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Tag: chronic pain
Feldenkrais for Fibromyalgia
Feldenkrais for Fibromyalgia
How Feldenkrais Can Help Fibromyalgia
The Feldenkrais Method is a way of changing your habits in order to make movement easier, more comfortable and more enjoyable (while making your brain more flexible). Feldenkrais rhymes with ‘rice’ and is named after it’s inventor, Dr Moshe Feldenkrais. Read more about Feldenkrais here.
Hello, my name’s Jodie and I’m a Physiotherapist with over 25 years experience in working with people who have chronic pain, including many people, past and present, with Fibromyalgia. Read more about my work experience.If you are battling with daily pain and fatigue, I can truly empathise. I used to laugh about the fact that I seemed to have had pain in every part of my body. I figured that it helped me develop new forms of self-treatment that I could teach my clients. I also felt that it made me a more compassionate therapist.
However it was a strange surprise when a few years ago I was diagnosed with Fibromyalgia myself. Since my mid 30s I have used Feldenkrais, Pilates, diet, exercise, massage, medication and meditation to help deal with variable daily pain and fatigue. My rheumatologist suggested that the reason that my Fibro has not stopped me from having an active and satisfying life is simply good management. So now I am on a mission to share with you the things that have worked for me over the years.
Although I have tried many approaches, the Feldenkrais Method is by far the most effective and powerful tool I’ve discovered to help with the persistent and sometimes severe pain of Fibromyalgia.
Over the years, I have seen many people with severe pain and movement difficulties turn their lives around using Feldenkrais. One client who had not experienced even one minute without pain for over 20 years did Feldenkrais with me for 3 months before he experienced his first 2 hours of being pain free. The pain-free periods gradually got longer and more frequent. After one year he was pain free most of the time. When he experiences pain now he knows how to find his way out of it again using the Feldenkrais Method.
This leads me to share with you 6 reasons why the Feldenkrais Method and is so suitable for many people with Fibromyalgia:
- Encouragement – a sense of relaxation and wellbeing is often experienced from the very first time you do a movement lesson and the enjoyment makes you want to continue
- Slow gentle pace – the slow mindful movements make it safe and help avoid flare-ups,
- Energy conservation – the focus is on efficient movement and reduced effort – imagine how much more energy you would have if you could bring this approach to everything you did!
- Flexibility and adaptability – each person is unique and different, and the exercises are easily adapted to your particular situation and needs
- Prevention – you become more sensitively tuned into your body so that you realise more quickly when you are doing something that will end in pain later
- Autonomy – you can learn to do Feldenkrais for yourself, reducing the need for hands-on treatment
No matter what your pain is like, how long you’ve had it, or how severe it is, almost everyone can improve their pain by improving their movement. The latest neuroscience suggests that the pain in Fibromyalgia, is not due to a problem in the tissues themselves, but to a dysfunction in the way the brain and nervous system transmit and interpret pain signals. This results in an increase in sensitivity to pain and to pain amplification.
The movements in Feldenkrais can help to decrease pain and improve your ability to perform everyday activities. The gentle, mindful movements send new and different messages to your brain through pleasant sensations, changing the way your brain and nervous system function. You begin to understand how some of your movement habits may not be working for you and you discover new options. This is a learning process which includes your whole body and your mind, not just the parts of you that hurt.
If you’d like to learn more, you can view video of a talk I gave to the Fibromyalgia Support Network of Western Australia. This includes a short Feldenkrais ‘Awareness Through Movement’ lesson you can try while sitting in a chair.
As you may be able to tell, I’m passionate about the Feldenkrais Method, so I hope you will feel free to contact me at Free2Move if you have any questions or if you’d like to book in for an individual Feldenkrais appointment.
Change Your Brain to Relieve Pain: An Introduction to Feldenkrais
Change Your Brain to Relieve Pain: An Introduction to Feldenkrais
Have you or someone you care about been experiencing chronic pain, with persistent or recurring episodes of pain or tension? Have you tried treatments which only work for a short time or don’t work at all? Then this enlightening evening about the Feldenkrais Method will open your mind to a new possibility – the possibility that your problem does not lie within the body part where you feel it, but in the brain and nervous system.
