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Beyond Chronic Pain: a Personal Journey to Create Healthier Habits
Beyond Chronic Pain: a Personal Journey to Create Healthier Habits
Finding Vitality and Joy in your life
Physiotherapist Jodie Krantz shares her healing journey towards a more satisfying and comfortable way of living within with her own body. Retracing her steps, Jodie invites you to join her on a challenge to improve your own quality of life and perhaps that of your nearest and dearest.
I reached the age of 50 with my body in a condition better than many my age. Being a Physiotherapist I had always done some form of exercise. My weight was in the upper end of the healthy range for my height. I didn’t smoke or drink to excess – ever. I’d always watched what I ate and ‘listened to my stomach’, stopping when I felt full. I considered myself very fortunate to have completed my training as a Feldenkrais practitioner in 1999. This was a profound learning process which gave me access to the tools to keep my body moving like a much younger person, even into old age.
Yet the small aches and pains had accumulated over the years to the point where there was never a day without some sort of pain. Headaches were frequent and although not severe, made me nauseous, fatigued and thick-headed. This very unpleasant feeling would last 2 to 3 days or more. Foot pain made it hard to walk for more then 20 minutes. My lower back twinged frequently, especially after sitting and in bed at night. I often complained to my partner about being tired. Worst of all, severe episodes of lower back pain had seen me bed-bound and off work for up to 5 weeks.
I knew what I had to do, but it was hard to do it. I had to change some fundamental habits I had formed in over 50 years. The intentions I set for myself were:
- To allow myself the ‘luxury’ of getting treatment when needed
- Improve my diet and rid myself of ‘addictions’ – sugar, coffee and alcohol
- Shed a few kilos
- Reduce my stress levels
- Increase my cardio-vascular exercise
- Get enough sleep on a consistent basis
There was no point changing everything at once. The body doesn’t like radical change and it’s usually not sustainable. The biggest challenge I faced was finding the extra time required, a challenge I know that many of my friends, family, colleagues and clients share!
Next birthday I turn 57. In the past few years I’ve turned my life and my pain around. Fatigue as I once knew it, is but a distant memory. I simply feel the happiest I’ve ever been in my life.
5 Ways to Counteract Sitting at Work
Five Ways to Counteract Sitting at Work
1. Micro-breaks
Eye breaks – every 20 minutes spend 20 seconds focusing your eyes on something 20 feet away from you (the 20 – 20 – 20 exercise). You should also blink the eyes a few times to lubricate them.
Deep breathing with an overhead stretch (sitting or standing). Interlace the fingers. Take a deep breath in as you raise your hands overhead and turn the palms towards the ceiling, looking upwards slightly. Repeat 3 times.
2. Walking breaks
Once every 30 to 60 minutes move away from your desk and walk briskly around the office. These short periods of activity that are simply part of your daily routine are known as ‘incidental exercise’. They are useful for preventing stagnation of the circulation. They help to raise your metabolic rate. There are many apps available to help remind you to get out of your chair.
You may simply get up, walk to another room and drink a glass of water or use the bathroom. It doesn’t necessarily mean that you stop working either. The break could be used, for example, to discuss something with a colleague or use the photocopier. Walking or jogging on the spot can provide an additional boost for your circulation. A short but brisk walk during the lunch break is another possibility.
3. Walking meetings and walking phone calls
Standing or walking during meetings helps increase activity level and lifts metabolic rate. If you use a mobile phone at work, make sure you have earphones with an inbuilt microphone. This way you can remain mobile while talking with colleagues or clients.
4. Walk to work
If you live too far from work to walk there, try parking your car further away and walking for the last 10 or 20 minutes. Taking public transport usually involves walking to and from the train or bus, which could be an improvement on taking your car. Research shows that we need an absolute minimum of 150 minutes a week of cardio-vascular exercise. This can be made up of any blocks of exercise that are at least 10 minutes long.
