Tag Archives: feldenkrais

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

Awareness Through Movement

October 30, 2017 betsyjbell

Dear one,

What appeared in today’s New York Times in Jean Brody’s Health post is a must share with you and all your friends. She talks about Feldenkrais, a technique and practice I discovered many, many years ago when what I needed most was Awareness Through Movement. Becci Parsons in my local Feldenkrais guru. She has saved me from debilitating arthritic pain in the past. In the present, she guided my mind and body through the process of a spine fusion by Dr. Peter Nora and the subsequent repatterning of my nerve damaged legs. Jean Brody wasn’t and isn’t about to require surgery for her pain. She just wanted a better quality “every day”. Please read on for her remarks. When you have read her post, go to Becci Parson’s website and find a class. She teaches all the time in convenient locations north of the ship canal in Seattle. Living somewhere else? Do a search and find a practitioner.

Be well and Keep Moving, Betsy

(To read about supplements that help with pain, go to this post.)

Trying the Feldenkrais Method for Chronic Pain
Personal Health
By JANE E. BRODY OCT. 30, 2017

After two hourlong sessions focused first on body awareness and then on movement retraining at the Feldenkrais Institute of New York, I understood what it meant to experience an incredible lightness of being. Having, temporarily at least, released the muscle tension that aggravates my back and hip pain, I felt like I was walking on air.

Thanks to Paul Rogers for this cartoon from the NYTimes.

I had long refrained from writing about this method of countering pain because I thought it was some sort of New Age gobbledygook with no scientific basis. Boy, was I wrong!
The Feldenkrais method is one of several increasingly popular movement techniques, similar to the Alexander technique, that attempt to better integrate the connections between mind and body. By becoming aware of how one’s body interacts with its surroundings and learning how to behave in less stressful ways, it becomes possible to relinquish habitual movement patterns that cause or contribute to chronic pain.

The method was developed by Moshe Feldenkrais, an Israeli physicist, mechanical engineer and expert in martial arts, after a knee injury threatened to leave him unable to walk. Relying on his expert knowledge of gravity and the mechanics of motion, he developed exercises to help teach the body easier, more efficient ways to move.

I went to the institute at the urging of Cathryn Jakobson Ramin, author of the recently published book “Crooked” that details the nature and results of virtually every current approach to treating back pain, a problem that has plagued me on and off (now mostly on) for decades. Having benefited from Feldenkrais lessons herself, Ms. Ramin had good reason to believe they would help me.

In her book, she recounts the experience of Courtney King, who first experienced crippling back spasms in her late 20s. Ms. King was taking several dance classes a week and practicing yoga, and she thought the stress of these activities might be causing the pain in her tight, inflexible back. But after a number of Feldenkrais sessions, she told Ms. Ramin, “I realized that the pain had more to do with the way I carried myself every day.”

Even after just one session, I understood what she meant. When I make a point of walking upright and fluid, sitting straight, even cooking relaxed and unhurried, I have no pain. The slow, gentle, repetitive movements I practiced in a Feldenkrais group class helped foster an awareness of how I use my body in relation to my environment, and awareness is the first step to changing one’s behavior.

One common problem of which I’m often guilty is using small muscles to accomplish tasks meant for large, heavy-duty ones, resulting in undue fatigue and pain.

The group class, called Awareness Through Movement, was followed by an individual session called Functional Integration with a therapist that helped to free tight muscles and joints that were limiting my motion and increasing my discomfort. Using gentle manipulation and passive movements, the therapist individualized his approach to my particular needs.

The ultimate goal of both sessions is, in effect, to retrain the brain – to establish new neural pathways that result in easy, simple movements that are physiologically effective and comfortable. Although the Feldenkrais method was developed in the mid-20th century, neurophysiologists have since demonstrated the plasticity of the brain, its ability to form new cells, reorganize itself and, in effect, learn new ways to do things.

The beauty of Feldenkrais lessons is that they are both relatively low-cost (group classes average $15 to $25, individual sessions $100 to $200) and potentially accessible to nearly everyone. There are more than 7,000 teachers and practitioners working in 18 countries, including large numbers in the United States. You can be any age, strength, fitness level and state of well-being to participate. The exercises are slow, gentle and adjustable to whatever might ail you. Their calming effect counters the stress that results in contracted muscles, tightness and pain.
Feldenkrais practitioners like Marek Wyszynski, director of the New York center, typically start professional life as physical therapists. They then undergo three years of training to become certified in the Feldenkrais method.

Mr. Wyszynski explained that he starts by observing how patients are using their skeletons – how they sit, stand and walk in ways that may cause or contribute to their pathology, be it spinal disc disease, arthritis, shoulder pain or damaged knee joints. In accordance with Dr. Feldenkrais’s astute observation, “If you don’t know what you are doing, you can’t do what you want,” patients are then given a clear sensory experience of how their posture and behavior contribute to their pain and physical limitations.

For example, some people may use excessive force, clench their teeth, hold their breath or rush, causing undue muscle tension and skeletal stress. Years ago, I realized that my frequent headaches resulted from an unconscious habit of clenching my jaw when I concentrated intently on a task like sewing or cooking. Feldenkrais teachers do not give formulas for a proper way of behaving; rather, they rely on their patients’ ability to self-discover and self-correct.
Once aware of their counterproductive habits, students are given the opportunity to experience alternative movements, postures and behaviors and, through practice, create new habits that are less likely to cause pain.

Mr. Wyszynski told me that there are more than 1,000 distinct Feldenkrais lessons currently available, most of which involve everyday actions like reaching, getting up from a chair, turning, bending and walking.

As a mechanical engineer and physicist, Dr. Feldenkrais understood that the job of the human skeleton was to accommodate the effects of gravity in order to remain upright. And he wanted people to achieve this in the most efficient way possible.

Using two tall foam cylinders, one perched on top of the other, Mr. Wyszynski demonstrated a guiding principle of the Feldenkrais method. When the top cylinder was centered on the bottom one, it stood in place without assistance. But when it was off center, perched near the edge of the bottom cylinder, it tipped over. If instead of cylinders these were someone’s skeletal parts that were askew, tightened muscles would have to keep the patient from falling over.
As Mr. Wyszynski explained, “Good posture allows the skeleton to hold up and support the body without expending unnecessary energy despite the pull of gravity. However, with poor posture, the muscles are doing part of the job of the bones, and with poor skeletal support, the muscles have to remain contracted to prevent the body from falling.”