The great news is that you can change your brain and relieve almost any kind of pain with an ingenious method developed decades ago by a scientist ahead of his time, Dr Moshe Feldenkrais. Put simply, the Feldenkrais Method is a way of changing your habits to make movement easier, more comfortable and more enjoyable (while making your brain more flexible).
Current pain science tells us that if you’ve had pain for more than 3 months (chronic pain), the main problem is usually no longer in the tissues, muscles or bones, it’s actually in your brain and nervous system, which is where all pain is sensed. The movements in Feldenkrais are designed to send new and different messages to your brain, changing the way your brain and nervous system function. Feldenkrais works with your whole body and your mind, not just the parts that hurt. Read more about Feldenkrais.
Presenter Jodie Krantz is the President of the Australian Feldenkrais Guild (WA Division) and has been a registered Physiotherapist for over 25 years. Read more about Jodie’s experience and values.
Jodie has helped many people with seemly intractable chronic pain turn their lives around, using Feldenkrais:
Feldenkrais: Changing your Brain “It is by far the most effective and powerful method I use. One client, who had not experienced a single minute without pain for over 20 years did Feldenkrais with me for 3 months before he experienced his first 2 hours of being pain free. The pain-free periods gradually got longer and more frequent. After one year he is pain-free most of the time. When he experiences pain now he knows how to find his way out of it again using the Feldenkrais Method.
“Another client with Rheumatoid Arthritis went from severe difficulty walking to being almost pain-free in a couple of months. Many people find Feldenkrais is a great bridge that enables them to move on to more vigorous forms of exercise such as walking or Pilates.”
So what are some of the things that make Feldenkrais stand out over other methods?
- Changes can begin to occur from the very first time you do Feldenkrais
- Improvement is usually gradual and cumulative – the slow, gentle pace is what makes it safe and helps avoid flare-ups
- Autonomy – you can learn to do Feldenkrais for yourself, reducing the need for hands-on treatment and maybe lessening the need for medication
- Prevention – you become more sensitively tuned into your body so that you realise more quickly when you are doing something that will end in pain later on
- Each person is unique and different, so the exercises have built in flexibility and adaptability to your particular situation and needs
To understand what Feldenkrais is you need to actually experience it. So come along to the Bodhi Tree and experience Feldenkrais first hand.
This is how the evening will go:
- Brief description of the Feldenkrais Method
- How it works to change your brain and your pain
- Experience a Feldenkrais “Awareness through Movement” lesson sitting in chairs
- Questions and Answers
- Informal chat with Jodie after the workshop
Introduction to the Feldenkrais Method: ‘New Light on Old Patterns’
Introduction to the Feldenkrais Method: ‘New Light on Old Patterns’
On Tuesday 11th November, Perth Physiotherapist Jodie Krantz from Free2Move in Mt Hawthorn presented a 2 hour workshop to recently graduated Physios at the Australian Physiotherapy Association branch office. Fourteen Perth Physiotherapists, who have graduated within the last 5 years, had the opportunity to experience the Feldenkrais Method first hand from a presenter with over 20 years experience in the field.
Ms Krantz invited participants to engage with questions such as:
- How do we change habits which no longer serve us?
- What about the stubborn, longstanding patterns which seem to defy change?
- Is there a ‘right’ and a ‘wrong’ way to move? or breathe?
- How can the discoveries we make about our own movement patterns enhance our ability to educate our clients?
- What does it mean to re-educate our movement patterns and why is it necessary?
- How can we have more power with less force? greater range with less strain?
The Feldenkrais Method is based on the life work of Dr Moshe Feldenkrais (1904 – 1984). Dr Feldenkrais, an inventor, nuclear physicist and judo expert, understood ‘neuroplasticity’ – the ability of the brain and nervous system to adapt, change and re-wire itself – long before it became a buzzword in popular science. His frequently subtle yet profound and powerful method of movement re-education is useful for anyone seeking to change patterns of pain and tension and replace them with a sense of ease and freedom.
The Feldenkrais Method is popular with Physiotherapists and people seeking to overcome chronic pain or neurological problems as well as athletes, dancers and performing artists, who wish to become more graceful, coordinated, efficient and powerful.
