Tackling the Dreaded Dowager’s Hump

One of the primary postural goals for manual therapists is restoration and maintenance of proper vertebral curves, which exist for a reason:  to provide the least amount of strain to muscles, tendons, ligaments and joints so they can carry on with daily chores.  If compromised, the risk of injury, protective muscle guarding and development of pain/spasm/pain cycles escalates.

It’s not entirely clear what causes it.  Most likely, there are many underlying causes.  Dowager’s Hump, hyperkyphosis, may be a multifactorial problem:  Length-strength imbalance, motor  control issues, degenerative disc disease, ligament laxity, and possibly certain metabolic problems top the list of potential causes.  There may also be a genetic link as well as it seems to run in families.

Since it’s more obvious when viewed from the side (and most people view themselves in the mirror from the front), hyperkyphosis can progress quite a bit before anyone seeks help  for it.

Dowager’s Hump can cause neck, rib pain and breathing disorders, but can also be asymptomatic.

Even in moderate cases, it can be difficult to lie on the back comfortably because the head is flexed so far forward.

Neuroscientists tell us our movement patterns are more or less hardwired by the time we are in our 20s, so why do dowager’s humps often develop later in life?  When asked, the legendary Dr. Moshe Feldenkrais, founder of the Feldenkrais Method (mindful movement to bring new awareness and possibility into every aspect of your life), simply responded “lack of variety of movement patterns”. 

As we age, aberrant patterns become habitual, repetitive and narrow; pain/spasm/pain cycles develop; we have injuries; our posture worsens.  The conversation between body and brain becomes increasingly difficult and unreliable.  Eventually, coordination, balance and movement may become very limited.

The first line of defense is postural therapeutics, i.e. Myoskeletal Alignment Therapy, in conjunction with home-retraining rehabilitation or referrals to competent functional movement specialists, including Yoga.

Lesson #4 from a Broken Ankle

 

Altruism: the principle or practice of unselfish concern for or devotion to the welfare of others. Women, therapists and caregivers tend to be altruistic.

Are you always taking care of everyone else and forgetting to put yourself first. Throughout the week, how often do you put yourself first? What about over the course of a month?

It can be difficult to remember our own happiness in addition to everyone else’s. Givers can be terrible at putting ourselves first. We give, give, give but forget to give to ourselves.

Lesson #4: Give to yourself.

There’s a down side to putting everyone else’s concerns before your own.

When you relegate yourself to last place, you wind up exhausted, you don’t sleep well, your diet tends to suffer, you deal with more physical pain and the effects of chronic stress. How do you rate?

I’ve had a couple of months now to make changes in my life in order to ramp up the goodness in my life. Here’s a little exercise you can do to see how you’re doing: Write down 5 things that make you happy; then write down the last time you did each of those things.

As you review how you’re doing on your happiness exercise, never make yourself “wrong” for what makes you happy. (That’s something especially women do far too often.) It’s much better to just be honest. So, if shopping makes you happy, don’t beat yourself up, think your happy thoughts!

This week, sit down and figure out where you can begin to put yourself first by doing activities that you love. Even the little things like getting a manicure, taking a walk with your significant other or having a glass of wine or beer with your friends really matter and contribute to your overall happiness.

Have a wonderful and Happy New Year! See you soon.

Lesson #3 from a Broken Ankle

My life experiences have made me a self-sufficient person. I’m able to do lots of different things from light electrical and rough carpentry to shoeing a horse to grooming a dog and, of course, correcting musculoskeletal problems in the body. This is both good and bad.

It’s good because I can handle lots of different problems without help.

It’s bad because I can handle lots of different problems without help.

American culture values independence, but sometimes we can take it a bit too far. For many of us, success goes hand in hand with self-sufficiency. Anything, we are often told, can be achieved through hard work—which usually implies work done on one’s own.

For those raised in the United States, the idea of independence may bring to mind iconic stories about “rugged individuals”—pioneers, mavericks, or resourceful immigrants who built a life on their own terms. But while bravery and perseverance are valuable traits that help us make our way in life, these stories can idealize autonomy, instilling unrealistic expectations of attaining our goals solo—and these narratives also overlook the fact that we benefit enormously from the help of others.