5. Active computer work stations and fit desks
Active work stations and fitdesks are a fantastic way to increase activity levels during the working day. Treadmill work stations allow you walk while you work. Cubii is an under desk elliptical that you can use while you work, without your knees hitting the desk. It has bluetooth connectivity so you can keep track of how far you have pedaled on your phone. Here is an interesting article that compares cycling desks with treadmill desks. The treadmill desks are more expensive but don’t interfere as much with productivity and the ability to work on a computer.
Stretches you can do at your desk
Stretches at work are helpful for reducing muscular tension and feelings of stiffness.
The following stretches can be done without leaving the vicinity of your desk. They target the most common places people feel tension after being at a computer.
READ OUR DISCLAIMER Please seek medical advice before commencing exercises, if you have a painful or medical condition.
Spine twist – Sitting in your chair, twist around to one side and look behind you, hold for a few seconds and repeat to the other side. This exercise helps stretch the shoulders, lengthen the back and fills the lungs with air, expanding the chest.
Forward bend – Sitting in your chair, slide your arms down your legs and let you head hang forwards, hold for 2 or 3 breaths in and out, then return to sitting. This gently stretches the lower back if it has been arching or compressed. It may help to help relieve lower back tension.
Pectoral stretch – Stand up, interlace the hands behind your back and raise the arms slightly towards the ceiling. The pectoral muscles at the front of the shoulders often become tight while using a keyboard. This exercise helps to lengthen them.
Back bend standing – Stand up, tighten the buttock muscles, use the hands to support the lower back and gently lean backwards, while looking upwards. Repeat several times without holding. This helps to counteracted a rounded lower back that can occur from slouching.
Stop sign stretch – Stretch one arm out in front of you with your elbow straight and your palm facing forwards, as in a policeman’s stop sign. Use the other hand to gently stretch the fingers back. Hold for a few seconds then repeat on the other side. This forearm stretch helps prevent Golfer’s Elbow (pain on the inside of the elbow).
Forearm stretch – Make a soft fist with one hand and extend it out in front of you, elbow straight. Turn the thumb side of the hand slightly towards the floor. Use the other hand to gently bend the wrist downwards. Do not do this stretch if you feel strain in the wrist. You may feel a stretch in the forearm if the extensor muscles which attach to the outside of the elbow are tight. Tight wrist extensors can lead to Tennis Elbow.
Also refer to our article “The Risks of Prolonged Sitting”
Improving Posture
Improving Posture
Have you ever tried to improve your posture? How well did that work for you? If you are not satisfied with the results, consider attending Feldenkrais classes. The Feldenkrais Method can help you achieve comfortable and effortless posture through ingenious and mindful movement exercises.
The changes become integrated into your every-day life. Soon you will find yourself sitting, standing and moving in ways that you never imagined could be so easy or comfortable.
Body Scan Exercise in Sitting
Sit on a firm chair with your feet flat on the floor. Come forward in the chair a bit so you are not using the back rest. Sit normally and close your eyes for a few moments. Notice your posture. Stay there for a minute or two just observing yourself. Then open your eyes again.
When you observed your posture, what is the first thing that came into your awareness? What parts of the body did you sense? Perhaps you thought about whether you were sitting or standing up straight? You might have become aware or your head, neck and back. Perhaps you sensed your spine and checked its alignment. Maybe you tried to correct yourself. These are things many of us were taught to do growing up.
Consider that parts of your body that may not have been included in your awareness. Your hands and feet? Your chest and rib cage? Was your abdomen free to move with the breath? How long could you sustain this posture comfortably
3 minutes to Better Posture
Now try this short exercise with Ruthy Alon. Then go back to the sitting body scan above and feel the difference.
About Ruthy Alon
Ruthy is an international Feldenkrais trainer who studied and taught with Moshe Feldenkrais for over 20 years. It is hard to believe that in this video she is 85 years old. Ruthy is still teaching, a huge inspiration for those of us interested in healthy ageing.
4 Reasons why trying harder to sit or stand up straight doesn’t work
1. When we try to straighten the spine we often increase effort in the muscles of the back without releasing the flexor muscles in the front of the body. The result is one muscle group working against another. This causes spinal compression.
