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Pain
Lessons: Learning to Heal by Ellie O'Steen, LMT Pain
Management (Photos Have Been Added to Help You - THANKS TO ELLIE!!!) Stretches Stretches should be done on a frequent basis, preferably hourly . Stretches may be held 10 seconds to as long as 1 minute . Start out with 10-30 seconds for the first few weeks. Don't overdo! MY GAME PLAN for dealing with my chronic pain: 1. Define my Personality Type 6. The R E T R A I N Principle R
rest & relaxation (within limits) It is not unusual to have some soreness for a few days because of beginning a stretching program. If you do, back off on the intensity and only hold the stretch for 10-15 seconds but don't quit. Remember! This is a new activity for your body. DON'T QUIT!!!! Week
#1 Knee-towards-chest
Lying on your back (on floor or bed), move the right knee in the direction of your chest but stop when you feel a GENTLE pulling in the buttocks and lower back area. Take in a deep breath, feeling your ribs expanding, and slowly exhale. Take up slack if you feel a nice release & repeat with deep breathing. Release the knee, put the foot down on the bed and slide your leg out straight. Caution:
do not lower your extended leg down to the bed! *****Repeat with the opposite leg, paying attention to your breathing.
Sitting in a firm chair with legs apart and bending forward loosely from the waist with head and hands towards the floor. Bend as far as you can comfortably! Breathe out as you bend forward. Return to sitting position by rollingup your spine using your arms to assist, if needed.
**This stretch has a number of ways to perform it. Choose what is best for you in the most relaxing manner. Lying on your back, bring your right knee towards your chest but not all the way. Holding your leg behind your knee with your hands, straighten your knee towards the ceiling. **if you cannot straighten the knee without putting a lot of strain on your upper body/neck, choose another form of this stretch. Hold for 10-30 seconds paying attention to your breathing. Do not hold your breath!! Lower your leg to your chest then lower the foot and slide the leg down. Repeat with opposite leg.
Lying on your back with your right knee next to the open doorway and bent... ....place your heel on the side of the wall (next to the doorway) and straighten your leg. Scoot your body backwards until you can have your knee out straight. Lie back and relax, allowing the back of the thigh to GENTLY lengthen & release. . . .
Seated on the edge of a sturdy, firm chair and keeping your back & upper body straight, bend forward at the hips and towards your outstretched knee. Only bend forward to where you feel a slight 'pull' in the back of your thigh. This should be a comfortable position! . .
Lying on your back with your knees bent, cross your right leg over the left knee. Let the knees fall to the right side gently & stop where you feel the stretch at the left hip and/or side. **Keep the upper body and shoulders FLAT on the floor or bed. As your flexibility increases, you may raise the left arm alongside your head. Don't force!
caution: always remove the top leg before returning to feet flat position! Repeat with left leg over the right knee. . 4. 'Arm Cross' {no photo of this} Still lying on your back with the knees bent or extended, let your right arm drop across your chest towards the left side. Hold 5-10 seconds or, to comfort. With the left hand, grasp the right elbow, gently pull the elbos to the left side. **There should be NO pain but only a comfortable stretch. Back off if there is any pain! Repeat with opposite arm. 5. 'Pelvic Tilt' {no photo of this} DO SLOWLY! Feel a gentle stretch. Breate in deeply, hold 4-5 seconds, release the breath through the mouth. a) lying on your back with knees bent and feet flat. b) tighten the abdominal muscles and buttocks as you gently flatten your back against the bed/floor. Hold 5 seconds. c) Relax! Do NOT arch your back as you relax. You can place your hand under the small of your back to monitor the flattening. Repeat these 5-8 times. **Pay attention if one side of your pelvis seems tighter. You may want to do a few extra pelvic tilts concentrating on just that side;. It takes concentration, too! These can also be performed in your car while at a stop light to keep the back relaxed. Nice, easy, small movements! That cannot be emphasized enough....do these with small, tiny movements.
Lying on your stomach, grasp your sock or loop a towel around your ankle and gently pull your ankle towards the buttocks. Keep upper body flat! Do NOT arch back!
Do these gently so as not to stress the knee joints! . .
This is a yoga pose and gives a good stretch of those tight abdominal muscles. Lying on your stomach, raise up on your elbows, breathing out as you raise up. Hold that position for 5-10 seconds; release; lower your body down to your stomach. Try placing a pillow under your chest if you don't feel comfortable with pushing up with your elbows. .
On all-fours, place a pillow behind your buttocks & between the lower leg and buttocks. Slowly sit back on the pillow & fold forward reaching your arms out in front of you slowly letting your breath out as you fold forward. Go slowly & gently! Don't force!!! **caution if this in anyways bothers your knees or lower back...do not do this! .