I wish you the best of health. Betsy

Be Well health tips

surgery for arthritis

June 12, 2016 betsyjbell

Gentle Reader,

There comes a time when surgery for arthritis makes sense. I have reached that time. I began blogging at www.NoWheelchair.wordpress.com in 2004, to share strategies a person with arthritis could use to avoid taking medication or having surgery. My posts have been about my own journey to manage increasingly severe osteoarthritis and spinal stenosis, and more recently a condition known as listhesis, or the collapsing of vertebra to the left and to the right. As my Feldenkrais practitioner keeps telling me, “You’ve got a complicated spine.”

It has been an interesting process to dedicate this year to a protocol of my own making. I have gone to a physical medicine specialist, Dr. Ren, at the Polyclinic who suggested physical therapy for eight sessions. The PT exercises did nothing to alleviate the weakness in my legs, nor the pain, lovely as it was to show up to the attention of admiring young men twice a week.

I decided to take Dr. Ren’s offer of an injection of steroids in L5 and L4 and I had a good four pain free weeks. With less pain, I was able to pay attention to my gait and realized I was so unstable on my right side that my right hip was swinging out with every step. I decided to go back to Becci Parsons, my Feldenkrais practitioner for help getting symmetrical again. Walking everywhere with hiking sticks helps with symmetry. My strong upper body lifts my weaker legs up and the hiking sticks keep me parallel. They are less for balance than for lifting weight off the collapsed vertebra.

Nerve pain came back after a short time. Dr. Ren thought I might be a good candidate for surgery. Becci has had two operations for very similar conditions so I went to her neurosurgeon, Dr.Peter Nora. Dr. Nora has twenty years of back surgery under his belt. When I met him, I looked at his hands which are small and delicate. A good sign. He put me through the diagnostic paces where you resist pressing your knees together and then apart; your feet in and then out; your knee lifting against pressure; all of which I passed with flying colors. It seemed obvious this 79 year old woman showed no sign of weakness. He tried one last diagnostic tool: I stood against the wall pressing my heals, my back and my head against it. The test: stand for ten minutes in that position. I lasted 5 seconds before my legs gave way.

I so appreciated Dr. Nora’s willingness to listen to my experience. When I stand around for a while, the right leg loses feeling and will not support my weight. Think about when standing around is what we do as humans: hanging out in the kitchen with family while we cook; looking at a painting in the museum; holding a drink at a cocktail party or reception; singing in the choir at church; waiting in line at Starbucks, at the airport, at the bank. All of these scenarios result in weakness and the sensation of getting ready to fall over. Dr. Nora heard me and kept trying moves so he could reproduce my experience in a controlled clinical setting. Thank goodness. I once had an orthopedist kick me out of his office after I told him I walked to Broadway and Madison from the 3rd Ave bus stop, a distance of about a mile, most of it up a steep hill. I was using my sticks so I could do it.

Dr. Nora explained the surgery by showing me the MRI of my spine from the bottom to the top as if you were looking up a tube in which the spinal cord runs. Between L3, L4 and L5, the poor spinal cord disappeared completely. He will carve off the bonein those areas to stop the pinching of the nerves. It could be a big change for the better. Since I have been avoiding surgery for so many years, there is no guarantee all the nerves will come back, but the pain should reduce considerably.

You would think I would get in for surgery for arthritis as quickly as possible. But my calendar is full this summer with harvesting the raspberries (bending, lifting and twisting), camping with family, traveling to Hawaii with a granddaughter and several graduations. The first stretch of time when I could commit to no bending, no twisting and no lifting for a month begins August 16th. So that is when the surgery is scheduled.

In the mean time, Dr. Ren’s Assistant, Diana Ferdana, who calls me pharmaceutically naive, meaning I have little experience with drugs, prescribed Gabapentin. This drug prevents seizures and also blocks nerve pain. Side effects bother me as I am a little loopy, a little sleepy, but the benefit of the smallest possible dose is considerable. I still take Shaklee’s Pain Relief Complex to keep other arthritis under control, like my thumbs and fingers and shoulder. She also gave me an industrial sized back brace which I wear when picking raspberries, doing laundry, emptying the dishwasher, sweeping the floor. You get the idea, bending, lifting and twisting.

I still go to the Xgym every week. My trainer has talked to Becci and together they have a workout plan that stabilizes my core while building upper body strength. These exercises don’t ask much from my weak legs other than stability although I am doing controlled lunges with hiking sticks. Staying fit is important when heading for major surgery. The guys at Xgym will help me get back on my feet when the surgery is over.

I am still walking most days although forty minutes to an hour is as long as I can go without sitting down to give my back relief. So no hiking with my group. This is the hardest loss for me as I have been in the wilderness nearly every week since 2004, summer and winter. Happily there are plenty of parks nearby with old growth forest and trails, but there is nothing like deep wilderness. I miss it and my hiking buddies.

I share all this personal experience with the hope that you or someone you know will take heart in their own struggle with arthritis. Don’t give up and sit down. We have to keep moving to avoid further damage and disability. At this point for me, I can do damage by over-doing so I have to learn to listen to the signals that say, enough. Most days at least a mile of walking works. I begin each day with tiny Feldenkrais movements to activate the core, the psoas and the multifidae that go up and down my spine to stabilize it. Just half an hour of that careful “exploration”, as Becci calls it, makes the difference for movement all day.

So, Be well, Do well and Keep Moving.
Feel free to share this. And don’t forget to like me on Face book.

Comments and questions are encouraged.

Betsy

206 933 1889

Arthritis, Keep Moving: Managing Arthritis

Cortisone for Sciatica

April 8, 2016 betsyjbell

Gentle Reader,
Sciatica, sciatica, sciatica. On every hand I hear people complaining about sciatic pain, drop foot, back difficulties and arthritis in general. I have had more acute sciatic pain plus a long stretch of time at home (no travel plans until July) so I decided to try cortisone for sciatica. I first focussed on discovering the cause. What would a medically trained physician have to say about my condition?

