Archive for exercise – Page 2

Myth of Maximum Heart Rate

Question

What should my target heart rate be for safe exercise now that I’m reaching into my 60′s? or now that I’m ….?

Answer Part 1

There has been a consensus from people in medicine and in the various fields of exercise training that your maximum heart is determined by the following formula:

220 minus your age =’s Maximum Heart Rate

Then you take a percentage of that to arrive at your target heart rate for training.  Let’s first look at this formula stated above.

Background

This formula has been too casually utilized.  It has been promulgated as being scientific and over time has become the erroneous guideline for many in determining individual training levels.

It was founded in 1970 by Dr William Haskell.  There is a very good article in the New York Times that challenges this myth of maximum heart rate.  Below are excerpts from it:

The common formula was devised in 1970 by Dr. William Haskell, then a young physician in the federal Public Health Service and his mentor, Dr. Samuel Fox, who led the service’s program on heart disease. They were trying to determine how strenuously heart disease patients could exercise…

The subjects were never meant to be a representative sample of the population, said Dr. Haskell, who is now a professor of medicine at Stanford. Most were under 55 and some were smokers or had heart disease…

…At that point, Dr. Fox suggested a formula: maximum heart rate equals 220 minus age.

But the formula quickly entered the medical literature. Even though it was almost always presented as an average maximum rate, the absolute numbers took on an air of received wisdom in part, medical scientists said, because the time was right.

Answer Part 2

The American College of Cardiologists and the American College of Sports Medicine have come out with different guidelines.  I have seen that the American Heart Association used in the past the old formula.  I don’t know if they are still recommending this 220 minus age, equals your maximum heart rate.

Many have used the Karvonen Formula–See this link for an easy and quick calculation (and calculator)

Heart rate = ((Max HR-Resting HR)*%X/100)+Resting HR. (where %X =%MAX)

There is a great summary on a Wiki page here.  It provides more information than many would want.  It has other measurements and of course you can find the cited references.  Nice job.

So where does that leave us.

Answer Part 3

OK, whenever there are at least three answers proposed, be careful.  That means here, be careful!  I think that we don’t have a simple answer.  Also, we just don’t really know.  So in light of doing a treadmill test or similar at a human performance testing laboratory–what do we do?

We could use our common sense (or uncommon sense, as the case may be).  Take measure of who is asking.  What kind of condition are they in, any medical concerns–use a doctor to rule out medical problems.  What is their exercise history both recent and past composed of. Etc.

I personally like the Karvonen Formula or one of the other similar ones (they seem to differ in the range of standard deviations allowed).  In addition, I also like the Scale of Perceived Exertion.  This scale has shown good reliability with different groups of people–but it has doubt for some populations (caveat emptor).  Many people have derived their own modified Borg Scale.  Different groups have assigned different numbers meaning different levels of exertion.  (here and here for example)  Most importantly find your own subjective report that you can use consistently to gauge your work effort.  Be smart and be aware always.  Don’t use scales of any kind without retesting.

This retesting is important.  By retesting I mean how do you feel after exercising at your level of exertion.  How long does it take for you to recover–both in immediate heart rate (and breathing rate) and in the following days.  How you are sleeping and waking are always good barometers to pay attention to in determining how stressed you have become or not.  Also consider your mood swings and general level of energy.  This evaluation is always seen in our relationships with both are family/friends and in difficult situations especially.

Summary

Training is never done in isolation to how ones heart rate only is responding.  One needs to pay attention.  This attention would benefit by having a check list (hmmm another article someday)

Hopefully some of you will read this article and add what you have found to be important in determining your level of work.  Add your comments below.

Good training–may our hearts expand and receive the benefits of training beyond the base physiological parameters of regular exercise prescription.

 


 

Shoulder Pain: Case Example Using Mini-Bands

Background

Shoulder problems are one of the big money makers for people in the medical field.  As with many problems there are many factors and different categories of these problems.  This statement of shoulder pain is a very poor title for discussion.  It is the common moniker that many of us use for a wide variety of different problems.  In other words, shoulder pain does not even describe the problem, only the symptom.  Only subsequent questioning and discussions can bring clarity to what is the problem.  Shoulder pain can be referred pain from other sources like the neck, ribs, heart and lungs and many other problems.  These origins of the shoulder pain don’t even have to be in the neighborhood of the shoulder.

