week. The person can do it more throughout the week, and I think that’s a good idea, but there’s only so much time I can expect out of clients. Because I’m getting used to this myself too, this seemed like a nice way to start things.

In terms of research to back this up, Moseley’s group has had some good success clinically, but haven’t really studied something of this nature yet. There are a ton of studies illustrating the benefits of using motor imagery in conjunction to physical therapy, but again, this isn’t really motor imagery, and I’ve only seen studies on neurological patients.

As far as I know, the only population trying something like this is athletes, which is a good thing. I’m not big on training people like athletes, but it’s uncanny how often the athletes are ahead of the researchers.

Peyton Manning recently had to sit out of practice due to an ankle injury. He needed to give his soft tissue some time to relax. But, he knows his brain is always on. That’s why you still see him doing mental reps:

Peyton Manning mirror neurons

Hard to argue with the results. Sensory input -watching film and reading pictures => Motor output -destroying defenses (except when it’s cold). Maybe Eli should work on his mirror system more. BOOM! Hall of famer my ass!

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Posted in: Miscellaneous, Pain