I imagine most people begin in the doctor’s office. You, who read my posts, may be among those who seek alternative care first. I have done Feldenkrais, Deep tissue sports massage, private pilates, Myofascial Release, Raiki, Alexander, Therapeutic Yoga, chiropractic, Physical Therapy—what am I forgetting? Ah, yes, my wonderful team at the Xgym, half the time and twice the results. Personal trainers who tailor my 25 minute workout to build upper body, leg and core strength while protecting my back.
My first injury happened in 1989 with a major exacerbation in 1992. Back then I did all the above and my doctor of choice was Stan Herring, a neurosurgeon who now limits his practice to the University of Washington Huskies and the Sea Hawks. He’s the doctor who looked at my x-rays and a later MRI and asked if I’d come in a wheelchair. “Get strong, Betsy. Your bones are no good for surgery so get strong.”
If you know me and see me on Face book, you know that is exactly what I have been doing. Weekly hiking, daily walking up and down the hills of West Seattle, long walks in exotic places in the off season, cross country skiing and snow shoeing when we have snow in our Cascades.
The sciatic has gotten progressively worse affecting my right leg and causing numbness and sometimes extreme pain. I put myself under the care of Dr. Ren at the Polyclinic. She is a physical medicine doctor who specializes in keeping people moving who suffer from back related problems (among other things). She confirmed that I have extreme spinal stenosis and osteoarthritis, two herniated disks at L4 and L5. She sent me to physical therapy for eight session. As has been true with previous visits to PT’s, I had fun with those young specialists and enjoyed their stretching, icing and exercises, but nothing beneficial came of it. In fact, the gross motor activities prescribed may have made my condition worse.
Next step was to get the shot of cortisone for sciatica in the L5 area where the narrowing is so small, it’s a wonder any nerve impulses get through at all. I’ve been scheduled for this procedure three previous times and canceled each time. I wasn’t ready. Dr. Ren did a fabulous job. Her needle found the spot producing an electric shock that sprung my leg all the way to my two middle toes to life with a jerk. After I caught my breath, I congratulated her.
The first day I felt wonderful and so moved stuff around in the garage. Stupid. Without the pain, I realized my gait was completely cattywampus—right hip collapsing with each step, left leg struggling to hold me up. Something whispered to me, “Go back to Becci Parsons and let her healing hands remind you how to stand and walk and sit and roll over.” Becci is the Feldenkrais therapist who got me back on my feet after the herniation so many years ago. She is a former dancer and has the same “keep moving” spirit I have. She has suffered from a similar herniation and has ended up with surgery. She can move fluidly with nearly equal strength on both sides (her right side has some weakness and lack of nerve response when her foot gets caught).
Becci, after three session, has me sitting on my sits bones with a nature curve in my lower spine, pressing one heal to the floor on the exhaling breath while lifting the right heal ever so slightly. I am paying attention to the distance between my arm pit and my hips on both sides, keeping that distance equal. I am paying attention to every muscle group that tries to help lift that right heal. Tiny movements with laser focus to re-pattern the injured nerves and muscles. She checked out my gait with the hiking sticks and said it was remarkable how my shoulders remained even, my right side did not collapse and my left hip didn’t swing out. That decision on my part to walk everywhere with hiking sticks was the best self care for my condition. It gets me a seat on a crowded bus, too.
I have an appointment for a new MRI although Dr. Ren’s assistant Diana didn’t see how the stenosis could have gotten any worse. Then I will have a surgery consultation with Becci’s neurosurgeon. I hope I don’t have to go there, but I am willing if it would help me gain real strength on my right side.

pain free from cortisone injection for sciatica — Hiking sultan canyon trail off hwy 2 in the North Cascades

The blessing is not being in pain. I stopped taking Shaklee’s Pain Relief Complex which inhibit the pain path without any side effects. Low and behold, other arthritis pain showed up in my hands. I don’t hike as far as the other members of my gang of hikers, but I am strong enough to lead the pack and am pain free. My hiking friends have been solicitous, gradually increasing the length and the elevation gain. Last week and next will be 700 ft of altitude gain and six miles round trip (Boulder Creek trail of Hwy 530). I know it well and there are places to stop if I need to let the others go on.
There is something about spending a day in the wilderness every week that keeps my spirit soaring and my sense of well being strong. I’ve mentioned before that our gang has scouted out wheel chair accessible wilderness walks for that time in the future when one of us can’t walk. So far, I don’t need to be pushed.
I share my pain, suffering and healing stories in case they resonate with something you are going through, or someone you know. If you have any interest in connecting with any of the practitioners I have used, please follow the hot links to them. If you are interested in trying the supplements and dietary changes that have been so helpful to me, please check out this post in particular. If you have questions or comments from your own experience, I and my readers would love to hear from you.
Thanks for reading,
Be well, Do well and Keep Moving,
Betsy
206 933 1889

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

Heal Back Pain

October 30, 2015 betsyjbell

new purse cropped — This new purse holds my hiking sticks. The new normal: carry sticks when I leave the house walking anywhere.

Heal Back Pain

I struck gold when mining my magazine and journal basket in the bathroom recently. In a 2011 issue (January) of Seattle Woman Magazine, Nancy Shatz Aton gives us 10 ways to heal back pain. This excellent list comes from her book, The Healthy Back Book: A Guide to Whole Healing for Outdoor Enthusiasts and Other Active People. It’s a book on my wish list, for sure. Here are her 10 suggestions with my comments. Put this away somewhere handy for when you need it, or put the suggestions to use right now.

Most Americans suffer back pain at least once during their life time and some of us develop chronic lower back pain conditions that give us grief on a regular basis. That would include me. I am so happy I saved and now found Nancy Alton’s tips for managing this pain.

Take charge of your healing. Although working with a knowledgeable practitioner who discusses every aspect of an injury can be helpful, it is important to realize you are in charge of your own healing. Whether you experience back pain daily or only a few times a year, living with it is about self-management. This is the premise of my GrandmaBetsyBell blog: self-care. Picture the various types of therapies available to you as spokes of a wheel. Imagine yourself as standing on the hub of that wheel. You can select any combination of therapies, or spokes, from that big wheel.