Here I just wish to talk about a particular case illustrating some basic principles of movement and stability of the shoulder complex and using mini bands.   If you are experiencing painful shoulders, please do not limit your assessment to what is given below.  Remember what is said in the above paragraph.  First ask other questions.  If there is any doubt in your mind have your doctor clear you first before embarking on trying out a musculoskeletal approach only.

Case Example

This young man who works a sedentary job and participates in weekly yoga class had been noticing increasing discomfort  of both shoulders but especially the left one.  Simple lifting the arms above the head would reproduce his symptoms.  They would get better on the right with continued movements but not on the left.

A brief assessment showed the following.  His posture looked casually very erect.  (Although is head was slightly forward and his thoraco-lumbar area was over extended, and his scapula’s winged bilaterally).  His neck demonstrated limited rotation and sidebending bilaterally especially to the left, his more affected side.  His lower neck spinal mobility was more restricted in these movements.  His shoulder mobility was with a flexion deviation in abduction. End ranges in abduction and external or outward rotation were slightly limited.   Resisted testing was weaker in extension and external rotation with arm above the head.

His mid to lower thoracic mobility was restricted in rotation–his mid to upper thoracic  was restricted more in extension.

In all his shoulder mobility testing, he demonstrated poor initiation of the scapula, especially on his affected, left side

Basic Approach

We worked on basic joints and glands (calisthenic type) exercises and foam roller to help restore some of his spinal mobility.  He improved so that his mobility was more normalized in his spine and shoulder.  His most provocative test now was his resistance to external rotation of his left shoulder when his hand was above his head.

It is interesting to note that in the classic muscle test position of external rotation with his elbow at his side, he had no problem.  I find it always helpful to hunt around to see if different positions will provoke his symptoms.  Also during these movements the scapula had a lag or latency in it’s sequential recruitment.

Mini Bands

Since he was essentially not activating his scapula enough in order to move his arm, work on this provided the changes he needed.  By working on basic pulling activities and cueing the scapula to perform better he was able to complete his recovery.

One problem I find in recommending exercises is compliance.  The simpler and easier the exercise the more compliance you will have.  This is a real struggle for me as there are so many areas that a person needs to learn about to move effectively.  If you can start the movement and break it into pieces, you can sometimes deal with this compliance issue effectively over several sessions of training.

This photo shows the 9 inch long loop called the mini band in action.  Here we started with simple setting of the posterior shoulder muscles.  We can emphasize scapular retraction while loading more of the external rotators to act as stabilizers.  This movement reminds me of the ole chest expanders we used as kids.  (Hoping to become like Charles Atlas and rule on the beaches).

Mini bands are great.  I constantly refer my clients to an online store called Perform Better.com.  Here is the link to their mini-bands.  They are a closed loop and give you what thera-band still gives (sans the knot, tying the ends together).   I just find I use these a lot more and they are so easy, portable and just fit the bill so well.  (no I don’t have any financial relationship with this company–except when I give them my money for their products)

We used a variation of this set up that is shown in the above photo.  What you see here is the mini-band looped around his wrists while pulling on another band (monster band, listed under mini-bands in the above link)–this monster band is 20 inches vs 9 inches in the mini-band.  You can use them separately or together as shown here.

One of the advantages of using a closed loop to do any type of rowing movement is that you can develop two directions at once.  This combined movement is very good for activating the stabilizers in this case.  You see on regular rowing you work on mainly retraction/extension of the shoulder.  Here with a closed loop (and the addition of the mini band) you emphasize this external rotation with a variation of horizontal abduction.  Turning on multiple planes of movement will really drive the shoulder complex to be more stable with proper cueing.

Another advantage to this arrangement is that it is very simple to set up and take down.  Space and equipment considerations are minimal.  Just get in there and do the work.

Progressions

The mini bands come in a variety of resistance.  I often have my clients purchase the yellow, green and blue mini bands.  Also buying the 20 inch loop (called a monster band with in the mini band section), will give you a large variety to try many different things.

