Introduction
Humans aren’t the fastest or strongest animals, but nothing matches our versatility. We can do back flips, run for miles, dance ballet, climb cliffs, throw curveballs, and play the harmonica. We’re born to run, and also to walk, climb, dance, and do millions of other things.
Yet a sedentary lifestyle has been compared to smoking in its effects on health, and chronic pain is the biggest source of physical disability in the world. Everyone knows physical activity works like a “miracle drug,” but few people get a big enough dose. Part of the reason is that movement has stopped being fun. Kids now specialize in one sport younger and burn out faster. Adults have “workout routines,” and the experience is often exactly that: work and routine.
Todd Hargrove’s answer is play. Play evolved to help animals solve complex problems when they can’t be sure what comes next, and all animals build skill, resilience, and fitness through play, not by “working out.” If you want to get better at a sport, find exercise you’ll keep doing, or even get out of pain, you’ll need to play with movement. That means moving in a way that’s fun, exploratory, varied, intuitive, and personally meaningful.
The mainstream approach to training and therapy is all work and no play. It treats the body as a machine to be “fixed,” instead of a living system that organizes itself, adapts, and learns. And complex problems like these often have surprisingly simple solutions. Even top training experts admit it’s hard to know how work in the gym carries over to the field. The surest way to play a sport better is to play the game, and keep changing how hard you play, how often, and by what rules.
Chapter 1 — Movement Health
Hippocrates said, “It is more important to know what sort of person has a disease, than to know what sort of disease a person has.” Hargrove sees movement health the same way, as something that belongs to a whole person. Fitness, skill, structure, mobility, posture, and pain are all part of it. So are rest, the people around you, and the places you live.
Rest matters because stress plus recovery equals growth. If you don’t fully recover, you can’t fully adapt. People matter because the most popular workouts, like CrossFit, yoga, Zumba, and spin class, run on group energy. And places matter because they either invite movement or shut it down. Green fields, hiking trails, and dance floors get you moving. A town with no sidewalks, a job of constant typing, and a living room with every couch pointed at the TV all tell you to sit still.
But of everything that gets an animal moving, the most natural is play.
Chapter 2 — Play
Play helps animals build resilient bodies, get fit, learn movement and social skills, and become more adaptable and creative. The more intelligent the animal, the more it plays. Humans, the smartest of all, play the most. Wayne Gretzky, Ronaldinho, and Johan Cruyff each credit play and pure love of the game for their success, and they worry that overly regimented training and specializing too early do more harm than good.
Play also feels different. The psychologist Mihaly Csikszentmihalyi coined the word “flow” for being completely absorbed in something that takes skill and concentration, when the right actions seem to happen on their own. Exercise that’s unpleasant and meaningless might burn the same calories as exercise that puts you in flow, but you’re less likely to come back tomorrow. People who exercise because they enjoy it, or because it gives them a sense of mastery, stick with it longer than people who exercise to look better in selfies or swimsuits.
Play knows when to stop, too. Animals and babies stop playing when they’re sick or stressed, so play almost never cuts into recovery. Competitive adults are the exception. They can love running or CrossFit so much that they keep going even when it’s piling on stress.
And play is a kind of tinkering. Instead of planning every step, you fiddle with things in a semi-random way, and they tend to sort themselves out. Soccer players juggle balls on their shoulders. Basketball players spin balls on their fingers and dribble two at once. These tricks have no practical use, but the attitude behind them is part of how these athletes mastered their sport. Tinkering works because the body isn’t a machine. It’s a complex system, and complex systems play by different rules.
Chapter 3 — Complexity
Running a machine is a “complicated” problem. Running a body is a “complex” one. For complicated problems, like building a plane, expertise and planning are essential. For complex problems, they aren’t enough. The classic example is raising a toddler, which complete amateurs do well all the time. Toddlers organize themselves and usually do fine with food, shelter, love, and attention. But they’re so unpredictable that even an expert in child discipline might fail to get one to behave.
Here’s a telling sign. You won’t see engineers arguing over what makes planes fly, but experts argue all the time about how to raise kids or grow an economy. When qualified experts disagree about the basics of how to solve a problem, it’s most likely complex. Losing weight, gaining muscle, and sleeping better are all complex. And complex problems often have deceptively simple solutions. Eat less and move more. Go for comfortable runs and add miles slowly. That isn’t always easy, but it isn’t rocket science, and it’s easy to overcomplicate. A program full of rules about sets, reps, and technique can kill your motivation to do it at all.