Ms Krantz describes Feldenkrais as a scientific approach to movement re-education, which focuses on improving the human capacity for learning. It involves directing the attention to the body in a relaxed, enjoyable and mindful way, while exploring slow, gentle yet unusual movement sequences. This helps Feldenkrais students become more aware of muscular habits and tension patterns, allowing them to discover new and more efficient patterns of movement. Ultimately Dr Feldenkrais was not just interested in flexible bodies but in flexible minds.
In her work as a Physiotherapist, Ms Krantz finds that the Feldenkrais Method is particularly helpful for people with chronic pain issues such as back pain, headaches, shoulder pain and hip pain.
“Feldenkrais looks at the whole body and how the different body parts work in relation to each other” said Ms Krantz. “Instead of focusing on the pain itself, the focus is on pain-free, comfortable movement. The relaxing and enjoyable movements have a positive effect on physical and mental well being, helping break the vicious cycle of pain, tension and poor posture, which often occurs with chronic pain.”
Ms Krantz has been invited to present another workshop for the Australian Physiotherapy Association on the Feldenkrais Method in 2015 on the topic of Feldenkrais for Chronic Pain. She will also present a Chronic Pain workshop for the Australian Feldenkrais Guild next year.
7 Steps to Reducing Tension Headaches
7 Steps to Reducing Tension Headaches
By Principal Physiotherapist Jodie Krantz
To get relief from tension headaches, follow this process to ensure effective diagnosis and treatment.
Step 1: Get a check up from your GP
Although most headaches are harmless, it’s a good idea to see your GP to ensure it is not being caused by something more serious. You should see your doctor immediately if you have severe pain, which is not relieved by normal over-the-counter medications, if it was related to a head injury, or involves loss of consciousness, fever, vomiting, blurred vision, difficulty speaking or numbness of the arms or legs. Your doctor can assist with diagnosing the cause of your headaches. Tension headaches and migraines are the most common cause of headaches and many people have a combination of the two.
While visiting your GP, consider discussing your stress levels and mood. Anxiety and depression can be contributing factors when you have recurrent headaches.
Step 2: Start keeping a headache diary
This will help you to keep track of your headaches, to know whether you are improving and to get a better understanding of the likely triggers for your headaches. Taking your headaches diary with you when you visit a health care professional assists with the process of diagnosis and treatment of your headaches. Download a headache diary here.
Step 3: Get a headache assessment from your Physiotherapist
See your Physiotherapist for a check up. Ask for an assessment of your posture, flexibility, muscle strength and endurance, as these factors are likely to be contributing to your headaches. Some headaches are caused by referred pain from the small facet joints in your neck. These headaches often respond well to gentle mobilization techniques.
A common cause of headaches is poor posture. People who get recurrent tension headaches are often holding their head too far forward, causing the muscles at the back of the neck to work overtime. They may also have a tendency to hunch the shoulders forwards and upwards, tightening the upper trapezius and other adjacent muscles. These muscles are often the primary source of the headaches which are felt in the back of the head and neck, in the temples and behind the eyes. The pain is often described as being like a tight band around the head.
Once you’ve had an assessment your Physiotherapist can help you work out a treatment and / or home exercise programme to relieve your headaches. At Free2Move our approach is to provide the minumum necessary one-to-one treatments and get you self-managing through a customised exercise programme in the shortest possible time.
Request a Headache Assessment at Free2Move
Step 4. See your Dentist
Jaw tension is another common cause of tension headaches. It’s a good idea to have your dentist check whether you have been clenching or grinding your teeth. A lot of people – some dentists say most – clench their teeth in their sleep. This will be evident from the wear patterns on your tooth enamel. A night guard (occlusal splint) can often reduce or even eliminate headaches associated with jaw tension. The Feldenkrais Method is also very helpful for reducing jaw and neck tension, which can lead to headaches.
Try a free Feldenkrais Lesson on Releasing your Neck and Jaw. You can also see your Physiotherapist for one-to-one assessment and treatment of jaw pain or tension.
Step 5: Get an ergonomic assessment of your workstation
Do you sit at a computer for long periods of time? How is your posture while you work? Although most people try to maintain good posture at their desk, this is hard to attain and even harder to sustain if your ergonomic set-up is incorrect. Consider asking your employer to arrange an ergonomic assessment of your workstation. To request an ergonomic workstation assessment in Perth Western Australia, Contact Us at Free2Move.
