Saturday, November 26, 2011
SmartCore Training is a 70-minute DVD by Staffan Englelid, PT, PhD, CFT. This video is the best group of core exercise I have ever seen. The DVD progresses from basic core strengthening through intermediate core techniques that make the core active in everyday activities to cutting edge exercises needed by athletes. How many times have you known someone (maybe even yourself) to hurt her back as she was leaning forward and twisting? Mastering Staffan’s intermediate exercises would prevent most of these injuries. I think this is especially appropriate for Pilates and yoga practitioners as well as physical therapists, personal trainers and anyone with chronic back pain. It sells for $39.95 through Championship Productions.
Fascial Fitness is a 58-minute and 20-page booklet combination produced by Robert Schleip, PhD, a fascia expert and structural integration practitioner from Germany. He has been working with fitness experts to create movements to rehabilitate and condition the fascial network throughout the body. The movements are like undulations, but bigger and adapted to more traditional stretches and exercises. This is like giving yourself a myofascial release in your own living room. Fascial Fitness is available through Fascia DVDs for $44.95.
The 10 Minute Rejuvenation Plan outlines a 5-exercise routine that was developed by Buddhist monks. As it was originally explained in a book published in the 1930’s the exercises are difficult and could cause injury. Carolinda Witt has ingeniously broken down the exercises into manageable steps with wise safety precautions. The book sells for $14.22 at Amazon. A companion DVD is rare, but useful, too.
Mary Bond’s healthy posture DVD, Heal Your Posture: A 7 Week Workshop will be available soon, but maybe not in time for Christmas. Mary is the author of The New Rules of Posture and a fantastic movement educator. She has a gift for making esoteric principles of alignment easy to understand and use. You can see clips from the DVD and request to be notified when it is ready at her website.
While I’m plugging products, I should mention my new program, Undulation Break, which reminds people to undulate with 22 videos and a smart timer to set to your schedule. Although I originally designed it for people who spend multiple hours at the computer (ergonomic experts recommend taking a short break every 20 minutes), I’ve found it useful for anyone who needs a reminder to undulate. It is just $24.95 and you can try it for free.
Monday, November 14, 2011
Last night as I was driving in Seattle, light rain glistened off the pavement and the street lights sparked. I saw a man jogging with a stocking cap, rain jacket and bare feet. On one hand, I’m a proponent of barefoot walking so we pleased to see that 49 degrees and light rain didn’t deter this man from getting his exercise. “Way to go!” I thought and then, “Ouch!” Barefoot jogging on concrete is too harsh. I would recommend walking barefoot in the summer and in flexible shoes in the winter, which leads us to the:
Exercise of the Month: Rolling Through the Feet
1. Start in standing alignment, with your feet and knees pointing forward. Keep this alignment as you walk, avoiding letting your knees fall in and/or your feet to point out too much.
2. Set your foot down, heel first then roll through your foot trying to feel the little bones in the middle of your foot. Your arch will bounce back rather than collapse if you distribute your weight across your foot. This is like setting down a beautiful footprint from heel to toes.
3. As you lift your foot, peel it off the floor with a little push from all five toes as they leave the ground. Use all of your toes evenly.
4. Let the speed of your walk increase. You can keep this flexibility in your feet even when you walk faster and even when you are wearing shoes.
Karin Edwards Wager, a colleague from Portland, OR, has written a great article on how to choose shoes. Her advice will make it easier for you to walk with ease.
Friday, November 4, 2011
My left shoulder blade has a twinge this morning. I keep exploring this sensation, moving my shoulder up, down and in circles. I’m attempting to make it better, or worse, but it nags without change. My mind, of course, wants to know: “How did this happen? What did you, body, do wrong?” When my shoulders hurt, it is usually because they’ve been too helpful. In this instance, my shoulders tried to help my hips.
Yesterday, I enjoyed a fabulous yoga practice that focused on grounding and hip opening. Hip opening has little to do with shoulders, but whenever my body attempts something challenging, my shoulders always try to help by lifting or straining. It reminds me of myself as a child, the eldest sister, who needed to perfect my younger sisters’ actions. “Here, do it this way.” “No, no, no, you better let me do it.” My shoulders apparently haven’t given up this annoying habit.