For most of my life, I’ve been the go to person to ‘fix’ things, to get things done. Being something of a perfectionist, I have, more often than not, opted to do something myself because I know it will get done correctly. This is both good and bad . . . It’s good because I improve my skills and knowledge base; it’s bad because I add another reason for not asking for help.

Be honest, you’ve done it too, right?

When Glenn was alive and we were ranching, his favorite response to any worker asking for a raise was “When you can keep up with my wife, you’ll have earned a raise”. We were two peas in a pod – both multi-talented and willing to learn new skills and leave our comfort zones in order to accomplish something. While it certainly sounds like a compliment, is it really?   Might it not be better to increase effectiveness through collaboration? In addition to gaining the benefit of suggestions you might not have thought of independently, you may find people willing to assist with the refinement of your ideas, thus increasing the effectiveness of your approach.

This was lesson #3 from my broken ankle. There are times in life when, no matter how independent and self-sufficient you are, you’ve got to ask for help and graciously accept that help. Instead of being the go-to person, you are dependent on the help and assistance of others to accomplish everything that needs to be accomplished – like getting to the grocery store and doctor’s appointments.

 

Mindfulness plays a big part in being able to do this. So, what is mindfulness? Ah, shame on you if you don’t know . . . it means you’re not reading your e-mails or following me on Facebook . . . but you’re forgiven.

Mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us.

Being mindful simply takes creating some new and healthier habits.

Most of us would like all new, upcoming years to be better than the current year. Personally, I would really like 2018 to be better than 2017. To that end, I’m learning the lessons from having broken my ankle, practicing healthy habits including mindfulness and being grateful for all the absolutely wonderful things in my life.

And, I encourage you do the same. Don’t allow stress to wear you down, beat it down with mindfulness. Take up or expand your Yoga (or other) practice. Slow down. Appreciate more. Sit less. Move more.

Wishing you a very happy holiday season and end of the year. See you soon in the New Year!

Lessons from a Broken Ankle: Lesson #2

Our bodies are incredible – truly. They are hard wired for survival. They have automatic responses to prevent and heal injuries. Some of those automatic responses tend to drive us a bit nuts these days, such as mucus buildup; but that is one of the automatic responses our bodies have against pathogens.

In my lifetime, I’ve been sickly as a child, I’ve been injured multiple times, I’ve been a chronic pain patient and a functional quad – and through all of that my body has never failed me. And, it’s not failing me now with my latest injury, a broken ankle.

This experience has reminded me how much we are able to disregard discomfort in our bodies. It’s reminded me how sneaky stress and discomfort are. It’s taught me that if you can’t move your body like you did at, say 30 or 35, you’ve got some work to do!

When I was much younger, 40 was considered “middle age”. Currently, “middle age” runs from about 60 – up to about 70 if you’re in great shape. I’m somewhere in the middle of that, and while I’ve been able to do everything I need to do while my ankle heals and this experience has shown me that I’m in better shape than I thought; I’m not in as good shape as I’d like to be.

So, now let me ask you some questions.

Think about your age and physical condition. Pretend that you’re single and care for an extremely active young child. You live in the country, on a hillside, must maneuver stairs, can’t drive and have a cell phone for a lifeline. You broke a leg, or a pelvis, or an ankle, or your knee, could you do it on your own? Could you hold out for 24 hours or so at a time until the next round of caregivers stops in to help out? Could you get down on the floor, lift yourself back up (without putting weight on the injured leg), get around on crutches? Wash yourself, your dishes, make meals, take care of your child? Try some of these chores for yourself not using your “injured” leg and without putting any weight on it. If you feel like you can’t do it, why can’t you? Where are you weak, stiff, inflexible, or shakey?

Think about your age again. Thank about your physical condition. And, this time consider your gender. How many sit ups can you do? I’m not talking about crunches – with your knees elevated and someone holding your feet. I’m talking about full body sit ups, all the way up.

How many push ups can you do? Full body or do you bend your knees?

Can you stand up from the floor without using your arms/hands?

Can you touch your toes? Great if you can . . . if not, what’s stopping you?

Can you lay flat and roll over without relying on your legs or arms?

Can you stand up to one leg from a chair without using your arms (and balance)?

Is your upper body strength sufficient to lift your body weight?

How fit and flexible do you choose to be as you navigate your ‘golden years’?