  1. First I will start with a yellow or green band in the upper body for sedentary folks
  2. Next I will add the two bands as in the second photo
  3. For people who have issues in grip–whether arthritic hands or other problems, you can easily use the loops around the forearms
  4. Also the loops placed more proximal will reduce the force needed–this makes it very doable for anyone–I even use these ideas with a 93 yo woman who is progressive working just with the mini bands and also a 40 inch loop.
  5. This rowing movement for those who have issues of rotatory instability with the arms above their heads need to further progress.
    1. We start from simple rowing movements where the elbows are pulled closer to the sides while the forearms are more parallel to the floor
    2. Next we work into getting around a 90/90 degree position of shoulder abduction with external rotation while the elbows are around 90 degrees
    3. I’m not too strict here about the 90/90, just having them move towards this position and have their forearms more vertical works quite well

Summary

Retesting will clearly show if we are in the right direction.  I will immediately retest their provocative movement pattern.  If it is better, that is stronger, better movement of the scapula/humerus and thoracic spine–I know this has been a good choice.

There are of course many ways to deal with this problem of instability.  Try out this variation if you haven’t.  Let me know what you find.

Best in training.

As always, contact me if I can be of further assistance–Peter

Relaxation of Effort

Proper Practice

In all training we are guided by certain principles.  The Yoga Community often places proper emphasis on proper practice.  One of the keys to skillfully practice is to relax ones effort.  Today we are often mindless doing and exercising.  Often the accumulated tensions of the day and life are held during our practices.  Therefore it would seem proper to point out this dis-stressful style.  Lets look at when you would emphasize this “relaxation of effort” in your practice.  Your practice could be Yoga asanas, Meditation or any movement endeavor/exercise or performance.

Enjoy It

When we start practicing an asana (again it could be a musical instrument or learning to run hurdles), we start doing something.  Often in the context of yoga asana, people are taught to do a form and then  learn to relax into it and enjoy it.  That sounds just fine.  In practice for most of us, it obviates the basics that need to be established primarily.

Sometimes a student is working at performing a particular asana (again think exercise or your choice or other skill).  If they have difficulty with it, they may stop working on it.  They no longer feel like they are enjoying it.  It just isn’t fun anymore.  This Yoga stuff isn’t really right for me.  I try something else.

Trying to perform something and then being unable to do it can be frustrating.  If the emphasis at the beginning is to enjoy it and relax and one doesn’t, then do you give up?  The whole act of practicing is not to perform something perfectly, nor to necessarily find it enjoyable and be so relaxed at the beginning.  (If you are a high level person that can hold a perspective truly of joy in the mind, then this article is not for you).

Practicing is about developing ways of sensing and doing that were not available at the beginning.  It is a journey filled with lots of work.  Perfecting this work/practice will give enjoyment and you will develop over time this “relaxation of effort”.

Hard work

Notice that a gymnast that is able to effortless perform a routine on the rings or balance bar does not start with trying to relax their effort as the primary practice.  It is only after much sweat, extreme focus/sacrifice and over a long time that they can look so beautiful and effortless.

Yoga Sutras

This classic text by Patanjali has 4 chapters/padas.  The second pada, 47th sutra starts out talking on how the posture is made perfect.  The first part in sutra 47 states that it is through loosening the effort or relaxing the effort, that then the posture/asana becomes perfected in it’s steadiness  and easefulness.

Note that the sutra before, that is sutra 46 states that a posture is that which is steady and easeful/comfortable.  Again this steady and comfortable is not what you do.  It is what happens as you WORK in asana.  Often people are teaching to become something at the beginning that we are not at the moment.  Once again, practice is needed which will provide these qualities as almost side effects of proper practice.

Now in looking at the first part of the definition of asana (in sutra 46), steadiness in Sanskrit is called sthira.  One of the first places in the Yoga Sutras that speak about sthira is in the first pada, sutra 13.  Loosely restating the Sanskrit (via Swami Veda Bharati)–…this effort towards sthiti/steadiness is called practice.

The next sutra in the first pada, sutra 14, then pretty much lists the qualities for ones practice to become solid.  (The beauty and depth of the Yoga Sutras are not being communicated here–just an introduction to some guiding principles and how they can guide this relaxation of effort in our practice).

Firm practice when:

  • Practice is done for a long time
  • Practice is done without an interruption (think long term here)
  • Practice that is done right and proper (details are 4 and beautiful, but will not be discussed here)
  • Practice is done fully, completely (not haphazard or partial)

Relaxation of Effort

So one can be guided by such a profound text like the Yoga Sutras.  In this case, one is practicing not to perform something perfectly.  One is practicing to create a steadiness and stability of their asana (again think dance performance, faster sprinter, etc).  This control of that which is not under control, is achieved through practice (only in part, see YS 1.12).