The two most important factors are your chair and your monitor. Most good ergonomic chairs have 3 levers underneath, one to adjust chair height, one for the angle of the seat and a third for the angle height and position. The back rest should also be adjustable so that the lumbar support is in the right place. Get your chair properly adjusted and each day when you sit down to begin your work check that it’s in the right position. Use a footstool if required and ensure that the top of your monitor is level with, or just below the height of your eyes.
Speaking of eyes, when was the last time you had them tested? Eye strain can also be a cause of tension headaches.
Last but not least, get up out of your chair and walk around once an hour at the very minimum. There are some great programmes and apps now to help remind you about this. Make sure you have a system in place.
Step 6: Improve your exercise regime
It’s not a theory, it’s a fact: regular cardio-vascular exercise can reduce the frequency, severity and duration of tension headaches. Exercise helps because it improves circulation to all your muscles, reduces stress and tension, and has a beneficial effect on the brain and nervous system, through which all pain is sensed.
Aim to spend a minimum of 2.5 hours every week participating in an enjoyable form of moderately vigorous activity. The ideal is 30 to 60 minutes of exercise at least 5 days per week. You can walk, swim, cycle or play sport – anything that increases your heart rate and gets you breathing a little more deeply. This needs to become part of your regular routine, so it’s a good idea to put a structure in place that supports that.
Walking often works because it’s free and you don’t need any special equipment or environment. It’s also a form of locomotion and an fundamental ability to maintain as you get older. So walk to work, walk your dog or walk with a friend and help each other maintain your exercise goals. If it’s too wet or hot you can even walk inside your local gym or shopping centre.
Step 7. Reduce your stress levels
Stress often contributes to recurrent or chronic tension headaches. People who are stressed may resort to unhealthy ways to reduce stress, such as excess use of alcohol, smoking, taking pills or drugs, overeating, excess consumption of sugar or caffeine. Some people avoid facing their worries and concerns by being so busy they never have time to slow down or by watching TV to avoid thinking or feeling.
Important aspects of reducing stress are eating a balanced nutritious diet, participating in regular exercise and getting adequate sleep.
Healthy ways to relax include things like going for walk in nature, taking a hot bath by candlelight or getting a massage. Consider doing some gardening, listening to music, or playing with a pet. You could consider taking classes in Feldenkrais, meditation or Tai Chi. Whatever you do, build it into your weekly routine and set aside time that you will devote to relaxing your mind and body.
Reducing stress includes taking responsibility for the way that you manage problems, thoughts and emotions. If you can’t change the circumstances that result in stress, change the way you respond to it. For help and support with managing stress in Australia, talk to your GP about a referral to a Clinical Psychologist. You may be eligible for a rebate through Medicare.
Common Types of Arthritis
Comparison of Rheumatoid and Osteo Arthritis Common Types of Arthritis
Arthritis is a common condition causing joint pain, stiffness and swelling. The most common types are Osteoarthritis and Rheumatoid Arthritis. These are distinctly different. In this article we will describe Osteoarthritis, Rheumatoid Arthritis and Fibromyalgia.
Osteoarthritis
Osteoarthritis (OA) is the most common form of arthritis. It occurs when the cartilage that lines the joints wears down. This may be due to past injury, cumulative wear and tear or simply the ageing process.
OA commonly occurs in the large weight-bearing joints of the body – the hips, knees, feet and spine but it can also affect any of the synovial joints in the body, including the fingers, thumbs, shoulders, elbows and jaw. There is usually stiffness in the morning and pain may be worse after prolonged or heavy activity.
Over time the cartilage becomes thinner and loose pieces debris can float in the synovial fluid, which lubricates the joint. The bony surfaces of the joint can also develop projections called osteophytes. These may contribute to pain and inflammation.
Research shows that keeping active and maintaining your weight in the healthy range is the best approach to managing osteoarthritis. Advanced osteoarthritis can result in loss of normal strength and mobility. Eventually surgical options such as arthroscopy or joint replacement may be indicated. Physiotherapy can help delay the need for surgery.