At least I am conscious of this pattern so I can try to change it. I’m usually aware of my shoulders’ tendency and tell them, “Relax, the rest of my body can handle it.” This incident is a reminder to stay aware. It also makes me wonder where else in my life am I being overbearing in the guise of being overly helpful.
In the meantime, I’ll spend the next half hour on a self-designed, shoulder-strain-relieving yoga practice and then a few minutes with a tennis ball to release the remaining trigger points. Meanwhile I will consider how I can learn to let things be.
I’ve been here before with my shoulders and I will be again. Mind-body learning is a life-long process that starts with a body sensation that leads to awareness through exploration and contemplation that becomes an opportunity for growth and change.
Wednesday, October 26, 2011
Structural integration (Rolfing, Hellerwork, KMI, SOMA) is known for being deep. Depth is what attracts most clients. “I really want you to get in there,” one client tells me. “I’m glad this isn’t one of those petting massages,’ says another. The process of affecting the body’s fascial network is profound, but sometimes it is only skin deep.
I took a workshop from Liz Silverman Stewart this past weekend – Tracking the Recipe; Sessions 1-3 Review. Liz knows our proclivity to go deep and she encouraged us to work instead with the most superficial layer in the first session.
Unlike deeper, more complex, fascial layers that split, divide, dive and twist, the superficial layer is a single continuous sheet, like an internal wetsuit. Gil Hedley, a master anatomist, has dissected this layer, which you can see at his website. (Don’t look if seeing dissections grosses you out. Do look if you want to see many images of fascinating fascia.) If the superficial layer is not flat or free, it binds to underlying structures and limits movement. Releasing the adipose layer opens a window to the deeper layers in the following sessions.
Release of the superficial layer can be intense like deep work, especially when the entire layer is engaged, or at least much of the layer. That is what I practiced during the workshop. I also received a session in this manner and can feel the space it created for my whole body to move more freely, as though I changed out of clothes that were too tight in places. I can feel the glide of my adipose layer sliding easily beneath my skin giving my movement a sumptuous quality. My forward bends feel delicious from my hips to shoulders and even into the back of my arms.
Releasing the superficial layer is one way that structural integrators help our clients become more comfortable in their skin. (The fascia graphic is from the Hellerwork Client Handbook.)
Thursday, October 13, 2011
Since I published Relieve Stiffness and Feel Young Again with Undulation, people have asked me for undulation videos. Undulation Break includes 22 videos and the user can choose how often each one comes up on the computer. In addition, I created a video to explain how it works, which is available on YouTube.
I used to work at a desk all day and I used to have chronic neck pain and headaches. An answer to this problem is to interrupt the stillness of what I call screen-eye lock. It takes movement to transform stiffness and tension into renewed productivity. Undulations are my favorite movement as they allow the body to get what it needs rather than responding to the mind’s dictates. Even though I don’t work at a desk all day anymore, I still enjoy the undulations on my computer for the times when the screen attracts my eyeballs like a magnet and my computer posture resorts to a slump.
In addition to the videos, Undulation Break also includes 16 different music tracks, 20 reminders for fluid movement and a small library of help and hints for good posture and ergonomics. I hope you’ll try Undulation Break. You can download it and use it for 5 days for free at http://www.paratec.com/sbform/v65_ub_downloadform.htm.
The program is based on a stretching program created by Para Technologies. It was designed to prevent repetitive strain injuries such as carpal tunnel syndrome and eye strain.
Now that I’ve finished with my video career and this commercial, I can return to writing. You can expect more regular posts with book reviews (Stretch to Win by Ann and Chris Frederick is coming up) and exercises in the weeks to come.
Friday, July 29, 2011
This CD set includes two discs. In the first, Kabat-Zinn explains how and why meditation works and gives a soothing pep talk for those ready to try this for the first time. He outlines the seven principles that underlie mindfulness:
1. “As long as you are breathing, there is more right with you than wrong.”
2. The power of the present moment is a resource that is often overlooked.
3. The present moment isn’t always to our liking. That’s true whether you have chronic pain or not. Most of us spend a lot of energy distracting ourselves from the present.
