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 

Movement

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Doing Dishes With Back Pain: Strategies for Success

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For most of us, doing the dishes is not exactly the highlight of our day. For those of us with back pain, this chore can be daunting, uncomfortable, or even seem impossible. There are many strategies that can help this task become possible, manageable, or even easy. A lot of this comes down to our posture and movement patterns, our attitudes, and our willingness to break down the task into chunks.

Posture and Movement Patterns

How we hold ourselves can make a big difference in how our bodies feel. Being in a forward bent position for a long time puts extra strain on the back. Because the dishes are down and forward, it is easy to find yourself in this slumped position, but it is possible to do it differently!

  1. Position yourself for readiness:

The closer you place your body to the sink, the shorter the lever arm is that your body has to hold. In other words, if you’re holding a heavy pan far away from your body, this is a lot more work on your back than holding the pan close to yourself. Just wear an apron so your clothes don’t get wet! 

You could also bring the dishes closer to you by using two dish pans. One on the bottom, and the other one upside down which would bring everything up closer to you. This will allow you to wash the dishes a little higher, and not have to bend down as far to scrub dishes at the bottom of the sink. A long handled scrubber may also be helpful.

2. What’s under your feet?

Think about your feet, as you are holding your weight through your legs as you stand. Try standing on a soft cushy pad to help spread the forces coming up from the ground.

Another strategy is to have one foot placed on something, such as on a stool, or inside the cabinet that is in front of you. Every so often, switch which foot is elevated. This will both keep you more upright, and allow your legs to alternate sharing the load. However, the downside of using a stool is that it brings you further away from the sink. This makes it all the more important to elevate the dishes by using two dish pans, as described in #1 above. 

Notice that this individual in the left-hand picture does not need to be bending from the waist in order to see the dishes. This position causes the back to work harder than it needs to. This person should instead be looking down at the dishes by tipping just their head, not their whole back. 

3. Dishwasher strategy:

Use the automatic dishwasher as much as you can. Believe it or not, this actually saves water! However, loading and unloading the washer can be troublesome for many with back pain. At the Wellness Station, we can teach you how to optimize your body mechanics for success based on your individual characteristics.

Generally speaking, try to position yourself as close to where you are putting the dish as possible. In other words, don’t try to reach and crane to the far corner of the bottom rack holding a heavy plate! Walk around to the side, send your bottom back, and place each dish with ease. In other words, keep your center of mass (your pelvis) over your base of support (your feet) so that when you reach forward, you can counterbalance by sending your bottom back. This is something we can teach you to do effortlessly at the Wellness Station.

Attitude and Mindset

If we see dishes as a cumbersome chore, it will continue to be so. How can we change our attitude and mindset relative to this task to make the most out of it?

  1. Mindfulness:

Don’t have time to meditate? Make doing dishes your meditation. Pay full attention to your experience. Notice the sensory information coming from the splashing water. Notice your fine dexterity skills required to grasp and scrub. Relish in the small dopamine hit from each completed dish, and the sense of accomplishment from finishing the task. Feel gratitude for having food to eat, dishes to use, and modern technology to support the ability to feed yourself and your loved ones.

2. Bring the joy to the experience:

If mindfulness isn’t cutting it, what else can you bring to the experience? How about playing your favorite music and making it into a dance? Listening to your favorite podcast to educate yourself while you work? Or perhaps rewarding yourself upon completion with a tasty snack or self care routine. 

Breaking it down

Many of us can’t tolerate dishes because of the amount of time spent standing. If the above strategies are not helping as much as you would like, consider breaking down the task into chunks and taking movement breaks.

  1. Break into chunks:

Rather than trying to push through and finish dishes as quickly as possible at the expense of a sore back, how about breaking it into chunks? Unload the dishwasher, sit down. Load the top rack, sit down. Load the bottom rack, sit down. Wash the pots and pans, sit down. Remember the lesson of the tortoise and the hare! If sitting down is not necessary, or even preferable, consider moving about with other household responsibilities and coming back to washing dishes later. 

2. Movement breaks:

Try incorporating some gentle movement breaks into your dishwashing routine. It might be helpful to do movements that incorporate the opposite movement of your body. As doing the dishes involves some bending forward with your arms in front of you, how about some bending back with your arms behind you? Here is a movement break that are great for incorporating into your dishes routine: Hip and Shoulder Extension

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

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Exercise and Chronic Pain: A Guide

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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:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461882/ 

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491894/ 

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Top-Down vs Bottom-Up Processing: Applications to Movement and Pain Science

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Top-down and bottom-up processing are ways of interpreting stimuli

Top-down processing refers to the utilization of previous knowledge, beliefs and expectations (existing schemas) in the perception of incoming stimuli. The higher levels of our brain make judgments about what we are experiencing based on past experiences.

Bottom-up processing focuses on the incoming sensory informationin real time, and does not require prior experiences. It relies on raw data from our sensory organs, which then transmits information to our brain which perceives the information. 

In other words, in top-down processing our higher brain directs our body. Your higher brain creates a story, and can tell your body what to do. In bottom-up processing, the body is informing the higher brain, which has no reliance on our preconceived ideas.

How might these types of processing relate to the development of pain behaviors?

**We have written several articles related to the neuroscience and psychology of chronic pain. Please browse our previous blog posts for a deeper dive on this topic.** 

Consider an injury in which someone bends over, picks up a box, and injures their back.

  • During the injury and for a short time afterwards, bottom-up processing would contribute to the pain experience.

  • Nociceptors in the injured tissues would send signals to the brain, which we would experience as pain. From the bottom (body) up to the top (higher brain), we are receiving sensory information that we perceive as pain.

