When rest in not an option but a requirement

Spoiler alert!! This post may be a bit of the show Pity Party: Table for One...

I have been struggling with a nasty cold this week. It started late Tuesday night with a little stuffy nose, and blew up on Wednesday and Thursday to full on can't breathe or swallow without feeling like I was drowning. I actually put myself to bed at 5 pm on Wednesday and didn't get up until Friday morning at 6 am. A full 37 hours in bed.  Although I felt significantly better on Friday, and was able to get through my day at work, I bailed on my weekend plans to help my dad and spend some time at my Camp. This is completely unheard of in my world.

I am always on the go. I rarely take a weekend off to hang around. There is always something to do. I feel like I am wasting precious time if I just hang out and chill on the couch. I don't like to sit still and when I have any sort of free time, I schedule it with something. I am not a work-a-holic by any means. I totally enjoy my play time. Probably more than most 50 year old's should. Unfortunately. not taking down time eventually catches up with you.

Rest and recovery is just as important as work and play when it comes to a healthy life. Taking the time regularly to do nothing, to stop running all over and just allowing yourself to chill will help you to stave off muscular aches and general malaise. It helps to rejuvenate your resolve to be successful and be able to still play like a kid.

I was able to clean off my kitchen table, do my dishes and bag up old magazines. I'm now exhausted and my cough is back. Seems some rest is still needed to get me back to level playing ground. Perhaps more regularly scheduled rest time would have allowed me to avoid this nasty cold and the required and forced quiet time.

I am anxious to get onto my list of things to do. I feel bad that I missed a visit with my dad and some play time at Camp, but until I feel better, rest has to be at the top of the list. When I do feel better, I think maybe it needs to be scheduled into the list on a regular basis. I mean, this munchkin makes it look easy. Maybe we can all take a cue from her and embrace the relaxation on occasion.

"Is it a miracle or the human spirit that raises us beyond our expectations."

"I knew I had to forgive in that moment because if I carry around that resentment, it would eat me alive."

In a world full of anger and hate, this story on Sunday TODAY with Willie Geist was a breath of fresh air. It's a great example of how letting go of anger and truly forgiving can help your body to heal faster. As the doctor in the story said, " I think forgiving was the key to his recovery."

What do you need to let go of today to help you move and live a better life?

Pain management

If you browse thru any magazine or even Facebook ads these days you will inevitably find an article about the over prescription of opioid medications for pain management. I have worked with people who have used them for years and still complain of unmanageable pain.

I frequently get questions regarding tension headaches. Chronic headaches can be really debilitating and stop us from really living life. These headaches may be common in relation to neck pain and stiffness, but exercise has been shown to relieve pain and stiffness Doing some gentle range of motion, learning to exhale and get your shoulders to relax can help to decrease the tension and pain.

Recent pain science is showing that education and mobility may actually be more effective at managing pain than medication alone. In this Ted Talk, Lorimer Mosely explains more clearly about why we feel pain. 

Did you know:

• Pain is a normal signal from the brain that lets us know something is wrong, but that once tissues heal (6-8 weeks) that signal should go away.
• How your brain processes pain effects how you experience that pain.
• Past experiences can influence how our brain perceives pain.
• Your body was designed to move in 3 planes of motion and the more we limit that motion, the more limited we get so when we try to move outside that motion our brain may perceive a threat and therefore signal pain and stop motion.
• People who believe they will get better actually have less chronic pain.

This stands to reason that if we can interrupt the signal from the brain we may be able to manage our pain a bit easier and therefore not need as much pain medication. 