My ideas of fitness have changed from this experience. I don’t believe the medical ‘tests’ for fitness come near to where we need to be. I’ll be working on my own fitness throughout my recovery and will continue after that. I love the way I live and can’t imagine having to change my lifestyle long term.

Lessons from a Broken Ankle: Lesson #1

Our bodies are incredible – truly. They are hard wired for survival. They have automatic responses to prevent and heal injuries. Some of those automatic responses tend to drive us a bit nuts these days, such as mucus buildup; but that is one of the automatic responses our bodies have against pathogens.

In my lifetime, I’ve been sickly as a child, I’ve been injured multiple times, I’ve been a chronic pain patient and a functional quad – and through all of that my body has never failed me. And, it’s not failing me now with my latest injury, my broken ankle.

This aging body of mine still has some lessons to teach me, it seems. And, I’m very grateful that my mind is still willing to learn.

I found it very interesting that when my ankle broke, I felt no pain . . . none at all. I was even able to set my ankle and keep it in place until I got to the hospital and felt remarkably little pain – until the ankle was reduced and properly reset. Wowzer! I felt that right through anesthesia!

The next few days were very uncomfortable while I waited for the swelling to go down. But, within a short period, just a few days, really, I was up and about on my crutches, scooting up and down the stairs on my butt, taking short walks on the crutches outside getting my Vitamin D. I was trying really hard to listen to my body during those days, elevating the ankle when it said “Enough!”, and felt like I was healing well.

And, then . . . <drumroll, please> came the surgery . . . My ankle was healing well, it did not need resetting, and only two of the three fractures needed some help. So my medial and lateral malleolus were plated and screwed (inner and outer ankle bones) – when this heals, I’ll have a bionic ankle. And my surgeon was great – she loaded me up with local, so coming out of general anesthesia I felt pretty good. Until the next morning! And, that’s when I could tell I’d been cut on, drilled into, plated and screwed. Ouch! I took my pain pills and stayed as quiet as I could with my leg elevated for a couple of days.

After my stint as a chronic pain patient, I’d thought I’d learned most of what there was to know about pain, both chronic and acute. Possibly, another of our automatic protective mechanisms kicked in and allowed me to forget some of what I’d learned, or possibly I still had some learning to do . . .

This experience has reminded me how much we are able to disregard discomfort in our bodies. It’s reminded me how sneaky stress and discomfort are. It’s taught me that if you can’t move your body like you did at, say 30 or 35, you’ve got some work to do!

This series of blog articles will be about what this experience is teaching me.

Lesson #1: Slow down!

While I’m not very competitive, I’ve always been an over-achiever. I tend to move quickly and accomplish lots in a short period of time. I might even take a short-cut now and then; as I did the night I broke my ankle – instead of taking the time to put on real shoes, I slipped into flip flops to rush outside to take care of something. Poor choice of footwear . . . they’ve been relegated to dog chew toys . . . Yup, those $100 orthopedic flip flops were donated to Bear and Nala (some of the rescue dogs I work with).

First lesson: Slow down.

Yes, I meditate – not as often or regularly as I used to, or should. Yes, I do Yoga – not as often or regularly as I used to.

We’re all human. We’re flawed. None of us is perfect. We get busy and let things slide. We try to be in too many places at one time. Guilty as charged! And, now I have a couple of months to get back into meditation, and other forms of self-care, while I consider how to move forward from this injury.

One of the best ways to slow down is by keeping a gratitude journal. It makes us focus on the things that feed our souls, keeps us focused on the positive aspects in our lives. From Greater Good in Action, Science based practices for a meaningful life (Berkeley):

TIME REQUIRED
15 minutes per day, at least once per week for at least two weeks. Studies suggest that writing in a gratitude journal three times per week might actually have a greater impact on our happiness than journaling every day.

HOW TO DO IT
There’s no wrong way to keep a gratitude journal, but here are some general instructions as you get started.
Write down up to five things for which you feel grateful. The physical record is important—don’t just do this exercise in your head. The things you list can be relatively small in importance (“The tasty sandwich I had for lunch today.”) or relatively large (“My sister gave birth to a healthy baby boy.”). The goal of the exercise is to remember a good event, experience, person, or thing in your life—then enjoy the good emotions that come with it.

