Feldenkrais, Health and Wellness
Lorraine Davis
Mindful Movement at The Wellness Station

Find out more about how you can participate in the mindful movement classes offered at The Wellness Station, including Breakout Yoga and Awareness Through Movement.

Mindful Movement at The Wellness Station
Feldenkrais, Balance
Lorraine Davis
Balance For Life

Balance tends to decline with age and inactivity. Do not let these difficult circumstances affect your balance and increase your risk of falling. Follow this blog to gather insight in the mysterious systems that allow us to maintain our balance, and learn more about the services The Wellness Station offers that can help enhance these systems.

Balance For Life
Lorraine Davis
My Journey to Embodiment With Feldenkrais 
My Journey to Embodiment With Feldenkrais 
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The Two Arrows: How to Minimize Pain-Related Suffering

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Pain is one thing. Suffering related to the pain is another. We often do not have total control over our pain, but we can learn to have more control over what grows around our pain:

The stories we tell ourselves about our pain, and the ways that our pain impacts the rhythms of our life.

Buddhist philosophy often refers to two arrows. Imagine a person in the forest gets struck in the arm by an arrow, and pain results. That is the first arrow. Then, the person begins to think… “What’s going to happen? Am I going to get an infection? Am I going to lose my arm? How will I be able to work? What’s going to happen to my family? Who is going to support them?” That is the second arrow.

The first arrow is the pain itself- the event and the raw sensations of the pain. The second arrow is what our mind does in reaction to the event. Our mind assigns meaning to the pain, creates a narrative, compares our pain to our past pain and our expectations of future pain, emotions ensue, and suffering results.

The first arrow we generally cannot control. The second arrow we can. 

Beware of the second arrow. The second arrow often grows bigger than the first. This second arrow is what contributes to prolonged suffering, unhelpful beliefs about our pain, and perhaps withdrawal from our lives, our loved ones, and our loved activities.

Tendency towards a second arrow of suffering could be considered a habit. How do we become more aware of and break our unwanted habits? Check out our past blog post, “Befriending Unwanted Habits” for more information.

Becoming aware of the two arrows is the key to minimizing the impact of the second arrow. This can apply to physical pain, but also any other event that triggers anxiety or other negative emotions.

Try this as an example. Consider an event that brings about distressing feelings, be it physical pain, or emotional pain such as anxiety, fear, sadness, or frustration. Perhaps this is an event that happened recently. Try to identify the first arrow, and then identify the second arrow. What are you telling yourself that is creating the second arrow?

For instance: “Today, I spent a long time gardening. Now my back hurts. What did I do wrong? Is there something damaged in my spine? Perhaps I need to get imaging. What does this mean for my future? Should I stop gardening? Is there something wrong with me?”

1. Identify the arrows

Can you identify what the two arrows are?

→The first arrow: Temporary sensations of discomfort experienced in the low back.

⇉The second arrow: All of the thinking that happened afterwards. Self-blame. Catastrophization and medicalization of the pain. “Predicting” the future. Assigning meaning to the pain without evidence. Consideration of avoidant behavior.

The second arrow makes the pain worse, and can create a feedback loop that contributes to a chronic pain pattern. Once we can start identifying the first arrow and distinguishing it from the second arrow, we can question the second arrow or let go of it to minimize suffering

2. Create a new response

After identifying the two arrows, notice if there is resistance to letting go of the second arrow. Where does that resistance come from? What is the harm in letting it go? 

Now, create a new response. Letting go of the second arrow, let’s pay attention to the first arrow. The intention is to accept the first arrow, and then practice self-kindness

Acceptance: Acknowledge and accept what is happening right now. Consider the mantra “This belongs too.”

Self-compassion: Then practice saying something kind to yourself. Imagine the first arrow happened to someone that you dearly love. A partner, a child, etc. What would you say to them if the first arrow were to happen to them?