Rheumatoid Arthritis
Rheumatoid Arthritis (RA)Â is an inflammatory auto-immune condition in which the body’s immune system attacks the joints. Morning stiffness can typically last for half an hour or longer after rising. Pain and inflammation can be severe if the condition is left untreated.
This form of arthritis commonly attacks many joints in the body on both sides. This includes the small peripheral joints in the hands and feet, spinal joints, shoulders, elbows, knees and hips. In Australian diagnosis is usually made by a rheumatologist based on history, clinical examination, blood tests and X-rays or scans.
In RA, the synovial lining of affected joints becomes inflamed and the joints are red, hot and swollen. Without treatment there is thickening of the joint capsule. The adjacent cartilage and bone can become damaged causing joint deformity. RA can also affect blood vessels, lungs, heart and skin. New medications are available that help prevent the joint destruction and tissue damage, which people with rheumatoid arthritis previously developed.
The cause of RA is unknown, but it’s more common in women, affects smokers more than non-smokers and there are appear to be hereditary factors.
Gentle exercise helps rheumatoid arthritis sufferers to relieve stiffness and promotes good circulation, maintaining joint mobility without aggravating pain and swelling. Examples are walking, swimming, hydrotherapy. Feldenkrais can also help to maintain mobility without causing excessive joint strain.
Fibromyalgia
Fibromyalgia is not really a form of arthritis, but it has many similar features. These usually include chronic pain, aching and tenderness in multiple soft tissues and joints without changes on Xrays or blood tests. Fatigue, sleep problems, anxiety, memory problems and / or mood changes are also common. The cause is unknown, but being overweight and inactive is a risk factor.
READ MORE about how Feldenkrais can help Fibromyalgia.
VIEW VIDEO presentation on Fibromyalgia by Jodie Krantz – includes gentle Feldenkrais exercises in sitting.
Treatment: How We Can Help
Physiotherapy, Clinical Pilates and the Feldenkrais Method can all be helpful in managing the pain of arthritis and fibromyalgia. This is where our experienced Perth physios can really help. At Free2Move we initially provide a full assessment, hands-on treatment and home exercises. Therapeutic exercises help to maintain strength and range of movement without aggravating pain or swelling. Exercise also helps with circulation which supports the healing process.
CLICK HERE to read about Turmeric, a natural supplement to help ease arthritis pain and inflammation.ÂThe best place to begin is by booking an individual assessment, so that we can work out which treatment or exercise programme is best suited to your needs.Â
Recovering from a Lumbar Disc Injury
Recovering from a Lumbar Disc Injury
A disc bulge or prolapse can occur in the neck, lower or middle back. The lowest lumbar discs (L4/5 and L5/S1) take the most weight and often form a ‘hinge point’ for movement of the trunk. By far the majority of lumbar disc injuries occur at these two levels.
Basic Anatomy and Pathology
To understand a disc bulge or herniation first requires a basic understanding of the anatomy. The spine consists of a series of 24 vertebrae, plus the sacrum and tail bone at the base of the spine. Each inter-vertebral discs sits between a pair of vertebrae, acting as a shock absorber and allowing the spine to bend. Each disc is a mini-hydraulic system, with tough, concentric fibrous layers on the outside (the annulus fibrosus) and soft mobile material in the centre (the nucleus pulposis).
A disc bulge occurs when a weakness in the outer wall (the annulus fibrosis) allows the disc to change shape. The material on the inside (the nucleus pulposis) bulges outwards deforming the outer wall, which may put pressure on sensitive surrounding structures including the nerve roots. This is a common and less severe form of disc injury.
A disc herniation (also called a disc prolapse) occurs when pressure on the disc causes the softer nucleus material to crack the outer wall of the disc and leak out.
Most commonly the material bulges towards the back of the body, either centrally or to one side, where it may put pressure on sensitive structures such as ligaments and spinal nerves. Local swelling and inflammation may increase this pressure. Irritation of the nerve roots in the lower back may cause sciatica – pain anywhere along the course of the sciatic nerve, which passes through the buttock, down the back of the thigh, where it divides in two branches which go down the lower leg to the foot. (Not all leg pain associated with lower back problems are caused by sciatica however.)
