Our habits define us more than our anatomy. Form follows function. Moshe Feldenkrais wrote in Body & Mature Behavior that anatomical peculiarities only partially explain our behavior. It is our repeated output patterns - movements, thoughts, emotions - that become our state of being, bringing our anatomy along with them. Our structure is the carrier and executor of our behavior and is formed and re-formed by the stresses of our habits. Yet most clinicians are obsessed with finding the exact structure involved in a client's current state of misfortune with little attention paid to the outputs that brought about the structural changes in the first place.
"The idea that faulty behavior is a personal misfortune often leads to the conclusion that it must be covered up." Feldenkrais
Let's take, for example, pes planus. This unfortunate collapsing of the arch is almost always an acquired anatomic deformity from years of postural habits causing maladaptation in the rear- and mid-foot. If this collapse were to occur acutely from an accident, the pain would likely be severe and an emergency room visit would certainly beckon.
However, most flat-feet are painless and are only seen clinically once the sequelae of the faulty behavioral patterns have reached critical mass. Why is this? Because the mode of doing has become so habitual, and has been given repeated approval with every step, that it feels "right". The means of sensing any other mode of doing have been lost, along with movement variability, so with each step that collapses the arch becomes the "right one". So is this an anatomical problem as it ostensibly appears?
We keep striving forward with precise tools and techniques to identify the exact anatomical lesion or abnormality — in my mind, this is misplaced precision. Don't get me wrong anatomy absolutely matters, but mostly in the context of behavioral patterns which, in the majority of clinicians and coaches, is only superficially addressed. In the example I discussed above, does correcting the deformity automatically change behavior? I would argue no, unless we have made the client intellectually aware of a better way of doing along with ample opportunity to learn the difference. This is likely partly the cause (along with neural sensitization) of why so many surgeries and other tissue-based interventions fail over time. They have not been sufficient to alter behavior in a way that modifies tissue load.
Our neurological wiring has evolved into networks of patterned behavior designed to efficiently complete tasks mandated by the environment. Anatomy provides the frame to carry out these behaviors; the changes to structure are the tangible result of our habits. But once we open up some behavioral options for new habit formation, anatomical abnormalities don't seem quite so concrete and problematic.