This effort to becoming steady and stable is our practice.  This steadiness is not rigidly still.  This steadiness is the absolute control of the mind and sensory motor system.  It is that which provides  the direction to correct practice.  This practice then takes time–often long hours of practice, done in the way outlined above.  It is not something that just happens without these focuses.

Then as our practice develops in these ways of becoming stable and easeful, we automatically find that there is a loosening of our effort.  Relaxation of effort is not prescribed first as a primary methodology here.  Of course practically you work and relax and repeat.  Just do not underestimate the primacy of working as outlined in the first and second padas of the Yoga Sutras.

Continuing Practice

Steady practicing leads to relaxation of effort.  It begins to flow.  (Practicing means you have a goal.  This goal is that which you focus your mind, body and effort on.)

Relaxing is always easier after working fully, completely.  There is a rhythm to relaxing.  It alternates with hard and skillful work.  Later it becomes not hard, but no less work.  One begins only later to appreciate the lessening of struggle of working FULLY.  One then moves into the  joy of “hard work.”  It is no longer an effort.  One starts noticing that they are just more relaxed.  This richness of practicing is worth the work.

Again if there is anyway I can be of service, please feel free to contact me here.

Effective Exercise

Strong Mind and Body

Do we get the best results from our exercise selections?  How do we select which exercise to perform?  Besides matching the proper exercise for the problem we have, what else is important?

Is being effective due to:

  • The proper selection of the correct exercise?  or
  • How we do that exercise/movement?

Effective Exercise

First we must congratulate ourselves because we are doing exercises.  Next we have usually identified some reason for putting down the remote and/or getting out of bed.  Now let’s move quickly on to someone who wants to perform their particular task or skilled movement better.  It could be that they want to jump higher, cut quicker on the field, get into better shape/condition or simple perform a yoga posture that is particularly challenging.  Let’s take the latter case to illustrate several of these points on how to effectively exercise.  (We are expanding the definition of exercise and bending the definition of yoga asana here to make some points, knowing that the purists may start off disagreeing too early here)

Yoga Asana–Chakrasana

This is not a complete description of how to do Chakrasana.  We are using this posture/asana as an example of some one who wishes to do an exercise or asana effectively.  (This example could be extrapolated into many of the “corrective exercises” being given and performed today.

Let’s start with looking at a typical example of someone wanting to be more flexible.  They have taken up Yoga asanas in a class.  At some point the teacher has progressed to this pose called Chakrasana or wheel.  It is fairly vigorous for many, as can be seen by the picture above.  Again this could be an example of someone wanting to jump higher and get stronger in their legs who at some point starts doing one leg squats.  It really doesn’t matter the movement activity by itself.  It is again looking at how to exercise effectively.

Truly in exercise/movements it would be best if we knew ourselves well.  (Know thyself–OK, end of philosophy).

  • Where do we move well–actually where and in which directions do we have ease and dis-ease
  • What movements are strong/stable/powerful and have endurance (both in mobility and in stability)
  • Which tasks and/or skills do we prefer and which ones do we stay away from
  • Do we move smoothly and in a coordinated fashion
  • Do we breathe or frequently hold the breath with frequent efforting
  • Can we stay focused and pleasant in our mind or just the opposite

These are just some of the aspects or questions to ask in order to get to know HOW we move and therefore better know ourselves.  Knowing ourselves better will allow us to move better.  We can take full advantage then of the exercises or movements being selected.

Maybe Chakrasana (or single leg squats) are not the best exercise at the moment.  Maybe the way in which we do them is not allowing the benefits of those movements to create the tremendous results that await us.

Where (location and direction) and how do we move well (and where/how we don’t)

We need to look at large patterns of movement.  We want to see and feel how the body moves in all directions from the major areas of the body while performing a variety of movement patterns/tasks/skills.

  • Bending and reaching
  • Twisting
  • Pushing and pulling
  • Squatting and kneeling
  • Rolling and crawling
  • Sitting and standing
  • Walking, running, hopping and jumping

Where in the body do we move a lot and where are we stiffer.  Often this inquiry stops here.  It is insufficient.  The shoulders may be tight in lifting them above our head but have a lot of movement in the opposite direction.  Especially important is to notice difference from side to side and up to down.  Maybe our hips are able to extend (backward bend) well but our shoulders cannot open in that same direction.  Maybe one shoulder does more opening that the other–do you see that in Chakrasana then you would create a rotation of the trunk.