4. The common two ways to deal with the present are to turn away from it through escape activities or to obsess on it and feel victimized.
5. A third way is to open to and befriend current experience to the degree you choose.
6. Whatever is happening, have kindness and compassion toward oneself. And suspend judgment, which contracts the mind and body and compounds pain and suffering.
7. The purpose is to not make anything go away or fix something. It is simply to find a respite through non-doing so life’s natural propensity for change and healing can take its course.
If you’re already familiar with the history and effectiveness of mindfulness practices, you might be tempted to skip to the second disc and that’s OK, but the first one is quite interesting.
The second disc includes several meditations of varying lengths, starting with a simple, short breathing meditation and one 18 minute practice. Even if you’re not the type to sit still with hands folded in your lap for any length of time, I think the way it is presented is a good start for anyone who is coping with chronic pain.
In The Pain Chronicles, Melanie Thernstrom tells of Franz Mesner who was able to tranquilize patients with his voice, which coined the term “mesmerize.” Jon Kabat-Zinn’s voice has this quality. Just by listening to the CDs, without even doing the meditations, I dropped into the calm, soothing nature of his voice and let go of a layer of stress.
Monday, July 18, 2011
Almost everyone I know, myself included, complains of tight hamstrings. It’s no surprise since we sit so much, spending hours with knees bent. To stretch, most people try to touch their toes, but that’s not the most effective way to lengthen the hamstrings. This group of muscles (the hamstrings are actually four muscles on the back of each thigh) requires careful attention to alignment to release the entire compartment.
Try this stretch and notice where you feel sensation. If you feel burning, back off. It doesn’t take much pressure to lengthen and align this muscle group.
Lie on your back with your knees bent and feet on the floor.
Keep equal weight in your left hip and right hip.
Bring the left knee into your chest and keep it in line with your left ear. Don’t let your knee fall to the outside or you’ll avoid stretching part of the hamstrings.
Wrap a yoga strap or belt around the left foot and hold the ends in both hands.
1. Keep your knee in line (I know I’m repeating myself here, but it’s important.) and straighten the knee so your heel presses up to the ceiling.
2. Stop where you feel the first sensation. Hold the stretch and direct your breath into the back of your thigh.
3. See if you can find the amount of pressure that allows the muscle to relax. This is less than how much we usually put into a stretch.
4. Repeat on with the right leg. Then try the following variation to release different places in your thigh.
1. Again keep your knee in line with your ear on the same side and keep your knee as close to your chest as you can.
2. Straighten your knee without moving it away from your chest. This usually gets deeper into the muscle compartment. Direct your breath to where you feel the stretch.
3. Repeat with the other leg.
By the way, the model for this exercise is my friend and fellow writer, Rebecca Ross of The Composed Domain.
Wednesday, July 13, 2011
Everyone has a range of two little or too much exercise. For the average person, one weekend of gardening can cause a back ache. Or it might take a couple weeks without moderate or vigorous physical activity for weakness to turn into stiffness and achiness. Most people do fine with regular exercise here and there with not too much at any one time.
I liken this to a wide road with shallow shoulders. When we exercise the right amount we stay on the road. If we verge to the side of overexertion and strain a muscle, we stray off the pavement and get bogged down in the gravel. It takes some work, maybe seeing a health care provider or doing some stretches or extra time in the hot tub, to get back on the road. Sometimes we get too busy with work to walk, do yoga, lift weights, whatever our usual exercise routine is, so our muscles lose strength, our cardiovascular system loses steam, our organs lose vitality. This is the other side of the road. We’re heading for the ditch of lethargy, aches and pains.
The better our physical condition, the wider the road and the easier the shoulder. With inattention or injury, the road narrows, the banks steepen, the ditches turn to ravines. For people with chronic pain, the road has dwindled to the thickness of a tightrope strung high. This isn’t a glamorous high wire circus act; this is a trembling person, already off balance by pain, who doesn’t want to fall.
Managing the tightrope can be a full-time job. Every activity must be considered as potentially being too much or too little. Vacuuming the house might send one tumbling off the rope into a free fall to the net below, so that an arduous journey is required to climb the ladder back to the rope. Each person’s ladder is a unique combination of treatments. Finding the personal combination of therapy is as relevant as discovering what throws one off balance and into the net.