Here are some ways to quiet your nervous system down: 

• Aerobic exercise...ideally 30 minutes per day but this can be broken into 10 minute chunks and can include anything that gets your heart rate elevated.
• Sleeping at least 6 hours/night. Yes, if pain limits sleep it can actually make the pain worse. Finding positions of comfort can help this.
• Manual therapy and progressive exercise 
• Yoga and meditation
• Positive Affirmations
• Balancing your activities and taking one task at a time, such as with doing laundry. If you have 3 loads of laundry to do, you may take 3 days to do it vs trying to get it all done at once.This may take you longer over all, but when our brain feels less threatened by laundry the signal will then go down
• Be patient with yourself and respect the healing process.
• Reconnect with your normal movement patterns and allow yourself to move through a variety of motions. Over time, your brain will recognize that motion is no longer a threat

As a physical therapist, I do not prescribe medication. My goal is to help you learn to manage your pain through movement, manual techniques and education. Pain happens. It's normal. If you are experiencing pain trying PT may help. If your MD recommends medication, also talk with them about the other options listed as well as working with a physical therapist or other manual therapy provider to your liking. Find a way to quiet your brain and lessen your pain and then get off that medication and get on with the fun in your life.

Are you ok? You look stiff today

Did you ever notice that when Tom Brady is on fire the announcers say "Wow! He is so amazing still. Can you believe he's 40?" and when he isn't connecting (and his star receiver's are out) they say "Well, you know, he needs to be cautious because ..he IS 40".

I had a quick visit to my MD office today for a Ppd check. The first thing the administrative assistant asked me was “Are you okay, Laura? You look stiff today.” My reply was "actually I am kinda stiff today.. and yes I’m okay."

I then saw a patient who was concerned over ongoing morning stiffness one year after a total knee replacement. After reassessing the ROM, strength, swelling and recent change in activity we concluded that this was normal stiffness. The question after that was do I have to do mobility work forever?

As I get older I notice that my neck, back,shoulders and hips all have their moments of stiffness. This is particularly worse in the morning. If I’m consistent with doing my mobility work I can move easier and am less stiff by the time I make the coffee. If I'm not, I walk into the doctor's office 2 hours later looking stiff.

In the case of my patient, doing a routine of easy movement helps make the first steps to the bathroom more bearable.

Sadly, being sore and stiff in the morning is normal as we get older. It is part of the normal aging process for our vertebral discs to lose height. It is normal for the water in those discs to be reabsorbed through the night and to be disbursed through the body as we move throughout the day. It is normal for joints to be stiff from being in one position for a long period, especially if we've had surgery.

I am not one who believes that our every day activities need to stop as we age. I think issues occur because we stop moving for a period and things stiffen up. Then we decide we want to pick up where we left off, we jump back to where we were and we get hurt.

I have found that doing some easy moving of the major joints in all 3 planes of motion really helps to decrease the morning stiffness quicker. If I stretch after I do some heavy work, I'm not quite as sore later. If I build up my strength gradually, and keep at it consistently, I have less tweaks through the day.

We DO have to keep up our exercises, in addition to the yard work/vacuuming/power washing/any fun sports activity that isn't housework...etc. When we take a break for a while, we need to start over and progress gradually. We DO have to put the work in to be able to continue to do the fun (and not so fun housework) in order to keep doing.

As for Tom Brady...sometimes he is on, sometimes he is not. I know for sure he is consistent with his work ethic.  I don't think being 40 is slowing him down one bit. 

So you want to lift that heavy object...

We recently cut down a 50 year old tree at my camp. We all worked like busy little worker bees to get the debris cleaned up. The guys were able to chunk the big old trunk into manageable pieces but they are still quite heavy

I hear all the time people saying they "can't lift" something because they are afraid they will hurt their back. I also read and hear people give advice about lifting with their legs and not their back. While this is true, when I see people demonstrate how they lift, the mechanics are not quite right.

We are supposed to move. Our backs are supposed to bend. If we are strong enough we should be able to lift a heavy object without injuring ourselves...and yes, your back will bend a little.