Look at the picture again and you see that the hips are opening well in backward bending.  The lower back spine is bending a lot.  The rib spine or thoracic spine is not backward bending at all in the mid to upper back.  The shoulders are also tight in this same direction.

Isn’t it interesting to note that this person is doing the general direction of this Wheel pose.  It is just HOW they are doing it that is of note here.  Therefore they will be over using hips and low back (and neck) and under using shoulders and mid-upper back (and wrists).

What if we knew where we moved and didn’t.  This might totally change what we do and how we do it.  Of course the results would be vastly different.  Our learning then and what we pay attention to would be expanded.  The changes across many different systems could be facilitated (musculoskeletal, fascial, nervous system, respiratory, immune, etc)

What movements are strong/stable/powerful

Again looking at this picture, we can ask several questions.  I know it would be better if we actually had a video.  Then truly we could appreciate the movement qualities better.  This picture and discussion will at least highlight the points of this article.

Looking at the two ends of this Wheel pose–which end, the leg or arm end, looks most stable?  You can see how the weight of the body is carried behind the arms.  Are the shoulders weak or only stiff?  or both?  Address whatever is involved with a more appropriate regression of this pose first.  Identify weakness and lack of stability of the shoulder complex with the arm above the shoulder level.  There are many ways of doing these tests/movement regressions.  We will not go into that detail here.

Looking at the middle of the body and seeing how the front of the lower back (the belly) over lengthens.  The lower back  over shortens.  How much of this over extension of the low back is a mobility problem of the thoracic spine in extension?  (or/and does it involve lack of stabilization of the anterior belly region.)

First you would have to decrease the challenge of this activity.  Take them out of trying to do this asana.  Place them on the floor and have them roll from belly to back with only the arms and head.  Do they activate their belly enough to transmit the rolling through the trunk from the arms.  Could their shoulders and thoracic spine be so stiff as to even impede this movement. Further investigation would be warranted.  This again is just to highlight a perspective of looking and asking questions.

By looking at more of these larger movement patterns, it will become clearer.

Which tasks and/or skills do we prefer and which ones do we stay away from

I wonder if this person loves to do backward bending movements where the shoulders are not flexed near their end ranges (that is over head position, above shoulder level).  So let’s make up a scenario that I see frequently in the clinic.  They would do  easily cobra or lying on their stomachs with arms by their sides.  Even Camel pose (tall kneeling and bending backwards to place hands on heels) would be available.  Any superman type position or boat pose would be done with substitution and difficulty.  They would never practice hand stand as it is too tiring.

If this lack of using the extremities over the head (in Chakrasana) causes such stress, then it may need to be regressed or made easier.

This easier movement may allow the proper awareness and adjustments to overusing and underusing that is being outlined here.

Do we move smoothly and in a coordinated fashion

This examination of coordination and agility reinforces many of the above observations.  Again whatever we move well and strongly, those are things we do.  We always use what we have even when trying to do something else.

Let me digress from this example to talk more of our preferences and avoidance’s in general movement.  We use the same patterns of movements and habits even in opposite directions.  It is not unusual to see someone who is trying to sit on the floor and has a lot of left knee pain (for example–in a cross leg, sukhasana pose).  Sometimes in looking at them you see their weight shifted to their left hip, although they are leaning a bit to their right.  You find they are in right sidebending of their trunk.  When you ask them to sit on a chair and turn right and left they still have most of their weight on their left sit bone.  In other words they do their movements of rotation and still maintain their right side bending of their trunk.  Their coordination remains dysfunctional even though you would give them a movement to change it.

This latter dysfunction a very important point to discover.  Our movement habits often remain and don’t change just because we are doing some corrective asana or exercise.  The WAY we move becomes also very important.

Do we breathe or frequently hold the breath

OK, breathing is so important.  It is a barometer of our mind and nervous system.  Sure at the beginning one may fine this breath rhythm disturbed.  The habitual and repetitive nature of an interrupted breath is very detrimental to our learning and proper response to the exercise.  A jerky breath relates to a jerky focus of the mind and all the other negative effects in all systems.