As you write, here are nine important tips:
1 Be as specific as possible—specificity is key to fostering gratitude. “I’m grateful that my co-workers brought me soup when I was sick on Tuesday” will be more effective than “I’m grateful for my co-workers.”
2 Go for depth over breadth. Elaborating in detail about a particular person or thing for which you’re grateful carries more benefits than a superficial list of many things.
3 Get personal. Focusing on people to whom you are grateful has more of an impact than focusing on things for which you are grateful.
4 Try subtraction, not just addition. Consider what your life would be like without certain people or things, rather than just tallying up all the good stuff. Be grateful for the negative outcomes you avoided, escaped, prevented, or turned into something positive—try not to take that good fortune for granted.
5 See good things as “gifts.” Thinking of the good things in your life as gifts guards against taking them for granted. Try to relish and savor the gifts you’ve received.
6 Savor surprises. Try to record events that were unexpected or surprising, as these tend to elicit stronger levels of gratitude.
7 Revise if you repeat. Writing about some of the same people and things is OK, but zero in on a different aspect in detail.
8 Write regularly. Whether you write every other day or once a week, commit to a regular time to journal, then honor that commitment. But…
9 Don’t overdo it. Evidence suggests writing occasionally (1-3 times per week) is more beneficial than daily journaling. That might be because we adapt to positive events and can soon become numb to them—that’s why it helps to savor surprises.

Here’s the link if you’d like more information.

 

Slow down, breathe deeply and be grateful for all the wonderful things and people in your life.
I look forward to hearing how you get on with your journal.

Stress, Aging and Muscle Balance

You’ve heard it before . . . The effects of stress in the body are cumulative.  But what does that really mean?

Let’s start with life is stress, begins at conception and ends when you die.    As you grow, you accumulate stress, but not too much . . . babies and kids are fairly resilient due to not having accumulated lots of stress in their young lives.  Once you hit puberty, stress starts to accumulate more quickly – maybe you remember when it was no longer as easy to put your foot in (or near) your mouth.  Pretty soon, we’re grown and off to college, then work, marriage, kids, buying houses, etc.  Now you’re into your twenties, and wouldn’t think of trying some of the body positions you did when you were, say, 5 or 6.  Why not?  Is it because you feel you’re too mature to try?  Or is it because those positions are no longer comfortable (but perhaps not impossible) to achieve?  Chances are, you’ve already lost some of the range of motion you had as a child, although you’re probably not aware of it.

Life goes on.  In your thirties, even more stress has accumulated, and you’ve lost even more range of motion.  But, again, you probably aren’t very aware of it . . . yet.  By the time you’re in your 40’s, you begin to realize that you’re not as flexible as you used to be.  Maybe you chalk it up to your desk job, or getting older.  But, the truth is, that had you continued to use your body like you did as a child, and managed your stress (which now includes physical, mental and emotional stress – not just life stress) to minimize the long-terms affects in your body, you should be as flexible (mentally, emotionally and physically) as you were in your late teens or early twenties.

Hard to swallow, isn’t it?  And, just exactly what does this have to do with exercise?

Exercise is a double edged sword. Do it correctly, and the benefits are unlimited. Do it incorrectly, and sh## can hit the fan. In my line of work I get to see a lot of people who are exercising incorrectly, either due to bad advice, or due to not understanding what’s involved.   For instance, one my older clients has been fighting a musculoskeletal imbalance caused from sitting too much.  Part of the problem is in the quads – the rectus femoris muscle, which also acts as a hip flexor.  So, my client decides (on her own) to strengthen her quads by going up and down the stairs in her house.  Oops!  Why?  Because every time you lift your legs, you are activating the hip flexors, and going up and down stairs puts lots of strain on the shortened hip flexors and overworked quads.

Have you done something like this?  Tried a new weight machine at the gym that didn’t work out so well?  Maybe you didn’t understand why . . . you just realized that perhaps that machine wasn’t the right one for you.  Maybe it wasn’t the machine at all – perhaps (a) you weren’t physically fit enough for the manner in which you used the machine, or (b) you exacerbated an existing musculoskeletal imbalance you were not even aware of.  Food for thought . . .

Exercise has become a double-edged sword.  Before you decide to up your exercise game, it’s a good idea to get balanced before you start.