Tune into the mind-body connection. I find it interesting that this is her #2. Becoming self-aware is key. Pain has a physical component, but it also derives from our emotions. We tell ourselves a “story” about why we have low-back pain. We sometimes ignore the emotional side of the tale, But thinking that way overlooks the powerful role emotions play in the story of pain. Both the rational explanation and the emotional component are part of the mind-body connection; that is, how our minds and the emotions, thoughts and feelings emanating from them affect our bodies. “Like all experiences, pain is influenced by everything that is going on in a person’s life at the time, and probably everything that has gone on in the past,” says Dr. J. David Sinclair, a pain-management specialist in Seattle.
Move often. Keep Moving! It is ideal to exercise your body every day. Of course, after a back injury you’ll need your doctor’s OK before you begin exercising. Resume normal activities and movement patterns as soon as possible; moving your body leads to healing. A 1996 health campaign in Australia erected billboards and produced radio and television spots with messages such as, “Does your back hurt? Get up and take a walk.” And “Back pain—don’t take it lying down.” The campaign conveyed the message that engaging in the daily activities of life is often the best treatment for back pain. During and directly after the campaign, the rate of medical payments for back claims fell more than 25 percent!

Find a good rehabilitation specialist. When your back goes out, often the first person you call is your primary care doctor. Next time, you might want to try booking an appointment with a physiatrist (fi-see-a-trist) as well. My primary doc. sent me to Dr. Ren, a physiatrist, or Sports medicine doctor. Way more useful than a referral to the orthopedist. Dr. Ren urged me to walk 30 minutes every day, with hiking sticks, if necessary. No sitting down because of the pain from sciatica. Keep walking. She offered me hard drugs, but so far I’ve been able to get by with the Shaklee Pain Relief. She encouraged me to change from Aleve to Tylenol which I think will be good for my stomach. More than 3 Aleve a day made me sick to my stomach.

A physiatrist is a specialist in treating illnesses and injuries that affect how people move their bodies, and ae especially well qualified to deal with back injuries. Physiatrist believe in educating patients about their conditions and helping people understand that movement is an important tool for easing low-back pain.

Try out different bodywork treatments. Hands-on therapies can be incredibly healing. Adding one or more of these complementary practices to your medical care might promote healing, ease pain and contribute to a sense of wholeness. More than 80 types of therapies fall within the category of massage, from Swedish massage to RuiNa. It’s worth finding a well-recommended practitioner and looking into unfamiliar bodywork therapies. Your road to healing may begin with an appointment with a bodywork practitioner. Have you thought about trying Bowenwork, Rolfing, Heller work structural integration, hypnotherapy, chiropractic care, osteopathy or acupuncture?

Strengthen Muscles. Back injuries often stem from muscular imbalances. This is why practicing yoga or Pilates can be so beneficial for both easing back pain and preventing future back pain episodes. Both yoga and Pilates help develop a person’s core strength, which includes the abdominal, pelvic floor, buttocks, hip and lower back muscles. During class, you strengthen these muscles, build muscular endurance and learn how to initiate movement from the core area. The way you move on the mat will begin to carry over into your daily life, which can correct poor postural traits and eliminate the corresponding low-back pain. Two other movement therapy practices that have proven successful in easing and healing low-back pain are the Feldenkrais Method and the Alexander Technique. I have posted my recommendations and experience with Myo fascial release therapy, Feldenkrais and Pilates for low back pain.

The caveat here is you will be paying for these therapies out of pocket in almost all health insurance plans and it is expensive. I just began a 4 week course with a therapeutic yoga specialist and see results already. Four weeks cost $150. Every Myo facial release session with Cedron Sterling costs $160 for 90 minutes. His work has made a huge difference and certainly worth the expense. Most of us cannot afford these wonderful therapies that keep us out of the orthopedist’s surgery theater.

Mediate. Practicing meditation can help bring relief to back pain. Mindfulness meditation had numerous benefits for the chronic back pain sufferers who took part in an eight-week study reported in Pain in 2008. These patients experienced less pain, improved physical function, pain acceptance and better sleep. Meditation can be any activity that elicits the relaxation response in a person, which simply means your body calms down, lowering metabolism, blood pressure, heart and breathing rates. Forms of meditation include the relaxation response, transcendental meditation, mindfulness meditation, tai chi, repetitive prayer and walking meditation. Practicing any movement therapy that has you focus on your breathing while moving your body with intention can be a meditative experience.

Watch what you eat. Inflammation often causes pain and swelling. You can modulate your body’s inflammatory response system through diet. Through simple changes, you can decrease your likelihood of generating an overly high inflammatory response during a back pain episode. To decrease inflammation in your body, include the following foods in your diet: cold-water fish, fruits and vegetables, whole grains and high fiber foods and water. The following food can increase inflammation, so minimize these food types in your meal plan: red meat and high-fat dairy products, sugar white food, flavored drink and highly processed foods.

I have posted an extensive commentary on foods that reduce inflammation. The best of these posts is here.

If it involves a disk, be patient. Disk herniations heal without surgery more than 85% of the time and several studies have shown that after two years, people who have had surgery and people who have not had surgery recovered at equivalent rates. If you feel your back pain stems from a herniated disk or disks, try all avenues of noon-operative care. “Probably upwards of 40 percent of people who eventually get surgery aren’t happy with it in the end,” says family physician Sarah J. D’Heilly, MD.

My original injury involved a herniation at L5. It is much less protruded now and had pretty much healed, although that is the place here the sciatica pain originates.

Keep trying. Sometimes a doctor or a practice might not be the right fit for your low-back problem. If you try a therapy or new practitioner and don’t find any relief or see any progress after a handful of sessions, it might be time to move on. This can be discouraging. Still, it is worthwhile to try new paths to healing, whether that means trying a different bodywork technique or Pilates or talking to your back specialist about other options. It is also helpful to think about the term healing, which isn’t defined by a cure. There isn’t always a cure for low-back pain, but you can begin to see yourself as a whole person with low-back pain. Healing might mean learning self-care methods to alleviate your pain, practicing yoga a few times a week, seeing your doctor as needed and living your daily life a fully as possible.

My new normal is never leaving the house to walk anywhere without my hiking sticks. Sometimes I don’t need them. But it lowers my anxiety and allows me to keep walking when I have them with me. I recently bought a new purse that holds the folded sticks. I can look relatively sheik going to the opera with this purse, don’t you think?

Be well, Do well and Keep moving.