Sitting on the edge of the bed or chair, gently lean to the left bringing your right arm above your head and over towards the left side. Breath out as you stretch. Hold for 5-10 seconds. Return to upright. Repeat to opposite side. . . . .
Standing or sitting upright, try to bring your arms behind your back and grasping your wrists/hands. Deep breath in and let it out slowly. Do not arch the back! . . .
Standing or sitting upright, bring the right hand TO the top of the right shoulder blade, elbow pointed upwards. You may use the left hand to hold the elbow in upright position. Breathe in deeply exhaling through the mouth. Hold for 5-10 seconds or longer, if comfortable. . . .
Sitting in upright position, bend the head forward while letting out your breath. Grasp hands together & PLACE hands on top of head letting the weight of your arms do the stretching of the neck. do not pull the head down or force!!!!! Hold for 5-10 seconds. Repeat. {great stretch to use when on the computer for awhile!} .
Using a dresser or wall to steady yourself, step forward with the right leg, bending the knee but not bending past your toes. Keeping your left leg straight and heel flat on the floor, you should feel a comfortable stretch in the back of the lower leg. Be sure the back foot is pointing forward (as opposed to turned out sideways) and your heel is flat on the floor. Hold for 5-10 seconds. Repeat with the other leg. You may use the dresser or wall to lean againt to support the upper body & keep yourself steady. . Alternative Calf Stretch You can use a stair or thick book to stretch the calf muscles. Stand with the balls of your foot on the edge of the stair/book and lower your heels. Hold for 5-10 seconds and change feet. Also use a wall, chair, dresser,etc. to steady yourself and keep your balance. DYNAMIC STANDING POSTURE How you stand and move is very important for proper breathing and lessening pain. 1. Stand with your feet about shoulder width apart. {when your feet are too close together, your neck, back & leg muscles tighten in order to maintain your balance. A wider base of support is more stable and uses less muscular effort.} 2. Relax your knees...do not lock them! 3. Try to hold the abdominal muscles in and squeeze the buttocks muscles at the same time. This is difficult and takes time to learn and achieve. Don't give up but just try to be aware when you're not doing this. 4. Wear comfortable low-heeled shoes. Heels over 1- 1 1/2 " are bad for your posture because they tilt your weight too far forward and strain your back muscles.
Sitting with your body's weight on the two bony prominence of your pelvis ('sit bones'), you will have your back arched slightly and most relaxed. For best support, use a bath towel rolled/folded at your lower back or purchase a good lumbar roll pillow. Finding 'neutral' - Neutral is a position between too much low back curve and too much low back flattening. In the neutral position, your low back is the most stable and most comfortable, pain-free position. The Pelvic Clock. Lying on your back with the knees bent, imagine your spine is a clock. The upper portion of your low back is 12 o'clock; your tailbone is 6 o'clock. Try to gently rock back and forth between 12 o'clock and 6 o'clock with small motions. Think about where, in the middle of 12 & 6 o'clock, your back feels most comfortable. Abdominal bracing: This is a deep contraction of the abdominals (isometric) which provides support for the low back during activities. Toned abdominals also keep our organs in place where they function better instead of having gravity 'pull' them downward. NOTE: If you wear a low back support, do not wear it for long periods of time but rather as a "reminder" to hold the abs .Of course, some heavy-duty jobs require that you wear these and that is good. BUT....be sure that you fasten the support under the naval and not around the waist like a belt. Its purpose is to support the pelvic bones and abdominal muscles so that's where it should be!!! Try wearing the support when you perform activities i.e. vacuuming, raking, mowing, lifting laundry/heavy objects. At other times, USE YOUR ABDOMINAL MUSCLES. STABILIZATION EXERCISES FOR STRENGTHENING Position: Lying on your back with knees bent. 1. Tighten abdominals and roll pelvis towards the back, slightly flattening the back. **With your abdominals relaxed, you can usually slip your hand under your lower spine. With the abdominals tightened and pelvis set, you c annot slip your hand under your lower back. Hold while continuing with the following. When you lose the pelvic tilt (neutral position), stop and re-set neutral (pelvic tilt)! *****Do these exercises slowly and carefully i.e. to a count of 1-2-3-4-5 down, 1-2-3-4-5 up. Remove your shoes & wear socks for best sliding movement. 