The other side of the tightrope – inactivity – is just as dangerous. Chronic pain creates and exacerbates weakness. Every day some exercise is required or else one risks falling off the other side of the wire with a similar climb up to the rope of equilibrium.
My teacher, Donna Bajelis, taught me the analogy of the tightrope. My clients, especially those with chronic pain, find it useful to keep on track with activity. They use continual self-care to lower the rope to ground-level, widen it to a balance beam and eventually recreate a broad road. Everyone can broaden their path with regular exercise. If you’re on a tightrope, work toward a balance beam. If you’re on a beam, work toward a narrow path. If you’re on a path, create a road for yourself. If your road is already broad, what will it take to make it an eight lane highway?
Wednesday, July 6, 2011
Saturday, June 11, 2011
First of all, proprioception is essential for balance. As we get older, our balance often diminishes. This is partly due to muscle weakness (see the article on the Single Leg Stance), but another factor is the ability for the body to sense where each part of itself is in relationship to the ground and up.
Proprioception is also a factor in pain perception. Proprioceptive nerve endings sense the body’s location. Nociceptive nerve endings sense pain. Scientists are finding an inverse relationship between proprioception and nociception. When proprioceptive nerves are not functioning optimally, the nociceptive nerves become more active and pain is perceived more easily. It’s worthwhile to improve your proprioceptive abilities; if you’re in pain, it’s essential.
There are several ways to improve your proprioceptive abilities. The field of rehabilitation uses balance exercises; wobble boards have been found to be very effective. Bodywork is another option, especially bodywork like structural integration where the client stays aware and involved while the practitioner is manipulating tissue. Yoga and Pilates are also helpful, since attention is maintained on how parts of the body relate to each other during the exercises. Undulations also have the same effect. Since undulations focus on the relationship between one vertebra to another, it is helpful to improve proprioception in that area.
If you have signs that your proprioception is waning, you might want to use multiple techniques to improve it. We don’t necessarily need enough awareness to do gymnastics, but we all need appropriate proprioception to walk (which includes standing on one leg with each step), balance and accurately perceive pain.
Saturday, June 4, 2011
Friday, May 27, 2011
The first thing I like about this book is that it focuses on fascia, which plays a large role in most muscle and joint pain. The Ming Method is unique in how it addresses fascia health through a 3 step process. As Chew states:
"The bottom line is you're as young as your fascia. Or to put it another way, the quality of your fascia determines the age of your body . . . fascial hygiene is just as important as dental hygiene."
Amen! He has my full attention with wisdom like that and I'm impressed with the program he outlines. Here is a summary of The Ming Method.
1) Before adding exercises or stretches, it's important for your fascia to be as healthy as possible to avoid injury. Chew recommends 2 1/2 quarts of water a day plus some supplements that he's found to be beneficial for fascia. Many of his patients achieve a reduction in pain with this first step plus the added benefit of younger looking skin.
2) There are two types of stretches included in the book: spinal stretches that decompress the spine and fascial stretches. I found the spinal stretches to be quite unique. They work down the spine from neck to tail. Although difficult at first, I can really tell a difference from them. The fascia stretches are more familiar to me, but I like Chew's instructions for whole body involvement to tether the entire fascial chain.
3) The strength section is the least unique in the book, but I would trust Chew's exercises (he's a former bodybuilder and martial artists) as the right complement to his exceptional program.
Thursday, May 19, 2011
Saturday, May 14, 2011
This blog usually focuses on how movement (or lack of it) affects your life, but today I am verging from my usual refrain of “You are what you DO” to the more familiar phrase, “You are what you eat.” Muscle action, connective tissue health, metabolism and feelings of well-being all depend on a complex series of chemical reactions. The chemicals the body gets to work with – good or bad – all come from our food so what you eat affects how well you move as well as how good you look.
My opinion is that food grown from healthy soil and eaten when fresh has the best composition of vitamins, minerals, phytonutrients and other ingredients we don’t understand yet which are needed for a healthy body and mind. Food grown with chemical fertilizers or pest control has less nutritional value. New research is proving this is true. To assure my supply of fresh, nutritious vegetables I join a CSA each year.