The body is a lot like an ant colony. It’s made of billions of cells that each mind their own local business, like taking in food, repairing damage, or sending signals to other cells. They have no idea they’re part of a larger plan, yet together they form an intelligent body. We aren’t machines. We’re ecologies. With so many moving parts, looking closer doesn’t always help. Many of Hargrove’s clients with low back pain have been given more than five different diagnoses by different experts.
Coordination is spread out the same way. If it depended only on orders from the brain, it would fall apart the moment your attention shifted. But you don’t crash the car when you stop thinking about driving. That’s why taking conscious control of your movement, like bracing your core or firing your glutes, probably won’t help and may make things worse.
Complex systems can also get stuck. After you sprain an ankle, damage causes inflammation, which makes the nerves more sensitive, which causes more inflammation. Usually a calming loop takes over, as healing allows movement and movement brings more healing. But sometimes it never kicks in. Pain prevents movement, which prevents healing, which prevents movement. Playing with movement is a way out. A new stimulus, even a random one, can shake up the system and wake up healing that fell asleep at the switch. Variety is also what keeps a living system tough. A car missing one tire can’t move at all, but a dog with three legs gets along pretty well.
So how do you guide a system you can’t command? With limits instead of orders. You could order your kids to go outside or read a book. Good luck with that. Or you could take away the screens and tell them they can do whatever they want. They might find something better than you’d have thought of. Self-organizing systems do best with freedom inside the right limits. So stay humble, and act more like a gardener helping something grow than a craftsman shaping an object.
Chapter 4 — Stress and Adaptation
The gardener’s main tool is stress. All exercise, even play, is a form of stress, and almost everything about your physical health was built by it. “Good stress” is usually short, controllable, and maybe even fun, like a roller coaster, a few sprints, or a crossword puzzle. “Bad stress” is long, unpleasant, and out of your control, like traffic jams, insomnia, or an abusive relationship, and over time it leaves you weaker. That’s why exercise is healthy and chronic emotional stress isn’t.
To change, the body needs a reason. Your muscles aren’t bigger because bigger muscles cost a lot to build and keep, and the body won’t pay that cost unless it has to. You have to send a strong message that the body as it is isn’t getting the job done. And it’s “use it or lose it.” When the stress goes away, the gains slowly fade.
Recovery is the other half. One study found that high school athletes who slept less than eight hours a night were 1.7 times more likely to get hurt than those who slept more. Stress also depends on how you see things. Your body reacts less to how big a stressor is than to what it means to you, whether it feels threatening or harmless. If you don’t see a challenge, there’s no stress response. If you do see one, even if it isn’t real, your body reacts anyway.
Hargrove ties this together with a simple picture: a bucket. Everything that stresses you, like exercise, work, money, poor sleep, and illness, goes into it. As long as it isn’t overflowing, you can recover from each stress before the next one comes, and you may even grow stronger. The right amounts can make the bucket itself bigger. But when it overflows, you get warning signs, like pain, fatigue, or anxiety that doesn’t fade with rest. If it keeps overflowing, the bucket shrinks, and chronic stress can wake up hidden weaknesses toward chronic pain, anxiety, autoimmune disease, or insomnia.
The bucket also changes how you think about cause and effect. When back pain suddenly shows up, it’s tempting to blame the last small stress, like a soft hotel bed. That’s like blaming your bankruptcy on the last latte you bought before your account went into the red. The goal is to slowly grow the size of your bucket over time. Every good plan does that the same way: raise the stress gradually, and keep it varied.
Chapter 5 — Fitness
The stress most people choose on purpose is exercise, and it’s supposed to make you fit. But fit for what? The cold? A punch to the gut? A zombie apocalypse? There are many kinds of physical stress, so there are many kinds of fitness. A CrossFit champion, a champion triathlete, and a champion squash player are each perfectly fit for their own sport. None of them is anywhere close to ready for elite competition in the others.
Whatever kind you choose, movement works like medicine. A 2015 report from Britain’s Academy of Medical Royal Colleges called exercise a “miracle cure.” It cuts the risk of dementia, type 2 diabetes, some cancers, depression, and heart disease by at least 30 percent each. Whatever exercise you enjoy helps low back pain about as much as massage, chiropractic, or many surgeries. Running doesn’t wear out your knees. It actually improves function and reduces pain. And one analysis of more than 60,000 people found that exercising just once or twice a week lowered the risk of dying from any cause by 30 percent.
Movement is like food. You need a Goldilocks amount, not too much and not too little, and you need a balanced diet. If you’re short on vitamin A, doubling up on vitamin B won’t help. The bench press is a fine exercise, but if it’s all you did, you’d come up short everywhere else. And if all you do is bike or run, you won’t challenge your mobility or coordination much.
