Active Motor Learning and The Observer Effect for SCI Rehab – “Murder in the City”| Feb 16 – 22 2025

2/16

My legs have filled out so much in the past 24hrs, I say my legs, but that leaves out my abs, low back, and pelvic region as well! It’s truly remarkable what constantly putting new stimulus on your body does. Whether it be new textures and materials, new exercises, or even just new mental imagery to help tie it all together! I’m so freaking stoked about this progress, it’s unreal! 

Also, this dump angle change has only improved my quality of life so far, everything is easier! I don’t know what that steeper dump angle was doing for me except tightening up my hamstrings!? I guess back in the earlier days after the accident it was necessary? But not now.

The constant sensation on my legs is really helping! And my knee inflammation on my right knee is like, totally gone! Just need to keep up the progress!!

The feeling through my feet and floors of my feet right now is intense! Everything is waking up so significantly!

Wow. What an amazing morning. I haven’t had a morning like that in forever. I’m really lucky to have Callie, she makes everything so special. I feel so trusted and in a safe place with her. The sensation increase has been incredible! 

My quads have overtaken my hamstrings, in terms of proprioception and strength I feel! My hamstrings aren’t constantly fighting me! My abdomen is holding me up even better, engaging more throughout my lower abdomen and more evenly on my left and right sides as well! 

It’s been really interesting working through my pelvic movement, and really focusing in on initiation of steps, and how they rock and rotate during each step as well! That’s been a huge development these past couple days as well! 

Holy smokes!! I was in a slightly precarious position, in tall kneeling, and I was able to support myself on one knee (with hand supports) and swing my leg back and forth to initiate the movement to get myself into a half kneel by myself?!?! That was really cool!!! I need to figure out how to pull my leg forward enough to get into the half kneel position?!

I’m really interested to know how dancers and gymnasts maintain their muscle mass and strong neurological connection while also increasing flexibility? There’s a mental block in my head currently that says, “the looser you are, the weaker you are” how do I quiet that intrusive thought and fill it with the right ideas? I think some reframing is in order!

Yeah, eccentric loading?!? Seriously relives tight muscles so well!! My legs were stabilizing me better than ever during all this overhead back work on the cable machine! I’m really excited and happy that this new seating position is helping my legs even more! Honestly, I think I need an adjustable seat to change seating angle!?!

You ever close your eyes, and really hone in on your feet? To make sure they’re there and feeling? Holding you up? Because that’s what I just did as I was pulling this hoodie off. It really helps. Small things. They all add up!

  1. Legs straight on their own (no knee support) while I’m in the walker
  2. Initiating leg movements for walking/ initiating and getting myself into a half kneel
  3. Getting myself up onto 2 legs from a half kneel
  4. Holding my torso up in the standing frame

These are all areas I really want to focus in on in PT. I need to have some talks and discussions about how things are going, and how we can possibly adjust some of the things we do for targeting these goals!

2/17

I updated some of my goals from yesterday, let’s have that talk with the PT’s today! I think this will give me a bit more structure when I go. I think there is something intrinsic with having me initiate movements on my own. Maybe get help after I start, but important for me to always be initiating, and then attempting to complete them on my own. I’m not sure exactly what this is, it reminds me of how infants learn, you don’t have mom and dad down there on the floor, initiating the steps for them? It’s just the infant. I wonder what this term is called? 

Here’s what I found on this topic and idea,

• Intrinsic Motor Learning – Learning that happens from within, through self-driven movement and exploration.

• Active Engagement – The idea that the nervous system rewires best when the individual is actively involved rather than passively guided.

• Self-Generated Movement – Like how infants develop movement patterns by trial and error, without external initiation.

• Motor Independence – Ensuring the person initiates and controls movement as much as possible for better neural adaptation.

In rehab and PT, this often falls under “Task-Specific Training” or “Active Motor Learning”, where the focus is on self-initiation, repetition, and progressive independence in movement patterns. What’s interesting is how I really like to be doing these ideas at home, and get maybe a bit more assistance from the PT’s? I think the idea of repetition is also important, but there seems to always be more going on than what we seem.

