Sunday, February 22, 2015

Moving Through Lent: The Thing about Chairs

Note: Most of the time, I try to respond to peoples' comments via email if I have access to their email. (Okay, I'm a little sporadic, but I try!) However, for this series, it might be more helpful to be able to have some conversations about things that come up, so I'm responding directly to comments on posts.

Approximately 32* hours into Lent, I was ready for Lent to be over. Why? Because I was tired. I am giving up chairs for Lent. In the interest of full disclosure, I am writing this on a Sunday, and I am totally cheating and using the couch right now. It's snowy and cold out and I don't think it's possible for me to avoid the couch the entire day while I'm stuck inside. You want to know why not? Because it's exhausting to hold yourself up against gravity the entire time you're awake.

Think about that for a minute. Holding ourselves up against gravity seems like a very basic thing that we should all be able to do, but it is extremely difficult for most of us. I am speaking as someone who doesn't sit a lot at work, and when I do, it is often on a stool without my back being supported. I go to the gym 3-4 times per week and hiking (or cross country skiing or something) once or twice a week. What I mean to say is, I am what most people would classify as fit, and yet it was hard for me to hold myself up against gravity the whole time for one and a half days. Not even the whole time! There's sleeping, where I wasn't holding myself up. There was lying on the floor and stretching. There was sitting at the (long) Ash Wednesday Mass, and there was sitting in the car to various places that I had to be. Crazy, isn't it? We aren't strong enough to hold ourselves up against gravity. Y'all, that is just messed up, and yet it is where most of us are. Is it any wonder that we feel like we are falling apart? If we aren't strong and effective about the way that we react to gravity, then we impose further loads beyond that, whether it's exercise or just taking care of the normal tasks of daily life, something's going to break somewhere.

I've had a beef with sitting for a while. It hurts me to sit for too long. I stopped being consistent about a Bible study at church because it's over an hour of sitting in terrible folding chairs, and I hurt when I sit like that. I love learning new things, but one of my least favorite things about continuing education is sitting to learn it. I tell my patients all the time to get up frequently from where they are sitting at their desk.  However, I never really thought about how bad an actual chair is until much more recently.

Here's a bullet point list of some things that are wrong with chairs:

  • Every time that we sit, our hip and knee joints have almost the exact same load at the exact same angle. Not the best way to use a joint!
  • Many chairs are designed to be comfortable; this is actually a problem, because it usually means that it conforms to our bad posture, thus keeping us in that posture (usually rounded through the spine) and perpetuating our problems.
  • Because we are comfortable, we tend to sit longer. 
  • Even chairs that are uncomfortable still tend to promote that round posture that we all use (especially tucking our tailbone underneath us).
  • The angle that we are in when we sit in chairs makes it harder for blood to flow in our legs, as well as increasing the sharpness of the angles of certain blood vessels in key spots. This means that the blood hits the vessel more and increases the amount of plaque in those areas!

There's more, of course, but those are some of the things to think about. Now, while sitting in general is something to avoid doing too much of, sitting on the floor has some distinct advantages over the chair. More bullet points, anyone?

  • We have to use a much more full range of motion through all of our lower extremity joints just to get down to the floor and back up. This means that we also have to use the muscle at much different lengths than just getting up from a chair. Plus you have the exercise of getting up and down from the floor!
  • When you are sitting without support, the muscles have to do the work to hold you there, we don't outsource the work to the back support of the chair! (Thus, the increased fatigue for me!)
  • Sitting on the floor is much more conducive to frequently shifting positions. Partly because we are not restricted by the chair and partly because it helps for comfort. This further changes the loads on the joints and it keeps everything from being in one position for too long.
  • Because you are not just letting your body be supported, you are more likely to get up and do something else a lot more often.
  • When our back is not as rounded, it means we have better rib excursion (the ribs expand more easily) and we breathe better.

I was pretty happy to hear that there are already several of you that prefer the floor for sitting. Awesome! I'm thinking that there are plenty of us, however, that have been on some sort of chair or couch or recliner a lot of the time. Me included. There's a reason I'm on the couch today, folks, and it's not because it's good for me. But that's okay, we can still join the ranks of the floor sitters.

