August 22, 2023

Health and Wellness, Movement, Mindfulness

A Traveler’s Guide to Staying Supple, Comfortable, and Fit

August 22, 2023

Health and Wellness, Movement, Mindfulness

Throughout the summer, many of us have been active traveling and will continue doing so through labor day. This could involve long car rides, flights, and disturbances in our usual movement and self-care routines. Some people specifically avoid traveling due to back pain or similar issues, or perhaps suffer through increased pain which detracts from the joys of vacationing.

Here are some tips to keep you and your body feeling happy and healthy throughout your travels!

Breaks from prolonged sitting

The number one most important thing is taking frequent breaks from sitting, no matter the mode of travel. Prolonged stillness, especially constricted in an enclosed space of a vehicle or plane, is the recipe for soreness and stiffness.

Rather than only taking breaks for the biological need of needing to use the bathroom, consider the biological needs of your musculoskeletal system. The body’s tissues do not like to be in the same position for too long, especially positions that involve increased pressures on certain areas (e.g. the low back).

In fact, studies have shown that prolonged sitting is associated with increased pressures on the intervertebral discs of the lower back. This study demonstrated that disc height, particularly between the L4 and L5 vertebrae, is significantly impacted by prolonged sitting without breaks. The loss of disc height was not present with brief positional changes performed every 15 minutes. Changes in disc height during prolonged sitting may be associated with low back pain, sciatica, and functional disability.

At the least, try to stand up and walk around once an hour. Consider setting timers so you remember to stop and move around. If you can do it every half an hour, great! If it is not possible to take a break this often, never go for more than two hours without getting up. If you’re not able to get up, change your position often! Trust your own experience and honor your body’s request for appropriate breaks.

Targeted movement breaks

Maximize your breaks from sitting with specific movements/stretches that help to reverse the effects of sitting.

Notice that in sitting, the hips and knees are flexed to around 90 degrees. Most people also tend to sit with some flexion in the low and mid back. This shortens certain muscles/tissues, particularly around the spine, hips, and knees. By specifically performing movements that lengthen those tissues, you can help prevent your body from getting quite as stiff and sore during long trips.

Consider trying some movement snacks (see our Movement Snacks blog) to break up your car trip, particularly the first three videos that you can do standing up (perhaps using your car or a picnic table for support).

Another favorite is a standing back extension, which involves pressing the hips forward to extend the back and hips. This movement can be done as shown below, or by pressing the hips forward into a support surface such as your car, a chair, or a picnic table, while gently holding on to the support surface.

I also love to do a version of a sun salutation that you can do while standing. This involves reaching up to the sky, down to the ground, and cycling through this while breathing.

You could also do standing pelvic circles, imagining you are standing with a small hula hoop around your waist, and you make circles with your hips within the hoop.

It may also be helpful to consider how the spine moves in space, and engage in movements in which you move the spine in each of the three directions (flexion/extension, side bending, and rotation). See our How the Spine Moves blog for more information.

At the Wellness Station, we will help you create specific, individualized movement routines that you can integrate into your travels.

Ergonomics and posture

While sitting for a while during travel, it can be helpful to enhance your ergonomics and posture. See our Posture Part II blog for more specific information.

The main factors to consider here are:

Appropriate back support

Consider having an inflatable travel ball to stick behind your back in the car or on the plane to help support your spine.

The above can be ordered from Amazon and deflated to the level that fits best for your body size and your seat.

Changing Position Often

Try not to get stuck in one stagnant sitting position. Cycle between being more reclined and less reclined. Change where you are holding your legs. Move the ball around to some different positions.

Sitting movement breaks

Similar to changing position often, try to incorporate specific movement breaks while sitting. You can be doing the pelvic clock. You can be gently pumping your ankles, stretching your hips, rolling your neck. Some planes even have specific in-flight videos for sitting stretches you can follow along to.

Establishing a vacation movement routine

Many people let their routines slip away on vacation. “I’m on vacation- why would I be exercising?” While of course you want to have plenty of time to immerse yourself in new experiences, or perhaps sit on the beach with an ice cold margarita, vacations are no time to be sedentary. Don’t you want to be feeling your very best to fully enjoy your vacation, rather than feeling stiff, achey, and out of shape?

How can you re-establish a movement routine while traveling? Bringing a yoga mat and some very minimal supplies (ankle weights, therabands) might be an option while traveling. If not, perhaps there is a hotel gym and/or pool that you could enjoy. When bringing equipment and gym access is not possible, think of what body weight movements you could do (e.g. variations of squats, lunges, push ups, cat cow, step ups, etc.)

Consider opting for an active vacation. How can you explore new places with your own two legs? Is there a hike in the area you would like to explore? A bike trail? Swimming in a pristine lake or a salty sea? Or perhaps a walking tour of the downtown must-sees.