So how much do you need? Health agencies like the World Health Organization recommend at least 150 minutes a week of moderate activity, and ideally 300. Moderate means easy, steady movement like brisk walking, where you could talk but would struggle to sing.
Hunter-gatherers show what a natural dose looks like. The Hadza tribe in Tanzania get about 135 minutes of activity a day, and their 65-year-old elders keep up just fine with young adults. Much of that is walking, five to ten miles a day. And walking is safe. With heavy barbell squats, the difference between a good workout and an injury might be a few plates on the bar. With walking, the margin for error is huge. If you did nothing but walk a lot, you’d be in better shape than most Americans.
When you do train, work on your weaknesses. If you can already run a six-minute mile, getting down to 5:30 won’t change your life. But if you can’t do a couple of pushups, getting to ten might be easy and make a real difference. Still, people tend to train their strengths. Hargrove sees dancers who do yoga in their spare time and frail older women who’d never consider lifting weights. Part of play is the courage to be a beginner for a while. And mix things up, because a healthy meal for one day isn’t a healthy meal every day.
Hargrove boils it all down to three rules. Move around a lot at a slow, easy pace. Often move with some urgency or pick up something heavy. And every once in a while, move like your life depends on it. Consistency beats perfection. A so-so plan you follow for years beats a perfect plan you drop after a few weeks. And something is far better than nothing. The difference between nine and ten hours of exercise a week is tiny, but the difference between zero and one is huge. So do something you enjoy and find meaningful, even if it doesn’t check every box.
Chapter 6 — Environment
Cheetahs that live in zoos suffer from gastritis, kidney disease, high stress, and early death. You don’t need to be a zoologist to see that most zoo animals don’t look happy. The modern world is a bit of a zoo for humans too, though nicer, and usually with better Wi-Fi. Many people live in a small apartment full of screens, commute by car, work at a computer, and keep up friendships by phone. Everything about that setting says stop moving and start sitting.
We underestimate how much our surroundings shape us, maybe because we overestimate our self-control. You can go against the environmental grain if you’re determined, but there’s less friction in life when you go with it. The outdoors is a good example. People like exercising outdoors better than indoors, and they’re more likely to stick with it. In one study, people walking at their own pace in nature walked faster than on a treadmill, yet said it felt easier. Even a view helps. Hospital patients with a window facing green space healed faster and asked for less pain medicine than patients facing a brick wall.
The psychologist James Gibson coined the word “affordance” for features of your surroundings that invite certain actions. A couch invites you to sit. A tree with low branches invites a kid to climb. So you can change how you move by changing what’s around you. Hargrove leaves soccer balls, kettlebells, and resistance bands in plain view around the house, and he can’t resist a few swings when a pull-up bar is within reach.
Here’s how to use this. Spend time in places that invite activity, especially outdoors. Learn basic moves you can do anywhere, because you can’t spontaneously cartwheel on a patch of grass if you don’t know how to cartwheel. Find groups that make you feel valued when you move, not guilty or ashamed. And use what the modern world offers, like the hundreds of YouTube tutorials waiting for any dance step you want to learn.
Chapter 7 — Structure
Your surroundings shape how you move. So does the shape of your body, though not the way most people think. Because anatomy is right there, ready to be scanned and operated on, people assume it’s the key to movement, and especially to pain. Pain usually gets blamed on damage, like a bulging disc or a torn rotator cuff. But the link between damage and pain is far weaker than you’d think. Structure is overrated as a cause of pain, and underrated in how it shapes coordination. Everyone’s skeleton is different, so everyone has to explore to find the movements that work best for them.
Structure isn’t fixed, either. Bones and tendons are always adapting to the stresses they face. In children missing their tibia, the main bone of the shin, surgeons can move the smaller fibula under the knee. Once it bears weight, within a few years the fibula looks just like a tibia. Your body today is the result of years of adapting to how you’ve used it.
Two lines of research show how loosely damage and pain are connected. First, almost anywhere you point an MRI on a person over 30, you’ll likely find significant damage, even where nothing hurts. The surgeon Dr. James Andrews scanned the shoulders of 31 pain-free professional baseball pitchers. He found abnormal cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent. His conclusion: “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an MRI.” Second, many popular surgeries work no better than a placebo, and some common shoulder surgeries work no better than exercise.
Damage still matters. A herniated disc makes pain more likely. Think of damage as kindling for a fire that other things may or may not light. So if you’re thinking about surgery for chronic pain, ask your surgeon some good questions first.
