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Adult Tummy Time: Why you should be doing it every day.

We’ve all heard babies should have time on their tummies. Tummy time is not about their    bellies. It is about their back and helps them develop a spine strong enough to help them lift their heads, sit up and prepare to stand and walk. Imagine a toddler trying to walk with their spine and hips still in the fetal position. The prone or tummy position stretches out the front of the body and strengthens the hips and back. This creates the strength and balance necessary for continued development and healthy alignment. If you’ve been around babies who are just starting tummy time, you know that it isn’t always welcome at first. But, as the baby gets stronger, it becomes another fun way of exploring and interacting with their environment. Adults need tummy time too, but for entirely different reasons. 

When I recommend tummy time to my teen and adult clients, I often get “the look.” That “what you talkin’ about Willis?” face. I laugh, then explain. 

Adults (let’s include kids and teen in this conversation too) rarely spend time laying on their stomachs. Some health professionals also recommend not sleeping on your stomach, which in my opinion, only makes sense when there is a medical issue, injury, or significantly limited range of motion in the neck. For many of us, it is just fine and actually a good idea. It promotes neck range of motion and helps us get back what we lose during the day from looking forward constantly. Sleeping positions could take up another entire article. If you are interested, you may want to check out my blog on pillows.

Back to getting prone during the day…

Our culture is set up so that we are almost always sitting. Toileting, eating, working, driving, relaxing, etc. all involve chairs of varying structure and   comfort. Chairs didn’t become common until the 16th century. Since then, we’ve kept making them more and more cozy and   comfortable. Our bodies have become very accustomed to chair sitting. Chair sitting isn’t necessarily bad, but most of us are using them irresponsibly. We collapse into the chair, letting the chair do the work of keeping us upright. We allow our tailbones to tuck under and our head to sink forward. What does this look like? The fetal position!

The fetal position.

Our bodies become sticky in the positions we are in most, especially if we don’t move them regularly through a full range of motion in different planes (think yoga, tai chi, dancing or similar). Add up the hours you sit in a day. For many of us that will be 12 plus hours. Ouch! Not only does our fascia thicken and tighten with lack of movement. This habitual positioning creates muscle imbalances. Some are far longer than they are intended to be, and others are short. Both are probably tight. What to do? The good news is that our bodies are very resilient.

To get on the path to tummy time, the first thing you should know is proper pelvic positioning. There are a variety of landmarks, but this is probably the easiest for most people to find. Stand sideways in a mirror. Feel the bones that stick out the furthest in front on both sides of your hips. These are known as the anterior superior iliac spine or ASIS. Now, find the pubic bone. Put your fingers just under your belly button. Press in and slide down until you feel a bone. That is the top of your pubic bone, which is also part of your pelvis. These three bony landmarks are all connected. Now try this movement that will remind you of The Rocky Horror Picture Show. Tilt your hips, so the pubic bone is further forward than the ASIS landmarks. Now try tipping the ASIS points back and your pubic bone forward. The goal is to line them up in the same plane as shown in the picture. This is the position where your lower back is the strongest. It is also the best position for diaphragmatic breathing and pelvic floor function!  This position also  allows the upper body to stack up in best alignment. So if you can’t get rid of your neck or shoulder pain, check your hips!

You may be able to feel the landmarks better if you get on the floor on your tummy. A floor is best to try this. A bed is too soft and will skew your results. Make sure to have your chest and shoulders close to the floor also. Can you feel those three points touching the floor? If not, reach your hand to feel the landmarks.  What isn’t touching? Can you tilt your pelvis back and forth to get there? If you can’t your fascia, muscles or joints are probably sticky. Don’t force it. Instead, stay there and see if your body will slowly adjust. Give it time. It may take a few minutes or a few months. But moving toward proper pelvic alignment is a huge step to better overall health and less pain. If you have trouble achieving this position with gravity helping you, you will have a tough time working against gravity while standing. 

If this is too hard, start on the bed, but move to the floor when you can. You can take your tummy time further by adding a ball to stretch your abdominal fascia and muscles. See more in my video Belly Stretch.

While in tummy time, you probably won’t have anyone entertaining you or cheering you on like you may have had as a baby during tummy time. But you can entertain yourself. Read, play a game, listen to a book or music, watch the news or some Netflix or better yet, meditate. Get your family and friends doing it too!

If you need help finding proper alignment and deciding how to get there, make an appointment. I’m happy to help!

Ice or Heat? Which is best for pain?

This is a common question with a complicated answer.

I taught at Creighton University for 20 years.  Before my students asked almost any question, they already knew the  answer I would give them. It became a running joke.  The answer to almost every question about how to treat an injury or a diagnosis is…

…it depends.

A good healthcare practitioner (Western or Eastern medicine) knows they are not treating a diagnosis or an injury.  They are treating a person. We are all very similar, but we are all extremely different. There are no clear answers.  There is good solid research out there for many issues we face, but what we have is really a drop in the bucket.  And, the answers often change as new knowledge is always emerging.

Dr. Gabe Mirkin coined R.I.C.E. in 1978. This stands for rest, ice, compression and elevation. It has been a commonly accepted practice for treating injuries but there has never been great evidence to support it.  It has also led to many common misconceptions about what to do for all types of pain.

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In this short article, Dr. Mirkin discusses how icing or cooling actually delays recovery. Our natural response to injury is inflammation.  It is a natural part of the healing process.  Icing constricts blood vessels and prevents healing. However, he does say that icing may help prevent pain, but we should only do it for short ten minute periods immediately following an injury.

The Cochran Library provides us with a systematic review of heat and cold for low back pain. There is moderate evidence for heat and very little evidence for cold.

What about the R. or the rest in the R.I.C.E. protocol? The NIH provides a fact sheet on low back pain. There is strong  evidence that you should not stop moving. You should move gently within a safe range of motion respecting your body’s pain limits.  This movement pumps the muscles pulling healing blood deep into the tissues.  This pumping also mobilizes the lymph which is critical for healing. If you are not sure how much you should move based on your injury, talk to your healthcare practitioner.

What should YOU do?

  • Discuss your options with your healthcare provider. There may be other variables you should consider when deciding how to treat your pain. For example, if you have a condition that decreases your ability to feel, it may not be safe to use either heat or cold.
  • If you are not experiencing an acute injury, the evidence points to heat. But, heat doesn’t mean hot.  Gentle warmth is best.blaze-bonfire-burn-672636
  • Everyone is different. Even though the evidence might point to heat, if you are in pain and ice enables you to decrease your pain enough to move and complete your daily tasks, ice may be the better option for you.  Life keeps on going despite our pain but use it sparingly.  Keep in mind that cold decreases your ability to feel so move with caution after using cold.
  • If your goal is to move or stretch your muscles and fascia, the evidence points to warmth.
  • You can do both. Alternate heat and cold.
  • Remember that both should be used with caution. Don’t put either directly on the skin. Place a layer between the modality and your skin such as a bath towel.
  • The American Chronic Pain Association provides a Resource Guide addresses many options including heat and cold.