2. Some of us work so hard in our back muscles to maintain good posture that we end up bowed backwards, thinking that we are actually straight. This ‘military’ style of posture can lead us to be stiff and stuck in our movements. People who do this are usually unaware of it.
3. A common frustration in trying to improve posture is that the changes only work while you are consciously paying attention. As soon as you stop doing that, you slip back into old habits.
4. Yet another problem with this method is that the effort to straighten can result in restriction of the breathing.
4 Ways that Feldenkrais helps improve posture
1. Focusing on dynamic, not static posture
Moshe Feldenkrais described good posture as ‘the ability to move equally easily in all directions’. This is dynamic posture. By contrast, static posture may involve trying to hold yourself still when you are sitting or standing. This may cause breath holding. It’s also literally impossible be completely still. We actually maintain our balance in upright positions by using subtle swaying movements.
2. Reducing effort
As you learn where to let go of unnecessary effort, you will discover how to find more efficient support from your muscles and bones. Learning to move easily in and out of a particular position is just as important as maintaining good alignment.
3. Learning first while lying down
To learn a new way of supporting the body against gravity Moshe Feldenkrais first taught a variety of movement lessons lying down. The reason is that lying down makes it easier to reduce muscular effort. This helps you sense what you are doing more clearly so you can make small adjustments towards greater efficiency. It means you are less likely to fall into inefficient habitual patterns and postures.
4. Expanding the self-image
In the Feldenkrais Method you will learn to bring your attention to each part of the body that is involved in an action. You will learn how even seemingly unrelated parts of the body such as your hands, feet, eyes, ribs and hip joints can influence your posture. The more parts of your body that can be included in your self-image, the more clearly you will know what you are doing. In the words of Moshe Feldenkrais ‘When you know what you’re doing you can do what you want’.
“When you know what you’re doing you can do what you want” – Moshe Feldenkrais.
Relieve Lower Back and Hip Pain with Feldenkrais
Relieve Lower Back and Hip Pain with Feldenkrais
Exercising with Lower Back or Hip Pain
Lower back and hip pain can make it hard to exercise. The alternative – not exercising – can lead to increasing weakness and stiffness, with a tendency to gain weight.
Even if you have already tried other forms of exercise without success, Feldenkrais is different. The focus during the movement classes is on learning to sense your body movements more clearly. Increasing your awareness of your movement habits is the key. That’s why Moshe Feldenkrais called the classes ‘Awareness Through Movement’
‘When you know what you’re doing you can do what you want’ Moshe Feldenkrais
How Feldenkrais Helps
By reducing effort and shifting your attention to the quality and smoothness of the movement, you discover new ways to move with comfort and ease. As you learn to let go of tight muscles, range of movement in your lower back and hips improves. You compare different movement options and discover what works best for your unique body. Better coordination and control of your muscles brings a sense of effortless power.
Help break the cycle of pain and tension in your lower back and hips by enrolling in our regular Feldenkrais Classes in North Perth. All classes are run by a qualified Feldenkrais Physiotherapist.
READ MORE about Feldenkrais Classes.
Feldenkrais and Insomnia
Feldenkrais and Insomnia
The Problem of Insomnia
Insomnia (difficulty sleeping) is incredibly frustrating experience. Discomfort while lying down can not only hinder your ability to fall asleep but also rob you of genuinely deep sleep. Sleeping in an awkward positions can lead to waking up sore and uncomfortable in the morning. The tiredness and discomfort can haunt you throughout your entire day. Worrying about getting enough sleep only makes it worse. Does this sound familiar?
How Feldenkrais Can Help Insomnia
Sometimes insomnia may be caused by a medical condition. It’s important that you discuss this possibility with your doctor. However often insomnia is caused by a busy mind and a tense body. Feldenkrais helps you to bring the mind and body into a relaxed, harmonious and settled place, ready for sleep. Some exercises can even be done while you are lying in bed.
