Mindful Movement Part I: Practices for Healthful Aging

It is well-known that exercise has tremendous benefits for all aspects of health. Exercise is extremely protective for cardiopulmonary and metabolic fitness, mobility, balance, muscle and bone strength, cognitive and psychological health, and much more. 

What if we are having trouble exercising because of the very things we are trying to protect? Our shortness of breath is preventing us from walking greater distances. Pain in our joints is preventing us from lifting weights or getting up and down from the floor in a yoga class. Our imbalance and fear of falling is contributing to sedentary behavior. 

These kinds of limitations in physical activity will ultimately contribute to the functional decline that so often occurs with aging, which will further discourage people from participating in traditional exercise routines. 

When it comes to society’s messages about exercise, we are taught that more is good. 

Put in more effort for greater benefits. We often hear “no pain no gain”. On the contrary, for people who are actually experiencing chronic pain and mobility issues, these messages are not inclusive and can further dissuade people from exercising. It changes the way that we think about movement- rather than relating to movement as a privilege that is empowering, movement is seen as “work”, a task to complete, an activity that is associated with pain.

If we want to improve our relationship with movement, it has to work well for our bodies, and we must enjoy it. When you observe children in a playground, you can feel how they love to run, climb, and try what is challenging  – pause, imagine those kids for a moment, can you feel the joy in your own body? 

Improving your relationship with movement will be a gift that keeps on giving!

• You will begin to understand your limits more clearly, knowing when to put in more effort and when to scale it back.

• You will become more aware of how your body moves, so you can move in a way that feels good to you.

This will make movement more intrinsically rewarding, as it is with children. The enjoyment of movement will support healthy levels of physical activity and fitness.

What is mindful movement?

In order to find more enjoyment in our movement practice, we must maintain mindful presence while we move. Our bodies are always present, but where is our mind? Mindfulness is simply bringing one’s attention to the present moment without judgment. We can not truly enjoy anything unless we are there for it. 

Many of us are used to sitting and meditating, drawing our attention to our breath, sounds, and thoughts. By applying this same mindful presence to physical movements, we can become more aware of how we move. This foundational awareness gives us a greater sense of connection to our bodies, and the ability  to change habitual movement patterns that may be placing unwanted stress on the joints and tissues.

Decreasing strain, improving comfort

For example, think about the movement required to follow the upward flight of a bird. If we are only moving from our neck, this may be a pattern that puts additional strain on our neck. If we find that your chest can participate in this movement, we can bring more ease to our tissues during bird watching.

Bring your hand to the back of your neck. Now, look up towards the sky. Does the back of your neck stay long, or does it compress? Now, practice looking up again, but this time put your hand on your chest bone. Does your chest bone rise, or does it stay where it is? Does allowing your chest bone to rise, thereby keeping length in the back of your neck improve the ease and comfort of looking up?

If we are able to change our patterns in ways that improve the efficiency of our movement, we can take strain off our tissues and feel a greater sense of comfort, ease, and enjoyment in our movement practices- as well as the rest of our lives!

The ability to move mindfully will support flow, a positive mental state in which we are fully immersed in what we are doing.

Moving in a state of flow brings intrinsic enjoyment because we are present, engaged, challenged but not too challenged. Consider this the next time you are engaging in movement or exercise- how can you find a state of flow, an embodied presence in what you are doing?

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

Images: 

1. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.thirtythousanddays.org%2F2017%2F06%2Fseven-factors-that-predict-healthy-aging%2F&psig=AOvVaw1_n376b_mdhLa_vO8Hr0m4&ust=1679328220136000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCLDnuqKv6P0CFQAAAAAdAAAAABAE 

2. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.pexels.com%2Fphoto%2Fbird-looking-up-6026823%2F&psig=AOvVaw1ABOzYFDAOdYp--V8kw3Hg&ust=1679840752025000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCICTzMyk9_0CFQAAAAAdAAAAABAE 

The Power of Belief: Saying No to Nocebo

As the fields of cognitive science, psychology, and new biology continue to develop, the scientific community is beginning to understand more about just how powerful our beliefs are. The way we think affects our behaviors, our mood, our perceptions, and even the way we move and experience pain. Most of us have heard of the placebo effect- this is a beneficial effect that occurs after a particular stimulus that cannot be directly attributed to the stimulus, but rather to the belief that the stimulus had a positive effect. This occurs due to both expectancy and conditioning. We expect something to happen, perhaps because it has happened for us in the past, or because someone has planted the idea into our heads that something will happen. This expectation has a neurophysiological effect, which activates particular circuits in the brain that will actually contribute to the expected effect.

The specific neurophysiological mechanisms of how thoughts can impact our physiology are not fully understood, partially because our understanding of consciousness is still extremely limited. However, it is clear that our thinking can impact our body. If you have any doubt about how thoughts can impact our physiology, consider this thought experiment. Does imagining yourself biting into a lemon trigger any kind of physical reaction? Why might that be? 

While the placebo effect can certainly be used for good, we must be wary of its dark cousin, the nocebo effect. The opposite of a placebo, nocebo is a stimulus that creates negative expectations that result in negative health outcomes.1 This might be done intentionally, but more often it is an unintentional adverse effect commonly experienced through interactions with healthcare providers. Ever have an experience in receiving imaging (an X-ray, MRI, etc.), and the provider makes a comment such as … “Wow, no wonder you have pain! Your spine is a mess!” Or another favorite, “Geez, your knee is bone-on-bone! I’m surprised you can still walk! Time for a knee replacement…”. After hearing this information, the nocebo effect can occur, and one may actually begin to experience more pain. It can also impact behavior- perhaps by believing that one’s knee is bone on bone and walking should be difficult, one might stop walking as much, or may begin to compensate while walking. This can lead to actual tissue changes such as deconditioning, excessive tension in various muscles, and more. The negative belief that resulted from imaging and the subsequent conversation with the doctor ended up resulting in a greater experience of pain as well as impaired function. 