Hands-on therapists often fall into the same trap. Many claim to change bones, muscles, and fascia in minutes with their hands. But mature fascia takes more pressure to reshape than hands, foam rollers, or even steel tools can apply. We aren’t made of clay. If we were, our backsides would be misshapen after a few minutes on a park bench. There’s no evidence that a chiropractor’s adjustment puts vertebrae back “in,” and massage therapists can’t find by touch the spots that feel tight to their clients. These treatments can still ease pain, but they probably work through the nervous system, not by changing structure.
Adults can still change their bodies by adding muscle or losing fat. Dropping twenty pounds will make you a better runner, and adding it will make you a better sumo wrestler. But mostly, the best way to build the body an activity needs is to do that activity. Training off the field is a side dish, not the main course.
Chapter 8 — Mobility
That’s true of mobility too. Cheetahs need a lot of mobility, yet you’ll never see one doing anything to stay limber. Their everyday life gives their bodies everything they need. Young kids follow the cheetah’s plan too. Until about age six or seven, their mobility comes mostly from free play, and the results are pretty good.
Then they slowly lose it. By college, most can’t sit comfortably in a deep squat. But losing mobility isn’t mostly about age. It’s easy to keep if you use it often enough. Hargrove remembers walking the streets of Vietnam and seeing 80-year-old men and women eating soup or waiting for the bus while sitting on their heels. In the West, we sit in chairs instead of on the floor, and we reach for the computer mouse instead of tree branches, so we lose the range we don’t use.
More flexibility isn’t always better, though, because flexibility has a cost. People with very stretchy connective tissue can do amazing things in a circus tent, but they face more risk of joint damage and chronic pain. Loose tissue also costs power. A stiff tendon has more spring, the way a golf ball bounces higher than a flat tennis ball. That’s why elite runners have stiff hamstrings and ankles. They use that stiffness to bounce down the road. The body tends to get rid of any movement slack it doesn’t need.
And despite what many athletes believe, stretching hasn’t been shown to prevent sports injuries. What works better for hamstring and groin injuries is strength work where the muscle works as it lengthens, like the Nordic hamstring exercise.
You don’t need a stretching routine to keep what you have, either. Cats sleep 20 hours, wake up, have a quick stretch, and then move like cats. For people, look at a playground. Climbing and swinging on monkey bars work the shoulders at every angle, and getting up and down from the ground works every joint in the legs. You can play this game anywhere. Get into a position like squatting, lunging, or all fours, then reach a hand or foot to a random far-off spot while keeping your other points of contact. Yes, this is basically Twister.
Chapter 9 — Posture
Posture is another place where people try to fix themselves with rules. The usual warning is that if you don’t correct your posture, you’ll end up with back pain, “text neck,” and more. But the overwhelming majority of research doesn’t show that posture causes pain. Sitting at work isn’t linked to low back pain, and a review of 99 studies found no good evidence that awkward postures, lifting, bending, or twisting at work cause it.
That makes sense once you remember people aren’t machines. Unlike car tires, you adapt to uneven alignment, and you’ve had years of daily practice with your usual posture. Bodies aren’t IKEA parts made in a factory mold, either. Asymmetry is part of the plan. The powerlifter Lamar Gant had a very crooked spine. If he’d listened to the experts about the dangers of loading a bent spine, he never would have broken world records in the deadlift.
The best posture is one that keeps changing. You fidget, shift in your chair, and move from one leg to the other because your body keeps moving the load around. The best posture for you now is different from the best one a couple of minutes from now. Hargrove’s lower back sometimes gets stiff from standing a long time at a party or a museum, and it feels better almost right away when he sits. In a slump! Some of his clients prefer exactly the opposite. Good posture is individual, always changing, and depends on what you’re doing. A one-size-fits-all rule can’t capture it.
In fact, rules can make it worse. Core exercises help back pain no more than brisk walking, or even exercises that relax the core. People with back pain actually brace their core more, so they move in ways that are “stiffer, slower, less variable and more guarded.” Bracing is an instinctive reaction to pain, but over time it wastes energy, limits movement, and squeezes the joints. The physical therapist Peter O’Sullivan often helps clients feel better by getting them to do less work with their abs, not more. As the ecologist C. S. Holling put it, “Placing a system in a straitjacket of constancy can cause fragility to evolve.”
A better approach is to explore. Posture is really about coordinating your trunk with your arms and legs, and about balance. So crawling, walking, swimming, dance, yoga, and tai chi all tend to improve it. And everyday posture takes surprisingly little core strength.