Whatever your journey may be, try to prioritize staying active so you can make the very most of your vacation. At the Wellness Station, we can help to gradually progress your fitness to help you be able to move towards the trip of your dreams.

A biking exploration of Jasper National Park

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

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152382/

Lorraine Davis

August 8, 2023

Balance, Exercise, Health and Wellness, Movement, Physical Therapy

Balance Part II: Strategies for Improvement

Lorraine Davis

August 8, 2023

Balance, Exercise, Health and Wellness, Movement, Physical Therapy

Last month, we discussed factors that control and impact our balance. Consideration of these factors can help us become more aware of what to do to stay safe and prevent falls, as well as targeted exercises to improve our balance that are based on scientific principles.

How do we improve our balance and prevent falling?

If we recognize the influence that the physiological, psychological, and environmental factors have on our balance, we can be strategic in how we improve our balance and decrease our risk of falling.

Stay active, making sure you are keeping your muscles strong and healthy for life. Have a movement practice that incorporates functional strengthening and balance challenges.

Enhance your somatosensory system by regularly stimulating your feet. Think of your feet like antennas that provide messages to your brain about your balance. Massaging your feet with balance pods are a great way to keep the nerve endings responsive.
Consider more time spent barefoot, especially during balance exercises. This will allow your feet to feel the ground and your toes to spread out, creating wider points of contact with the ground. In daily life, consider shoes with a thinner, more flexible sole, and a wide toe box.

Ensure you are taking care of your eyes and vision by regularly visiting an ophthalmologist. Make sure you use a nightlight when going to the bathroom at night, and remove any trip hazards from your path.

You could also consider the role of vision to challenge your balance during exercises. Notice that keeping your gaze stable on an object in front of you helps your balance. Moving your eyes around will make balance more challenging. Closing your eyes will make it the most challenging!

Recall in Balance Part I, we discussed how being overly reliant on vision can contribute to a stooped posture, as many people will look down to the ground with their whole body rather than just with their eyes. When walking, practice looking down with just your eyeballs as needed to see the ground in front of you, rather than with your whole self. If you had a light shining from the tip of your nose, and a light from your chest bone, you should be able to maintain these lights at the level of the horizon while walking, rather than keeping the lights cast downwards.

Make sure your vestibular system is healthy, and recognize the impact that vertigo, seasickness, and certain medications can have on your balance.

Likewise, you can progress your balance exercises by introducing changes in your vestibular system. If standing on one leg has become easy, can you do it while slowly turning your head from side to side, or up and down?

Optimize your environment: Make sure your environment is conducive to not falling! If icy sidewalks, crowds, or uneven trails are not for you, make sure you modify appropriately, perhaps bringing an assistive device or a loved one to help you stay steady.

You can also use the environment to improve your balance, by intentionally walking on trails and standing on uneven or “squishy” surfaces.

Train your balance… but don’t overshoot it! A mistake many people make while training their balance is going past their edge. If standing on one leg consistently leads to excessive wiggles, wobbles, and you are unable to find your steadiness, then you are simply practicing being unsteady, rather than practicing finding steadiness. You want to be close to your edge, without going over it!

Find an exercise that feels moderately challenging, but you are able to find steadiness and ease with practice. If not, modify the activity to make it more or less challenging. Standing at the kitchen sink, by the counter, in the corner of a room, or in a door frame are excellent places to practice balance, as you have the option of supporting yourself with your arms as needed.

By finding this edge and achieving success with practice, not only can we improve the physiological components of balance, but we can also improve the confidence we have in ourselves, thereby decreasing our fear of falling and subsequent risk of actually falling!

Follow along with this video, which incorporates seven balance exercises and strategies, “Feldenkrais style”! It instructs in balance challenges including standing and walking with a narrow base of support, closing the eyes, getting up and down from the floor, dynamic weight shifting, and practice with “falling”. Best to do this video near something to hold on to as needed.

At the Wellness Station, we can help you recognize and make changes in the factors that could be impacting your balance. We will provide you with individualized recommendations and movement lessons to help you improve your balance, your confidence in yourself, and your ability to continue to do what you love.

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

Lorraine Davis

June 13, 2023

Exercise, Healing Pain, Health and Wellness, Holistic Body, Movement, Physical Therapy

Exercise and Chronic Pain: A Guide

Lorraine Davis

June 13, 2023

Exercise, Healing Pain, Health and Wellness, Holistic Body, Movement, Physical Therapy

It is well known that exercise is an extremely beneficial activity that can elicit substantial improvements in many different measures of health, well-being and fitness.

Exercise is a broad category, as there are many different types and manners in which exercise can be carried out. (See Movement, Physical Activity, & Exercise blog for more information.)