How can we use the power of belief to support our health and function? For starters, question negative beliefs, whether these are personal beliefs or from someone else. Anyone who receives imaging should be well informed that structural abnormalities found on imaging do not correlate with pain or function. While people with low back pain may have some abnormal findings on their MRIs, so do asymptomatic people.2 If 100 random people were taken off the streets and underwent imaging, there would be plenty of people with abnormal results with no pain, as well as people with crystal clear imaging who are in severe pain. If people attach too much value to their imaging results, they give up on their belief in themselves to get better. “I have stenosis and arthritis in the spine… physical therapy certainly can’t fix that!” Someone who maintains this belief is deciding that their situation is not in their control, and they are less likely to believe that they will get better. They will be less likely to participate in therapy, more likely to experience pain and dysfunction, and may seek more aggressive treatment options. 

In addition to questioning negative beliefs, create your own positive beliefs! Evidence shows that the use of positive affirmations can lead to improved performance, well-being, and more.3 The use of positive affirmations is a prime example of using the placebo effect to trigger positive health outcomes. By changing our beliefs about ourselves, we can change our behavior and function. This can be very helpful for those of us experiencing pain. A simple exercise could be creating several positive affirmations to repeat to yourself morning, afternoon, and night. The affirmations could be phrases that you don’t currently believe, but what you wish your life was more like. For example, consider the following positive affirmation: “I am strong. I am resilient. I am at peace with my body.” For someone experiencing chronic pain, it can be very difficult to experience peace with one’s body. However, having a sense of peace with oneself can have extremely beneficial effects, including downregulating tension in the body and decreasing the affective components of pain. As we continue to repeat these positive affirmations, they will gradually shift our mindset, beliefs, and experience of life. Ever try to force a smile while upset? Similar to the use of positive affirmations, simply smiling will bring about positive changes in mood, as our brain associates the mechanical act of smiling with happiness.

1. https://journals.lww.com/painrpts/fulltext/2017/03000/nocebo_and_pain__an_overview_of_the.2.aspx

   2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6118107/ 
   

   3. https://www.mindtools.com/pages/article/affirmations.htm

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

Reduce Anxiety Through Mindfulness (Without Drugs!)

Anxiety disorders are the most common mental illness in our country, affecting over 40 million US adults each year.

The prevalence of anxiety has been steadily rising, especially among younger individuals, which may be attributed to societal factors such as lifestyle habits (less movement, poorer sleep quality, work-life balance), social media, the pandemic, and overall existential dread due to issues such as climate change.

When stress and anxiety levels are high, the body releases high levels of stress hormones which can be toxic over time, damaging the body and mind similar to other toxic chemicals found in our environment. The good news is we can learn how to reduce this anxiety naturally without the use of harmful medications. In addition to counseling and psychotherapy, we can all incorporate accessible strategies to help appropriately manage stress and anxiety on a daily basis.

Here are some of my favorite tools that I use and recommend to many of my patients:

1. Breathwork

Breathing practices can be incredibly calming for our nervous system. By slowing down our breath, we naturally shift into a more parasympathetic state of the nervous system (rest and digest). Our breath is always happening in the present moment, and by focusing attention here, we can avoid dwelling on past regrets and future insecurities. A simple breathwork practice is timing the breath while gradually extending the exhale. Start by inhaling for 4 seconds, followed by a brief pause, then exhaling for 4 seconds, followed by a brief pause. Gradually increase the length of the exhale to 6 seconds, perhaps to 8 seconds. Continue for several minutes.

Consider trying a video, such as this for a more "visual" experience:

2. Meditation

Meditation is a practice that can help to calm the inner chatter of the mind to foster a state of peace. Regular meditative practice allows us to be more mindful in our inner world as well as in our relationships with others. Meditation involves bringing attention to an object of the present moment, such as breath, sound, sensations, or even movement. Focusing attention on the breath, or some sensation of the breath is an excellent practice for beginners. Try sitting comfortably in a chair or on a cushion on the floor. Take several breaths, beginning to slow down the breath. See if you can keep your attention fully on the sensation of your belly rising with an inhale, and falling with an exhale. Each time you notice your mind has traveled elsewhere, gently redirect your attention back to the breath.

Helpful tools for meditation include guided meditations on YouTube, as well as apps such as Headspace or Waking Up. Tara Brach is also an excellent meditation coach, psychologist and author with resources on her website: www.tarabrach.com

3. Movement

Gentle, mindful movement can be incredibly calming for the nervous system. This could be a restorative yoga practice, a Feldenkrais lesson, or even just a walk. Try going on a walk outdoors without any distraction- no phone, music, or podcasts. Direct your attention to objects of the present moment, such as the birds chirping, the stunning visual field of blue sky, flowers, and trees, or sensations of the body such as the contact of the feet on the ground, the fresh air flowing in and out of the lungs, or the breeze on the skin. Tap into your senses!

It is important to practice these on a regular basis to build up resilience, rather than ONLY practicing them when stress and anxiety levels are high.

Just as we would not only go to the gym when we are feeling weak, we should not only practice self-care when we are depleted. Practicing these strategies only a regular basis will promote neuroplasticity, sustained behavioral change, and will allow us to access inner peace and calm when we need it the very most.

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