CSA stands for community supported agriculture and it is a way for people to purchase direct from farmers each week through the growing season. I support the Sol to Seed Farm in Carnation. In return I receive a box of vegetables from June through October that I know are grown sustainably and are good for me. I’ve learned to like new vegetables. Sol to Seed’s arugula is absolutely fantastic and they introduced me to kohlrabi, now one of my favorites. Even the familiar lettuce and kale and beans and potatoes are welcome, not to mention the joy of fresh tomatoes in August and always a pumpkin in October. When I pick up my box each Wednesday, I have a week’s supply of good food and usually a couple of recipes to help me figure out what to do with all of it.
Over a dozen farms offer a CSA in King County. Puget Sound Fresh provides a directory of farms throughout the region. Small farms and large farms are included, many offer programs year round. If you’re not in the Seattle area, just do a search for community supported agriculture and you’ll find a rich resource of cost-effective nutrition near you.
Monday, May 2, 2011
It would be nice if we could build self-care like a massage or fascial into our lives on a weekly basis. Most of us don’t have the time or money to go for a spa treatment every seven days even though everyone could use the relaxation. This month’s exercise is adapted from Align for Life written by Dan Bienenfeld, which includes many exercises that complement a structural integration series, but they are also great for everyone. Try this to relax your face especially if you’ve been working at the computer for a while.
1. Put your hands on the sides of your face with your fingers just below your cheek bones. Firmly press in, then up and to the sides to draw your mouth into a big smile. Release and let your face relax.
2. Hold your chin with your fingers above the jaw bone and thumbs below. Press firmly and slowly, tracing the jaw bone all the way to your ears.
3. Find the space between the top of your jaw bone and below your cheek bones with your finger tips. Massage in circles as you slowly let your jaw drop.
Thursday, April 21, 2011
It’s easy to see why people find it difficult to differentiate the modalities without having experienced them. Baniel’s nine essentials are oh-so-compatible with structural integration and especially with undulation. Here’s a brief summary of the essentials for vitality, but I encourage you to explore more for yourself.
- Attention – Awareness is the first step in any change (please see my previous blog post) and Baniel explains why. Awareness increases brain activity, which makes new patterns possible.
- The Learning Switch – Fight or flight and freezing caused by stress have turned off the learning switch for many of us. Regaining beginner’s mind can turn it back on.
- Subtlety – We’ve been conditioned to force being the path to accomplishment, but it blocks the intelligence of intuition. Subtlety is needed to find all movement between the extremes.
- Variation – Up to this point in the book, I’ve been nodding my head in agreement, but here is where I start to say out loud, “Yes, YES.” Variation in movement increases brain synapses, decreases rigidity and allows for dramatic transformation.
- Slow – When we move fast, there is no room for new experiences, railroading us into unproductive patterns. Moving slowly is counterintuitive, but better for harder tasks.
- Enthusiasm – Although it seems as though enthusiasm is something that comes from without, Baniel asserts that it is a skill we develop from within. In Hellerwork, we call this inspiration and maintain that it is fundamental to wellness.
- Flexible Goals – We’re back to undulation here. Baniel suggests that we try three different ways to accomplish a goal. “Getting off course” is often just what we need to expand our capabilities.
- Imagination and Dreams – Brain patterns are equivalent when imagining and doing things in real life. Playfulness creates a more flexible brain. It’s strange that we use less imagination and have fewer dreams when we get older, when we need them the most.
- Awareness – This feels like an extension and deepening of the first essential, attention. After adding subtlety, variation, enthusiasm, flexibility and imagination, the reader is able to be more aware, bringing all nine essentials together.
Baniel includes a couple of useful movement exercises in each chapter and dozens of examples that make the reading easy. If you get this book, please let me know how it affected you.
Friday, April 15, 2011
Everyone stands dozens of times a day with little or no awareness of their posture. When we do an assessment in a structural integration session, most people are surprised to find that their toes and knees don't face forward, their pelvis is not level and, most commonly, the hips are forward of the ankles so the low back sways to counterbalance. That is an opportunity to move from the first stage of learning, Unconscious Incompetence, to the second, Conscious Incompetence.