Symptoms
With a minor lumbar disc bulge or herniation, pain will be localised to the lower back, possibly radiating to the buttock or thigh at times. The pain is usually worsened by prolonged sitting, bending, or simply staying in any one position for too long. In more severe cases, pain may extend down the leg on one or both sides, or alternate sides, sometimes as far as the foot. The pain may be constant or may come and go.If the disc impinges on a nerve root, there maybe be neurological signs such as numbness, pins and needles or loss of power in parts of one or both legs. People with significant neurological symptoms may have to consider surgery, however surgery poses significant risks and in most cases it is worth trying less invasive approaches first.
Things to consider
Please bear in mind two things. Some people have a disc bulge on MRI or CT scan but no pain at all. Also pain often comes from more than one structure. You could have an un-diagnosed problem in addition to the disc bulge, such as a jammed facet joint or sacro-iliac joint or soft tissue pain from muscles and ligaments, which cannot be imaged well with CT scanning. Inflammation, instability or minor mal-alignment may not show up on any scan. Just because a disc problem shows up on your scan does not prove that this is what is causing your pain.
Can a disc heal?
Now the important question about the disc. Can it heal? YES. A major prolapse or herniation may not heal by itself and surgery may be advisable in some cases, but potentially a bulge and small to moderate sized prolapses can be healed by the body’s own repair processes in time. How long? That depends on how severe and how unstable it is, your age and most importantly how much stress you put on it, which is the part you can control. It also depends on the state of your spinal and abdominal muscles, as weakness or imbalances in these may be part of what caused the problem in the first place.
With a disc bulge, the walls of the disc are still intact, and healing time is shorter, though in some cases it can still take months. With a disc herniation (prolapse) it can take many months or even years to resolve.Once you injure your disc, it will be unstable for a period of time (months or years for a severe prolapse). This means that the disc will bulge a lot more than usual when you are weight-bearing (eg standing, sitting, bending, lifting) and typically gets worse as the day goes on. An unstable disc is more likely in a young or middle aged person because as you get older the disc dehydrates and the nucleus becomes more rigid – stiffer but more stable. Young people may heal quicker after a disc injury due to tissue repair processes.
How to recover in the shortest possible time
Acute stage:Â severe, disabling, constant pain
- Rest. Rest. Rest some more. Get horizontal as frequently as you can during the day. Take time off work. Avoid sitting as much as possible and if you do sit never slouch on the couch. Lie down or stand leaning back against the wall if you are tired.
- Avoid lifting anything over 2 – 5 kg and avoid any thing else that aggravates the pain.
- Don’t stiffen against the pain. Try to keep moving and relax your muscles. If possible get up and walk around regularly but lie down again if pain starts to worsen.
- Learn some gentle exercises that you can do at home to maintain your range of movement and activate the spinal support muscles. Get professional help from an experienced Physiotherapist for this.
- See your doctor for a neurological examination and medication to assist with managing the pain. Too little pain medication may result in severe muscle spasm and create a vicious cycle of pain and tension. Too much analgesia and you may unknowingly move in a way that aggravates the problem.
- Try other pain relieving measures such as a heat packs, cold packs or a TENS machine.
- If you absolutely have to sit, try various back supports to improve your posture and spinal stability for example an individually moulded back brace can be fitted for you and worn a few hours a day to improve spinal stability and comfort while you are on your feet. A lumbar support cushion can often help when you have to sit.
The single biggest factor in disc healing, in my opinion, is NOT STRESSING IT. You want to maintain your physical fitness, range of movement and strength to the best of your ability without aggravating the pain. Aggravation of the pain may mean that you have pushed the wall of the disc out further again, worsening the bulge.
Importantly, no practitioner can ‘put a disc back in’ though some claim to. The temporary relief of pain associated with adjustment / manipulation may be due to the release of neuro-chemicals – your body’s own pain relieving substances. Massage and physio can relieve other aspects of the pain such as joint stiffness and muscle spasm, but this is also temporary. There is also a high risk of aggravating a disc injury with spinal adjustment, manipulation or even massage.
Be very cautious with any exercises. You have to start with very minimal subtle exercises and progress vary carefully under professional guidance and listening to your own body.
