Saturday, October 22, 2016

Creepy Crepitus, The Strange Scary Sounds You Hear When You Move

I woke up in the middle of the night troubled by a dream that my teeth were crumbling, my bones dissolving. I walked downstairs to get a drink of water, my heart already running fast, when I heard a creaking sound. At first my anxiety amplified, then I realized it was just my knees. It wasn’t a scary sound, but what has become the familiar, occasional creaking as my bony knee caps and ligaments loudly reminded me that I didn’t stretch my thigh muscles as much as I needed to.

Strange noises that come from our bodies—creaking, crackling, crunching, grinding, popping, and snapping—are known as crepitus. My clients find them creepy, or sometimes downright scary, but the noises don’t usually signify as much destruction as people assume. In this article, I’ll explain what these noises mean and what you can do to improve your body’s health so they aren’t so frightening.

“The popping sounds from my knees must be my arthritis. It must be getting so bad that the bones are rubbing together.” I’ve heard that sentiment dozens of times as clients try to give an explanation to grinding. Fortunately, the real reason isn’t as destructive. Granted, arthritis is commonplace, especially as we get older, but it would have to be very advanced to get to the point where bones actually rub together. It also helps to know that arthritis doesn’t correlate to pain. Many people have arthritis that doesn’t cause pain or other symptoms.

A common cause of crepitus is gasses escaping from joints or muscles, like the sound made when cracking knuckles. Unless the sounds are accompanied by pain or swelling or unless they start after an injury, they are generally considered harmless—even if they are loud.

Another cause of a popping sound is when ligaments or tendons snap over a joint. This happens when a ligament or tendon isn’t flexible enough to stretch around the joint, and often occurs when stretching hip flexors. There are nine hip flexors; to thoroughly stretch them all requires a variety of movements. Since few of us (me included) don’t regularly do all these movements, the tendons can lose flexibility. One way of avoiding the snapping is to stop stretching and moving less. I don’t recommend that! My advice for popping tendons is to limit the range of movement to just before the pop and to stretch regularly to this point. You can develop the awareness of sensations to feel for and avoid the pop. When I stretch regularly, my tendons get healthier and over time (it’s not an overnight fix by any means) my pop-free range of motion increases.

A similar noise is caused by calcification of the tendons. It most often occurs in the tendons of the shoulder, but any tendon can be affected. Calcium salts are deposited in the tendons of muscles that are overused when there is lack of blood flow. Chronically tense shoulders are a prime environment. Based on the grinding sounds that I hear when I roll my shoulders, I have a salt mine inside my tendons. It’s not too surprising since I use my arms a lot in my work.

However, I was once able to dissolve the calcifications in my shoulders and had a week of noise-free shoulder rolls. That was after taking a three-day undulation workshop. By simply moving my body fluidly for hours, my shoulders—and knees and fingers and every other joint in my body—worked out all their inflexibilities and crunchies. Knowing the cause of crepitus—and more importantly, knowing that it doesn’t have to be permanent—takes the fright out of these disconcerting noises.

If you want to read about something really scary, click the link to this article I wrote nine years ago titled Scary Sarcopenia about the very real danger of losing muscle mass as we age. But don’t let it give you nightmares either. You can fight the sarcopenia monsters with regular strength training.

Wednesday, May 27, 2015

Dynamics of Soft Tissue Injuries and Healing in Yoga

I was recently interviewed by Eva Norlyk Smith of YogaUOnline to preview a class I am teaching on soft tissue injuries. In the interview, I discuss how dynamic soft tissues are, plus knowing about how they work gives us insights to prevent injuries and speed healing.

You can sign up for the course, which includes two one-hour video segments, plus a yoga practice and a bonus range of motion practice HERE. If you sign up in advance, you have the opportunity to ask questions during the class. I look forward to sharing what I have learned in my practice as a structural integrator and from my researching to prepare for the class.