Goodness. What a day. Sometimes, I’ll tell ya what, these days are long, and filled with a lot of activity. It is -1F outside, it’s chilly in the apartment right now. Today’s been a rough day for the body, idk if it’s just really cold or what, but it’s been tough.

Today at therapy, Kim gave me quite the compliment, I must say. When I was working on holding myself up in the standing frame, she went to my profile, and commented, “wow! You are really straight, Joe.” And then further explains, that someone with my level of tone, it really does show how much work I am putting in to not get contractures. Those are basically when your tendons and sometimes muscle tissue harden (calcify) and basically need surgery to have them “removed” it’s terrifying. It’s honestly like one of my biggest fears ever because if that happens, my chances of walking again would go away so drastically. It’s so sad. It’s wild to think that our body will basically turn into a bone if you don’t move them. Wild. sad. scary. it’s sad because this is the reality i have to live in. I have to keep moving and keep getting better!

The floor work we did was really great too! I’m really happy with the half kneeling work we did too!

The braces! gotta setup an appointment for thus!

The sit to stands with the strap! these all went so well too! I was really excited to have been able to try to do sit to stands without a huge amount of a knee block! these went well!

The book, I ordered, I’m really excited about too! more to come on that!

Nothing is new, everything is just observations and building off one another. i truly believe this. we are all just building off someone else’s work, or story. it’s honestly pretty inspiring to think, really!

11:17pm, down on the floor to stretch out. 

2/18

So, using my arms and retracting my shoulders really was helping my glutes and low back engage?? Not only that, but just holding them up and into the side also helped?? It’s so weird, even Kim was having a harder time explaining why this happened when I was in the standing frame and doing hip hinges?! They felt so good! My body was engaging so much! Right now my whole low back , glutes, core, and quads are feeling so engaged?? Why is this?! Just muscle overflow? 

Something about drawing my breath “down” while contracting my abs feels really good!? I really enjoy this, I need to incorporate this into my movements! I wonder why this is?! It feels like each breath “down” is filling my legs, core, and body! I need to keep doing this!

Wow that was legit, physical practice and psychological readiness? Dive into that more how mental imagery helps with this!

2/19

So, I’m about to get the (Chalazion) “charizard” taken out of my eyelid like a scoop of ice cream. Wish me luck. 

So, it happened. They opened my eye up like the guts from a fish, and filleted my eyelid. The doctor had told me that I had a lot of scar tissue built up around the hardened oil and junk, since it had been in there for so long. Not gonna lie it went really well during the procedure, my legs were calm, as was I! I really focused on my breath, and kept myself calm. The whole procedure was under an hour, and wasn’t too bad. It was only when they tilted me back upright, did I start to not feel so great.

My body wasn’t stoked about this, I’m lethargic, and tired. My body got tight, and the drive home I was pretty out of it. Need to get some shut eye. 

I think it’s interesting, talking to Jake about RCT’s, and the connection with our brain, and the psychological effects that play in these as well. The placebo effect and observer expectations, I think are interesting to have called out. I also think this ties into the Heisenberg Principle, which is the quantum effect that observing something affects the outcome of the particle measured. So, In other words, the more accurately one property is measured, the less accurately the other property can be known. I think this is actually related to the observer expectations, as well as the placebo effect, ideas in medical science for drug and additional medical apparatus trials?