Betsy

Arthritis, Keep Moving: Managing Arthritis

Keep Moving

September 25, 2014 betsyjbell

Hello, Gentle Reader,

In end every post with “be well, do well and Keep Moving.” But I spend most of my day at the computer, sitting for hours. What’s to be done? You probably don’t move all day at your work, either. I was talking with my hair stylist, suggesting a trip for her family to La Push and Second Beach, and her first question was “How long does it take to get there?” Riding in the car for anything over an hour is too much sitting for her. She moves all day long. So does my renter, a finish carpenter working long hours on high end construction sites. The last thing he wants to do at the end of the day is an exercise program. He is constantly in motion on his job.

We are all different in our daily routine. If we want to make a change to our weight, or our stamina, or the comfort in our joints, we need to change it up. Movement that is different from the routine is the movement that makes a difference in your health quotient. Keep Moving means different things for different life styles.

Here’s my routine:

6:00 or so Up, stumble into the kitchen to draw and heat a 16 ounce glass of water and squeeze half a lemon in it. This wakes up my stomach and helps digestion.

6:30 after a relaxed complete bowel movement (chewing the warm lemon water helps this), I lie down with the Back2Life machine, which gently lifts the pelvis in a passive Feldenkrais type movement.

6:45 a 10 minute yoga routine which includes Cat-Cow movements (see a past post for pictures), Downdog and calf stretches.

7:15 Meditation and early morning writing.

7:40 Breakfast and reading

8:40 approximately, in the office at the computer.

10:15 break for tea and while the kettle boils, visit the chickens to feed them and collect eggs.

More sitting.

What I do is plot the walking I will do each day. Today I walk a mile to the Uptown Velvet Foam coffee emporium where I will write for a couple hours. The walk takes me down a steep hill, up another very steep hill and getting home it is the reverse.

How about you? Can you fit a walk in that includes stairs? One of the recommended ways to avoid osteoporosis is to climb 200 steps everyday, carrying 10 lbs of weight.

Move to Improve

What are we talking about here?

Everybody knows we need to be physically active. But if we have arthritis and hurt much of the time, wouldn’t it be better just to find a comfortable position, take our medication and not invite more pain. Movement makes you hurt, right?

Not necessarily. In fact the opposite is true. Trust me. Get up and move. Movement can have specific benefits for people with rheumatic or musculoskeletal disease (RMDs). Those joints that hurt with every step and every bend, will actually hurt more and more WITHOUT moving them. To keep the motion you have, you must move. Moving also improves circulation and will help keep other degenerative diseases at bay.

So what can I do? The most appropriate form of activity will depend on a number of factors including the type of RMD you have. Which joints are affected and how bad is the joint damage? Articles like this always tell you it is important to consult your doctor or physiotherapist about the type of exercise you need therapeutically, as well as the type of activities you enjoy doing to keep you healthy. One friend who was just one step from a wheel chair because of her arthritis, did not like any activity. Her chiropractor told her she just had to find an activity she loved. She stumbled on a scull, a single racing shell. She fell in love with the water and rowing. Got off all her medication. Began taking a prescribed regimen of food supplements from Shaklee Corp and went on to win world championships in her age group.

Find something you love to do and begin, slowly with guidance. Don’t stop.

Let’s see what physical activity is. Physical activity is any form of daily activity that involves movement, rather than sitting or lying still. This could include playing with children, doing housework, walking the dog, gardening etc. Being physically active can release stiffness and lift your mood. I find that the playing, housework, gardening activities often lead to more stiffness while some form of regulated, prescribed exercise reverses or controls those negative results from just any daily physical activity. In other words, exercise can make the fun stuff easier.

The term exercise describes planned, structured and repetitive movements that are performed frequently, at a given intensity and for a set duration of time. Exercise can be therapeutic, such as in rehabilitation, or taken as an enjoyable way of improving or maintaining:

§ muscular strength and endurance

§ flexibility and joint mobility

§ motor functions including coordination and balance

§ aerobic capacity and increased energy expenditure, which can help with weight control

§ bone mineralisation contributing to the prevention of osteoporosis

§ mood and self-esteem leading to increased positive attitude

Level of exercise

You have to decide what you can handle. One person may have an easy time doing water aerobics while another will have to begin slowly and increase intensity. For example, walking, cycling or swimming at a gentle pace (low intensity), might have an aerobic effect (increase your heart rate and breathing) for some people, while others would need to exercise at a moderate to high intensity to experience the same effect. How old are you? How is your general state of health? How advanced is your disease? How regularly have you been exercising? Are you carrying too much weight? Begin at a level of exercise that works for you.

Starting out

Always begin gently and build up slowly over time. It is better to do little and often than to try and overdo things and to push yourself too hard when you start exercising. So many people begin with fervor and peter out after the third day or so. I believe that dietary changes need to accompany a new exercise program to support your recovery. Here is an article about foods and supplements that help.

If you do need to stop exercising for any reason, always start again gently and build up slowly. When you reach your desired level of function, you will need to keep up regular activities to maintain this level.

How much exercise

When you repeat activities regularly your body will adapt over time and you will find you can do more with less effort. You may need to change up your program to continue improvement. People hit a plateau and get frustrated because they are not improving beyond a certain point. Make little alterations in your routine and your muscles will respond. It’s the surprise factor in training.

Really. Regular exercise slows, or may even prevent loss of function due to disease progression.

Ideally, do stretching/flexibility exercises every day, muscle strengthening and endurance exercises two to three times a week and some form of aerobic exercise for 20 minutes three times a week. Mix it up.

The key is to find things you enjoy doing so that being active is something you look forward to and becomes part of your daily life.

Did you know?

The word ‘fit’ comes from:

Frequency – how regularly you exercise

Intensity – how hard you exercise

Time – how long you exercise

Now the word fitness is used to describe health and the ability to meet the demands of a physical task.

What are we talking about when we say exercise?