Monday, January 27, 2014

TFC Day 20 - Organic, not Mechanical

Do you consider your progress to be less than optimal if it isn’t moving upwards on a straight line? Are your ideals for movement goal focused, such as running faster each time or lifting increasingly heavier weights? Unfortunately, we are made organically, like cats, dogs, antelope, and octopi. Our energy and cycles are in tune with the Earth, we make progress and we reverse and then progress again.
Perhaps the most important part of the Therapeutic Fitness Challenge is learning to assess your own physical and energetic condition and using your mind to help your body heal and increase fitness. One of the best ways to do that is to make comparisons. Today, we will redo the range of motion assessments from Day 1. You may notice “improvements,” and you may not. The body adds strength and flexibility in a non-linear fashion. Learning to realize the ebb and flow of your body is one of the most important things you can do for yourself. After the assessments, there is a breathing practice and a scheduling assignment. Do them in any order you wish.
Range of Motion Audio #1 (13 minutes)

Range of Motion Audio #2 (17 minutes)

Range of Motion Audio #3 (9 minutes)

Breathing Practice: Observe your breath. Notice the length of your inhale and exhale and the spaces between. If it isn’t already, extend your exhale so it is at least as long as the inhale. Spend 5 minutes with your breath making it as smooth as possible. Make a note of what you notice and compare it to your breath on Day 1 of the challenge.

Third assignment: Make a schedule for yourself next week with activities that will continue the progress you have made in the TFC.  

Sunday, January 26, 2014

TFC Day 19 - You've Got the Power

 Yesterday my husband and I took a walk through the woods. We ended up traversing a patch of logged forest and had to scramble over branches and logs for more than an hour.  Today we are quite sore all over and our energy is low. Because I put three day’s worth of exercise into yesterday afternoon, I am going to take a break today.

My primary goal in this Therapeutic Fitness Challenge is to empower you to reach a new level with your fitness. Improved awareness and energy management is the first step of getting fit without injury. I also hope that I’ve given you a new variety of activities to meet the goals of aerobics, flexibility, and strength. (On off-trail walk in the woods is a unique and fun activity . . . if you don't get lost or twist an ankle or get a Devil's Club stinger in your thumbs.)

On the second day of this challenge, you assessed your heart rate, leg strength, and flexibility. Today’s assignments repeat the tests so you can compare.

1. Sit comfortably with good posture breathe through your nose.  Keep your jaw relaxed but closed and breathe consciously for 5 minutes. If you feel anxious, try inhaling through your nose and exhaling through your mouth.

2. Keeping your heart healthy is one of the most important parts of fitness. Do your typical aerobic exercise and measure your heart rate 5 minutes into the exercise and at the height of your aerobic activity. Then stop exercising for 2 minutes and measure your heart rate again. Write down the numbers. From this webpage, determine: a) if you are exercising within your target range, and b) your Heart Rate Recovery. 

3. Time how long you can comfortably do a wall sit (instructions here) and write down the length of time you held the sit and the approximate angle of your thighs.  Keep your knees in line with your middle toes the entire time. “Comfortably” means that you aren’t wishing you were somewhere else, that you can breathe deeply, and that you can stand up again without groaning or hurting. (You can count seconds in your head, or you can use a stop watch.)

4. Stretch. 

5. Test your flexibility. It is important to do this test with no pain. Standing with slightly bent knees, bend forward to see if you can touch the ground. If so, notice if your fingers or palms touch.  If not, measure how far from the ground your finger tips are.  Bend your knees, stand up carefully, and write down your results.

6. Review the intentions you wrote. What progress are you making on them?

Saturday, January 25, 2014

TFC Day 18 - Put it Together

To stay fit requires being able to monitor your daily needs. What is the right amount of activity on any given day? That depends on what you’ve done in the days previous and your energetic and physical state. Today, you design your own practice. Here are some guidelines to help you.

1. Start with your breath and energy.  Notice if your energy is up or down, if your breath is even or irregular. Spend 5 minutes with a breath practice; choose one from the previous days or another that you like, one that supports an energetic state that you’d like to have.
2. With the support of improved energy choose your physical practice. How long has it been since you’ve brought your heart rate up? If more than a day, be sure to include at least 15 minutes of an aerobic-type activity. Include some flexibility as well, either undulations, stretches, or yoga. If your balance was not satisfactory yesterday, spend a minute or two working on that as well. If you aren't feeling strong, practice the core exercise video. Take the available time you have and divide it between the activities you need, choosing each one that is the best combination of safe and challenging.

3. For a mental practice, choose your favorite meditation or spend 5 minutes writing affirmations (day 3), watching your thoughts (day 4), or smiling at yourself in the mirror (day 12). It doesn’t matter if it’s dorky. It's effective.