It’s interesting, because the Heisenberg inequality (effect) relates the standard deviation of position and momentum. Those are both on the same side of the equation, showing they are inversely related to the Planck constant. Which units are Joule/ Hz. It also states that this also comes in many forms other than position and momentum, like energy / time. This is also interesting to note. I think it’s worth noting this additional note from Heisenberg himself, “”Of course the introduction of the observer must not be misunderstood to imply that some kind of subjective features are to be brought into the description of nature. The observer has, rather, only the function of registering decisions, i.e., processes in space and time, and it does not matter whether the observer is an apparatus or a human being; but the registration, i.e., the transition from the “possible” to the “actual,” is absolutely necessary here and cannot be omitted from the interpretation of quantum theory.” – Werner Heisenberg, Physics and Philosophy, p. 137 “

With all this still, I really would like to expand my knowledge on this subject, because it’s so extremely fascinating to me. I know there is still so much we are trying to quantify with how the brain sends and receives signals. It’s truly the most remarkable “thing” in this world. Sometimes it feels like the word “thing” does our brain a disservice because it’s so capable and amazing! Anyways, I’m trying to say we haven’t fully been able to quantify all the inner workings of our brain and central nervous system, and because of that, I’d like to continue expanding my knowledge to find out more about this relationship!

I’m just deeply fascinated with all the possibilities for not only where our mind can take us, but also how our mind works. I’m just trying to quantify and better explain the events, sensations, and emotions I’m experiencing throughout all of my recovery and life. I don’t want to stop my learning journey. Ive said it before and there is too much to gain and nothing to lose by continuing my learning journey. 

My eye has been watery all afternoon, this is annoying. 

Okay! Got on the floor!! My upper right thigh is feeling so full!!! This has been amazing!!

Murdered in the City. This song. By The Avett Brothers. It made me shed bloody tears of joy. Yes, those were real bloody tears. When I heard that song, I immediately thought of my brother Jacob. He sent me a song today by Jason Isbell, and I haven’t listened to music in this genre in a minute! So, when I turned it on, it reminded me of this one. So I turned it on. Goodness, this song really has always been such a favorite, but now it has a whole new meaning. It reminds me of my whole family, my mother and father, sisters, and brothers.

“I wonder which brother is better
Which one our parents love the most
I sure did get in lots of trouble
They seemed to let the others go

A tear fell from my father’s eyes
I wondered what my dad would say
He said, “I love you and I’m proud of you all
In so many different ways”

If I get murdered in the city
Go read the letter in my desk
Don’t bother with all my belongings
But pay attention to the list

Make sure my sisters knows I love them
Make sure my mother knows the same
Always remember there was nothing worth sharing
Like the love that let us share our name”

Murder in the City – The Avett Brothers

These words just resonate so vividly with me these days because all the thoughts and experiences I have been fortunate to have with my family, I cherish so deeply in my mind and heart. I think about all these times my brothers and I would go out to the woods and play, climb trees, you name it. I remember all the times I would see my older siblings, and look up so dearly to them. It just, hits so hard these days. That song.

“Always remember there was nothing worth sharing, like the love that let us share our name”

I just think about this, and although I’m still here, I almost died. I was almost gone. And who was there by my bedside but my family. After you lose everything, it’s very rare and very hard to find many better that will stick close to you besides them. I just love them so much.

2/20

Holy crap, I’m going pee, and I just noticed something! When I lean around, forward and backward, I was thinking about pushing through my feet to move me around. Mind you, my hands aren’t touched down at all! So I’m doing it right now, and I’m actively feeling my legs move and push my side to side, stabilize, and forward and backward!!?!? And I’ll I’m thinking about is pushing or lifting through my feet!! This is incredible!!!

This is HUGE! My legs weren’t just reacting—they were already engaged and stabilizing myself I think!! That’s the shift from conscious activation to an automatic neuromuscular response! I’m really eager to keep exploring and building off this! And I am wondering what is next! 

If I can get my legs to do this, I need to constantly be engaging them in more and more situations, plus giving them more proprioceptive feedback, which is what these compression pants are definitely helping with too! I’m just thinking, about my tall kneeling exercises, and how I can build off this to more positions upright and closer to standing? Or in the standing frame? 

This has been a game changer, my legs are showing up! And now I need to figure out more roles for them to play in my day to day! I know that getting on the floor is a great opportunity, but I still have to use the chair to get around, how can I bridge that gap? I need more functional roles for them to play! Getting them off the footplate, on the floor, and planted on the ground has been huge! 