There are a couple of things to think about when you sit on the floor. One is that you want your back to be fairly straight, but comfortable. Don't let your tailbone tuck underneath you and don't let your ears sit in front of your shoulders. Another is that you should be sitting on your ischial tuberosities (I don't want to mess with copyrights, so the link will take you to a photo). In layman's terms, your butt bones. Finally, as long as you're not slouching and tucking that tailbone, there's not really a right or wrong way to sit on the floor. You can sit with your legs crossed, you can straighten them out in front of you, you can kneel, you can bend your knees and put your feet flat on the floor. You can bend one knee and keep the other one straight, whatever. Do try to switch it up though!

When you're first starting on the floor, don't worry about being there for long. Start small and work your way up to longer periods. Eventually, it's great if you can get to the point where you can do whatever sitting task you want while on the floor. A couple of ways to incorporate it into your day is to put your laptop on a coffee table or something low (I use a foot rest) and sit on the floor while you're on the computer. It's great to eat on the floor, too. If you're not wanting to do something like that all the time, at least throw it in there once a week. It can be fun to do a picnic on the floor.  I found an interesting article about why you should sit on the floor while you eat. Fascinating! If you have kids, sit on the floor to play with them. (Want to know a secret? My friends have sometimes wondered why their small children seem to like me so much... It's because I sit on the floor and I'm with them at their level. They really respond to that.) You may notice that you have to get up from a sitting position a lot, because you have to do all the work of getting off the floor. No worries! Just look at it as extra exercise in your day.

If you need to when you first start, sit on a pillow. Sometimes the muscles and joints are not quite ready for those new ranges of motion, and sitting on something can help ease things into it.

When I first heard about how chairs can affect us vs. sitting on the floor, I decided to try to eat breakfast on the floor. I didn't last 5 minutes before my back was all, "What the heck?!?!" Not in a bad, painful way, but in a way where the muscles that weren't used to working were working and they were complaining. I have had problems in the past with my back stabilizers working as well as they should, and some of the exercises I tried were not cutting it. This has done better than all of those. Your back simply has to stabilize you if you're in a correct position.

Yikes! What a long post! But what are you going to do? There's so much to say about this, and there are really some stretches that would be good to discuss, and we should really talk more about truly fighting gravity instead of slouching, and so forth, but this is enough out of me for today. Believe me, sometime before Lent is over, we will discuss the whole standing thing against gravity. Yes, I know standing is something most of us do, and some of you probably do a lot, but many of us do not actually stand well, in such a way that gravity is not breaking us down while we try to stand up. We'll get there. Patience, grasshoppers.

In case this novella is not enough for you, there's more about the dangers of sitting here, or for those of you that want to rethink the chair in general, as well as the classroom chair in particular, this is another great article from K.aty B.owman here (that one also has a great graphic of some different non-chair sitting positions).

*It was 31 hours and 40 minutes. I was counting. I was tired.

Thursday, February 19, 2015

Moving through Lent: My Current Least Favorite "Joke"

I'll try to get these a little more spread out next week, but what can I say? This week of Lent is short.  It's already been a revelation both physically and spiritually. I know, 32 hours in, but it has definitely been kind of eye opening. I'm sure you'll hear more about that as we move on.

Funny thing happens if you sit on the floor when other people are around. Inevitably, someone will comment, "I'd be afraid to sit on the floor; not sure if I could get back up again!" And then they chuckle slightly at their plight, because that's just the way it is as you get older, right?

Maybe it is in our culture, but that's really not how it has to be. I find myself trying to come up with a socially acceptable response for the situation instead of blurting out my real thought, which is, "And you're okay with that level of mediocrity of movement in your daily life?!" Seriously, when did it become acceptable and expected that people get to a point where they are limited with getting up and down from the floor? Do you want to know the primary reason that they can't do it? Because they DON'T do it!

One of the things that I hope this series makes you think about is that we have muscle groups and ranges of motion that we rarely ever use. This is why we have so many problems so much of the time with things like getting on and off the floor. We get into our habits and don't do things that sound very simple on the surface, but make a big difference in the overall scheme of things.

There are a lot of fads in exercise, some good, others less so. What I hate are the exercises to work an isolated muscle group (quick, how many exercises or pieces of exercise equipment do you know of for the "core"?) There are a lot of things where we isolate the core and work our abs, etc. Yet, how do we need those abs to work in real life?  Even if you go to the gym consistently, that's not most of your real life. Those abs need to be able to give you a stable foundation for movement. We don't really want them to only be able to turn on strong with a specific ab exercise. We want them to be able to give control to the trunk while you are doing your daily tasks and movements, and that control needs to be enough for the task, not more or less.