Let’s relate this to the above example-

→The first arrow: Sensations of discomfort experienced in the low back.

♥New response: “This too. These sensations belong, they are what I am experiencing right now, and they will pass. I am strong, resilient, and have the tools that I need to get through this. Perhaps next time I will try some movements to warm up my body before gardening, and take breaks when my body begins to request them. ”

The quest to become pain-free is fruitless, because pain is an inevitable part of life. The first arrow will come. The quest to minimize suffering related to pain is realistic and achievable, and starts with becoming aware of the second arrow, and practicing self-compassion and acceptance whenever it arises. 

Summary of Key Points

  • Two metaphoric “arrows” can exist relative to our pain experience. The first is the initial event and raw sensations of pain. The second is our reaction- our thinking and behavioral changes relative to the first arrow.

  • First arrow = pain. Second arrow = suffering

  • Distinguish between the two arrows in your own life, and change your response to the first arrow to minimize the impact of the second.

  • To the first arrow: Develop any mantra that communicates self-compassion and acceptance. “This belongs too.” “I am safe.”

  • Feel how changing the response to the first arrow has the potential to minimize pain-related suffering

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

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Hip Hinging: What, Why and How?

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Hip hinging is a very powerful movement that our bodies can do, that allows us to bend, lift, squat, and even climb up stairs and hills. Learning what a hip hinge is and how to do it well helps us to move more efficiently, minimize pain and injury, and enhance our fitness routine.

What is a hip hinge?

A hip hinge is essentially any movement that involves… well, hinging at the hips! Typically, it refers to a movement in the sagittal plane (forward and back plane) that allows the flexing at the hips (creasing the fronts of the hips), and subsequently extending the hips (opening the fronts of the hips). Rather than the movement being initiated at the spine, knees, or elsewhere, the movement pattern is initiated at the hips.

The hips are a ball and socket joint, as the joint is the union between the socket provided from the pelvis (acetabulum) and the ball from the thigh bone (head of the femur). So hip hinging must involve motion relative to the ball and socket, typically the socket of the pelvis rolling forward and back over the ball from the thigh bone.

Examples:

Many daily movement patterns, as well as exercises that one might perform, involve hip hinging. Here are some examples of hip hinging:

  • Sit to stand: The act of getting up and down from the chair involves hinging at the hips, as to sit, the hips must flex, and to stand, the hips must extend.  

  • Deadlift: Lifting and lowering a weight from the ground using a hip hinge

  • Squat: Sitting the hips back and down as knees bend, standing back up by thrusting hips up and forward

  • Step up: Single leg hip hinge involving putting one foot onto a step or platform which hinges the hip, and stepping up by extending through the hip/knee. 

  • Kettlebell swing: Holding a kettlebell with both hands, hinging at the hips to send the kettlebell back and down, extending powerfully through the hips to send the kettlebell out in front 

  • Sun salutations in yoga: A yoga practice is full of hip hinging. A traditional sun salutation, that involves going into a forward fold, lifting half way up, coming up to standing, etc involves a lot of hinging of the hips.

Why is it important?

Hip hinging uses the strongest, most powerful muscles in the body. This includes the gluteals, the hamstrings, the erector spinae, and the abdominals. Powerful coupling between these muscle groups helps create high levels of force, allowing us to move ourselves efficiently and lift heavy objects without injury. For this reason, getting to know how to hip hinge, and using hip hinges very often during daily activities and within a fitness regimen is an excellent way to stay strong and powerful.

Try these at home:

Here are several common cues that I use to teach people how to hip hinge-

  • “Buns in the oven”:  Stand about 6 or so inches in front of a wall, facing away from the wall. Pretend the wall is an oven. Send your buns into the oven by sending your bottom back to touch the wall (hips go back, or hips are flexing, as your upper body leans forward. Once your bottom can feel the wall, pause. You are in a hinged position. Come back to standing by taking your buns out of the oven (hips go forward, hips are extending).