In Feldenkrais classes you will learn some quick and simple exercises you can do every day to improve sleep. You will also participate in some longer ‘Awareness Through Movement’ lessons that help you to let go of pain and tension.
During a class you will lie on a comfortable padded mat, close your eyes and tune into your body. As you are guided through a gentle series of exercises, it’s easy to let go and wind down from the stresses of the day. You learn to quickly and easily bring your mind and body into balance. This helps promote a deeper and more restful sleep.
Feldenkrais helps develop your ability to focus your mind on your body in a relaxed and non-judgmental way. Letting go of focusing on sleep itself and softly resting the attention on the body and the breath helps to overcome a restless mind and tense body.
Feldenkrais also helps you expand your options for comfortable sleep positions. It achieves this through gentle mindful movement explorations.
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Free2Move Exercise Rehab and Pilates Classes – Frequently Asked Questions
Free2Move Exercise Rehab and Pilates Classes – Frequently Asked Questions
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How Exercise Rehab Works – FAQ
Pilates is a system of body conditioning, which helps improve posture, strength, flexibility and core stability. It is named after its inventor, Joseph Pilates (pronounced pi-lah-tees), a physical trainer who worked in an internment camp during World War I.
Later he ran a studio in New York. As it was next to a dance studio, he assisted many dancers to overcome injuries. As a result some of the exercises he taught are very challenging, as they were designed for dancers, who required a very high level of strength and flexibility.
Exercise Rehab and Pilates Classes have been developed by our Physiotherapists to help overcome pain and movement problems and assist rehabilitation. At Free2Move in Perth , some common exercises have been modified to make them safer and more therapeutic. Other exercises have been eliminated, due to the risk of injury, which has been reported with conventional Pilates.
Recent scientific research has shown that sufferers of back pain often have a weakness in specific spinal, pelvic and abdominal muscles, known as the ‘core stabilisers’. Learning to sense and activate these muscles is a fundamental part of the Pilates technique. Often the core muscles are not being activated effectively or at the right time. The surface muscles may be over-activated in an attempt to compensate for a weak core or poor postural endurance.
Many Physiotherapists have found that retraining of the deep or ‘core’ stabilising muscles is essential in helping someone with back, neck, hip or shoulder pain return to optimal function. The carefully controlled stretching and strengthening exercises in Exercise Rehab and Pilates Classes often involve stabilising one part of the body, while moving another part. This helps you to build up the awareness, strength and endurance in your deep or ‘core’ muscles so important to good posture and comfortable efficient movement. These muscles are ‘stabilisers’ and they differ from your main ‘movers’ in a number of ways.
- They are deeper or closer to the central axis of your body
- They are extremely important in balance and stability of your spine
- The fibres of these ‘stabiliser’ muscles work differently from the fibres in your ‘mover’ muscles – they are slower to act and not as powerful, but they are able to hold on for much longer to help you maintain good posture
- It is harder to feel the core muscles working because they are both deeper and thinner than the surface muscles and they are designed to work by ‘holding on’ rather than shortening and lengthening.
- When the core muscles are weak the surface muscles (or main ‘movers’) often take over, resulting in pain, tension and spasm, as these muscles are not designed to hold you up for long periods.
Is Pilates difficult to learn?
Activating the core muscles is not a strenuous activity for the body and yet many people find it difficult at first to differentiate these muscles. It may take a lot of concentration and practice. For some people it feels easy but then certain muscles are sore the next day from unaccustomed use. Others find it takes a few weeks or even months before they are really sure they are activating their ‘core’ muscles, while keeping the surface muscles relatively relaxed.
What is a muscle imbalance?
Your muscles tend to work in pairs to support your spine and other joints. A muscle imbalance occurs when one muscle group becomes excessively tight and it’s opposing group becomes weakened. Muscle imbalance can cause poor posture. Conversely, poor posture can result in muscle imbalance. For example lower back pain can cause muscle tightness in the lower back, resulting in a ‘sway back’ (over-arching). The opposite group (the abdominals) then cannot work as efficiently, so it becomes harder to activate and weakened. Conversely, weakened abdominal muscles following pregnancy can result in lower back tightness resulting in a ‘sway back’.