Being aware of the problem is the first step toward having control over change and leads naturally to the third step. Conscious Competence is the ability, with awareness and concentration, to put a new skill into place, such as lining up feet and knees, dropping the pelvis to level, and bringing the hips back and chest forward. People are pleased to gain tools that give them some control over their symptoms, such as standing or sitting in alignment, using the core to protect the low back, or adding fluid movements to counteract repetitive motions. But these new behaviors take time to develop and the body-mind reverts easily to the unconscious pattern that created the problem in the first place. A client told me of a conversation overhead in her physical therapist's office of another patient who was discussing his shoulder problem. He was frustrated when he frequently fell back into old movement patterns that exacerbated his shoulder injury. This is true for everyone in this stage.
After the elation of the first couple of sessions, most clients want to know, "When will my new posture become automatic?" It takes much practice in the Conscious Competence phase to get to the fourth, Unconscious Competence. Repetition is necessary and reminders are helpful, one reason why I give the little movement homework handouts at the end of most sessions. For myself, I also use sticky notes, like "Sit Bones" on the computer or "Balance" on the bathroom mirror.
Most powerful of all is to demonstrate and explain the new skill to someone else. I implore clients to teach their children how to sit in alignment, to help their kids and to strengthen their own kids and to strengthen their own competence. Eventually, one will notice that they are in alignment without any effort - a cause for celebration! Then it happens more often. The old patterns return sometimes and that's OK, because we have the tools to bring about change for the better.
Saturday, March 26, 2011
There are recurring themes in this blog, ideas that bear repeating, such as:
Stay within your personal abilities to avoid injury
The cultural “push your limits” belief often results in strained muscles and ineffective compensation patterns. I love Nike’s slogan “Just Do It.” But that doesn’t mean that you have to do a marathon or lift all the weights in the gym. Just do whatever you do regularly do and you’ll naturally progress.
Add variety to your routine
This is especially important if you spend most of your day in repetitive tasks, like driving or computing or bodywork. Of course, I believe undulation is a silver bullet, a way to easily undo the strain of stillness and overuse. A client suggested that I include an “Exercise of the Month,” which I’ve done since July 2009. From undulations to relaxations to core strengthening, each month offers a quick and easy way to add variety to your fitness.
Mind, body and spirit are connected
Your attitude toward your body makes a difference in how much pleasure or pain you experience. Playfulness and compassion are better companions than rigid obligations and punishment. Trudging through exercise or work, although sometimes necessary, creates patterns of tension that can be harmful in the long run. Joyful activities create ease and are just as effective at increasing strength.
I hope that the ideas I present will help you live more comfortably in your body. I invite you to offer suggestions for future articles or share techniques that have worked for you.
Thursday, March 17, 2011
Staying strong enough to stand on one leg sounds easy, but the hip stabilizers on most adults (who sit most of the day) are too weak to do this without compensation. The answer is to stand on one leg in alignment every day. Build it into your routine, like when brushing your teeth or waiting for the computer to start up.
Stand tall and transfer your weight from both feet to one, without shifting your hip more than an inch to that side. I recommend holding onto a chair, counter or wall to start. Watch for and eliminate any of the following compensations.
Do not let your hip sway far to the side. Keep your side and rear muscles engaged so your hip does not jut to the side. Also, do not lift or drop one side of the pelvis as shown below. Your core muscles are required to keep your pelvis level.
If you can maintain balance on one leg without lifting or shifting your pelvis, let go with your hand and maintain the single leg stance building up to a minute or more. If you can’t maintain the balance without holding on, gradually reduce the number of fingers that touch the base of support.
By the way, the beautiful model in the photos is Tori, my new assistant. She is enthusiastic about structural integration, very pleasant and capable, and, obviously, a good sport.
Wednesday, March 2, 2011
It seems like an overnight phenomenon: a sudden, unexplained occurrence of back pain. But the conditions have been building, unnoticed for years. After age 35, our muscles turn to fat at the rate of about 1% a year in a process called sarcopenia. As we get older, we also tend to add pounds. The muscles that stabilize the hips get weaker and weaker, the body adds unconscious compensations, until eventually the back muscles that have been substituting finally give up. The only solution is to rebuild the strength of the hip stabilizers, usually starting from square one, a long and tedious process.