 

How to Protect Your Back (and other important body parts) When Gardening

 

woman standing beside purple flowers
Photo by Malcolm Garret on Pexels.com

Gardening is full of risks, especially when you are going from being very sedentary during the winter to all the bending, squatting, lifting and walking on uneven ground yard work and gardening require.

I created a short video to provide several tips for transitioning safely into this wonderful activity that is so good for your whole body and soul.

Find the video at: https://www.youtube.com/watch?v=qG9pvygvrBY or search Gardening Tips to Reduce your Risk Factors on YouTube.

Here is a quick summary.

Gardening with Plumb Line

  • Stretch your feet, calves and hamstrings before you head outside.
  • Practice squatting to prepare your joints. Use a door handle for balance until your legs are ready to support you.
  • Regardless of your body position (standing, bending from the hips, squatting, kneeling, sitting), always maintain a good low back curve.
  • When bending over build a bridge with your hand or elbow to take some strain off your low back. (see photo)
  • Balance your body from front to back from a plumb line that begins at your ankle. Keeping the weight in your heels will help. (see photo)
  • Switch hands frequently when weeding.
  • Wear well fitting gloves with a non-skid surface on the palms to reduce the grip forces required for grasping.
  • Keep your tools in good working order.

Legs Up the Wall: A Simple Pose with Huge Benefits

Legs Up the Wall pose is wonderful for so many reasons. I frequently recommend it to my clients who have low back pain, tight hamstrings, tight calves, leg cramps or foot pain. This pose is also great for calming your nervous system and pairs well with a short meditation.  It is such a simple looking pose but offers the body and mind so many benefits.

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Below are some additional benefits this position offers:

  • Stretches the hamstrings (back of the thighs)
  • Stretches the calves
  • Stretches and retrains the low back curve
    • It stretches all these areas (legs and back) in combination which is important in functional movements such as walking, bending and reaching.
  • Facilitates blood circulation
  • Facilitates lymphatic circulation
  • Relaxes the pelvic floor
  • Stretches the shoulders

But, what if I can’t get on the floor (and back up again)?

I encourage all my clients to practice getting up and down from the floor. Doing Legs Up the Wall Pose is a very purposeful reason to practice this skill.  Getting up and down from the floor uses many muscles and joints in a way we generally don’t during the day (and night). It is a skill we all need, especially as we age.

If you can’t get up and down without assistance, place a chair beside you to help with getting up and down. Take your time and do it mindfully. But, work toward being able to do it without a chair.  You never know when you might need this skill.  If you drop something important and it ends up bouncing a few inches under the couch, you may need to get on the floor.  If you have grandkids who are begging you to play picnic with them, you may need to get on the floor. Hopefully, you never need this skill because you fell, but if you do and there is no one around to help, you will be glad you have this skill. The process of getting down on the floor and up again is a good movement for your body.

Tools You’ll Need

Technically, you don’t need anything to do the pose, but there are a few items that can make your experience more comfortable and help you get the most from the pose.

  • A yoga mat can soften the surface you are laying on and encourage you to stay longer. You must be patient when stretching the back of the legs.
  • A towel can be folded or rolled up to support the low back curve. You should always maintain a healthy low back curve when doing the pose, so you are stretching with the back in a functional position.  If you can’t tolerate the towel, even with just one fold, you are too close to the wall. Work towards a combination of adding folds in the towel to increase the curve and getting your tush closer to the wall.  Be patient.
  • A yoga strap can be placed around the thighs or the calves to keep your legs and feet in line. If you find your feet tend to roll out or in, the strap will keep them pointing in the right direction and allow you to soften into the pose fully.
  • Therapy balls can be an excellent addition to the pose. You can place them under your back or shoulders for a little added release during the pose.
  • Thick socks may be helpful if your heels are tender. The added cushioning may make it more comfortable.
  • A book, music or a podcast can help you be more patient with your pose. Try just breathing for five to ten minutes, but if you’re not there yet and need some entertainment to get the physical benefit from the pose, that is absolutely fine.

You may want to visit my Self-care Products page to find the items you may need.  You’ll find helpful links to the tools. Let’s get started.

Doing Legs Up the Wall Correctly

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  • Start with your hips 10-12 inches (or more as needed) from the wall, so you are not placing too much tension on the back of your legs. Wiggle yourself closer or further from the wall until you feel a mild to moderate tension in the back of your legs. You may feel the tension in your calves, your thighs, your hips, back or all. There is not a right or wrong. You will feel it where you are the tightest first.  The sensation may shift around. You are stretching fascia as well as muscle. 20190226_132330
  • Keep your legs hip-distance apart and your toes pointing forward. If you have trouble keeping your legs and toes in this position, use a strap around your calves. This allows for even deeper relaxation.
  • Place a rolled-up towel under your low back to keep your low back curve from flattening. Start with a small roll and increase it to stretch this area.
  • Once you have the legs and low back in place, breathe deeply using your diaphragm. Be very patient. Continually scan your body from head to toe and soften any part of your body that has tensed up.
  • If you noticed that you are no longer feeling mild tension in the back of your legs, hips or low back, you might be ready to move closer to the wall. Try gently pressing the bottom of your tailbone closer to the floor. If this creates a pulling sensation, you’re ready to move a little closer. If the feeling was intense, just move a little closer, maybe half an inch.  20190226_132059If it wasn’t very intense, you could try moving an inch or more toward the wall. You can do this by placing your feet on the floor and walking your hips toward the wall.

Additional steps to add more benefit.

  • With your arms on the floor and your palms up, begin to slide your arms up to 90 degrees or more. This adds a nice shoulder stretch to your pose.
  • Use deep diaphragmatic breathing to calm your muscles and promote lymph circulation.20190226_132302
  • Make the pose even more beneficial by adding a therapy ball under your upper back. Allowing the ball to sink into your fascia during the pose can relieve tension in this area as well.

Your long-term goal is to be able to easily get down on the floor and do the pose with your bottom against the wall.  This may be in the near future for some of you but pretty far off for others. The short-term goal is to begin.  The benefits are worth the effort.

Thank you to Gessica Stovall, OTS for posing for the photos.

By Amy Mayer OTD, OTR/L, RYT

Are Teens Experiencing More Body Pain and Injuries?

This fall I have seen a surprising number of teenagers in my practice.  I think most people will say this is not surprising with all the phones and video games teens are using.  I agree.  boys-cellphones-children-159395But, let’s dissect this a bit more because teens are NOT going to stop using technology and devices are getting into the hands of younger and younger children all the time.  As a mom, grandma, and occupational therapist I must implore parents to do the best they can to balance tech time with lots of outdoor and indoor free whole-body play.

The teens I worked with last fall all were injured during exercise.  It was awesome that they were exercising.   I’m sure they and everyone around them most likely thought what they were doing was going to keep them healthy and protect them from injury.

Some of the teens were injured during exercise they were doing on their own, and two believed they were injured during training that was part of a school activities.  In two cases the activity was weight lifting, and one was following a DVD program. In all the cases the students said they had some instruction about how to do the exercise safely.  active-adult-athlete-703012When I asked them to describe how to do the tasks safely, it was quite superficial and, in most cases, included how to protect your back.  This is good, but it assumes the exerciser is starting with a body in proper alignment and know how to keep their back safe.

