The Self-Care Guide to Surgery: Mindful Movement for the New Year

Mindful Movement, Where You Are

Most of us make those New Year’s resolutions: I’ll lose fifteen pounds, I’ll work out regularly, I’ll settle the old score, I’ll make more money, etc., etc. Too many of us don’t seem to get those resolutions to resolve into something new and better. In my head, one of the reasons for that is we set goals too ambitious, instead of setting smaller and more achievable ones. To that end, I’d like you to think about your expenditure of energy in terms of movement during the day. It seems to me that most of us don’t move nearly enough, and that when we finally do move we effort a bit too much in our desire to fix everything quickly. Neither of these ‘fixes’ will fix anything, and in fact, just may make things worse.

Let’s start with that second idea first: it’s a new year, and we’re going to trim off the fifteen holiday (or before) pounds, then we’re going to get the new wardrobe, then the new job, etc., etc. We set very lofty goals, then stop fairly quickly when we feel defeated by the goals we’ve set, and we begin to feel like a failure. How to change this? It’s simple, really. We merely set smaller and more achievable goals instead of lofty grand ones. Instead of forcing ourselves to lose fifteen pounds, why not focus on eating a bit healthier with more of the good foods – vegetables, fruits, fiber and more water in the diet? Without going kamikaze and feeling the need to monitor everything that goes through the lips, we can simply start being a bit mindful of the things we ingest, and mindfully and gratefully absorbing them and their nutrients. Continue reading

Use it or lose it! A bodyworker’s guide to self-rehabilitation after injury – by Noah Karrasch

Picture of Noah KarraschMany years ago when I first met Susan Findlay, owner/director at NLSSM school of massage in London, she told me she would like me to offer a course on knees.  I responded that I didn’t feel I did good work with knees, but focused on getting better hips and ankles; then knees seemed to get better on their own.  Her response:  “If you’re not comfortable with knees, that’s the course you need to teach!”  At the time I wasn’t pleased with her response but I’ve come to see the value in it since.

I’ve recently given myself an opportunity to test my theories about bodywork much more strongly than I might have liked.  A few days ago I severely injured my right knee… working for several hours on a friend’s cold concrete floor, with lots of kneeling and twisting.  After several hours with just the right twist, I heard a loud ‘pop’ and felt that my knee was very unhappy.  As far as I could self-diagnose, it seemed I’d either damaged my lateral collateral ligament or torn the lateral aspect of the meniscus.  Either way I couldn’t put weight into the knee, couldn’t bend or flex, and couldn’t get comfortable for quite some time.

Anyway, what an amazing opportunity to self-rehabilitate!  And I’m pleased to say it’s working:  48 hours after the initial shock, I was back to about 75% function in that knee, and continuing to feel stronger by the hour.  I think the ‘formula’ that’s working for me gives us all something to think about.  While I can now negotiate lifting myself up a step through that leg and knee, I can’t yet sink through the knee without a great deal of pain, and I don’t see the value of too much pain.

So what’s working?  Why am I getting better, without MRI’s and surgery?  Can we all get better with a bit of self care?  I think we can, but we’ve got to do a bit of work instead of expecting the work to happen to us.

1. I’ve not pushed myself too fast or too far… there’s very little twisting involved, and precious little bending and flexing yet.  On day three there’s finally a bit of flexing and extending the foot on a stair step.  Only gradually should we trust ourselves to give a bit of flexion while still doing most of the lifting work through your arms, if your toes, knees or hips are complaining.  You’ll have a pretty good sense of what’s too much and what’s just right in terms of the paces to put yourself through.  The big toe pushups from my book Meet Your Body remain the single most important piece of work I can recommend to rehabilitate one’s entire deep line, but especially the knee.


Meet Your Body by Noah Karrasch – featuring the big toe push up and other exercises for releasing trauma in the body

2. I’m always interested in breathing, or at least in staying relaxed while I work to rehabilitate, and I invite you to look at the same.  Current Heart Rate Variability studies suggest that a great deal of basic health is predicated on remembering to breathe in and out, regularly, approximately 6 times per minute.  This causes a greater HRV which facilitates heart function, strengthens the immune system and reduces inflammation among other wonderful features. When we push too far and too fast, we stop breathing.  It’s that simple.

3. I tend to want to look for longer lines of transmission in my body.  We’ll rehab ourselves faster if we’re as interested in what’s happening in that big toe on that same side foot, and how it relates to what’s going on in our low back, as we are in what the knee itself has to say.  While stretching the big toe hinge by holding onto a table and lifting into the toes, can you also keep your low back back, while stretching your head to the opposite side and looking behind you?  Can you see the value of trying to find lines of holding and getting breath through them to help find that most important holding spot and release and resolve it?

4. Finally, I do subscribe to the ‘use it or lose it’ school of thought.  I’ve seen too many frozen shoulders or creaky knees where patrons told me that it hurt if they moved, so they’d simply quit moving.  Well, how does one expect to get better if one hides from the challenge?  While I can understand the thought process, I can’t condone it.  We must move through pain and fear to get to the other side!  For too many of us too much of what we call debilitating pain is simply fear-based lack of movement into and through a problem spot.  Consider that movement can be seen as oiling rusted hinges throughout the body; they won’t start moving freely right away!  It will take a bit of time and energy to make them work smoothly again.