I encourage you to prevent this problem in your own body. Appreciate a strong, well-endowed touché. Start early and exercise often to build your bum. (In other words, it might be better if your rear was bigger.)
One of the easiest ways to learn if you have developed destructive compensation patterns is to observe yourself in a single leg stance. This exercise also builds balanced strength around the hips. I’ll give step-by-step instructions for a Single Leg Stance, as the Exercise of the Month, in my next blog post. You’ll also get to meet my new assistant, Tori, who will model correct single-leg posture and demonstrate ineffective patterns. Stay tuned.
Friday, February 25, 2011
When it's been extra stressful or extra cold, after heavy exercise or a day of non-stop yard work, sometimes your back just wants a massage. While no appointment massage centers are popping up all over and it's nice to be pampered, you can give yourself a massage.
Step One: Take two tennis or racquet balls, put them in a nylon stocking with a knot between them and another knot to hold them in.
Step Two: Lie down on the tennis balls under your upper back just inside the tops of your shoulder blades with each tennis ball on either side of your spine. Bend your knees so your feet are on the floor. Place a pillow under your neck if needed.
Step Three: Gently roll so the balls slowly slide down your back only as far as your midback. Do not roll the balls under your low back.
Step Four: Roll off the ball carefully and repeat as needed.
If you don't have tennis balls, you can get a similar effect with the Back Massage undulation, but this takes more core muscles.
1. Lie on your back with knees bent and feet on the floor.
2. Press your tailbone to the floor then release.
3. Press your right hip to the floor then release. Then press your left hip to the floor and release.
4. Progress up your back about two inches at a time; press one side down and then the other, resting in between.
5. When you get to the top of your shoulder blades, go back to get any spots that feel missed.
Tuesday, February 15, 2011
Sunday, February 6, 2011
The following summarizes the most insightful and newsworthy topics from the book. I invite you to join me for a book club discussion of The Pain Chronicles on Wednesday, February 23rd from 5:00 to 6:45 at the King County Library Administrative Service Center.
Damage to pain circuitry results in greater pain. While acute pain is a protection sign, ongoing distress can create a new disorder in the body’s pain-modulating system. Nerves that have been transmitting ongoing pain messages can amplify the signal, shouting when only a whisper is needed. Also, damaged sensory nerves may not repair optimally and then fire haphazardly. The longer pain lasts, the more likely the pain-modulating system will be damaged – including aging of the brain.
Pain relief improves healing. In other words, toughing it out through an injury doesn’t improve your chances for recovery. The most dramatic example is when anesthesia was first introduced for surgery. Patients who had took advantage of the advance (or more accurately, patients whose surgeons offered this alternative) tripled their chances of surviving the surgery.
The power of the mind to mitigate pain has been potent enough to mimic anesthesia for patients. Franz Mesmer, a German physician in the middle 1800s, successfully hypnotized over a hundred patients to feel no pain during surgery. (This is where the word mesmerize comes from.) Acupuncture is sometimes used for anesthesia in China and its success can be attributed to patients’ belief as well as its effect on the energetic channels. Like the placebo, mind control over pain requires the patient’s desire to be healed and belief in the person administering the treatment.
The relationship between the client/patient and her provider has as much to do with the possibility for recovery as the treatment. Patients who believe that their provider is personally invested and will do everything to help them are more likely to believe in and follow the treatment, which increases its chances of success. Likewise, having a partner who is supportive aids the chances of healing, while a partner who is dismissive gets in the way.
One of the many difference between male and female brains affects how their brains mitigate pain. Receptors on brain cells determine how well opioids such as codeine and morphine work. Men respond better to medicines that target mu receptors. Women respond better to medicines that target kappa receptors. Most opioids currently on the market target mu receptors.
Side effects of the War on Drugs create an underuse of the most effective pain-relief medications. Physicians are concerned about prescribing opioid medicines, which leaves some people under-treated. Patients are concerned about becoming addicted, which reduces their compliance and diminishes the pain relief. There is a difference between being physically dependent on a drug (which occurs for everyone with opioids) and being addicted (which occurs only for a small percentage of people who take these drugs). Also, while concern over opioid use is rampant, long-term use of anti-inflammatories and acetometaphine can actually produce more harm to the body, as they damage the stomach and liver.