  • “Roll the roller”:  Stand with a foam roller against your upper thighs. Roll the roller down your thighs by sending bottom back. Come back to starting position.

  • In kneeling: “Sit back towards your heels”: Knees on a kneeling pad, sit hips back towards heels as hands reach forward. Return to starting position.

  • Step ups: “Pull the thigh back”: Put one foot on a step or stool. Lean forward slightly. Step up, pulling the thigh back. Lower back down to starting position.

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

Images:

https://orthoinfo.aaos.org/link/6e0531e00f714f43a2cb1f93fae0e762.aspx

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Trouble Committing to your PT “Homework”? You’re not Alone!

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The benefits of physical therapy can be immense, but only when one is an active part of the healing process. The learnings, lifestyle suggestions, and exercises taught by the provider are not confined to the clinic, but must seep into the rhythms of one’s day to day life. Otherwise, the time spent in physical therapy can be fruitless, or at least not as effective as it otherwise might be. Afterall, the time in the clinic only makes up a small fraction of one’s life. What one does outside of the clinic is up to the individual.

Why do so many have trouble bringing these practices home? The most common reasons are lack of time, lack of confidence in one’s own abilities (known as self-efficacy), lack of understanding of or agreement with the recommendations from the PT, the PT giving “too much” homework, forgetfulness, or simply being stuck in one’s habits with difficulty inviting changes to a fixed routine. Additionally, the desire for a “quick fix” to one’s pain or injuries, and subsequent disappointment with the realization that PT is an ongoing process and not an instant cure, can often set up a substantial barrier.

How do we address these barriers?

Establish a Commitment to Oneself

In order for PT to be effective, one must fully commit. The commitment goes beyond simply showing up for scheduled appointments. The commitment must involve willingness to have an open-mind, take on an active role in one’s healing, learn new things, willingness to invite in the new and to say goodbye to what is no longer serving.

Before scheduling a first appointment, one might ask themselves, “Am I willing to fully commit to this? Why or why not?”

 

A Strong Therapeutic Relationship

As PT is a two-way street, a strong relationship between provider and patient is necessary. This means the ability to engage in deep communication: active listening and responding. As a patient, one must communicate their needs, and be open to suggestions provided by the therapist. 

If the patient feels that their needs are not being met, or if they are not understanding the suggestions provided by the therapist, they must make this very clear. For example, if one feels that their PT is giving them too much or too little homework, the patient must communicate this. That way, the two can work together to find a program that best fits the needs of the patient.

It is critical that a patient feels a sense of trust and connection with their therapist. Without this, the therapy is built upon a weak foundation, and it will likely be ineffective. Without trust, the patient will not trust the therapist’s suggestions, and probably will not follow through.

Check out our previous blog post to learn more about what goes into a strong therapeutic relationship.

 

Self-reflection

Throughout the process of PT, the therapist will help guide the patient towards desired goals. The patient must also continuously engage in a process of self-reflection to ensure they are continuing to commit to an active role in therapy.

Here are some questions a patient could ask themselves throughout the process:

  • How and when am I going to do it?
    - ”It” refers to the suggestions and exercises from the PT
    - Establish a firm time and place to carry out the homework

  • Why am I doing this?
    - Focus on the “why” can help provide motivation. Why is this worth doing?
    - Remind yourself that you are doing it to better yourself, your health, well-being, comfort, etc. Or to become a better person for those that you love.
    - Remember your goals for PT, and write them down

  • What is going to get in my way?
    - What are the barriers? Is it time, space, commitments to other people?
    - How can you address those barriers?
    - If it is forgetfulness or lack of understanding, work with your therapist to find what helps you with this. This might be the PT sending reminder emails, taking detailed videos of the exercises, or it could be self-reminders by putting sticky notes up at home or in the office, keeping track of your exercises in a journal, or creating events/reminders in your calendar. 