Try moving only so far as the breath can flow well.  This does not mean that you can’t cause strain.  That is ridiculous.  As one continues to do repetitions or hold the pose, the breath should be noted to start to flow well.  Otherwise there is not practice.  One is just violently stimulating the system.  Of course you have some changes even with the breath always being strained.  This abnormal breath rhythm though is very limiting and over the long term is detrimental to health and well being.

Can we stay focused and pleasant in our mind

Alright, take off the music headphones.  Pay attention to what you are doing and what you are feeling.  A good barometer like the breath is to ask whether you are pleasant in your mind.  GEEZ, you mean we have to be smiling all the time.  OK, less drama here.  Just note what happens to your overall sense of tensing and effort when you notice that your mind is not pleasant.  Whenever I ask this question in class or to individuals, I never fail to see an easing of tension, even a  : o )

Also when the mind is more pleasant–often you will notice an ease in the movements.  Try it just like you would try breathing with more awareness and ease.

Whew

So now when you exercise, you can ask more questions.  Effective exercise is creating the proper effect you want and/or that is available in the stimulation of the movement done well.  Effective exercise involves BOTH the selection of the right exercise the proper way of moving–

  • The Body
  • The Breath
  • The Mind

So before and during your next exercise session, take time to pay attention.  Use the movements to create opportunities to sense and breath.  Train hard up to your capacities.  To know your capacities, you must practice a lot.  You would benefit by coaching or skilled guidance.  Try using these principles–pick one, like having a pleasant mind.  Then go find a skilled coach/teacher and get some quality feedback.

Best of luck in your effective exercise.

Feel free to comment or contact me directly for a consultation.

Anterior Shoulder Pain!

The following is an interesting sequence of events of a new granddad who had recently been carrying around his 20+ pound grandson.

Case Presentation

A young grandfather was in my office the other day and his main complaint was left anterior (front) shoulder joint pain.  He denied any neck symptoms and no complaint of radiating symptoms.

Observation

He sat with his left shoulder lower than right.  His trunk was side bent to the left.  His shoulder elevation was limited by 15 degrees but not painful.  Resisted flexion and rotation of his shoulder reproduced his anterior shoulder symptoms and were weakened (probably inhibited/interfered with by pain and malposition?).  Also his left shoulder was protracted and slightly subluxed anteriorly.

His neck was blocked in left side bending and rotation of the lower neck segments.  He was not aware of this difference until formal testing.  Passive range was also blocked in the lower cervical spine in this left direction.

Also when I tried to side bend him to his left from caudal (head to tail) pressure on top of his shoulder he was easily moved.  Side bending to the right was markedly restricted in the mid thoracic (rib) spine.

Immediate investigation

I started with the hypothesis that there was a strain to the shoulder, possible due to poor stabilization of the shoulder complex–that was brought out in a more pronounced way due to having to carry around his grandson for long periods.  He could have over recruited his neck and set up very poor neurmuscular motor and sensory flow to the upper quadrant area.   Since he had such a pronounced movement dysfunction in thoracic side bending, I thought it would be interesting to see what if anything this lack of side bending may have to contribute.  (Both to mal-position of the shoulder on the opposite side and poor transference of stabilizing forces through the trunk).

  1. Tried to initiate active assisted trunk side bending to his right (remember he was already in a left side bent position).   This did not occur readily so looked lower.
  2. His right hip was carried in external rotation in sitting, his right hip internal rotation was limited.
  3. In sitting:  immediately had him place his right hip in internal rotation (foot out to the right side)–until we could cause him to shift his weight onto his left IT (sit bone) and gently start encouraging his trunk to side bend to the right–slowly as this side bending became easier we facilitated left side bending also of his lower neck segments.
  4. Had him sit straight again and noticed:  His shoulder less protracted and less subluxed.  He gained 10 degrees in shoulder elevation.  His resisted movements were much less provocative but still weak in external rotation.
  5. Finished with some activating/strengthening/stabilizing exercises for the scapula and shoulder complex.  Included cervical and thoracic active mobility also.
  6. Upon completion of the exercises, there were no reported symptoms with the previous provocative movements.

Summary

OK, not everything that walks into my office has such an easy resolution.  I just thought this case at least demonstrates some of the interesting connections that I find in working with people.  Also it has been my experience over many years that once could have started in different places and shown success.  I think success does not necessarily always mean such a quick resolution to a person’s problem.