Maybe, I can try to move myself around a little but with my feet on the ground? What muscles do I need to use to do that? My quads to push backwards, and what to pull forwards? This really could help me with “Bridging the Gap”?!

Wow, I’m initiating movement from my legs!!! I have my feet on the floor, and I’m pushing! And I’m moving! It’s not much! But it’s happening! I’m pushing backwards!!

Floor time this evening was pretty good! Did some good movements, my lower legs are engaging a bit! And I can feel so much more into my right thighs as well! What was also weird, is that as I was laying on my back, I fell asleep for maybe 2-3 minutes! And I somehow kept my knees pointing up?! That was wild! 

Time to actually get some rest! Until tomorrow!

2/21

Man, I’m really feeling these feet pushing hard into the floor and footplate! They’ve been doing a good job today, holding me up, being more active, and getting myself around! I’m really seeing them fill out!

Something too, as I sit here right now before getting ready for bed, I was able to get my right leg kicked up so high! I was able to *almost get my leg kicked up and over my knee! With some assistance from my hands to help at the hips! I can see that day coming where I can actually kick my leg over on my own! And then, as I get into the bed, I can get my right leg to pull up! As I’m in the bed, I can flex my hip, and get my leg to pull up and try to get on the bed! These small movements will add up over time! 

“We have to remember,” Heisenberg says, “that what we observe is not nature itself, but nature exposed to our method of questioning.” I know this idea is about quantum mechanics, but it can be applied to other areas of science as well! And I wonder, is this relevant for what I am doing? Is my whole process of physical activity, thought, and intention helping my legs because I am thinking about this situation differently? 

So, as I’m thinking about this particular question, the insights from the AI are as follows, 

“Yes, absolutely! Heisenberg’s idea isn’t just about quantum mechanics—it speaks to the broader concept that our way of observing and interacting with something changes its reality. This is hugely relevant to what you’re doing.

Your approach to rebuilding strength and reconnecting with your legs isn’t just a passive rehabilitation process—it’s an active transformation that involves shifting how you engage with and perceive your body. The way you think about your legs, feel them, and even dress them is shaping your reality. You’re not just waiting for movement to return; you’re questioning, imagining, and immersing yourself in the process, which changes the experience itself.

In neuroscience and psychology, this aligns with concepts like neuroplasticity and embodiment. By engaging with your legs differently—mentally and physically—you’re creating new pathways and reinforcing activation, making your experience fundamentally different from someone passively following a rehab routine.

So in a way, your method of questioning—your approach to feeling, engaging, and envisioning your legs—isn’t just reflecting your body’s recovery; it’s shaping it.”

2/22

Today is my best bud’s birthday! It’s John boy’s birthday today! Dangit I wish we were closer so I could see him more! I sure do miss him!

I can feel my quads fighting down there! Fighting for real estate! Telling and quieting my hamstrings. That they don’t need to be on all the time! My quads are fighting every day now to get my knee and hip into full extension. I can feel the squeeze and fullness increasing in my quads, and how they are really trying! It’s been interesting thinking about muscle tone, and now realizing that we have to mindfully direct that sensation and excitation to the right areas. To my feet, to feel grounded. To the calves, to support my ankles. To my quads, to get my knee straight, and hip straight. For my hamstrings, to stabilize the knees and lift my heel when stepping. For my hip flexors, to initiate the step, tied in with my abdomen. For my glutes, the powerhouse of the step. Go get keep whole torso upright, to get my leg in extension! And my core, stabilize, initiate, and feel the connections between my upper and lower body. 

This whole thing with muscle tonus, it’s just excitation signals, with no inhibitory signals. I need to keep helping my body learn when to turn on and when to turn off. 