When challenges are faced, it is important to be kind to oneself. Every moment of every day is a chance to begin again, re-focus, and re-prioritize this commitment to oneself.

 

Having a “PT journal” is a helpful tool to keep track of one’s commitment, intentions, progress, as well as for keeping a record of exercises completed and other provided interventions. This could be a very casual notebook, scratch paper, or the “notes app” on one’s phone. 

Here is an example of a tool that someone might use. Start by printing out several blank templates of the days of the week, perhaps divided into AM and PM. You could write what you intend to do in each blank, and give it a ✅ upon completion (or only write in the log once you have completed the activity).

After the initial effort of implementing a new practice into one’s routine, after around three weeks, one might find that it no longer takes as much discipline, and one might even look forward to these practices as the benefits become more clear. New habits take a while to fully form. Many have heard from pop psychology that new habits take 21 days to form. However, evidence shows that this is a myth, because the formation of habits is dependent on MANY factors. Generally, the most “simple” an activity is, and the more obvious the reward is (e.g. like drinking water every day), the quicker that habit will form.

On average, habits take about 66 days to form, after which they become “second-nature” or effortless.¹

The best way to create this new habit? Have an external cue (e.g. a sticky note) to perform an activity in a consistent context (e.g. a space in your home), and repeat it. Again and again and again. Perhaps the same time every day. Eventually it will become automatic.

At The Wellness Station, we aim to create a close, trusting therapeutic alliance. We seek to provide learning experiences, so the patient feels “on-board” with the process. We recognize the inherent challenges in this process, and are compassionate towards those who are having difficulty. Through close communication, your therapist will help to address any barriers throughout the therapeutic process, and together you and your therapist will steer the ship in the direction of your choosing.

 

Summary/Key Points

  • Physical therapy is a process that is guided by your therapist, but requires the patient to have an extremely active role

  • This involves a commitment from the patient to follow the suggestions from the provider, and to work together with the provider to address any barriers that come up relative to home practice 

  • The working relationship between the provider and patient must be built on trust and deep communication. 

  • As a patient, one should ensure they are fully committed by asking themselves why they are doing PT, what might get in their way, and how they will respond to these challenges along the way. 

  • Strategies to help improve participation in the home program might include having a PT Journal for self-reflection as well as for a log of exercises.

  • Additionally, have an external cue, such as sticky note reminders around the home or office, which provide visual cues to practice exercises. Or perhaps creating calendar events to practice could also be a solid reminder system. 

  • After consistent practice of an activity in a particular environment, the habit will become automatic and effortless, which takes an average of 66 days (though could be much sooner or later). 

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/

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Takeaways from Glucose Revolution

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For anyone who has not yet read Glucose Revolution: The life-changing power of balancing your blood sugar, it is most definitely worth the read. It was written by a French biochemist, Jessie Inchauspé, and is the holy grail for anyone hoping to learn a little more about nutritional biochemistry.

Inchauspé provides background information about how what we eat and when we eat it can trigger glucose spikes, in which the amount of sugar in our blood goes up very quickly. Over time, many glucose spikes can be taxing on our organs, our mental and physical health, and can put us on the road towards serious health issues. Even if we have not been diagnosed with diabetes or prediabetes, chronic spiking of glucose can negatively impact our health, well-being and our waistlines.

The chronic spiking of glucose can lead to insulin resistance, chronic inflammation, atherosclerosis (and related heart events), as well as weight gain.

The book does not suggest dieting, as going on diets is often unsustainable. If we choose to restrict what we eat, we will often experience the “yo-yo effect”, in which we temporarily deprive ourselves only to drain our will-power and eventually return to our old ways.

Rather than dieting, if we are hoping to improve our health for the long-term, we must change the relationship we have with nutrition and exercise to be evidence-based, more enjoyable, and strategic.

How does this relate to physical therapy?