Aerobic / cardiovascular – Exercise that raises the heart rate and breathing, e.g. walking, cycling, swimming, dancing etc. at a moderate or high intensity

Balance – The ability to control the body’s position when either stationary or moving

Endurance – How long you are able to exercise at low, medium or high intensity

Flexibility – The ability of muscles to stretch. Stretching muscles helps to keep them supple and relieves stiffness

High impact – Exercises where the body weight impacts forcefully against a surface, for example running or jumping

Low impact – Exercises where there is minimal impact through the joints and pelvic floor or where the body is supported whilst exercising, e.g riding a bicycle or swimming

Mobility – The ability of joints to move through a range of motion

Posture – Good body alignment

Strength – The extent to which muscles can exert force by contracting against resistance (e.g. free or fixed weights, bands, moving in water etc)

Weight bearing joints – Joints that support the weight of your body against gravity when you are upright, i.e. your spine, hips, knees, feet and ankles

Weight bearing exercises – Exercises where your body is working or moving against gravity, for example walking (swimming is non-weight bearing because the water supports your body weight) Weight bearing exercises also help maintain bone density and reduce the risk of osteoporosis

I went to the Arthritis Foundation. Their website has excellent articles about taking control. This posting borrows from their pages.

Be well, Do well and Keep Moving, Betsy

Betsy Bell’s Health4u

206 933 1889

Betsy@hihohealth.com

Be Well health tips, Keep Moving: Managing Arthritis

Healthier bones

April 30, 2014 betsyjbell 2 Comments

Gentle Reader,

Do you ever have the experience of anticipating a really big event that is going to make demands on your body? You become more aware of the little aches and pains, the warning signals that all is not well? Maybe bone health has gotten worse. You worry about an escalation of the little twinge into something big right in the middle of the planned for event. You think about Traveler’s Insurance and then read the fine print that says unless you buy it with 14 days of purchasing your plane ticket and paying for the experience, you have to declare a pre-existing condition. Are these twinges enough to be called a pre-existing condition?

By now, you know that I have been living with a diagnosis of spinal stenosis and osteoarthritis. These are both age-related and trauma induced arthritis. My first trauma was in 1989 and then the herniation in L5 was exacerbated in 1993 by sitting in a slouched position in an airplane for 7 hours. At that time, I went to Dr. Stan Herring, sports medicine doctor to the Huskies sports teams and neurosurgeon. He told me my bone health as revealed in the MRI pictures were so bad, he was surprised I wasn’t in a wheel chair.

Over the past year my right leg has been going numb and weak from time to time, especially when standing for a long time, like in choir or wandering through a museum. Last June, I walked all over Paris with a numb right leg. No pain, just a feeling of distance, dissociation from that limb, even when walking around without a hiking stick or other means of extra support. In fact, I hardly ever experience pain above a 3-4 on the old 10-point scale. Probably because I pop an herbal Shaklee Pain Relief Complex tablet at the slightest twinge of pain.

I decided to call Dr. Herring’s office to see how he is treating his athletes these days. His practice has changed and he directs other doctors now. He is not a provider in my AARP Advantage insurance program. So, I met Dr. Ren at the Polyclinic for a review of my most recent MRI and a comparison to all the others I have had in the past. Three conclusions are worth sharing with you.

1. I do have bulging discs including a new one at L2, moving up the spine. But none is penetrating the spinal cord. I have what she calls a genetically narrow passageway for the spinal cord. This explains why I am so like my father in arthritis of the back; he suffered terribly. It was ironic, since he was an Orthopedic surgeon and performed hundreds of laminectomies and fusions over the course of his practice. He couldn’t operate on himself, so he never had his own back fixed. You can see where I get my “do it yourself” attitude.

2. There has been some improvement in the spinal stenosis and osteoarthritis since the last MRI. This I count as a victory and I attribute it to the fact that bone replaces itself slowly over time. Given proper nutrition and other care through strengthening and toning muscles, bone can improve. I am thrilled that my bone health has improfed. What a fabulous result! I will continue to visualize the formation of healthy new bone. I will certainly continue with a diet loaded with fruits and vegetables and lean meats and fish, plus little or no gluten or dairy. I am committed to continuing my workouts at the Xgym, because stronger muscles build stronger bones.

3. Dr. Ren called me her poster child, to be improving bone health at 76, almost 77, instead of getting worse. She also told me that low back problems on a major trip would only cause discomfort and was not life threatening. No need to update my will on account of my back issues and numb leg. Whew…

Let me review my early morning routine in case it would be helpful for you.

1. Lie on the floor for 12 minutes with my knees bent over the Back2Life Machine.

2. A Feldenkrais hip opening exercise, 10 counts with each leg. This video shows an extended version of my routine. A full hip opening practice in two parts. I limit myself to the dropping of the knee, extending the heal and back up again, 10 times on each side. If you are a beginner with Feldenkrais, I recommend following her program from start to finish for best results. You can later incorporate the segment that seems to give you the most benefit.

3. hanging upside down on the gravity inversion table for a total of 25 breathes. Here is a video of an expert doing her back mobilization exercises on this inversion table. It makes me seasick. I have never been able to work the way she does, but I can vouch from the success I have had with lengthening a stretching my spine. She inspires me to work up to what she demonstrates.

All this before breakfast. In addition, each week I walk a couple miles most days which include steep uphill climbing (I live in West Seattle on top of a hill and my destination is on the top of another hill a mile a way, therefore Up and Down going and coming.) On Tuesday I practice yoga with an instructor who builds slowly to the big poses and I stop when a twist gets to be too much. On Wednesday I hike in our mountains surrounding Puget Sound, usually 6 miles, more or less. On Monday and Friday, Clayton works me out at the Xgym, concentrating on 5 muscle groups and in a controlled manner, bringing them to complete fatigue. It takes 25 minutes. None of this takes a long time, except for the luscious outdoor experience on Wednesday. I hate to miss it when I have to. Nearly anyone could put this into their schedule.

I also take several supplements that improve joint mobility and strength muscles tissue: Fish oil, Vitamin E, Vitamin C and Calcium. They all work better because of an excellent catalyst, Shaklee’s multivitamin and mineral tablet. I take the one for seniors which is especially formulated for the aging absorption for someone over 50.

The special event, you might ask? A friend and I are going to hike 100 miles in England following the “highway” used by Lady Anne Clifford, a 17^th century noble woman who owned most of Northumberland and Yorkshire. We will walk from castle to castle beginning just north of Leeds, hiking for 9 days in the dales, wild and dramatic country to Penrith in the Lake District. It will be June, long days and with any luck, not too much rain. I will leave the end of May, feeling confident that my self-care and hiking sticks will see me to the end. I’ll be home on June 20^th.