What are some other common imbalances?
Podiatrists tell us that 70% of Australians have pronated feet (dropped arches or flat feet). This can affect the alignment and cause muscle imbalances around your ankles, knees, hips and spine. In the neck and shoulders, the muscles that pull the shoulders forwards and upwards tend to be too tight or over-active in some people. The muscles that pull the shoulders down and back tend to be too weak. Other common imbalances occur in the rotator muscles of the shoulders and hips and in the inner and outer quadriceps muscles of the knee.
How can muscle imbalance be corrected?
Exercise Rehab helps to correct these common imbalances by strengthening the weaker groups and stretching the tight muscle groups, helping you to find neutral alignment. To find out whether or not you have any muscle imbalances, see your Exercise Rehab Physiotherapist for a detailed assessment. When you are doing your Pilates exercise programme with Free2Move, your Physiotherapist will be checking that you are in a ‘neutral alignment’, helping you to overcome muscle imbalances and to get your core muscles working.
What are the benefits of Exercise Rehab?
The main benefits are improvements in strength, flexibility, concentration, breathing, balance, coordination, posture and body awareness as well as relief of many chronic aches and pains. Exercise Rehab is also helpful for those with pelvic floor muscle weakness, as most exercises incorporate the pelvic floor as part of the ‘core stability’ system.
What conditions can be helped?
Exercise Rehab helps conditions such as arthritis, tense or tight muscles, and lack of strength. It also addresses posture problems, scoliosis, neck or back pain, sciatica, headaches, shoulder, and hip pain. It’s safe for most people with arm, knee or foot pain and is excellent for pregnant and postnatal toning.
At Free2Move North Perth, we have a special interest in Exercise Rehab based on Pilates exercises for chronic pain and joint hypermobility. We find that the increased strength and stability really helps to reduce pain levels.
What are the main principals of Exercise Rehab?
- Maintain the normal spinal curves (slight arch in the lower back = neutral alignment). Your Physiotherapist may advise you to make small changes to your posture or position to help you find a neutral position. This helps ensure that you activate the correct muscles and avoid over-activating other muscles.
- Keep your shoulders back (to neutral) and down. The common pattern is for the muscles that pull the shoulders forwards and upwards to by over-active, resulting in neck pain, headaches or ’round shoulders’.
- Breathe in during the hardest part of the movement. The diaphragm moves down when you breathe in to help create a ‘cylinder’ of muscles which support the spine.
- Pull up your pelvic floor during the hardest part of the movement. The pelvic floor helps create the floor or base of the cylinder. It also helps you to engage the Transversus Abdominus muscle, since the two muscles are connected near the front of the pelvis. The Transversus wraps around from your back to your front, almost like a corset, forming the sides of the cylinder and helping to support your spine.
- Slow, smooth, even movement, in time with breathing. This helps improve your coordination and muscle function.
What are the stages of learning in Exercise Rehab?
- Poor awareness of posture, muscle use and inefficient movement habits
- Developing an awareness of posture, muscle use and movement habits, but unable to make changes
- More aware of posture, muscle use and movement habits and able to consciously make changes and improvements. Pain and tension decreasing.
- Much more aware of posture and muscle use, comfortable and efficient habits have developed which don’t require conscious attention or correction, pain and tension are either well managed or eliminated.
How long will it take until I feel better?
Different people progress through these stages at their own rate. The ability to learn and incorporate the new patterns of muscle use varies widely. Although some people have underlying structural problems which cannot be changed by exercise, most pain and movement problems have a functional component, which means that they respond well to changing how you move and use your muscles.
While Exercise Rehab is usually not a ‘quick fix’, some people experience pain relief as soon as they become more aware of how their posture or movement is aggravating their condition. With Free2Move Exercise Rehab sessions, we find that most people take around 6 weeks before they feel a real difference. You should not expect to experience a long term change unless you are willing to commit yourself to 6 to 12 months of regular practice.