One of the most important points I find is to see the relationships that exist.  Possibly an isolated approach of the shoulder or neck may have proved helpful.  If the whole pattern that is involved is not understood/recognized, then in more protracted cases, important elements may be ignored.

Now

Let me know what you think.  If there is any way I can be of service, please contact me here, for a consultation.  Thank you.

Greatest Therapy Ever

Retrospective

Do you know the greatest therapy for a movement problem.  Practically if we are walking and talking, over time we will all experience life’s aches and pains.  This problem could be based on a recent trauma or just accumulated over our natural course of living the “way” we do.  So what do we do?

We often see someone who is an expert or helped someone we know.  Maybe we first see someone in a medical field or sports/rehabilitation area.  Let’s say we have developed a chronic neck complaint.  It comes and goes somedays.  It is aggravated by turning our head to look behind.  Our local MD told us to take some Asprin and get some exercise.  Anyway we aren’t getting any younger and this pain in the neck (we are told) is to be expected.

OK–now if this sounds familiar or even possible–we still would like to know what is the best thing to do.  What is the greatest therapy that could relieve this problem?  There are certainly lots of advertisements and no lack of recent claims for guaranteed relief.  Over time we have seen so many different types of therapy for similar problems.  The interesting observation is that some of them do work and many of them don’t.  It seems like we have ranged in our search from prayer to medication.  We have used tried body works of many kinds.  There are have been a variety of energy medicine approaches.  Proper exercise and a variety of modalities have their adherents.

Observation

Paying attention is key in anyone using some of the above mentioned methods (body work, energy medicine, exercise, modalities).

  • First do not seek the answer to what to do (Should I get Chiropractic or Physical Therapy treatment for my chronic stiff neck)
  • Start asking questions which lead you to first paying attention (What makes this problem worse and better?)
  • Compare moving in one direction to the opposite.  Really look at and feel how you move as well as how it feels.  Don’t just focus on the pain.

Next Step

First realize that the above observation outline is way to brief to properly address all the inquiry that is needed.  It is just a reminder that in finding what therapy to select, you start with observing yourself first.  Do not blindly follow an advertisement or blindly follow some anecdotal recommendation on who to see.  Let’s say you want to get going and get some relief or help.

The Greatest Therapy Ever Part 1

In my over 30 years of experience as a Physical Therapist and Yoga Teacher, I haven’t found it.  Wait, don’t leave just yet.  My point here is that I have seen so many different approaches come and go.  Many of them are still around as the time frame of even 50 years is relatively short.  It’s like the above waterfall picture–much has come and gone in this world of therapy.  (mainly gone in popularity of the ever changing present).

History

When I was a younger in the 50′s-early 60′s, if you had a sore neck you just continued along your way.  If it got bad for some of the older folks, they saw a medical doctor, who usually advised drugs and surgeries (many of which we don’t do anymore–we do new and improved ones now days).  A few saw a Chiropractor, often for a lengthy amount of time.  Physical Therapy was often palliative using modalities (heat, cold, ultrasound and cookbook exercises).  Some people did massage but not for these kind of pain problems (mainly a rub down after a workout at one of the athletic clubs).

I did not hear about energy medicine until that later 60′s and 70′s when therapeutic touch and acupuncture started to be known to me.  Later in the 70′s and 80′s Yoga and Osteopathic Manual Medicine came into view.  I trained to become a Physical Therapist in the late 70′s and started teaching Yoga in the 80′s.

Since then I have trained in many disciplines and continue to participate in continuing education in fields of health and fitness and yoga.

The Greatest Therapy Ever Part 2

This topic is the wrong topic for looking for help with pain and movement problems.

The Greatest Therapy or the Best Exercise or the Perfect Posture, etc is only a guide to begin.

Look to the Way in which these methods are used.  It is in the details of how a practitioner implements these helpful therapies.  It is in the details of how we practice these therapies or methods.

Note the variety of the therapies or methods used today.  There are certainly some popular ones.  As I have said before, they do tend to come and go.  Some of them have been around for longer though.

  • Look at all of them from this stand point of asking questions.
  • Do they provide more questions for you to answer, or do they provide only a cook book approach (the latter can be useful in acute problems)
  • Learning how to improve something that has been a problem for a long period of time doesn’t happen in a short period of time
  • Enter into a training program where you are being evaluated on a regular basis.  (this evaluation includes your own)
  • Practice under supervision.  Get regular feedback.  It is invaluable

There are many helpful approaches.  The approaches under the guide of a skillful eye is what is most productive in the relief of the problem.  If the underlying problem is eliminated or eased the accompanying symptom must improve.