There are many factors to consider when determining what kind of exercise might be best for an individual. These individual considerations might include health conditions, fitness level and experience with exercise, injuries, goals, cultural factors, socioeconomic status, access to safe spaces to exercise, personality, and the existence of chronic pain. One size does not fit all when it comes to exercise.

At the Wellness Station, we provide holistic care based on the biopsychosocial model, which takes these differences into account to create individualized movement programs.

Can Exercise Help with Pain?

Pain is an extremely complex, subjective experience, it is difficult to apply generalizations to this topic. That being said, exercise can be extremely helpful for individuals with chronic pain for several reasons.

However, individuals with chronic pain may become more physically inactive which may be due to fear-avoidant behavior (they may avoid movement for fear of triggering their pain), depression, or many other reasons.

Inactivity can make chronic pain worse, as the tissues of the body will become deconditioned, inflammatory processes may increase, and weakened tissues may become more likely to be irritated and strained from acute stressors.
Exercise, when performed appropriately, can have tremendous health benefits for all individuals, those with chronic pain included. Engaging in intentional exercise can help improve metabolic, cardiorespiratory, and musculoskeletal functioning, and also triggers the release of endogenous hormones (endorphins) that help us to feel good and decrease our sensitivity to pain.

Exercise can improve the confidence we have in ourselves and in our painful body parts, which can also help with our experience of pain. This confidence helps us feel empowered to make positive changes, and less limited by fear of movement.

Targeted exercise can help to nourish tissues with fresh blood and nutrients and improve tissue strength and resilience.

It is clear that exercise is helpful for pain both directly and indirectly, but one must consider how exercise might be applied differently for someone experiencing chronic pain compared to an individual using exercise solely for fitness gains.

An Exercise Program with Chronic Pain: Factors to Consider

The interventions chosen at the Wellness Station are highly individualized, as the intervention will depend on the unique characteristics of the individual.

The individual will be encouraged to be generally more active in physical activities that are enjoyable and do not trigger pain.

If the activities (such as walking) do trigger pain, it is a matter of changing the movement patterns involved in the activity. Often, people with chronic pain experience a pain pattern during specific activities because they have adopted compensatory, stressful and inefficient movement patterns. Unless these patterns of movement change, the pain cycle may continue. It is our job at the Wellness Station to identify these movement patterns and help you to change them.

In addition to changing movement patterns, we can also make changes in the parameters of the activity (including the frequency, intensity, or duration of the activity). For example, engaging in several shorter walks throughout the day rather than a longer walk, if long walks trigger pain.
The individual will learn not to push into pain, as this oftentimes will reinforce the pain pattern, contributing to flare ups. Rather than pushing into pain, the individual should learn how to listen and respond to the pain, as pain is your body’s way of communicating information to you. Contrary to the popular mentality of “no pain no gain”, “it’s got to hurt to be effective” when it comes to exercise, if you want exercise to be helpful for your pain you must take a different path.

The movement program should also include specific, intentional practices that directly and/or indirectly involve the affected body area. If low back pain is the problem, the movement program will most likely involve the low back, whether that is performing movements that improve mobility, strength and control of the low back, or perhaps improving the movement capacity of a related body area (e.g. mid back or hips) to help spread out the forces of movement over more of the body. Engaging with the involved body part in this way is helpful not just biomechanically, but also psychologically, as it will improve the confidence you have in this area.

The movement program for an individual with chronic pain will likely be progressive, meaning it will increase in complexity over time, but the progressions will often be much more gradual than a program that is more oriented towards fitness gains. The parameters of the program and the decision to progress will be based on evidence of neuromuscular learning, comfort, and effect on the pain pattern. By contrast, progressions for a program solely for fitness would likely be based more on the subjective challenge of the activity (e.g. it begins to feel too easy).

Enhance your Fitness for a Better Life

Physical fitness can be described as the ability for all body systems to work together in order for us to maintain health, and perform daily tasks with ease. Strength, balance, agility, cardiorespiratory endurance, and body composition are all components of fitness. It is extremely important for all of us, including those of us with chronic pain, to maintain our fitness through exercise. As we age, it becomes harder to maintain our fitness, as our muscle mass and bone density begin to fade unless we regularly strengthen ourselves. Maintaining and enhancing our fitness will help us stay independent, active and involved in the activities we love, while helping us avoid falls, fractures, metabolic diseases, and more. Pain is often a huge barrier that discourages people from exercising, so addressing the pain as described above can contribute to improvements in fitness overtime.

At the Wellness Station, we use movement to empower people with and without chronic pain to take control in order to live happier, healthier lives.