Be well, Do well and Keep Moving,

Betsy

Let us know of your adventures. How you are preparing or maintaining your body to meet your travel goals? Sharing makes it all better.

betsy@hihohealth.com

206-933-1889

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

4 1/2 hours of driving…Oh, my aching back

May 9, 2013 betsyjbell

Gentle Reader,

Six hiking buddies escaped to the cabin of one of us on the Oregon coast just sound of Canon Beach. The sun shone and the sand was warm, inviting surfers, families and dogs to play even though it was mid week and basically empty of tourists or locals.

I was really hurting from the long hours of driving and didn’t want to miss a minute out doors. I had no Back2Life machine with me. But I got over my aches and pain fairly easily with a technique I’d like to share with you. In addition to several Pain Relief herbal tablets that inhibit the pain path nicely with no side effects.

Lie on the floor with your butt up against the front legs of a chair and your bent knee legs on the chair

seat. While in this restorative pose position, move in the very tiniest motions, a pelvic clock. Ten up and down movement between 12 and 6, then 10 between 1 and 7, then 2 and 8, then 3 and 9 and so on around the clock face. The pelvic tilt

is a miniscule movement using your abdominal muscles to produce a small swing from up to down. You can look it up under Feldenkrais. It works miraculously to unwind and restore balance to the lower back.

For a little eye candy, here is the sitka spruce forest we hiked in, a herd of elk crossing the dunes, the sunny beach and the wild flowers blooming their little spring hearts out.

Be well, Do well and Keep Moving.

Before you go, tell us what you have done to get the kinks out after a long drive or hours in a chair. Leave a comment.

Fondly, Betsy

206 933 1889

www.DoWellWithBetsy dot com

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

I did not know him: a cycle of pain

April 18, 2013 betsyjbell

My brother died. I went to Boston to be with his wife and children. At first the pain and suffering was all about my loss. In Boston I became one grieving sister in a sea of grief. I did not know all these other grieving people. Not his wife of thirty-five plus years and their three children, and all of his wife’s siblings, their spouses and their children. And then his friends from high school and college and his medical practice and their church and his men friends. Six hundred people in various degrees of pain.

I listened. I discovered that I have not listened well; I let the stories of others come in unfiltered. These stories gave me my brother. How bitter sweet to have him and lose him at the same time. The acute pain is mediated by the truth, the fleshing out of the man he was these years we had been separated by a continent and our too-busy lives. Today back in Seattle, I feel less pain. I also have far more compassion for his wife and their children who now begin the work of knitting a life without him physically present.

How are emotional pains like our body pains?

I recently found an interesting web site called the Arthritis Management Program. They published a graphic of the pain/fatigue cycle which you may find helpful. In a closed loop, each new painful experience pulls you further down into the pain and suffering. In this downward spiral, pain leads to depression which makes exercise difficult. One abandons the good diet. Sleep is challenging. All of these challenges occur while a loved one is struck down and then dies. Each of these symptoms can by themselves contribute to the other symptoms, and all can make pain and fatigue worse.

Even worse, they can feed on each other. For example, inflammation from the arthritis can cause pain, which causes stress and anxiety, which can cause poor sleep, poor sleep can cause depression, depression can sometimes make it hard to eat as we should, and these can lead to more pain or fatigue, and so on. The interactions of these symptoms, in turn, make our arthritis or fibromyalgia seem worse. It becomes a vicious cycle that only gets worse unless we find a way to break the cycle.

A support group for arthritis sufferers, a good blog (hehehe) or web site can trigger a cycle-breaking strategy. A memorial service in which all the sufferers participate can show the way to break the grieving cycle. Neither strategy is permanent. I have lost two husbands and this loss brings all that pain back. It was hard to sleep, to focus my mind on anything. I felt as though I was spinning. How must those much closer to my brother have suffered from the physical and emotional disruptions of death.

I always go back to my mantra of Keep Moving. If your arthritis pain gets too great to move in the usual ways, find new ways to move. A warm-water pool and a class for arthritics; gentle Feldenkrais movements; a quick trip to the Korean foot massage place (that was my strategy when I couldn’t sleep from the anxiety of my brother lying in the ICU with a stroke.) Call a friend and ask them to help you get out of the doldrums. Eat a salad with toasted pine nuts instead of chocolate cake.

You no doubt have been on this closed circuit pain path. How did you get out of it? Let us know.

If this has been helpful, pass it along, post it on your face book page, and like my business page while you are at it. 🙂

Fondly, Betsy

Be well, Do well and Keep Moving.

www.grandmabetsybell.com

www.dowellwithbetsy.com

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

Oh, my aching hamstrings

February 21, 2013 betsyjbell

Gentle Reader,

What a ski season it is here in the Northwest. The snow conditions surprise us every Wednesday as my band of 16-24 friends head up to the pass on a big bus (potty included). It’s a good thing to use this bus company for January and February when the road conditions are dicey and icy. The bus drivers have gotten stuck twice! The ladies who ski are mostly over 65. Yesterday I learned that one companion, a tall, slim brunette with impeccable make up and style is 80. We are still climbing logging roads and snow plowing down, but we have become partial to the groomed Nordic tracks, of which there are a few. One of oldest members skis with the blind across the US and Canada. We do have a special club here with a pair of set tracks for the blind skier and her companion guide. We often see dog teams, although mid-week is a quiet time to ski. People-watching happens on Saturday and Sunday. Yesterday the only viable skiing was on the reclaimed rail road track which snakes its way up from Seattle, through the pass and on East. Long ago this track was pulled up and remaining bed has become a favorite mountain bike and Nordic ski trail.

Pushing and gliding for 3 hours and 8 miles along this relatively flat track awakened muscles I had not used so strenuously. This morning I have been on the floor getting the creaks and groans out of my joints-back and hip and knee pain are no fun, nor are arthritis flare-ups. Several techniques work well.

1. tie a strong flexible tubing around your thighs, squat and walk to the left 20 steps and then to the right. In the picture, the tubing is around the ankles. I find the tubing stays put better at the thigh.

2. Lying on your side with your knees pulls up part way, lift one knee up and then back down in a clam-shell move. Several reps on each side.