Sub-acute stage:Â moderate pain which comes and goes
- Gradually get moving. Walking can be a helpful exercise for some people, others find it aggravating. Pace yourself. Listen to your body’s messages. Try walking in warm, waist-deep water, but remember anything can aggravate your symptoms if you over-do it.
- Restrict sitting to short periods of time if it aggravates your pain and always use adequate lumbar support, such as a BodyBolster or contoured lumbar cushion,  especially when driving or sitting at a computer. (Free2Move sell both.)
- Have a Physiotherapy assessment and get an individual exercise programme specific to your individual situation. Remember that the wrong exercises or exercising too soon can make you worse instead of better.
-  Get your Physiotherapist to show you how to test the safety of any exercise. Learn which type of exercises relieve your pain – for example spine neutral or extension based exercises are usually best for lumbar disc pain.
- Be careful but not overly cautious (or stiff) when bending and lifting. Don’t lift anything over 5 to 10 kg. Get your Physiotherapist to check your lifting and bending techniques.
- Learn to let go of the muscle spasm (Feldenkrais classes are amazing for this – more effective than a massage and you can do it for yourself).
- Improve postural awareness (Feldenkrais and Clinical Pilates)
- If you aggravate things go back to the acute stage.
- Have patience. A moderate disc bulge will take around 6 weeks to get better but only IF you do the right thing, but may never heal if you keep aggravating it.
- See your doctor if symptoms don’t improve.
What if it becomes chronic?
A ‘chronic’ condition is one that persists over time without improving, usually more than 3 months. Once a condition becomes chronic it is harder to reverse, because the body adapts to it. Changes occur in the way your brain interprets pain messages. Muscle imbalances and compensation patterns often develop. These may have been part of the initial cause of the injury, or may have developed as part of your body’s response to the injury. Either way once this occurs the disc injury and / or the pain associated with it become the body’s ‘normal’ state and you have to find a way to break the cycle.
Recent research shows that people who develop low back pain have difficulty activating the deep abdominal and pelvic muscles which are a part of the normal stabilising mechanisms of the lower back. The muscles may have become weak, difficult to activate, or there may be a delay in their activation, so that they are too slow to switch on. You may go to lift something for example and at the critical moment, if the muscles have not engaged to stabilise your lower back, the result is strain and further injury.
Muscle spasm or tightness is also extremely common in people who have chronic lower back. Immediately after your injury, the muscle spasm actually helps to protect you, It restricts your movement and helps avoid further damage. Long term though, the muscle spasm becomes a source of considerable pain and inhibits normal movement. Here’s an analogy: If you break a leg and don’t get it set in plaster (or surgically fixed) the bone might not ever heal. But if you left the plaster on for the rest for the rest of your life, the plaster would become the problem, rather than the solution to your problem.
Surgery may be less likely to be effective once pain becomes chronic, because surgery can help correct the structural problems but the defective way that the muscles are working can only be corrected by skillful muscle re-education. If you do end up having surgery it is absolutely essential to participate in a specific muscle and posture re-training programme that is customised to your particular strengths and weaknesses. It is very hard to work this out yourself, even if you are a therapist or movement teacher, because you will almost certainly have ‘blind spots’, things you are not aware of about your own habitual muscle use.
The major tasks in recovering your normal muscle function and posture are:
- Correcting imbalances which occur when one muscle group becomes habitually tight and it’s opposing group switches off or becomes significantly weakened.
- Sensing ‘neutral’ postural alignment in order to correct your posture.
- Learning safe ways to move and do everyday things so that you won’t re-injure yourself, for example learn to improve the way you roll over, get up from lying or sitting, bend, reach and lift so that there is the least possible strain on your back.
- Read More about Chronic Pain
Good luck and remember it will take time to recover. Make sure you get professional help so that you are sure you are on track, but also it’s critical that you learn to listen to your own body signals. For this I have not discovered anything better than the Feldenkrais Method.
Free2Move Physiotherapists are now able to offer secure video linked online consultations using Telehealth technology.
BOOK HERE
Copyright Jodie Krantz February 2020
Living with Chronic Pain
Living with Chronic Pain
Living with Chronic Pain
Pain that is present all the time or comes and goes but is present most days of the week can have a profound influence on just about every area of your life. It commonly affects mood, energy levels, relationships, sleep patterns, ability to work and participation in leisure activities.