Next

  1. Identify what you want different
  2. Ask many questions about it
  3. Participate in training classes and/or individual sessions with people who can provide skillful feedback
  4. Continuously and regularly re-evaluate and adjust your practice and therapies
  5. Get results!  If not review the above, add/delete until progress continues.  Learn and adapt.
  6. That driving force of progressing and re-balancing in all of us will provide the Greatest Therapy.  Just remove the obstacles in the way.

Consultation

If I can be of any assistance in your practices, please do not hesitate to call or stop by for a class or session.  Contact me here.

Practice and Training

Practice and Training

Climbing to our goals is a short definition of practice.  Training implies there is something we are training for, ie a goal.  In Yoga, they use the Sanskrit word Abhyasa.  There are many translations of it.  The grammatical reduction of the term we will use here.  Abhi is to face towards something (a goal).  As or as-a here is to sit, apply oneself, to sit here in the body, in the mind, etc.  So we are practicing only when we are sitting (not necessarily physically) or focusing our selves, our bodies, our breath, our minds, our attention towards that which is the object of our goal, our focus, that which we are doing or sensing.

As soon as our focus comes away from the point at which we were holding it, then no longer are we practicing!

10,000 hours of practice = Mastery

You know I’ve been practicing yoga (fill in your practice here) for ten years.  Well whoever said that may not have closely examined what they were doing.  You know, I sit for meditation for one hour.  During that practice, I am not meditating for one hour.  My mind has slipped from it’s focus and is no longer facing towards that point of concentration.  So when do we practice.  Really our practices could be strengthened by strengthening our capacity to focus the mind.  This means being able to concentrate.

This practice could be as simple as our workouts physically.  If we wander around the weight room or track, our practice is diminished.  If the activities that we are doing get interrupted by a constantly changing focus, we lose valuable time and effectiveness of our work.

The grosser our practice is the easier it is to maintain focus.  The more subtle the practice is, especially if only using the mind, the more difficult is it for many.  This is not always true for everyone.  Some find unfamiliar activities to be difficult to keep a focus, whether they are mental or physical.

Romantic Practices

Choose any goal and look at your practice.  Look at the above definition of practicing.  It is not easy to train in such a way.  It takes effort and perspiration to keep oneself doing the mundane, day in and day routine of practicing.  (Remember, mindlessly doing is not training–it’s just goofing off–which is certainly easier, I know this well)

Also look if we are practicing when in reality we need to be doing our real tasks in life first.  We all have duties and responsibilities.  Well maybe not everyone.  But look to see whether we are using our practices to avoid our living of life.  Are we following a workout because some imaginary polishing of our ego or beliefs.  Do spend an inordinate amount of time in the gym because we are working on our physical health.  (Maybe we spend a lot of time not in the gym–not talking about this problem here).

Often people go through stages in training.  (This includes this author)  At the beginning, we end up reaching for some lofty goal.  Our minds are focused not on our goal but on what we create in our imagination as this wonderful thing.  Soon withing weeks, months (and possible years), our enamored infatuation with our thoughts and feelings begins to dwindle.  We no longer are able to maintain this pin point focus.  Our attention wanders and we often loose interest.  We then stop the practice and say that it (IT) doesn’t really work.  It never really provided that feeling I first had.  I’m changing my mind.  It just doesn’t work.

EGADS

Sorry for shouting.  This pattern is historically memorable of the past.  Maybe some of you have not noticed this lack of skillful practice.  But it is is worth shouting about just to clear out the ole pipes (pipe dreams).

Now Yoga has a pretty nifty take on this concept of training.  Not only does it focus on defining practice, but it talks about the attributes that will make ones practice bear the fruit of ones effort.

All great performers, athletes, workers and craftsmen have followed that same sage advice and training protocol:

  • Practice for a long time
  • Practice without interruption
  • Practice in the right way
  • Practice thoroughly and completely

Then no longer will you be disturbed by all these other distractions.  Your mind, breath and actions will all lead you towards that which you have focused your mind onto.  Your practice will then take you directly to your goal.

Do It

OK, now just go do it.  Easy to say and as we all know–not so easy to do.  Practice-Practice-Practice.