And so far, this experience of rehabbing a very scary knee injury is bearing me out on these thoughts.  I believe my experience could be duplicated by most of us…those who are serious about getting better, first need to decide to get themselves better.  It seems we’ve become a generation of people who expect others to fix us and take responsibility for us.  A surgery might be easier, but more likely a 4—6 week recovery from a surgery just isn’t as efficient as a 2—3 week recovery from the work one does for oneself… can more of us begin to think this way?  Can we use the simple principle “Use it or lose it” more of the time?  Can we decide to first assess what’s going on in our body, second, remember to keep breath flowing through it, third, slowly ask the body to come back to balance, and last, to keep on keeping on without overdoing?  Such, I think, defines the ability to heal self.

So, the good news:  another learning experience, another healing, another opportunity for me, and possibly you, to practice what I preach.  While I wish we didn’t find ourselves in these situations, I truly believe we can still find our way out of them.  By slowly returning to a regular climbing of stairs, full range of movement through the knee hinge, and general attentiveness to the way we ask our bodies to work, we can heal.  I believe all of us could be inspired to slowly but with purpose, move into and through the pain and fear, and return to function and joy.

Noah Karrasch is a certified Rolfer and licensed massage therapist, and holds a teaching degree from the University of Missouri, Columbia. He teaches core bodywork skills throughout the midwest and also works with the Wren Clinic in East London. Noah has written two books on bodywork: Meet Your Body and Freeing Emotions and Energy Through Myofascial Release.

Curves, Twists and Bends: Pilates for Scoliosis – An Interview with author Annette Wellings

Annette Wellings is a Pilates instructor who suffers from major scoliosis. She began exploring different ways of keeping her body flexible and healthy whilst working as a linguist and artist in Australia and subsequently, she retrained in rehabilitation Pilates.

She is the co-author of Curves, Twists and Bends: A Practical Guide to Pilates for Scoliosis with Alan Herdman, the leading practitioner of Pilates in the UK since introducing it there in 1970.

How did you first find out about Pilates?

While working as a linguist and an artist in Australia and Fiji, I became increasingly aware of my body becoming more hunched and painful with scoliosis. By the time I was about 35, my spine was rigid and my torso was becoming increasingly twisted. I realised that I needed to do something and explore options, instead of passively sitting by and lamenting the degeneration of the spine. I began exploring different ways of keeping my body flexible and healthy, and I discovered Pilates.

How easy is Pilates to learn for the complete beginner?

The beauty of Pilates is its simplicity and versatility. Essentially it is a gentle form of exercise that is constantly adjusted and moulded to suit the particular needs of the individual. For the complete beginner, it is important to go to a good qualified teacher who understands your condition. Pilates is a subtle process and, like many effective exercise programs, it requires time and focus in developing a mind-body awareness. Rather than instant gratification or a quick-fix, it bears gradual profound benefits over time.

How can Pilates complement traditional rehabilitation medicine?

Whether individuals have opted for surgery or not, it is vital that people with scoliosis (particularly severe curvatures) keep the spine and body as healthy, supple and lengthened as possible. Pilates provides gentle exercises that can help improve flexibility, posture and alignment, and lengthening.

Pilates can be particularly useful for scoliosis, by teaching how to move and engage separate muscle groups. This can help tease out asymmetrical patterns of muscle use, encouraging the strengthening of weak underdeveloped muscles, and breaking down the dominant bossy muscles which develop on one side of the torso.

While surgery focuses on straightening out the spinal curvature, it is important to highlight that Pilates exercises are not designed to restructure the spine. Their purpose is to encourage flexibility and length, and enable the body and spine to be as healthy and supple as possible. As such, Pilates is suited to all people with scoliosis. The basic exercise movements can then be modified and developed more precisely to suit the particular shape of an individual curvature.

Your co-author, Alan Herdman, suggests that the message of Pilates is ‘Quality not Quantity’. How often would a typical scoliosis sufferer need to practice Pilates to feel the benefit?

Alan is right. Pilates requires you to be mindful and put time and effort into any program, particularly if you’ve got scoliosis. To get full effect and benefits, two to three times a week is a great start. Including it as part of your everyday lifestyle is ideal. There is no quick fix for scoliosis, and it’s good to put in consistent time and focus over the long term, learning and listening to your body.

In the book you look at different strategies for living with scoliosis. As a sufferer yourself, what is the best advice you can give to other people living with this condition?

First, accept your scoliosis and recognize that it makes you unique. It is a symbol of your individuality. Get information about your curvature, so that you understand and are aware of what your scoliosis involves (e.g. location, size and type of curve). You should explore options available for treating your scoliosis and keeping your body strong, lengthened and flexible. It’s important to make yourself a health care plan for life, including adequate rest, a healthy diet, and a gentle regular exercise routine to keep the body as supple and healthy as possible. Think length. It’s wise to avoid movements and circumstances which jolt or compress the spine.

In short, let go and listen to your body. Accept, observe and explore your condition with curiosity.

Copyright © Singing Dragon 2009