People living with chronic pain have often already tried many approaches to relieve their pain, ranging from Physiotherapy to medication to alternative therapies such as medical cannabis. Many have resorted to injections and sometimes even surgery.
Stress and tension associated with chronic pain can lead to anxiety or depression.  Sometimes you just feel like giving up, however exercise has been shown to be effective in managing chronic pain and tension as well as reducing stress and anxiety.
Safe Exercises for Chronic Pain
While exercise is an essential component in recovering from (or simply managing) chronic pain conditions, the wrong type, intensity or frequency of exercise can actually aggravate pain. This is where the professional supervision of a Physiotherapist can make all the difference, ensuring good alignment and correct technique.
At Free2Move we know how to get you exercising safely again, whether you are a trained athlete or you currently have a very low level of fitness. Our aim is not just to reduce your pain, but to safely assist you to regain your strength, flexibility and fitness. We provide structured programmes that work. You are always closely monitored and your exercises carefully progressed.
Our Physiotherapists address your aims and goals. Would you like to be able to walk more comfortably? To be able to return to your favourite sport? Or even just to roll over more comfortably in bed at night and to sleep better? It’s our job – actually it’s our passion – to be able to get you started again on the journey to better health.
Principles of Rehabilitation
Regardless of the cause or type of pain there are two main principles in rehabilitation:
- Repair the Structure – stimulate the body’s natural healing processes through balanced, appropriate and safely progressed exercise balanced with adequate rest
- Improve Function
- Distribute workload more evenly throughout the body
- Improve body awareness, posture and alignment
- Promote return to normal strength and range of movement
- Improve balance and stability
These principles underlie all of our individual and group exercise programmes.
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How We Can HelpTo change chronic pain, it’s usually necessary to change the way your brain and nervous system function in relation to pain. The Feldenkrais Method, which is supported by the latest neuro-science, is designed to change the way your brain organises your movement and posture.
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During a Feldenkrais individual or group lesson you learn
- to overcome habitual patterns of pain and tension and poor posture
- to create more comfortable and efficient options for movement
- to de-construct movements and then put them back together again differently
- how to relax the parts of your body that are working too hard
- how to engage places which have become forgotten or disused
- how to spread your attention throughout the whole body rather than being focused on the pain
Because the movements are so small and gentle, Feldenkrais is often the safest way to begin your journey back to greater ease and comfort. One-to-one sessions can progress to classes.
Read more about how Feldenkrais helps chronic pain
Clinical Pilates is a great way to strengthen the new movement patterns you have developed during Feldenkrais, without aggravating pain. In Pilates we closely examine the bio mechanics of your movement, looking to minimize factors which may be aggravating your pain. Our aim is to promote independent self-management in the shortest possible time frame.
Chronic Pain Overview
Chronic Pain Overview
Chronic or persistent pain is pain which is longstanding, usually for at least 3 months. At Free2Move our Physiotherapists have a special interest in treating persistent pain conditions, which often require a different approach. This means addressing the cause of the pain, not just relieving symptoms.
Causes
Back pain, neck pain, headaches, migraines, jaw pain (TMJ pain) and arthritis are examples of conditions which may become chronic. Fibromyalgia, cancer and irritable bowel syndrome are others. Sometimes it has a known pathological or structural cause, such as in a disc herniation or trochanteric bursitis. Other times no specific cause can be identified.
Recent research suggests that when pain has been present for over 3 months, sensitisation of the nervous system occurs. Although many people with this type of pain believe they have a high pain threshold, long-standing pain actually results in neurological changes which increase your sensitivity to pain.
How We Can Help
To change longstanding pain, it’s usually necessary to change the way your brain and nervous system function in relation to pain. The Feldenkrais Method, which is supported by the latest neuro-science, is designed to change the way your brain organises your movement and posture.
Principal Physiotherapist Jodie Krantz qualified as a Feldenkrais Practitioner in 1999 and has a special interest in treating persistent pain conditions. For 7 years Jodie taught Feldenkrais as part of the Bunbury Pain Management Programme. Feldenkrais is a whole body approach, but unlike Yoga or Pilates, it is not about exercise – it’s about learning to move differently.