2. SINGLE LEG HEEL SLIDE: Lying on your back with both knees bent, slowly slide one leg down then slowly slide it back up to starting position...maintaining the pelvic tilt during this move. Start with 5-8 repetitions IF you can hold the pelvis. Breathe in as your straighten your leg: breathe out as you bring it back to bent position. 3. SINGLE LEG HEEL SLIDE WITH ABDUCTION: This is the same as above except when your hip and knee are fully extended, slowly slide the leg out to the side, then back in. Return to the bent-knee position, as above. Follow breathing as in #2. 4. SINGLE LEG HEEL SLIDE WITH STRAIGHT LEG RAISE: This is a little more advanced so do NOT do this one until you can easily do #2 & #3 with 15 repetitions. Same as single leg heel slide except when the hip and knee are fully extended, slowly (count of 5) bring your foot towards your face & slowly lift your leg 3-4 inches off the bed/floor. Hold for a count of 5 then slowly return your leg to the bed/floor as if you had a raw egg under your heel & you don't want to break it. This teaches muscle control. Follow breathing as in #2. 5. SINGLE LEG HEEL SLIDE WITH ALTERNATE ARM RAISE: Same as #2 but as the leg slides down, raise the opposite arm over your head as high as you comfortably are able...do not force! MAKE SURE YOU MAINTAIN NEUTRAL POSITION WITH YOUR PELVIS...DO NOT LET YOUR BACK ARCH!!! (if you cannot do this without losing neutral and/or arching your back do NOT attempt and come back to this in a few weeks) 6. PRONE LEG RAISE: Lying on your stomach with a pillow under the chest and abdominals, if needed, slightly raise your straight leg (from the buttocks) 2-3 inches off the bed/floor. DO NOT ARCH THE BACK!!! DO NOT HOLD YOUR BREATH...breathe out as your raise your leg. Do slowly to count of 5. 7. PRONE ARM/LEG RAISE: This is advanced! Same as #6 but raise opposite leg/arm. Try to keep your neck relaxed with careful breathing. 8. QUAD SETS: Lying on your back with legs extended (straight out in front of you), pull your toes TOWARDS YOU contracting the quadriceps muscles in the front of the thigh. Hold for a count of 5 and relax. Start with one set of 5 reps and try to gradually work up to a set of 15 reps before the muscles get fatigued. {these are the muscles you use for walking/standing/climbing} 9. SHORT ARC QUAD SETS: Sitting on a bed with legs extended and a bolster or pillow under the knee for just a few degrees of flexion, pull toes towards you and straighten the leg. Perform count/reps as in #8 10. ISOMETRIC ADDUCTION: Lying on your back with the knees bent and feet flat, place a large, firm pillow or ball (i.e. basketball) between the knees. Squeeze the thighs together and hold for a count of 5. Relax. Perform count/reps as in #8. 11. ISOMETRIC ABDUCTION: Lying on your back with the knees bent and feet flat, TIE the thighs together with a sheet or long towel. Attempt to "pull" the thighs apart. Perform count/reps as in #8. WHY EXERCISE? A muscle must be used in order to remain healthy and responsive....the 'use it or lose it' principle. The more it is used, the more important is the delivery of oxygen and glucose...via the circulatory system. Man is an energy-spending organism. Any increase in musculoskeletal acitivity calls for the body to develop and deliver more energy to sustain the physical activity. If dysfunction affects the efficiency of the system, there is an increased energy demand. This applies not only to physical activity i.e. exercise BUT...normal daily activities as well. Consider this... "restriction of one major joint in the lower extremity can increase the energy expenditure of normal walking by as much as 40%" ! A muscle in a state of chronic tension/tightness caused by injury, stress or disease is working and exerting a pull against the fixed resistance of another muscle working in a static position. Now, the nutritive needs of these muscles are higher than if they were at rest in neutral length or contracting smoothly without resistance. The chronically tight muscle is in a state of REDUCED CIRCULATION. The small arteries and capillaries which help supply the cells with glucose and oxygen for energy are being squeezed. Hence, prudent exercise, aerobic type and strengthening type, is VITAL to your body's oxygen intake, proper circulation and giving your body more efficiency in its chemical processes. |
Alternative
"Knee-towards-Chest"
2.
Hamstrings
'Doorway
hamstring stretch'
'Seated
hamstring stretch'
3.
'Crossover' Stretch
Hold
4-5 seconds then remove the right leg from on top of the left and place
both feet flat on the bed/floor.
6.
'Quad Stretch'
**If
you just can't do this because of pain or unable to reach back, have
someone gently push your ankle towards your buttocks and hold for 5-10
seconds.
7.
'Cobra Stretch'
8.
'Mecca Pose'
9.
'Side Stretch'
10.
'Upper Chest Stretch - biceps'
11.
'Triceps Stretch'
12.
'Posterior Neck Stretch'
13.
'Calf Stretch'