I’m lying here, and feeling so much! My core, hips, glutes, inner and outer thighs, my quads! My knees! My shin and calves, and then my feet seem to have some tingle, but they are the only area that does. These compression pants/ leggings, whatever you want to call them, have been helping increase my circulation and nerve signaling so much’ just so much proprioceptive feedback from them, it’s been a great development! My lower abdomen is trying! I’m feeling him engage more and more throughout the day! 

My body is literally fighting for itself, and I’m directing the charge. I truly do think that not only do I have to initiate the movement on my own, but I also need to keep up my daily progress and progression. I think it’s been good swapping out some gym days to more dedicated time on the floor. My legs really have needed this. Now I need to figure out too, how to dedicate more time for my legs!? What else can I do?!

On the floor, lower legs REALLY feeling significant! My low back is constantly engaged, and my abdomen, on the left side, is still the most temperamental?! I’m laying prone right now, opening the hips, and letting my body really sink into this stretch! I’m going to try some single arm raises in tall kneeling! Let’s see how it goes!! 

Holy smokes!! I’m doing so much!!! Hand raises in tall kneeling, side shuffling the whole length of the end of the bed (~7ft)! And single leg/ knee pull throughs! My legs are feeling a tremendous amount of fullness with each new set of movements!!! This is awesome! I did 15 reps on each leg, they aren’t pulling up all the way, but I’m initiating the movement, and pushing my leg back to the starting position on my own!!! My entire body has been engaged with all these movements! Shoot, it was even a workout to “kneel crawl” over to the wheelchair off the edge of the bed frame, move my legs, and then grab the water bottle and grab a drink! Shoot! I’m always forgetting that behind the chair! It’s a convenient spot, but sometimes I forget it… out of sight, out of mind I guess? 

When I’m using the magic circle, to do addictions and abductions, I’m really trying to contract my muscles over the entire movement, eccentric and concentric movement phase. I know they gotta be working over the entire range, so might as well try to get them to squeeze over that voluntarily?! I feel something, that’s forsure! Also, when I’m doing the “magic circle breaths” I’m feeling my legs slowly fill up, even down to my toes! I think timing these exhales with effort is really helping! Also, definitely feeling these micro movements when I’m addicting my legs in a modified long sit position! Trying to get some higher reps of those in! I’m really feeling my whole posterior/ lateral side of my legs, glutes, and back firing up! 

I’m thinking, I really should use the theragun a bit more than I usually do! On my low back, glutes, quads, hamstrings! Honestly don’t a bad idea too, on my lower legs, to maybe help them start to wake up?

Also, for now on, it’s “kneel walking” instead of tall kneeling or kneel crawling! That’s what I’m going to look at it now in my head!

These hips are moving so much more freely and volitionally after today! I’m engaging them so much! Sensations are sky rocketing today!

Wow. For the first time in i don’t know how long. I’m actually comfy sitting and watching a movie. We watched Eastern Promises, what a wild one!

Wow. My ankles, calves, shins, outer shank, are all feeling a tremendous amount of sensation! This has been the most significant to date! My knees, too! I’ve really noticed how my feet are feeling more and more weight through them! My abs, definitely need to contract more and more! I guess it’s just 90 degrees of rotation about the hips, come on! I know you can eventually do that one day.

I just did prone arm raises! I had to also lift my opposite arm 180 degrees opposite from it, but I did it with my hand extended over head! I also flipped over into a long sit from prone rotating counterclockwise, with my left  shoulder leading, and moving onto my left hand, followed by my right! I usually had to go the other way, and now that was the first time I did it the other way!

What’s so interesting, is my lower rear, lower front abdomen. it gets sweaty? And my left hip seems to be the last truly “tight” area that is so difficult! I wonder why this is the case?!

This has been a week! I can honestly say things are getting so much better in terms of movements! I really think it’s not about what I’m feeling now, it’s about what’s contracting! I need to make a shift in mindset because I feel so much, so much everywhere! I will constantly be working through these new sensations, but I know that muscle contractions are the new and next big thing! Here we go!