The Nebraska Department of Health Education standard related to the use of technology states, “Students will analyze the influence of family, peers, culture, media, technology and other factors on health behaviors”.  This standard is becoming more and more critical as generations of people including kids, parents, and grandparents are using technology.  Our children are observing us.  This is how they learn how to react to stress, grammar and speech patterns, gait (walking) patterns, gestures, posture, how to spend time and energy, etc.  It is not just about how technology affects health behaviors but how our family and culture is using technology. It is much bigger than what I am going to focus on in this short article.

This health education standard is incredibly important.  To my knowledge, there is no direct description related to how this standard must be implemented in a school’s curriculum.  Use of technology affects health in so many ways including mental, emotional, and physical health.  Just in the category of physical health, it can affect eyesight, attention skills, coordination, posture, body weight, etc. With so much to teach related to health education, it would be easy to miss the details of posture and body alignment.

Kids are using technology with rounded backs, tilted hips, rounded shoulders, and flexed necks. They are sitting for longer and longer periods. They are less likely to spend long periods in activities where they are jumping, climbing and running with recess and gym classes being shortened.  All this creates tighter muscles and fascia.  All this tightness continues to pull their bodies out of alignment.  When the human body is chronically out of alignment, meaning the muscles that surround the joints are either overstretched and tight or shortened and tight, the fascia’s job is to thicken up to protect joints. The fascia is trying to protect us and support the function we are asking our bodies to do most.  The problem comes when we ask our bodies to do something very different such as lifting free weights or doing burpees.

You may have heard your teen (or younger) complain of aches and pains, and you know they aren’t lifting weights or doing burpees. If our bodies are chronically out of alignment and stuck, even simple activities can be problematic such as lifting a heavy trash bag, pulling a box out from under the bed, or catching the dog who got out of the yard. It can even be as simple as reaching for the shampoo in the shower.  We should worry if we hear kids complaining of pain from these simple daily tasks.  We should really pay attention when we know our teens are starting to participate in more demanding exercise type activities.

athlete-exercise-female-163330Typically, if our bodies were in proper alignment, it would be no big deal to grab a couple of 5-pound weights and start pressing them to the ceiling. But, if our shoulders are stuck in a rounded forward position with muscles that are tightened in either a short or elongated position (even just a few millimeters), and we lift those weights, we are asking for trouble.  Our complex shoulder joints are designed for complex movement and need to be moved through their full range of motion regularly to function best.  Regularly doesn’t mean 3 times per week for 20 minutes.  Regularly means daily, several times per day. Instead, the position our neck and shoulders see most is rounded forward grasping a phone or typing on a computer.  This idea applies to our feet, ankles, knees, hips, ribs, neck, elbows, wrists and fingers, too.

We must educate our kids on what proper posture is, and that is it not just standing or sitting up straight.  It starts at the feet and goes to the top of the head with many important details in between. We must take responsibility for our children to help be sure their bodies don’t slowly get stuck in a poor position. We must watch over them, and if we allow lots of sitting time, we demand lots of whole-body movement time.  We must watch to be sure their bodies are not slowly rounding forward at the neck, shoulders, and hips. We are setting them up for injury when they are old enough to decide on their own it is time to move and get fit.  They must understand that body alignment is perhaps the most crucial part of a fitness routine.  They will experience more success and fewer injuries if they pay attention to the details of alignment first.

tomas-salas-81163-unsplashEvery fitness program, regardless of age, should begin with an assessment of your body alignment no matter how young (or old) you are.  If you find details of alignment that need to be corrected, every program should begin with exercises that focus on bringing the body back into alignment.  Once proper alignment is achieved, full-speed ahead.

For details on correct body-alignment visit https://mayerwellness.com/.

Why I Don’t Process Insurance

I have had a very small private practice for many years and never processed insurance. I have also practiced within larger institutions who did process insurance.  Since I have formalized my private practice into a limited liability company, I have waivered back and forth regarding whether I should become a provider and process insurance, or not. I am in my 6th month of full-time practice, and I still do not process insurance.  Despite this, my practice continues to grow.

Occasionally something happens that makes me rethink my stance on processing insurance.  A client might ask about insurance or tell me they’d come more often if I took it.  They might say to me they have passed my name on to someone who could use my skills, but they won’t come because I don’t take insurance.  It may be because they can’t afford it, or merely because they think I should take it because I’m an occupational therapist. I have talked with people that are baffled by this choice, some that are irritated by it, and others that applaud me.

On the topic of not being able to afford “out of pocket” services… I know there are some who think that only the elite can afford to pay out of pocket for the services I offer.  I was a little concerned about this too. However, I have found that it is less about income and more about where people place their value. I don’t use a sliding scale or ask about salary when I intake a new client, but I do ask about the type of work they do to get a feel for how they use their body. Their job may or may not tell me about their financial status. buy-cash-coins-9660 I don’t know about their spouse, if they have one, or their savings account, or if they have a health savings account.  (I do make sure to tell them if they have a health savings account, they can use it since I am an occupational therapist.) With high deductible plans becoming common, more clients are expecting to pay out of pocket. Most of my clients don’t question this arrangement.  It is on my website, and I don’t proceed with my evaluation until it is clear that I don’t process insurance. I don’t want any suprises. I also never pressure clients to return.  It is up to them if they find value in my services and want to continue.  If they do, they decide when and how often. I also volunteer my services to be sure I am helping people who can use my skills but can’t afford them.  I do think it is essential to give back to the community and I am working with a local non-profit to do this regularly.

I continually reflect on how I want to grow my practice and how I want to shape my life.  When you own a business, it becomes your life.  I crave a simple life, and processing insurance is NOT simple. There are many rules to follow and tasks to complete that extend far beyond client care. I want as much of my energy, creativity, time, and problem solving as possible to go into client care.  On the flip side, I could charge more and make more if I took insurance.  In the state of Nebraska, if I accepted Medicare, I could make about 40% more per visit.  If I accepted other commercial insurance products, that number would go up. However, with others, it may go down. Some pay based on the service description (CPT codes) and others pay a flat rate often based on their determination of an average treatment time (usually 30 minutes). I have also compared my hourly rate to other practitioners around the country who have the specialized skills I use in my practice. Some practitioners charge more than triple what I charge.  The practitioners are not just on the coasts where the cost of living is higher — many practice in the Midwest.  I recently had a client who found an MFR practitioner in Oklahoma for her mother.  This practitioner has much less experience and charges double my rate. Ultimately, even though I could make more money, I want do not want any insurance company dictating how I interact with my clients, provide therapy and operate my business.

Recently I had an experience that made me reflect on my decision not to process insurance.  Usually, these experiences push me to reconsider processing insurance. Many times, I have reopened my provider application to Medicare, but something always stops me. This recent experience made me dig in my heels and affirmed why I don’t.  I don’t want to share too many details about what was going on with my client, but we had a great discussion about insurance, evaluation, and documentation.