Actually, it's more of a hip hinge than a 'back bend' but I tend to see people try to squat in fear of their back moving. Don't get me wrong, I think the squat pattern is an important one in life too and working to re-obtain the full ass to grass mobility we had as a toddler is great.  However, it isn't the most efficient way, from a basic physics standpoint, to lift something heavy. (Check out this Girls Gone Strong blog for ways to improve your squat).

Learning to hinge your hips, such as in a dead lifting pattern, can help you to maintain form and protect your back while lifting something heavy. In this video, Dr. Kathy Dooley demonstrates how to do a hip hinge and a way to practice it without weight. (PS..that kettle bell is 48 kg...or about 106 lbs.)

When in doubt, if you haven't been training, you haven't moved this way in a LONG time, and you can't push the object by yourself, grab a friend and get some help. Moving heavy stuff is always more fun when you have a workout partner 😃

The Law of Attraction

I have had a rough couple of weeks of feeling sad, lonely, anxious, scared and afraid. These are all very normal emotions. I was reminded today byThe Med School Insiders in the review of the book "The Subtle Art of Not Giving a F*ck" by Mark Manson (which you can find here on Amazon), that if we don't embrace these negative feelings we are likely to have a hard time embracing the good. Life cannot be ALL good ALL the time.

I've also been studying the Law of Attraction (which it the basis for the movie,and book, The Secret ) lately and working really hard on my positive affirmations. Unfortunately, embracing the negative emotions goes against everything about this law and these last few weeks have felt like a spiral into negative outcomes.

The other downside of constant negative emotion is the toll it has on your body. Your cortisol levels can go up and can exacerbate the fight or flight response. Over time this could lead to pain and then a feedback loop to further negative emotions.

What I've been learning about this Law is that if we want to break out of a negative pattern, we need to remember the pleasurable feelings and express gratitude for what we already do have. I start and end every day now thanking God for all that I have. It really does help to make the angst be less. We can also change our state by surrounding ourselves with people who we want to be like and who encourage us. We can put on some happy music and dance our way out. We can do some cardio exercise (I really don't think it matters if it's steady state or HIIT in this case). We can take a walk in nature and appreciate our surroundings.

Today I had a study date with some amazing women who think movement like I do. They reminded me of why I am passionate about what I do. They reminded me of the positive I have already in my life and all that is yet to come. On my way home, I didn't listen to my usual podcast, but I put on some music that makes me want to dance. I came home and did what I love to do: dance in my kitchen, and create a healthy meal full of protein, veges and a little pasta (I mean, who doesn't need some comfort food every now and then?) And I felt the negative slip away. The feeling that I will succeed and continue to celebrate all that I have, returned.

I know I will continue to have my ups and downs. I also know that both are transient. To have one we must have the other. It's only when we get stuck in the negative that things spiral out of control. Take the time to allow yourself to feel the sh*t and then believe in yourself again and find your way back to peace.

Kettlebell Swinging safely and effectively

I frequently hear people questioning the benefits vs risks of doing kettle bell swings. While I am not yet a certified kettlebell instructor, as a physical therapist I am most definitely a swing enthusiast. When done correctly it is a great addition to your core and hip workouts. I myself use it for conditioning work. And although I don't consider it a primary shoulder exercise, it can help to promote scapula stability.

To learn how to safely swing I recommend working with a certified instructor. You can find one near you here.  Having a coach to teach the mechanics is important to help learn the proper technique. Even though I'm not actively working out or at the Worcester Kettlebell Club, I still send Coach Evan Marcantonio videos to critique and for advice on progressions. Each time I learn something new.

Prerequisites that I look for to start to swing are good hip mobility and postural control. This video demonstrates some progressions which will help you learn how to swing correctly and get the most out of your workout with least chance of injury.

Using video can also help you to see where there are some corrections needed. For instance, at the top of the swing I am hyper-extending my back vs. completing the motion with hip extension and solid core. Brett Jones demonstrates a great drill that I will start to incorporate as well.

As you can see, the swing is a very safe and effective total body exercise when done correctly.