More glucose spikes means more inflammation. More inflammation means more irritated tissues, which leads to more pain. Excess weight also leads to inflammation, as well as increased biomechanical forces on joints, both of which contribute to pain. So, by improving our relationship to nutrition, we decrease inflammation, maintain a healthy weight, thereby making us less vulnerable to pain and unwanted strain on our tissues.

Takeaways

Here are the four takeaways that have stuck with me the most, and that I tend to recommend most often to clients who are hoping to enhance their blood sugar regulation.

Don’t “Diet”

If you’re on a “diet”, it is likely unsustainable. Consider asking yourself the following question: “Is the way I’m eating now sustainable?” Or “Could I see myself eating like this for the rest of my life?” If the answer is no, you probably would benefit from adjusting your mindset relative to what you are eating. Restricting calories or certain foods is likely temporary, and as soon as you stop doing it, your weight will likely bounce back to what it was before the restriction.

It is helpful to consider more the relationship you have to food and nutrition. To learn how to make decisions about food based on the best available information. To not deprive yourself of calories, but rather focus on nourishing your body with healthy, whole foods. Move away from counting calories, and towards counting how many different fruits and vegetables you eat in a week.

Seriously, try it. Over the course of a week, write down every single fruit and vegetable you eat. If you eat a banana seven times, this only counts as one, as I am referring to different fruits and veggies. At the end of the week, what is your number? Aiming for 20-30 per week is a great place to be. If you’re nowhere close to that, no worries! Try again next week.

“Dress” your Carbs

Ever wonder why taking medicine on an empty stomach might not be a great thing? Or perhaps drinking alcohol? When the stomach is empty, there is no buffer, and whatever you ingest has a quicker, stronger effect on your cells. Same thing with carbs: if you eat something that is high in carbs, particularly refined carbs (e.g. white bread, pasta, rice) or sugar (desserts) on an empty stomach, this will lead to a very high glucose spike.

Consider a green starter to each meal, which means having a vegetable before the carb. Or “dress” your carbs with fats, proteins, and fiber. The glucose spike from eating two pieces of white bread would be far higher than a sandwich with two pieces of white bread with avocado, greens, tomatoes, and a protein source in between. Better yet, choose whole wheat bread, as the fiber will also slow down the glucose spike.

Move After Eating

In the post-meal state, when the glucose is first starting to spike, your body is trying to figure out what to do with it. Is it going to go to the liver for long term storage? Is it going to go into the fat cells? How about the muscles? If you move a bit after eating, your muscles will start to soak up the sugar to use as energy, rather than going into fat cells. 

This doesn’t have to be intense exercise. Simply walking for five or ten minutes after a meal will help to decrease the glucose spike by sending the glucose into the muscles instead of the fat, which can be very helpful for weight management over time.

Apple Cider Vinegar (ACV) is your Friend

Vinegar can help decrease glucose spikes. This is particularly helpful if the vinegar is taken about 20 minutes before consuming something that could potentially spike glucose. It is important to only have a small amount, 1 - 2 tablespoons, and to dilute it.

As the taste of vinegar can be vile, I like to make an ACV tonic, which I drink a couple times per week. Here is the recipe:

  • 1 - 2 tablespoons organic raw ACV (maybe start with 1)

  • Liquid stevia to taste, or other natural zero-calorie sweetener (no sugar, as this will negate the effects!)

  • 1/4 tsp cinnamon (or keep cinnamon sticks in the bottle of ACV)

  • Big squeeze of lemon

  • 8 oz water

  • Mix it up, apple sliced and/or lemon wedge optional for garnish

Enjoy!

Written by Jacob Tyson, DPT - Physical Therapist, Yoga Instructor and The Wellness Station Team

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Back Away From Knee Pain and Balance Issues: Walk Backwards!