The bottom line, not processing insurance allows me to practice how I want to practice. It allows me to spend 100% of my time with a client addressing their needs exactly how I think is best (in collaboration with them of course).  The insurance company does not dictate how long each visit lasts and how frequently we meet. It cannot cap how many sessions we can work together. It cannot stop therapy if progress is slow or they deem therapy to be medically unnecessary Many clients begin with several visits, trail off, then come back intermittently as they need help.  Each client’s frequency and duration of visits varies widely.  Again, the client decides rather than the insurance company.

adult-annoyed-anxiety-133021Insurance companies want objective information.  They want proof that a person has pain.  They demand objective reproducible, measurable information to prove a person actually has pain, and proof that the therapy being provided is making progress toward an objective, measurable goal. There is not always a clear measurable deficit that accompanies pain.  Most of my clients can do all their daily tasks.  They go to work every day. They take care of their families.  They are happy and interesting people. They have normal range of motion and functional strength. Many have had imaging tests that do not show a problem.  …and yet they have pain. Sometimes the pain is mild and intermittent and sometimes it is severe and chronic. But, they are still functional.  They must be.  Life won’t allow less.  It is the quality of their experience that brings them to therapy.  My therapist friends might ask, “don’t you use a pain scale?”.  I used to.  It just doesn’t work for many of my clients.

A pain rating is a snapshot in time. There are times when a client walks in, and they tell me they are doing great right now, but they had pain during the weekend when working in their garden or while at work lifting boxes or it wakes them up at night.  The nature of fascial pain is that it does change.  It is not always in the same place or the same intensity.  It can increase and decrease depending on the overall tension in the body.  Tension can change with changes in activities and stress.  Both activities and stress change every moment of every day.  Pain can get a little better, then worse, then better again.  The path to healing is NOT always linear. And, some of my clients say they don’t really have pain.  They describe it as tension or tightness in their bodies. So, the pain scale doesn’t really work in my practice, and I no longer use it.

I also don’t typically take measurements or use assessments of any kind.  I may do some testing to pin down an issue, or take a measurement if a client has a specific concern about loss of stretgth or motion.  I do complete an evaluation with every new client.  I get a full history, and I evaluate their body alignment in great depth. We discuss their activities, work and wellness habits. This process helps me determine if there may be a connection between their experience of pain and their life habits. When it comes to them telling me about their pain, where it is, when it hurts and how bad, I simply believe them. I don’t have to have objective evidence (which often doesn’t exist) to prove they need therapy.  If they are spending their own money to get help, I don’t need proof.  _DSC0766 (2)I don’t waste any time collecting information I don’t need to help them. I spend 100% of my time collecting data that will help me help them.  The information I collect is often subjective, and part of the person’s lived experience and not a standardized assessment. Each follow-up session is 100% problem solving and treatment.  I don’t need to spend time repeating assessments to prove change is happening. I simply ask my clients how they are doing, and we go from there.

Note: I am not trying to state that health insurance for therapy services is not a wonderful benefit. It absolutely is. However, it comes with many requirements that shape both the business and the services offered.  It is far better suited for diagnoses that come with measurable effects and result in clear funcional deficits.  I want to offer something different for my clients who don’t always demonstrate clear measurable impairments or have functional loss.  The common thread in both groups is loss of quality of life.  That is very difficult to measure.

A Well-Aligned Squat is the Best Exercise You Can Do to Get Through the Holidays and into a Healthy New Year: Here’s Why

As we move through the holiday season, we may be super excited about all the wonderful foods that are part of all the different traditions and celebrations occurring this time of year. We may also be cringing just a bit about all the extra calories we’ll be consuming and the additional pounds we may add before year end. Some of us may already be thinking about our new year’s resolution to exercise more. Ugh.

Many American adults make one or more resolutions. Two of the most common are weight loss and exercise. Other resolutions include managing time better, saving more, to stop smoking, spending wisely, more time with family, learning something new, etc. The downside of resolutions is that many fail within just a few weeks of making them. Why? Behavior change is hard. Really hard. We are creatures of habit and familiarity is comfortable, even if it isn’t good for us.

Let’s be more specific and discuss exercise. Why do we fail after starting a new exercise program? There are as many reasons as there are people. Some of the most common are, we try to do too much too quickly, we don’t see results fast enough, or it hurts.

It makes good sense to ease into an exercise program. It is very hard on a body to go from minimal movement to intense bouts of exercise sprinkled in with minimal movement. For example, a person who has a job sitting at a computer most of the day and then sits on a couch for much of the evening leads a very sedentary lifestyle. Even though they may be good at getting up several times a day to take a walk to the break room for coffee and spend part of the evening preparing supper and completing household chores this is still minimal movement. This movement is also very limited in intensity and type of movement. The muscles, circulatory system, joints, etc. are not being challenged. When this person decides to start going to the gym and using the elliptical machine for 45 minutes, three times a week, this is an improvement, but this person still leads a mostly sedentary lifestyle.

Going from the sitting 6 to 8 hours at the office, then jumping on the elliptical is a bit of a shock to the system. A body that is stiff from little movement can be easily injured. Sprinkling in these intense bouts of exercise into a mostly sedentary lifestyle can make success challenging. Less intense activity for shorter periods more frequently is a better way to start an exercise program. Our office worker would likely experience more success by spreading the exercise throughout the day. For instance, they may start the day by getting up early and doing 15 minutes of yoga. Then they might reserve 10 minutes of a lunch break for taking a brisk walk. Finally, they might find 20 minutes in the evening for weight training. This variety of movement and intensity will begin to create a body that is both strong and flexible throughout a wide range of motion of the joints. Only then is a body ready for intense bouts of exercise.

For many people, there is another critical step necessary before engaging in any exercise program, even a gentle program full of variety. This step is essential to the success of any exercise program to prevent pain and injury. A body that is out of alignment will break down eventually. I usually cringe when people compare the human body to a machine, but I’m about to do it. Much like our cars require proper alignment to function, our bodies do too. If a vehicle is out of alignment the tires wear faster and unevenly, belts break, we hear rattling, and it may even become more difficult to steer. When we are out of alignment, our joints wear faster and unevenly, our fascia becomes thick and we hear popping and clicking, some muscles are short and tight, and others are long and weak, our balance can be poor, and movement can feel uncomfortable.

So, what do we do? It is not as simple as just standing up straight. Each of our major joints must be examined to determine if they are in or out of alignment. The first step is knowing what proper alignment is and what it is not. The next step is knowing what to do to bring joints that are out of alignment, into alignment. Unfortunately, this process is not as simple as it is for your car. You can’t pull into the body shop, let the technician make the appropriate adjustments, pay your bill and leave in perfect alignment. It is a little more complicated but still very achievable. We have two hurdles to jump. One, of course, is our body. The second is our brain. Changing both takes time and effort. Our brain is so used to feeling our bodies being in a specific position that even the most out of alignment body can feel very normal.Postures Even when we know what better alignment is, our brain easily settles into what feels the most familiar. This is true even when misalignment may be contributing to the pain we feel. Our brain and our body need repetition and deliberate practice to change.

Before I provide you with the best exercise for reshaping your alignment, I will first cover what proper alignment looks like. You may want to stand in front of a long mirror and play along.

  1. The feet should be positioned directly under the hip bones.
  2. The weight should be felt primarily in the heels of each foot and balanced evenly between the feet.
  3. The middle long bones of feet should point straight forward.
  4. The knees should point straight ahead and hinge in line with feet when bent.
  5. The hips should be level.
  6. The clavicles (collar bones) should be almost parallel to ground.
  7. The sternum (breastbone) should be perpendicular to the ground.
  8. Both arms should hang in line with the body with thumbs forward. The middle finger should be able to feel the seam of the pants.
  9. The eyes should be level.
  10. The chin should be down. From the side view, an imaginary line from the eye to the base of the skull should be parallel with the ground.
  11. From the side view, the ankle joint, knee joint, hip joint, shoulder joint and the ear should fall in a plumb line.
  12. From the side view, the tailbone should tilt away from the body. There should be a low back curve that allows the top of the tailbone to tilt towards the body and the bottom of the tailbone to slope away from the body.

These are some of the major body points you can actively work on to improve your body alignment. Just to be clear, you don’t want to find perfect alignment and stay in it always. Your body should be comfortable in and naturally fall into ideal alignment as much as any other posture.
adult-bare-feet-barefoot-1249546Since you are probably in front of a mirror right now, see if you can identify any of these common issues I see in many of my clients.

  • Feet are positioned wider than the hip bones
  • One or both feet turned out.
  • One or both knees are turned inwards.
  • The tailbone is positioned vertically with a flat low back curve.
  • One or both clavicles are angled.
  • One or both arms hang in front of the legs.
  • The back of the hands face forward.
  • The head is forward from the shoulders.
  • The head is tilted back with the chin up.

So, what is the exercise that can improve your alignment, as well as a host of other great benefits? With a few modifications, the squat. Here’s how:

  • Start by finding your best possible standing alignment from head to toes.
  • Stand with your feet directly below your hips and pointing straight forward. Keep the weight in your heels and balanced evenly between both feet.
  • Engage your thigh muscles as necessary, so your knees also point straightforward as they bend.
  • Find your low back curve.
  • Start the squat by moving your tailbone backward. The motion should feel like you are aiming to sit down in a chair that is just a little too far away (without actually sitting).
  • Your knees should never move forward past your toes. Keep your shins as vertical as possible.
  • Keep your head and chest upright.
  • You can use your arms as needed to maintain your balance at first.
  • Go slow and only go as low as you can comfortably manage your balance and knee alignment on the way down and the way up.
  • Stand all the way up each time aiming for the best possible alignment in your entire body.
  • Make every movement mindfully. Never compromise alignment for speed.

Here are a few more ideas if you are having trouble.

  • Place your hands on a table, counter or back of a chair for balance.
  • Place your hands on your thighs and slide them down your legs as you squat slowly and purposefully. Feel your knees pointing straight forward. Stand in front of a mirror if needed.
  • Start by dipping down just a few inches trying to go a little bit lower each time.
  • Sit down onto a chair and stand back up in proper alignment and without using your hands.

Here is a short video to help you see what a well-alligned squat looks like.

Most people want to know exactly how many they should do each day. My answer is as many as you can. If they still have a questioning look on their face, I say to shoot for 100. The look on their face usually changes to shock or surprise. If you are only squatting down a few inches and coming back up, you can easily do 30 in a couple of minutes. The better you get a keeping your knees in the right place, the faster you can go. The focus should ALWAYS be on alignment and not on depth or speed. Once you have the alignment perfect, go deeper. Once you can go down as far as possible without having to shift the knees forward increase your speed. Then, increase your repetitions.

I always make one more VERY IMPORTANT recommendation. The 100+ squats should be spread out over the entire day. A few here and a few there. The brain and the body learn better with spaced practice. I have clients who do squats while on phone calls, while their coffee is brewing in the morning, while they brush their teeth, before and during walks, and many other creative bits of the day. The key is to sneak them in where you can and while doing something else. Then you don’t have to carve out particular time to work on your alignment.

We can make this exercise even better by working on the shoulder and head alignment at the same time. I recommend you don’t add these until you have the legs perfect. When you’re ready, add the shoulder stretch. Scott SquatWhen you come to the standing part of the squat turn your palms up and move your hands behind you, leading with the thumbs. Gently pull the shoulder blades together keeping the shoulders down away from your ears. Bring your thumbs and fingers as close together as possible behind you. Be sure not to thrust the bottom of your ribs forward. The breastbone should remain perpendicular to the ground. Don’t compromise this alignment trying to reach your hands together. When you move back into the squat, let the arms move into a relaxed position or a position to help you balance always trying to keep the palms facing forward or up. Once you have this perfected, add the head. As you come up to standing, gently tuck the chin and lift the ears straight up while noticing the weight in your heels.

Many people who have a flat back or tucked tailbone experience a pinching sensation when doing the squat exercise. This is part of retraining the low back curve. Never push into this sensation. Instead, think about extending the body up and elongating the space between the tailbone and head as you come up. As you do this explore how far you can go before you feel the pinch. Continually move into the curve as much as you can without the pinch.  Apply this same thinking to any discomfort you feel in your hips or knees.

This exercise will do much more for you then just realign your muscles, fascia, joints and all your other tissues. It retrains your brain as mentioned earlier. The more your brain feels this proper alignment, the more your body will naturally fall into this alignment.
Other great benefits of the squat exercise include:

  • The repeated contraction and relaxation of the muscles act like a sponge, pulling more blood into the capillaries. The more blood you have flowing through your muscles, the healthier they will be.
  • You’ll build muscle. Improving your strength will prepare you for other modes of exercise as well as burn more calories.
  • You will balance the tension of the pelvic floor muscles which are important in urinary health nad function.
  • Your heart and circulatory system will be challenged in a different way than walking. The contraction and relaxation of the muscles move the lymph. Your lymphatic system rids your body of wastes and relies on pressure changes in the body to push the fluids through. There are many lymph nodes in the groin and abdominal area, so squats are ideal for promoting lymph flow.
  • It is excellent for improving balance. Try the exercise without shoes as much as you can to create more flexibility in the feet. Our feet are designed to be flexible and help us know where our body is at all times. This is critical for good balance.

To wrap up…
Do as many squats as you can throughout December, and you’ll be much more prepared to begin any exercise program you want in January!

If you feel like your body has extra challenges and you need help finding your best alignment, contact me.  As an occupational therapist I am familiar with all types of abilities and disabilities.  I can help design a movement program that meets your abilities and provides the just right challenge for you.

Happy squatting!
Amy
Mayer Wellness & Myofascial Release, LLC

Pain Management Self-Care Products: How do I choose? And, do they make good gifts?

One of the goals of Mayer Wellness, LLC is to help people design a life where they can reduce, eliminate and manage their pain to create a satisfying life. So, it is important to me that I teach my clients self-care. As all therapists know, what the client does between appointments is far more critical in making progress than the appointment itself. Receiving bodywork regularly is a wonderful part of a wellness routine. However, good movement habits and regular self-care is a must to keep pain and stiffness at bay.

I know from personal experience that my old shoulder injury will rear its ugly head if I don’t keep up my regular stretching and exercise routine. My regular activities include lots of shoulder movement, but when I’m at the computer more, I know I can’t skimp on my routine or I will pay for it. Most of the time some light stretching and weight bearing through the shoulders with some yoga keeps my shoulder in check. However, when it decides to flare up, I need more. That is when I turn to my self-care tools.

I have always been a lover of gadgets. Kitchen gadgets, yard gadgets, technology, and of course self-care gadgets. There are many tools on the market now. A search on amazon.com for self-care products resulted in over 8000 products. How do you choose?! One option is just to keep purchasing them, trying them out for a while, and see what you feel. This is what I have done over the years. I don’t believe I’ve ever returned an item. Not because they were all effective. Far from it. I didn’t feel right returning something after using it for a couple weeks, which I think is a fair trial period. So, I kept them and let them pile up.

After a couple decades of buying and trying I’ve landed on several self-care products, I can’t live without. I’m sharing this because I’m hoping to save you time, energy and expense. And, help you with your own self-care. 20181024_142634I use many of the products in my workshops and with my clients. I don’t sell any of them in my practice, but I have often been asked. I’ve considered it, but the retail business is entirely different from the therapy business, and I’m just not ready to go there yet.

Becuase I have been asked so many times if I sell the product or where they can be purchased, I created is a page on my website dedicated to the products I use in workshops, with clients, and recommend for self-care.  You can continue reading of just go right to my Recommdended Products page and poke around.

Amazon.com has a wonderful program (Amazon Affiliates) that actually pays me a small (very, very small) portion of any sale from a link to my website. So, full disclosure: If you buy something I recommend after clicking on my site link to amazon.com, I profit. It does support my private practice, so I very much appreciate it!

Another thought before I begin unveiling my favorites is gift giving. Those that know me, know I’m weirdly crazy practical. Many years ago for Christmas, I gave everyone in my family and extended family a TheraCane. If you are not sure what this is, it is a self-care tool shaped like a cane with handles that helps you get at the knots in your back. Everyone was a little confused at first now knowing what it was. After a few lessons, they loved it. It ended up being one of those gifts that kept on giving. So, if you need a present for someone you care about, you are sure to find something on my list. Unfortunately, we all have pain or stiffness now and then so if you are practical like me, then these products make great gifts. And, no, the TheraCane is no longer on my favorites list, but I may pull it out on an infrequent occasion.  Here is a link if you do want to check it out. Thera Cane Massager (Black)

You can choose to keep reading or I show and explain the tools in this video.

I am never without my number one favorite tool, the therapy ball. They literally travel with me everywhere. I have used them in the car, hotel rooms, planes, my office, during meetings. I have lent them out and given them as gifts. They are versatile and get can into tight spots almost anywhere in the body. Therapy balls are the primary tool I use in my workshops. There are many tips and tricks to getting in those areas deep in the hip shoulders you can never quite seem to hit.

The best therapy balls are dense but have some give when you press into them. They also have a “sticky” opposed to a slippery surface, so they do not easily slip away from you when you lean into them. Using balls that are too hard is not safe for many people and can damage tissues. Balls that are too soft such as tennis balls are not as effective and more difficult to use. It is also best to find a set of therapy balls that come in a pair and includes a bag or pouch to be used together or individually. This offers more options in your stretching routine.

The Acupoint ball is my personal favorite and the size and density I use in my Myofascial Stretching Workshop. It is excellent for most people, especially women, as they are slightly smaller than other therapy balls (about 2.5 inches). Acupoint Massage Balls PicA smaller ball easily gets in between muscles to reach deeper into the fascial system.

On my Recommended Products page, I have a link to a slightly larger set of therapy balls, a set of therapy balls of various sizes for targeting smaller areas, and a larger four-inch ball for the abdominal area. Yes, I own them all and use them all. They are all wonderful when used correctly.

You can use the therapy balls alone, but to really increase the effectiveness it is helpful to have a yoga strap and a set of yoga blocks. You can substitute a book for the block and a scarf for the strap, but the right tools make a significant difference.

A yoga strap is an excellent adjunct to your yoga practice or your myofascial stretching routine. Yoga beginners who are just diving into improving their flexibility appreciate the extra reach they get from using a strap. In your myofascial stretching routine, a strap allows you to move your extremities in an unlimited amount of directions to change the angle of your pressure with the therapy balls. While you can use a belt or a scarf, yoga straps come in different lengths and provide more options. My favorite yoga strap, the Therapist Choice Stretch Strap, has elastic loops you can slip your hands through to decrease the amount of grip needed to hold the strap. This allows you to relax your body more as you stretch. The downside of this strap is that it cannot be made into a circle for bound poses in more traditional yoga practices.

You may also choose a traditional yoga D-ring strap. This brand comes in lots of colors and lengths (6, 8 or 10 feet). Why different lengths? The longer your legs or the reach of your arms, the longer your strap should be. A very tall person might want the longest strap length to provide the most options for using the strap. A shorter person may do just fine with a shorter strap. I have an 8-foot strap which serves me well. I’m 5’7″. The D-ring also allows the strap to be made into a circle for binding or securing the body in certain positions.

Yoga blocks are essential for someone just starting yoga. Blocks allow you to ease into poses and support you when you can’t quite reach the floor or need extra space when moving through many poses. Blocks can also dramatically increase the effectiveness of your myofascial stretching practice when using the therapy balls. Yoga blocks come in different sizes and densities. Depending on your intention for use and your experience you may choose different blocks.

If you are purchasing blocks to use with your therapy balls, it is a great idea to have a set with two different sizes of blocks. This provides options with how far you can lift or tilt your body areas to angle into the therapy balls. The link on my Product Recommendation page offers a 3 inch and a 4-inch wide block.

If you are purchasing blocks to support you as you ease into a yoga practice, I recommend a broader 4-inch set of blocks. This width is often more stable and comfortable on your hands as you lean into them. If you want an even greater sense of stability with your blocks, choose a cork option. They are heavier but offer some give when leaning into them. I love my cork blocks. They are pricier, but when I’m doing a lot of sun salutations, they are helpful to provide a little extra room and stability with pulling my legs through from down dog. The brand I recommend offers both foam (in lots of pretty colors) and cork options in a 3 or 4-inch block set at a reasonable price.

One of my most used props in my toolkit is the half-roll. The calf stretch is the hands-down most crucial stretch you can do for keeping your fascial system relaxed and open. While you can use a rolled yoga mat or a book to do the calf stretch, having a half-roll is convenient and can be used for many other stretches or balance exercises. It also looks nice if you want to use it at your standing work-station (which I highly recommend). I keep one at work and one at home. I often use it while in the kitchen prepping supper.

I’m generally not a fan of foam rollers and almost never recommend them to my clients or use them in my workshops. However, many people do use them. If you do roll, I suggest you use a roller with texture. Smooth rollers may press into the tissues and loosen tight areas, but they smash everything else in the process. I recommend you roll to locate tight spots then press and hold to release them. A roller with texture gets in between the tissues and provides points of pressure deeper than a smooth roller can.

The hand-held single ball roller is excellent for when you don’t have time to get down on the floor and use a therapy ball. Using them in the car or at work is excellent. It is also an easy way to help out a loved one when they ask you to rub their shoulders. It feels great, and they make lovely gifts.

When you need to get in a little deeper a roller with two handles can really do the trick. This tool is pricey but by far the best hand-held roller. Great to use when a loved one asks for some TLC.

Many of us have pain and tension in our necks periodically. Getting into those muscles is tricky. Massaging and lengthening them is helpful and feels good. I own and use the following two products when my neck needs some TLC.

The Cranio Cradle gently presses into the muscles at the base of the skull.  It can also be used in the upper and lower back area. It is soft and flexible, but sturdy enough to support the weight of your body. You can also change the angles for your best stretch. It can be used anywhere you can lay down.

20181024_150235This neck hammock is easy to set up and provides a very gentle stretch. It is also suprisingly comfortable with little cushion in the neck and ear areas. You can control the amont of stretch by moving your body further from the connection to the wall/door.  The connectors are sturdy elastic so you feel well supported. Using a hammock can help train your neck to relax. To up the effectiveness while in the hammock, meditate.

While all these tools are great, there is nothing like an expert practitioner to help you find the tight areas and teach you how to use them to their maximum effectiveness. You can also purchase gift certificates for a workshop, a stretching consultation or a one on one myofascial session by contacting me directly.

How You Think About and Refer to Your Body Matters

How you think about your body shapes you.  Our bodies are not inherently weak with a need for protection.  They are inherently strong with a need for movement.

This blog post isn’t about loving yourself in the way you might think, although that is important.  I will not ask you to stand in front of a mirror and repeat how much you love yourself or your body.  But, I am going to ask you to reflect on how you think about your body and movement, and how you refer to your body.

I hear many people, not just my clients, but also friends, relatives, and people I run into at the store talk about how their bodies are failing them or how they need to be careful of their delicate neck, back, etc.  They reference their bad leg or their bad shoulder.  They refer to their bodies as weak, failing, old, bad, injured, frail, broken, fragile, hurt, delicate, deteriorating, etc. They refer to the damaged or painful area as “my bad leg” or “the bad side of my neck.”  It isn’t really their fault.  The media uses this language, but the biggest culprit is the retail system.  Skillful marketing tells us to protect our fragile necks with this new pillow, our aching back with this mattress, or buy these shoe inserts to protect your deteriorating feet. Our healthcare system even uses this language, but it is slowly shifting to person first language. Person first language shifts a statement about a person to place the person first and the issue second and removes labels such as victim.  Rather than stroke victim, we say a person who had a stroke.  A person shouldn’t be defined by or labeled as their illness, injury or disability. We shouldn’t define ourselves or our body parts by our illness, injury disability or pain.

I will make gentle suggestions that they try to be kinder to themselves.  It is ok to say, “the arm that hurts,” but it would be even better to refer to it as my left arm or my right knee. I might even get really over the top with some clients and encourage them to use language such as “the area that needs more love today.”  Words matter.  We should be as gentle and patient with ourselves as we would be with a small child.  On the other hand, we should also have high yet realistic expectations of ourselves and our bodies.  We should expect them to function well if we are treating them well.

I am asked very frequently about the best pillow to protect their fragile neck, the best mattress to protect their bad back or the best shoes to protect their injured feet. My response is never a product.  My clients are rarely prepared for the long-winded answer they receive. I usually begin with the statement that your (insert body part here which may be the neck, back, feet, etc.) should be flexible and strong.  If it were, you wouldn’t need to protect it with (insert product here which may be a pillow, mattress or shoe insert). You may want the (insert product) now, but if you work on increasing the strength and flexibility of your (insert body part), you won’t want or need it.

Our bodies do a heck of a lot for us.  We need to refer to our bodies kindly and feed them with not just kind words and thoughts but also proper nutrition and hydration. We also need to feed our bodies a variety of movement.

Our bodies are meant to move.  Our bodies are designed for an amazing amount of motion.  Our shoulders, hips, knees, neck, etc. can move through ranges of motion that support all sorts of activity.  We are made to be able to reach above our head by extending our arms and lifting up on our toes.  We can squat to the ground by bending our feet, ankles, knees, and hips.  We can twist our spine in diagonal patterns to reach across our bodies.

However, for most of us, this tremendous range goes unused for hours, days, weeks or even months.  But, we fully expect that when we do decide we need to reach way over our heads for the rarely used serving bowl, or stoop down and look under the couch for the dog toy everything will work as expected. Unfortunately, when we do need to move into these extremes our bodies protest, and something often goes awry.

Keep reading because I am not going to ask you to add a regular exercise program of CrossFit or gymnastics to start moving and strengthening all your joints. But, I am going to suggest that you become more aware of how you are moving (or NOT moving) your body each day. I’m also going to suggest that you have realistic expectations of your body.

Take a few moments and think about the last time you reached over your head.  Can you identify at least one instance of reaching high enough you had to lift your hands over your head in the past 24 hours?  The past week? Recent modern history? 20180929_184037Just kidding.  This may include placing your coffee on the roof of your car while you opened the door and tossed in your handbag or reaching for your heavy sweater on the top shelf of the closet since the weather has turned chilly.  Or, maybe it was several times in the yoga class you attended twice last month.  In any case, for many of us, it is not a regular part of our day.  So, the fantastic mobility of our shoulders goes unused and begins to take on the shape of what we are doing most of the time.  How many times did you reach out in front of you to type on a computer or check your phone?  How many times did you reach forward to prepare food or steer your car?  This has become the predominant motion of our shoulders.  As a result, they become stuck in this position. The shoulder blades spread across and up the back and the humerus, or upper arm bones, rotate forward. When stuck in this position, the mechanics of this joint are completely thrown off.  If you look in the mirror and see one or both arms hanging in front of your hips and you see mostly the back of your hands, your shoulder joint is probably stuck in this unnatural position.  The fascia thickens to support the joint in this position and support the activities you do most of the time.  But, when you need to reach the sweater on the top shelf, you feel the pinch and the tweak in the joint.

This same story can be told about the hips, the feet, the spine or the neck.  Our typical day to day movements are minimal, but our expectations of these muscles and joints are high when we need them.  I’m not just speaking to people with the so-called sedentary lifestyle.  Many people in our culture with the 8 to 5 desk jockey jobs do go to the gym and get in the recommended 3-4 times per week, 30 minutes of moderate exercise. But, what type of exercise?  Much of gym-based exercise is very linear, repetitive and limited in range of motion: treadmill, elliptical, bicycle, stair climber, rower. These machines keep our bodies moving in a limited range, not even close to the variety we have available to us and occasionally need to use.

So, what can you do?  Reflect on your daily ranges of motion.  When are you reaching?  When can you squat? Can you set up your life, so you ask your body to make these motions daily or even multiple times per day?  Here are some simple ideas.

20180930_135605Place your coffee cups and towels on a high shelf.  Then you’ll have to reach above your head at least twice each morning.  Put the toothpaste and your pajamas in a lower drawer.  Then you will need to squat at least twice each evening.  Think about how you can integrate a twist into your day.  Can you reach across your body to reach for the soap in the shower every day?  Maybe use your left hand to adjust the rearview mirror before you back out of the garage.  Notice your patterns and mix it up.  Ask more of your body but keep it simple and part of daily life. 20180929_183928

I have a chin up bar in the doorway between my kitchen and dining room.  While I am pretty far from being able to do a chin up, I stretch or hang on the bar several times a day. I use my arms a lot during the day doing sometimes intense pushes and pulls.  It is great for me, but I also need to move the joint in other ranges as well. The bar keeps my shoulders limber and strong in all directions.

If you are a person who has the opportunity to move all day as part of your job, you are fortunate.  This movement will keep you healthy.  My only caution is that you be sure you are moving in proper alignment and using your body in the manner in which it was designed.  If you move a lot but still have aches and pains, check your alignment. Small changes can make a huge difference. If you are the person who sits during most of the workday, can you organize your space for more reaching and squatting throughout the day? Small changes can make a big difference.

Again. Our bodies are not inherently weak with a need for protection.  They are inherently strong with a need for movement.

Side note: As an occupational therapist, I understand there are many people who do have illnesses or injuries that have left them disabled and make the suggestions I have in this blog entirely more difficult.  My basic suggestion stands that we should all, regardless of our ability or disability challenge ourselves daily to maintain as much motion and health as we have available to us. This suggestions also extends into mental challenges, but that is another blog. Namaste.

 

Break the cycle. Redesign life.  What does it mean?

Maybe you have noticed this tagline on my website. Perhaps not. I thought long and hard about a motto, slogan or catchphrase for my business and this is the result. I did not put it through a rigorous focus group evaluation process, so I’m not sure if the public understands what I mean. Hence, my next blog post.

What does it mean?

Break the cycle. This portion of the phrase is referring to the pain cycle. Over the past 27 years, I have seen many clients and completed countless ergonomic evaluations.

I was almost always called in to do an ergonomic evaluation because someone was experiencing pain. Unfortunately, it was quite rare that I was asked to complete an assessment to prevent a problem, but that is the way our healthcare system works. As I would talk with the person and evaluate how they use their equipment, I could get a clear sense of how much their work equipment and work habits have contributed to the pain they are experiencing. I could also get a pretty good feel for how willing they were to change their work habits. All this information, combined with years of experience helped me make a recommendation on whether they should seek out additional therapy or not.

For many people, a few tweaks of their workstation set-up and some changes in their posture, they are good to go. Their pain should settle down quickly. These are the folks that notice a pattern between their work and their pain and aren’t afraid to speak up. They notice they hurt while working, and they feel better over the weekend or while on vacation. They also notice this pattern early in the process and don’t just wait to see if it goes away. It might be their neck, back or hands that hurt. It doesn’t matter much where the pain is located. These people probably don’t need any therapeutic intervention such as occupational or physical therapy. Improved work habits will settle things down.neck pain

The next group is similar, but perhaps they need more changes to their workstation or work habits. They have also let things go longer. This may be because they didn’t want to make a fuss at work or they are just too busy to make the time for an evaluation. They are generally very fast paced folks who are a little more ingrained in their work habits. These folks will likely struggle a bit more to make the necessary habit changes which will, in turn, take more time for the pain to subside. I will often give them a little more support by offering some stretches they can do to help them to break the pain cycle.

Then there are those folks that have been experiencing pain for many months or even years. They may have also seen their physician and been prescribed pain medications or a splint. Their work habits may not have even been on their radar screen as a cause of the pain. Or, maybe it did, but they didn’t know they had the option to change. These folks need more help and support breaking the cycle. In addition to recommending changes to their habit and workstation, I also suggest they seek out therapy. The pain they are experiencing will probably not go away with changes in the work they do, at least not for a long time. Breaking the cycle takes more. Seeking out help from an occupational or physical therapist will help break the cycle and support hem through making changes at work.

I actually see all four categories of people in my practice now. People who are seeking myofascial release to prevent pain and primarily want to be sure their bodies are functioning optimally do occassionally find their way to Mayer Wellness, LLC. These folks are rare, but there is a shift happening. More people are thinking preventatively. It does take time, energy and resources but it is possible to design your life to focus on prevention.

The majority of my clients fall into the other categories. They are experiencing pain somewhere in their body and want help breaking the cycle. I may be their first stop in this process, or I may be one more therapy in a long line of traditional treatments, alternative medicines, and medications. There are so many people with pain and almost as many options for managing it. Most of the people that end up in my office are seeking not just to break the pain cycle but also figure out why the pain is there in the first place.

Although I hate to admit it, my skills are limited (tongue in cheek). My skills and my scope of practice are certainly limited. I can’t diagnose medical conditions. What I can do is help people work backwards through old injuries and surgeries, evaluate their posture and body alignment, evaluate their holding and body tensing patterns, evaluate their habits of movement during work, leisure and exercise, evaluate their stress and how they manage it, and finally evaluate the tension in their muscular and fascial system. Through this process, we connect the dots and create a hypothesis about where the pain may stem from. From there we begin to redesign their life.

The redesign process may be limited to reducing the tension in their tissues through myofascial release (MFR) techniques. For others, the redesign process may mean changing postural habits. Others may need a lifestyle make-over adding new methods for stretching their bodies or managing stress. For one client it was as simple as changing the way she sat on the couch with her family in the evening to watch movies. This simple redesign and a few MFR sessions broke her cycle of back pain and had her back on track.

Many people don’t know they have control and options beyond medication to manage and even eliminate their pain. And, these people aren’t unaware because they aren’t intelligent. While working at Creighton University and providing ergonomic evaluations, I helped heads of departments, physicians, attorneys and even exercise science faculty sort out their ergonomics and get rid of their pain. These folks most certainly have plenty of smarts. What they don’t have is my skill set. They have their own area of expertise. The attorney I helped undoubtedly wouldn’t expect me to be able to represent myself in court (should the need arise). I call on her to help me with that aspect of life.

Sometimes my clients, past and present, feel “dumb” that they didn’t recognize their poor posture or a movement habit I point out. I remind them of their own area of expertise, and they aren’t expected to know it all. They have me. And, when the time comes that I need something in their area of experise, I may call on them. In fact, I have. I have served technology professionals, physicians, nurses, physician’s assistants, architects, engineers, massage therapists, teachers, spiritual directors, teachers, moms, grandmas, plumbers, receptionists, delivery drivers, coders, executives, business owners, marketing professionals, caregivers, students, office managers, therapists, security professionals, athletes, stylists, dog walkers, optometrists, and many more.

Each person brings a perspective that consists only partially of their professional knowledge. Every individual has a set of beliefs about what it means to be healthy and well and what will help them achieve it. I learn so much from hearing their ideas and perspectives on wellness. Most are very open to my recommendations and whole-heartedly implement them to the best of their ability. The clients I am blessed to work with are very enthusiastic about simple lifestyle redesign ideas that will empower them to take control over their pain. It is exciting when they report back… wow, I feel better.

So my goal and the goal of Mayer Wellness, LLC is to help people…

Break the cycle.

And…

Redesign life.