Pain is a Request for Change

Few things are as distressing as chronic pain.  It saps your energy and takes an emotional toll.  Over time, a vicious pain cycle develops, one that seems to have a life of it’s own, often persisting even after the original cause is resolved.

Our bodies were created to be self-healing dynamos, given the right tools.  But, often, we’re so distracted by life that we’re not paying the attention to our bodies that they deserve, and we don’t provide the tools our bodies need to avoid postural distortion and developing pain syndromes.

Amazingly, though, making just a few simple changes in your life will set you up to once again live a pain-free life.

Pain often develops with injury or illness.  Chronic pain develops when the complex interplay between the Central Nervous System and the Peripheral Nervous System is dysregulated.  Each element of pain – especially stress – can add to or even start the cycle.

The current medical model in this country advises that pain medications are considered the last line of defense in the increasingly common fight again chronic pain for good reason.  The most commonly prescribed medications for pain management are prescription grade anti-inflammatories, opioids and anti-seizure medications.  All have severe side effects, up to and including death, which often further degrade your quality of life.

Massage therapy has been proven to be a more effective tool in pain and stress management than medications.  It’s been in use for the history of mankind.  Haven’t you used mechanical pressure to relieve pain – stretching an aching back or rubbing an area that hurts?  Research shows that massage stimulates the release of natural pain-relievers such as endorphins and reduces the devastating grip of pain on your body.

When I first met Gordon, he literally vibrated with tension and pain.  Gordon suffered with a nerve entrapment causing pain that most days exceeded 10/10 and was nearly suicidal.  The traditional medical approach was to surgically sever the nerve (a short term answer at best as nerves regenerate over time) and physical therapy made his pain worse.  Working together and using a multi-dimensional approach, we were able to restore his life and lifestyle with pain levels which have maintained below 2/10 now for several years – a more than 80% reduction in pain!

Using the food you eat to support your body, instead of eating for dis-ease, will also help reduce pain levels by reducing inflammation.  Discover the foods you’re allergic or sensitive to, and correct the adverse affect those foods have on your system.  Eliminate the foods from your diet that contribute to disease; eliminate and purge the effects of chemicals, heavy metals, pesticides and herbicides from your body.  Learn how to eat to balance your pH and to eat for health.

Christine’s case illustrates the dramatic effect diet can have on the body.  Christine suffers with arthritic degeneration of her spine, and came to me when her back pain ratcheted up to the 7-8/10 range and was interfering with her retirement lifestyle.  After a thorough assessment, it became clear that inflammation was a major contributor to her pain.  Just a few tweaks to her diet, and her inflammation was dramatically reduced, which brought her pain levels back to a manageable level (3/10 and below), allowing her preferred lifestyle to resume.

Our bodies were built to move, not sit behind a desk 40 hours a week, then behind the wheel of our car another 10 or more hours a week, sit to eat, sit to read, sit to watch television, sit to play games . . . The average American now sits 13 hours every day.  No wonder chronic pain is becoming epidemic!

I wish I could tell you that the simple solution is a certain number of hours at the gym 3 times per week, after all exercise is exercise, right?  I’m afraid not.  Once pain develops, you already have musculoskeletal imbalances, and it takes an expert to unravel the influences that contribute to those imbalances.

A recent case study of mine really illustrates this truth:  Bob was referred to me when his back pain was so severe, he could no longer stand up straight or work.  Bob was a “gym rat” and had unwittingly been continuing a work-out routine that was exacerbating his symptoms.  But, by using an approach of manual therapies combined with functional and corrective exercise, Bob could stand erect after just two sessions; after 8 sessions, he was balanced, pain free and back to work.  Before you hit the gym with pain, get properly diagnosed and have a plan to overcome the imbalances.

My clients know me as the go-to person when allopathic medicine fails.  When allopathic medical treatments fail, my clients come to me to help them devise a plan to address their complaints in a natural way, often without the need for medications or surgery.  It IS possible to unravel the unwanted influences on your body and regain your health.

Janet Lawlor is a holistic practitioner, Board Certified Bodywork Therapy, posture and pain specialist and a chronic pain survivor.  Janet is also a certified Yoga instructor and certified in Functional and Corrective Exercise.  She continues to train in techniques to help others overcome their chronic pain.  Her exclusive focus is on reducing pain, improving mobility and restoring quality of life.