3. Put one end of the flexible tubing in the door jam and loop the other around your foot. Stand side ways to the door and take the outside foot, lifting straight legged 10 reps. Turn and draw the foot away from the door across the body. This is a classic standing Pilates move. Change legs and repeat. Years ago I bought a heavy steel foot stool off Ebay to use for this exercise as it works better if you are standing a few inches off the floor. Gyms have portable durable plastic steps that can be used. Personally, my little upholstered foot stool would never be taken for an exercise prop as it sits by the front door. This is the best picture I could find. Imagine the end of the theraband as a knotted tube in the door jab, the bottom around your shoe.

4. face the door and, with the foot in the loop of the tubing, push it away from the door while standing erect, in perfect posture, on the other foot. Several reps on both legs will help.

I am glad I climb stairs every week (200), going up and down sideways with the grape vine step. I found yesterday that straight way skiing tired the knees. Most women have slightly knock-knees and prolonged straight walking, hiking or skiing stressed them. Whenever you have the opportunity to go up or down stairs side-ways, one foot behind, then in front, do it. Your knees will not stress on the straight-away as much. I am going to get someone to film me doing this. There are no pictures on the web that I can find.

Avoiding arthritis pain in the knees, back and hips can be challenging, and fun. Get out there and enjoy the winter weather if you are lucky enough to have snow. Don’t let the diagnosis of osteoarthritis or spinal stenosis keep you from moving. Browse the techniques I have offered in my blog postings and try some of them. Better still, leave a comment about the techniques you have found work well.

Fondly,

Be Well, Do Well, Keep Moving

Betsy

Injured at 52. Diagnosed and sentenced to a wheelchair at 55. Hiking, skiing, dancing and walking at 75. Read my story.

206 933 1889 betsy@HiHoHealth.com www.GrandmaBetsyBell.com

Arthritis, Be Well health tips, Health and Fitness, Keep Moving: Managing Arthritis

Are you feeling less alert?

January 31, 2013 betsyjbell

Gentle Reader,

If you are suffering pain from arthritis, osteoarthritis, spinal stenosis, the regular wear and tear of life, you need good deep sleep to help you heal. I’ve written about Feldenkris, a therapy that helps with these painful conditions. I’ve mentioned Becci Parsons, who got me on the road to sitting/standing/walking after herniating a disc. Today I am posting her helpful solutions and suggestions for next steps for anyone who suffers from lack of sleep. Read on….

Change Your Sleep. Change Your Life.

Are you feeling less alert?

Are you unable to think clearly or sustain your focus?

Do you have difficulty falling asleep or problems with frequent awakening during the night?

If so, you may be suffering from insomnia.

We tend to think of insomnia as the constellation of symptoms that we experience just before sleep or during the night when we awaken with our mind racing and the bed sheets twisted. The process of insomnia actually begins much earlier in the day for most of us.

How?

Through the choices we make about how we spend our time.

The obvious culprits:

That afternoon pick-me-up latte or caffeinated green tea smoothie.

It could take between 9-14 hours to fully metabolize the caffeine. Even if you have no difficulty falling asleep, the caffeine could undermine the quality and duration of your sleep.

Evening computer use or cell phone email/texting, watching tv or reading using an e-reading device. Blue light from many of these devices is as bright as daylight and activates the nervous system sending the brain and body into “wake up mode”.

And what about the emotional responses that are triggered by these late night, last minute, urgent communications?

Life in the twenty first century is stressful and fast paced. A full, zoom-zoom workday of 8-12 hours is often followed by a long commute and sometimes a cocktail or a glass of wine to take the edge off. We eat late, do a few more email or text messages; watch a movie, read or log on to Facebook in an effort to wind down. Unfortunately very few of these activities actually promote relaxation and set the stage for a good night’s sleep. Most of them tip the nervous system far in the other direction to a state of hyper-arousal.

Hyper-arousal is a chronic over-activation of the body’s stress-response mechanism. There’s no instant ON/OFF switch. When these pathways are repeatedly excited, they become the default setting. We essentially travel a well-worn path leading us in the direction of elevated blood pressure, holding our breath, clinching our jaw and lifting our shoulders, without respite. Many of these sensations fly below the radar of our self-perception and become the background noise of our busy, over stimulated lives.

What to do?

“For fast acting relief, try slowing down”. –Lily Tomlin

On the one hand, we can increase the quality and duration of a good night’s sleep simply by making better choices. Following a good sleep hygiene program is an empowering start. For more detailed information about sleep hygiene refer to the following link:

http://www.sleepfoundation.org/article/ask-the-expert/sleep-hygiene

We also need to hit the pause, re-set button during the day to get off of the cortisol/ adrenaline high that many of us associate with feeling good and being productive. Functioning under the influence of stress hormones is not a sustainable practice. Biological systems thrive with ebb and flow. Metabolically speaking, we need to interrupt the cycle of prolonged excitation and dial things down to a more balanced, calm and functional neutral.

Learning to move more fluidly between states of stress and relaxation is key. It is positive motion in the direction of re-establishing the natural biological rhythms of exertion and recuperation. Think of it as self-regulation with applied intelligence. When we develop the capacity to meet the demands of a stressful moment and the flexibility to return to a state of equanimity in a relatively short amount of time, not only will we sleep better, but we’ll also be a kinder, gentler, version of ourselves.

Becci Parsons offers workshops and private coaching in the techniques of the Sounder Sleep System^® in the interest of helping to create a more sane and peaceful world. Restful sleep is necessary for the healthy function of every system in the body and helps to regulate mood, energy and emotional intelligence.

The Sounder Sleep System^® is comprised of a variety of calming and sleep inducing techniques to be used during the day and at bedtime, taught while sitting or lying down. The simple exercises are designed to restore our natural capacity to rest, recover and heal from the stress of daily life, one breath at a time. They are elegantly simple and simply profound.

For more information about private sleep coaching or to inquire about the introduction to the Sounder Sleep System^® Workshop in February 2013, contact me:

Becci Parsons, Authorized Teacher, Sounder Sleep System^®

Guild Certified Feldenkrais Teacher^®

MotionSense Movement Education

bparsons@seanet.com

206.545.7272

www.BecciParsons.com

206.545.7272

Thank you, Becci. Be sure to leave a comment or suggestion of your own.

Fondly, Betsy

Be Well, Do Well and Keep Moving

BetsyBell’s Health4u

www.GrandmaBetsyBell.com

206 933 1889 1 888 283 2077

betsy@hihohealth.com