Chapter 10 — Skill
Arthur Lydiard, one of the most famous running coaches of all time, summed up his thoughts on running technique in three words: “Forget about form.” Explaining technique often doesn’t help. To turn a bike right, you actually turn the handlebars slightly left first, so the bike leans right. Telling kids that would probably just confuse them. In most cases, the best teacher is the activity itself.
Seeing and moving work together, so you can’t really practice one without the other. You wouldn’t learn to catch fly balls by practicing running one day and tracking balls with your eyes the next. But that’s what agility drills around cones do. In a game, agility means changing direction in response to an opponent or the ball, and cone drills take that part away. That’s why the best coaches make practice look more like a game. In soccer, they prefer small games, like four on four, over passing drills.
Where you put your attention matters too. The researcher Gabriele Wulf has found that focusing outside your body, like on a target, usually works better than focusing on your body, like on your wrist during a throw. Sprinters ran faster when they focused on pushing their feet into the ground than when they focused on their legs. Focusing on your body is even linked to choking. The coach Nick Winkelman has pointed out that an expert who’s choking moves like a beginner who’s learning. When it counts, focus on the goal, not the method.
The same goes for “correcting” technique. Close to 75 percent of elite half-marathon runners land on their heels, and heel-striking isn’t linked to more injuries. Trying to fix running form often just makes runners slower. So the physical therapist Greg Lehman suggests worrying less about small flaws and more about making the joint stronger, a strategy called “just load it.” Corrective ideas still have value as options to try. If bending your back hurts, get curious about whether better hip mobility helps, and if it doesn’t, try something else. Think in terms of options, not corrections.
Chapter 11 — Pain
That mindset matters most with pain. Most pain works like this: a body part is damaged, sensors near it detect the damage, and a danger signal goes to the brain. The brain decides protection is needed and responds by creating pain. Think of pain as the output of a highly sophisticated alarm system. Sometimes the cause is obvious, like a splinter. But think of all the times a pain came or went for no reason you could find. If pain simply tracked wear and tear, it would keep climbing with age. Instead, back pain becomes more common until about age 60, and then declines. Pain often comes less from local damage than from the alarm system itself.
The alarm exists to protect you. People born unable to feel pain bite through their tongues, get burns without noticing, and don’t know their leg is broken until it collapses under them. Tragically, they often die young.
But the alarm can be turned up or down. When the brain wants you to keep going, it blocks danger signals with what pain educator David Butler calls “the drug cabinet in the brain.” That’s why people in an emergency sometimes don’t feel serious injuries at all. What you see matters too. A construction worker once came to the emergency room in terrible pain after a nail went through his boot. When the boot came off, the nail had gone between his toes. Touch usually lowers pain, which is why rubbing an owie helps. And beliefs matter. Pain that seems dangerous hurts more. Expecting the worst makes pain more likely to turn chronic, while believing that your pain can get better, and that you’re the one who can make it better, predicts recovery.
Pain, anxiety, and depression may all be parts of the same defensive, on-guard state. That’s why few specific treatments beat general ones like exercise, sleep, and less stress. For chronic low back pain, the best treatments are exercise, cognitive behavioral therapy, and learning about pain. For many tendon problems, the best treatment is exercise that loads the tendon at the right level so it can adapt. The body adapts well to the right kind and amount of stress, so “just load it” often works. Recovery follows the simple, but not easy, plan from the chapters on stress and fitness: take on a healthy amount of physical stress, lower your emotional stress, and get plenty of rest. Do everything you can to let your body know it’s strong, safe, resilient, and capable.
Remember the toddler from earlier? With common-sense care, toddlers usually turn out fine, and complex pain often clears up after a few weeks of common-sense care too. But some pain becomes what systems thinkers call a “wicked problem,” like poverty or a failing marriage. Feedback loops lock it in place, and fixing one piece can make the whole thing worse. Movement helps pain, but what if moving hurts? The neuroscientist Herta Flor compares persistent pain to a memory that’s hard to forget.
Often the way out is to shake up the system. The push might be anything: a good massage, a weekend away, some yoga, or lots of walking. It works less because of the details and more because it nudges the system to reset, like turning a computer off and on again. If pain keeps coming back, it may have become a habit, and old habits die hard. But they can die. Addictions can be overcome, and trauma can heal. People who’ve had chronic pain for years can recover, and Hargrove knows this from his own experience and from many others. Change comes slowly, the way living things grow. Perhaps science will someday find a simple fix for wicked pain. Until then, keep playing with movement.