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Most of us are aware of the benefits of walking for a plethora of physical and mental health conditions. Walking is a necessary part of life for most people, and is what allows us to engage with the world around us. Walking allows us to explore our environment, is an excellent opportunity to spend time outdoors with our loved ones, and allows us to maintain healthy bones, muscles, hearts, lungs, and brains. 

When we think about walking, we are unlikely to consider walking backwards. However, walking backwards comes with a host of additional benefits, as it allows us to use our bodies and minds in a different way.

Here are some ways that backwards walking might help you:

 

May Help with Knee Pain

When you move backwards, whether it is walking, running, or going down the stairs, it reduces the compressive stress at the patella-femoral joint (the knee cap) as compared with moving forwards. This is based on the biomechanics of the movement . You might notice that when you go down stairs forwards, especially if you have a sore knee, that the increased bending of the knee required to go down the stairs forwards could further aggravate an irritated knee. Go down the stairs backwards, and this completely changes the forces on the knee!

Be sure to do this only after practicing on the first 2 lowest stairs, becoming very confident and comfortable with what can be quite disorienting at first.

Many clientele might enjoy going on walks, but notice that the further they walk, the more it bothers their knees. Especially when walking down hills. For these individuals, walking backwards might allow them to walk further and more comfortably!

Be absolutely sure of the terrain as you walk backwards, appreciate that this is challenging to your neuromuscular system at first)

A six-week study comparing a forwards and backwards walking program for individuals with knee osteoarthritis demonstrated that the backwards walking group had significantly reduced knee pain, increased quadriceps (front of thigh muscle) strength, and physical performance compared to the forwards walking group.

Improved Balance

Walking backwards has been shown to improve stability and improve balance performance for those at increased risk of falling. Why might this be? Practicing backwards walking may help to improve posture for those that have difficulties standing more upright. 

Additionally, our balance is controlled by many systems of the body, including vision, the vestibular system (inner ear), and the somatosensory system (sensory nerves). When we are walking backwards, we rely less on our vision (unless we have eyes in the back of our head!), and more on the other senses.

We must pay closer attention to the sensations from our feet on up in order to walk backwards, rather than relying on looking with our eyes at the ground with each step. If you alternate taking a step forward, and then backwards, compare the sensations in your feet – quite intriguing!

This can improve our spatial awareness and coordination, which enhances our balance and reduces our risk of falling.

Mindfulness and Awareness

Walking backwards is a practice in mindfulness and self-awareness. When we walk forwards, we are much more likely to go into auto-pilot, which in neuroscience is referred to as the default mode network. The little person in the control room (our brains) could be” reading a magazine” while we walk forwards, as we have been doing this our whole lives and it has become very automatic.

Walking backwards allows you to become more present with every step, rooting your attention in the here and now. This can be helpful for anxiety, as it produces a state of calm and presence. By shifting out of auto-pilot, we create new neural pathways and are more likely to experience learning and cognitive enhancements.

It is a neurophysiological fact that when we reverse a common function, we improve the skill level of that particular activity!

How To Implement Safely

When beginning to walk backwards, the most important thing is safety. Start at the kitchen counter: keep a soft hold on the counter, and practice switching between walking forwards and backwards.

Next, one could try walking throughout a room in the house, free of clutter.

Walking backwards on a treadmill is also an often. It is important to turn the speed down to the minimum, and hold on to the handrails to ensure safety. Try alternating between a minute of forward and a minute of backward walking, repeated in sets for as long as desired.

Walking backwards outside is also an option, but caution must be taken. One might start by only trying this when walking with someone else, who can serve as your eyes. Make sure you are in a clear path, free of oncoming traffic and obstacles!

The whole walk need not be backwards. One could mainly walk normally, but could try intervals of backwards walking (e.g. a minute at a time, 40 steps at a time, etc.) There is one area of my neighborhood walk that is about two blocks long, rarely has any cars, and has ample sidewalk and grassy areas. Whenever I get to this, I switch to walking backwards, which has become quite an enjoyable experience.