Serotonin is an important hormone that regulates both mood and pain, facilitating the brain’s ability to modulate sensation. Chronic pain consumes serotonin like a sponge soaks up water. Not surprisingly, depression is a common consequence of chronic pain. Research shows that depression is the result of pain much more often than depression causes pain, and the level of depression correlates to the degree of pain.
A common treatment for fibromyalgia could be helpful for many more people. Gentle stretching in a warm shower for 20 minutes at a time, twice a day, can relieve tension and small muscles aches. Like pain that gathers cumulatively, this treatment diminishes tension gradually.
A theme arose over and over again through The Pain Chronicles and although I already had witnessed it in my practice Thernstrom explained why it is so. Two people can have the same illness, the same pain, but experience a different level of suffering. One factor is brain chemistry. Dopamine, a chemical that is associated with feelings of love, diminishes pain. A study showed that people in love were less bothered by the same stimuli than their not-in-love counterparts. Also, frequency of pain is associated with the emotional state of the patient.
The most destructive pain undermines the person’s sense of self. Catastrophizing thoughts (“I’ve always been in pain; This will never stop; This pain keeps me from living my life.”) actually increases activity in the pain-sensing part of the brain. Arthur Kleinman, a medical anthropologist, suggests an alternative that has been shown to decrease activity in the pain brain. Creating . . . “an illness narrative that will make sense of and give value to the experience.”
Wednesday, January 19, 2011
Upon reflection, I realize that Paul Theroux is to blame. I’ve been reading Ghost Train to the Eastern Star each night, lying on my back with an extra pillow propped under my head and one under my knees. The compelling story and mellifluous writing have kept me up late many nights in a position that strained my upper spine. (I realize that the extra pillow is really to blame, not Theroux.)
Injuries are quite common when we get lost in our head (or in a book or watching TV), only peripherally aware of our bodies. The answer is to use the best possible ergonomics when involved in risky activities like reading in bed or working at a computer. I’ve piled up more pillows to create a back rest so I now read more upright. It also keeps me from reading for too long.
Pillows can cause neck pain when we’re fast asleep, too. A pillow that is too tall overstretches muscles and ligaments. A pillow that is too flat causes the muscles on the up-side of the neck to contract for hours. The answer is to adjust the pillow height to match your neck, and the sleeping on your right side might require a different pillow than sleeping on your left or on your back. My pillow has a different height on each side. The hard part is remembering to turn it when I roll over at night.
If you wake up with a headache or neck pain, evaluate your pillows and bedtime activities. A little investigation will help you troubleshoot the problem. Hopefully the solution will occur to you a little faster than it did to me.
Wednesday, January 12, 2011
The body needs a variety of exercise to stay healthy. Strength training for the muscles and cardio for the heart and lungs are the most popular. Your body needs range of motion exercises as well to keep your joints and connective tissue flexible. This month’s featured exercise is for your shoulders.
Caution: Watch the tendency to turn this into a strength or bigger-is-better exercise. The purpose is to move within your absolutely and completely pain-free, symptom-free range.
1. Start with your right arm. Moving your hand away from and then a little behind your torso, make easy circles with your arm, pivoting at the shoulder joint.
2. Slowly make the circles bigger, gradually growing to as far in front, over
the shoulder, and behind you as you can with absolutely no pain, twinges or tingling in your hand, arm, shoulder, or neck.
3. If your shoulder clunks, slow down and change the motion to avoid the noise. I think it helps to rotate the arm as you circle it, so your thumb points up as your arm moves up, thumb points back as your arm moves back, and thumb points down as it circles to your side.
4. Repeat with the other arm.
This is first and foremost an awareness exercise, learning to stay in your injury-free range. It also improves motion within the joint and the condition of your rotator cuff. Think of it like distributing oil through a hinge, each round getting a little smoother. The intention is to do just enough “reps” to loosen the range of motion a little, so the next time (maybe the next day?) you try it, the circles will be a little larger. If your shoulder tightens, you’ve done too many or the circles were too big.