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

References:

Images:

Lorraine Davis

May 16, 2023

Health and Wellness, Holistic Body, Movement, Exercise

Guide to Structuring Your Home Exercise Program

Lorraine Davis

May 16, 2023

Health and Wellness, Holistic Body, Movement, Exercise

Throughout engagement in the process of physical therapy, many individuals struggle with parameters of their home program. How often should I do the exercises? How many sets and reps should I do? Should I feel pain or stay away from pain completely?

Notice what all of these questions have in common: “Should”

Traditional physical therapy tends to be very prescriptive. Pre-filled templates with “3 sets of 10” of this, “2 sets of 20” of that. For many individuals, this cut and dry prescription makes sense, and creates a clear structure for engagement with the exercises at home. However, consider what this rigid structure deprives you of.

By the therapist deciding on the exact parameters of your home program, agency may be removed from the individual. The performance of the home program becomes less about facilitating a positive engagement with one’s body, and more about what you should be doing- a task to check off the to-do list.

Okay, so… there shouldn’t be any structure to my home program?

Our lives are a constant dance between rigidity and chaos. Too much structure, we have rigidity, close-mindedness, decreased spontaneity, and limited options. Not enough structure, we have chaos, confusion, and a loss of direction. How do we find a healthy balance?

The structure of one’s home program is highly individualized based on person, environment, and goals. What works for one person may not work for another. What works for you today may not work for you tomorrow.

Sometimes life is busy. Sometimes our environment is not conducive to completing our home program. Sometimes we don’t feel good. Rather than seeing the completion of your home program as all or nothing, how can you modify it to fit into your day regardless of what is going on in your life?

Consider creating a loose structure, with room for adding and subtracting

Perhaps practicing the whole series of movements in your routine can only happen three times this week. However, what about five minutes here and five minutes there to engage with the movements in a way that fits in with the rhythms of your day?

You find yourself lying in bed for a few extra minutes and you try bringing your knees to your chest, or rotating from side to side.

You are standing in the kitchen waiting for the water to boil, and you find your hips gliding.
You are getting up and down from a chair, and you decide to practice three additional sit to stands with awareness of your body mechanics.

Questions to ask yourself

Learning how to direct your own care is ultimately what we aim to teach you at the Wellness Station. Consider asking yourself the following questions to enhance this ability-

If I were my therapist, what might I want to know more information about?

Consider a situation in which you are engaging with physical therapy, but you feel that you “aren’t getting better”, or the exercises aren’t “working”. If you were your own therapist, what would you want to know more about?

How often do I spend time with the movements?

When our home program is a to-do list item, it can be very easy to rush through it and let it slip through the cracks. If you are spending no more than 10 minutes total each day engaging with yourself through mindful movement, and wonder why the therapy is not more effective, then the answer may be that you are not spending enough time with it. If you want to learn the language of your body more fluently, you have to practice.

It may be helpful to have a goal of how long you would like to engage in the movements, perhaps at a specific time each day. For example, 20 minutes in the morning before breakfast.

To further enhance the therapeutic effects, take 10 minutes here, five minutes there, two minutes here, five minutes there, to re-engage with the movements throughout the day.

Am I working “on” my body, or working “with” my body?

We could spend all the time in the world on our home programs, but if we are not doing the movements as intended, they will have little therapeutic benefit. If the way you are engaging in your movements is to accomplish a task, push through pain, or to just do what you think you’re supposed to be doing, then the intention is missed. The completion of the movements is less important than the manner in which they are performed.

The intention of the movements are to be able to pick up on the signals from your body with greater sensitivity, bring stimulation and change into your tissues, and grant agency to know how to respond to pain and discomfort. Keep asking yourself as you perform the movements… “Am I working on my body, or learning how to work with my body?”

In addition to a designated time for my home program, how am I implementing what I’ve learned into what I’m already doing throughout the day?

We live in our bodies 24/7, and we are already moving our bodies throughout the day, whether we are mindful about that or not. This grants us the ability to be engaging mindfully with our bodies pretty much all the time.

Getting out of bed or out of a chair- think about your body mechanics.

Standing in the kitchen- turn it into a dance.
Walking to and from rooms- what is that light from your chest doing?
Picking up a box from the floor- send your bottom back and tuck your pelvis when you come up.

By considering these concepts, your home program will likely become more rewarding, enjoyable, and instrumental in moving towards success in your therapeutic journey.

At the Wellness Station, we will guide you to creating an adaptable structuring that empowers you to direct your care and enhance your wellness, fitness and beyond.

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

Lorraine Davis

April 11, 2023

Health and Wellness, Movement, Mindfulness

Mindful Movement Part I: Practices for Healthful Aging

Lorraine Davis

April 11, 2023

Health and Wellness, Movement, Mindfulness

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: