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|Posted on July 19, 2021 at 6:05 PM||comments (74)|
I keep coming up against this response from clients.....Doing nothing. It is not unusual to have a client come in for treatment after a weekend and report increased soreness. Seeking to find triggers for this increase in symptoms, I ask, "so what did you do yesterday?" Sometimes, " I helped a friend move" or "I played pickle ball"....but more often..."Nothing" is the response.
Hmmm. "What does "nothing" look like?"-is my response.
"Oh, well I was just...
watching TV on the couch...
or playing games on the phone....
or on a zoom calls....
or reading in bed..."
any combination of the above and more.
Then I say..."And what does THAT look like?" Then we get to it.
Couches are hard to rest in well supported-most are too big. They just look comfy. Often the feet do not touch or we slouch back into the cushions. Time on a couch should be limited.
Phone use typically involves leaning over to play games for extended periods of time. This loads the back and neck and places prolonged work on the muscles that support the spine. Postures must be changed frequently and leaning over the device avoided.
Zoom calls are seated and often posture is adapted to the computer and and to get our best camera angle-not always the most sustainable posture.
Reading in bed typically involves a flexed, semi-reclined posture that is compressive and so very hard on the neck and back.
No big trauma like a fall or a twist has occurred but trauma from prolonged, poor positioning.
These activities are all static. When we doing nothing-the body is still working to maintain posture and promote functions like breathing, bloodflow, digestion to name just few.
Even with the best posture, it is important to change position every 20-30 minutes. This practice allows improved blood flow to areas of pressure, increased joint nutrition as the synovial fluid is encouraged by movement to shift around in the joints bathing the surfaces, and reduced muscle load by change of position.
In addition, since these "doing nothing" activities are relaxed activities, good alignment may be less of a priority. Depending on the activity and on the body, an individual may get a pang of warning...nor not. The strain and its response may not be noted until later.
My best advice is to be aware and proactive. Set up your "doing nothing" time for succes.
Seek to provide a place where you can achieve good alignment and support.
Just as important-get up often-even as much as every 20-30 minutes.
|Posted on January 29, 2018 at 5:47 PM||comments (406)|
It has been way too long since my first and only blog. I apologize. The daily activity of treating and billing and regular life hinders my blogging. I sit down with a drained brain and my blog ideas are blah. But I am going to try to just share observations that I hope may help people gain insight about PT, moving and caring for their bodies.
Each individual brings to the session their physical make up, their perceptions of what to expect and their own history. Some clients come to therapy wanting a quick fix. Maybe they have seen another therapist who has taken away the pain in one visit or maybe they have had an injection that worked instantaneously. This sets the stage for a desire for "fix it now". But if it is a return issue-should not the source of the problem be addressed? Sitting too long...over-exercising......or bending over too much...or dare I say hunching over the cellphone too much-to name a few examples.
It is so important to change posturing, movement patterns and habits. The body has its limits. Change allows for reduced strain on whatever tissue is taking the brunt of the problematic habit. Change may mean stopping a certain behavior or changing how it is done or maybe just taking more breaks. Change may require specific exercises to equip the individual. It is a process that is different for each client.
As a PT, I can only do so much with my hands and techniques-the rest is up to the client no matter what his/her physical make-up, perceptions or history. Each client gets to the place of change and improvement at a different pace.
If you are in therapy and feeling discouraged-ask questions, do your home program and pay attention to what your body is telling you-keep persisting. It is possible to change-Take heart and stay the course!
|Posted on August 1, 2013 at 4:44 PM||comments (405)|
The butt or shall I say the gluteals. A woman comes into the office with back pain. She bends over from her waist to get her insurance cards out of her purse which she has placed on the floor. Hmmm....that kind of bending done a lot will cause fatigue and eventually back pain.
On observation, the woman's buttocks is very flat -she does not seem to have much bulk to the gluteal muscles that make up the buttocks. She is likely bending the way she is-from her waist-because she does not have a great deal of strength. Nor is she likely aware of her gluteal muscles and how they can take the stress off of her lower back.
After an evaluation, our lesson begins, we begin a conversation about good body-mechanics and the need to use her legs for bending. All of her legs that is-yes, her knees as we are all told to "bend with your knees" but even more importantly she will need to be taught how to bend with her hips also. Bending and sticking the seat back while engaging the gluteals AND bending the knees. Not always the most ladylike way to bend but better for her back. If her back can tolerate it, we will perform some squats with this gluteal emphasis and give her these squats as one of her exercises to practice at home. She will need to practice and get use to the new way of moving so that she can transfer it over into her everyday movement patterns. By changing how she bends down, she may significantly reduce the stain on her lower back and her pain.
Some days, this pattern repeats with each client-whether for back pain or knee pain or hip pain or standing balance, training the butt-the gluteals-can have a significant impact on function and pain reduction.