Now consider the top-down processing that might occur for hours, days, weeks and months following this injury.

  • The higher brain might begin to tell stories and our behavior might change accordingly. “Bending over is dangerous”. Based on the past experience of pain with bending over, this activity is now associated with pain and fear- therefore, we avoid it.

  •  “I am weak, and cannot pick up anything heavy”. The emotional circuits of the brain are engaged, and a story is created about core weakness, and further avoidance of activities that involve picking up objects is perpetuated.

  • “I should be lifting like this, not like that”. A superimposed idea of keeping the back straight and bending only from the legs leads to a change in movement patterns, which may or may not be beneficial for that individual.

  • Now, whenever the back is bent in the future, the movement is deeply associated with pain and fear. The tissues that were originally injured might be healed, but weakened. The top-down processing that occurred after the injury may contribute to the development of chronic pain and disability.

Our work at the Wellness Station involves recognizing these movement patterns and behaviors that are habitual, and may be dysfunctional, stressful, or inefficient. We help you relearn how to move safely, comfortably, without limitations from fear or less than optimal movement patterns.

How does this relate to movement and exercise?

Many clientele will ask questions or otherwise indicate that they are functioning primarily in a top-down state. This presents as trying to do the exercise “correctly”, focusing more on what someone might observe from the outside-in rather than from the inside-out.

In order to optimize biomechanically-efficient movement patterns, there must be an interplay between top-down and bottom-up processing.

During a movement, the person might explore based on instructions from the therapist, previous experiences, or trying out various options. The higher brain might be saying “now listen to what your glutes are telling you when your feet are placed that way, and then compare that with the sensations, from the bottom-up, when you place your feet in a different way.” 

Consider the pelvic clock: Lying on back with knees bent, roll your pelvis towards 12 o clock (towards your head). Do this several times. Notice if you are pushing down through your feet as you go to 12. If not, try pushing down through your feet. Now bring your hands to your glutes (buttock muscles). When pushing down through your feet, observe that your glutes will contract. When not pushing down through your feet, observe that your glutes will not contract as much. The instructions “engage your glutes” would be top-down, and the instructions “observe what you feel in your glutes when you press through your feet” would be bottom-up. You could also observe differences in how your glutes are engaging when you place your feet closer or further from your bottom, or closer or further from each other.

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Guide to Structuring Your Home Exercise Program

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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

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Mindful Movement Part II: Yoga and Feldenkrais

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Our last blog discussed the importance of mindful movement as a way to recognize and change patterns of strain, become more connected to our bodies, and to find a flow state. Moving in this way will support a healthy enjoyment of movement and exercise, which will encourage us to stay active for longer. Below, we discuss two mindful movement practices that can be integrated into your lifestyle. 

Restorative Yoga

There are many organized movement practices that focus on cultivating mindful presence. Some styles of yoga, which integrate mind, body, and spirit can help improve the awareness that we have of our movement. Vinyasa styles of yoga such as power yoga are more focused on the physical challenge of the practice, aimed at building strength and working up a sweat. If we are new to yoga, a better option would be a slow flow, restorative yoga, or yin yoga class. These slowed-down practices allow us to tune in on a deeper level.

If we want to truly feel what is happening in the present moment and be able to learn from it, our nervous system respectfully requests that we slow ourselves down.

To practice yoga more mindfully, become aware of where your attention is drawn. Is it drawn to the teacher? Trying to emulate the shape of the flexible person in front of you? Wishing time would pass so you can finish all the items on the to-do list? 

Rather than focusing on doing, or achieving some yoga pose or transition, shift to an internal focus of what is happening right now.

What can you feel and sense in your muscles? What parts of you are connected to the ground? How does your mind respond to a physical challenge? Does the pattern of your breathing change when you are changing the shape of your body?

Feldenkrais Method

The Feldenkrais Method uses somatic education and gentle movement sequences to help people learn new and more efficient ways of moving their bodies. It is based on principles of whole body/whole brain learning. Feldenkrais practices integrate the mind, body, and spirit while bolstering self-awareness and supporting positive changes of habitual movement patterns.

For example, a person with shoulder issues can learn to reach overhead comfortably by engaging proper use of the pelvis and spine – See “pelvic clock lesson“ below.

This method can be performed in one-on-one sessions by a practitioner, and there are also group movement classes known as Awareness Through Movement.

A classic Feldenkrais lesson is known as the pelvic clock. By imagining that you are  sitting or lying on a clock, we can become more aware of our posture and the natural movements of the spine.

Try this now: Lie comfortably on the floor or in bed with your knees bent. Imagine there is a small clock under the back of your pelvis. 12 o clock would point towards your head, 6 towards your feet.

Now, how would you go about rolling your pelvis between 12 and 6? How does this influence the shape of your spine as you move between 12 and 6?

If you had a light shining from your chest bone onto the ceiling, would this light move? Does moving in this way have any influence on your breathing? What sensations can you detect as you move in this way?

What is the experience of reaching an arm up to the ceiling while engaging in the pelvic clock? How does your arm want to move along with your pelvis and chest bone? 

Follow along with this video to get a better sense of the pelvic clock in a sitting position.

The Wellness Station is a somatic physical therapy practice that integrates principles of traditional physical therapy, therapeutic yoga, and the Feldenkrais Method. Our gentle approach is aimed at helping our clientele improve their lives through movement-based interventions. 

We help you to identify the obstacles that are preventing you from being active, and guide you on the path towards enhanced health and well-being.

You might find that through our guidance and your participation in mindful movement practices, your love of movement will increase, and you will naturally find yourself moving more throughout the day. With this comes the excellent health benefits of exercise, enhanced bodily comfort, and a greater ability to participate actively in your life, FOR life.