What I like are the exercises that are functional and use a lot of muscles in the body at once. In real life, muscles don't move in isolation; they have to all work together to produce a really good movement. Going to the gym and using a bunch of machines is not the way to go (which is not to say that I don't like my workout at the gym, but I use the bike- and yes, there are some movement issues with that as well!-, and maybe do some bodyweight exercises or TRX; I think lifts can be a very good thing when done well- unfortunately, they are rarely done well- but you won't catch me on things like the leg curl machine or the triceps extension machine, etc.) I have a great exercise for you today that is all of the above goodness. It's functional, it uses more muscles in your body than you ever would have thought about, and it will help you not become one of the people who can't get up and down from the floor.


Here goes.

Lie down on the floor on your back.

Now stand up.

No, I'm not joking. It really is that simple, and that difficult. Try doing this as many times as you can in a minute, and count how many reps you can do in a minute. Then do it for another minute, but this time, you are not allowed to get up the same way twice. Just go as fast as you can (safely!) and move differently each time. Another way to switch it up is hold something in one hand straight up toward the ceiling. Keep it straight up the whole time and try to do it several times, then switch hands.

For some people, this will not feel like much of a challenge. Great! Make sure you keep getting up and down from the floor often, and it will not become a challenge. For some people, it may be a lot more challenging than you think; you may even get a little muscle soreness. It doesn't necessarily say that you're in terrible shape, but it does say that these are muscles that you don't usually use through these full ranges. Congratulations! You have started to use your body more in the way that it was meant to be used! I want to encourage you that if this is very difficult for you and you can't do very many reps in a minute, you will find that it can become much easier within a few days to a couple of weeks. It may still be work, but you will likely be surprised how much of a change that can happen in that amount of time.

Awesome! You're off and moving. How does it feel?

Note: Learn to love the floor. You know how I talked about being more "grounded" with movement? That's going to be extremely literal around here. There are a lot of tips that I have that involve some time on the floor. If you're anything like me, moving better means somewhat cleaner floors, because when I spend more time on the floor, I can't ignore them and have to clean them more often!

If you would like some more to think about in terms of how we are made to move vs. how we do move in an industrialized culture, I recommend this post.

Wednesday, February 18, 2015

Moving Through Lent: The One with All the Clichés

Seriously, friends, I don't think you understand quite how excited I am to do some posts about movement! I was so excited that I really only would have needed one or two people to express some polite interest in order for me to do this, but having so many people let me know that they are genuinely interested, I can't wait to get started!

First of all, a bit of a business note. I can't give you medical advice through the magic of the internet on a blog post. Unless I can actually see what you have going on, I can only give you some things to think about, and some suggestions of some fun things to try, but I cannot tell you what will fix your particular problems. Anything you try here is something that you have to figure out if it is a wise thing for you personally. Just because it's good for some people, it might be bad for you. Most of the time, you'll know your body well enough to know if you should try something or not. If you have any questions, one way to tell is that if you experience any pain (even twinges!) with an exercise or movement, you need to modify it or stop altogether. There should NOT be pain with movement.

When you try new things, they will often feel odd for a while. That's to be expected. Your body is used to the way that you're moving and that's your current "normal". But what is normal to us is not always (and I would dare say, rarely) optimal. Moving closer to optimal patterns of movement and postures is what will help you not "fall apart" as the years go on. The good news is, you don't have to get everything to be perfect in order to have things get much, much better.  As K.aty B.owman says, it's about progression, not perfection! (You'll be seeing lots of links to her stuff; she's got a great way of explaining things.)

What I want to accomplish with these posts is to give you some simple things that you can try to move your body more and to move it better. Most of them are things that you can hopefully incorporate into your daily life. They rarely take a lot of extra time, it's more that they require doing some of the same things you're doing, just doing them a little differently. Sometimes you may look or feel a little odd. I'm okay with odd. (And it's a good thing, too!... Wait, too personal?) Some will fit great into your daily life, so do them. Others may not work for you right now. Maybe you'll be able to do them later, or maybe those particular things won't work for you. As long as you try some different things, you don't have to do everything to get benefits. Remember, part of something is better than all of nothing!

One of the things that I love about anything in life when you choose to move forward, you never know quite where you'll end up. Making a small change here or there can really add up to some remarkable results. With something like this, changing your perspective a little bit about things that we see as a given (like chairs) opens up some possibilities that I had frankly never considered, and neither have a lot of my patients.

Last of all, be sure that when you do these things, you respect your current limits. Going beyond your current limits will only lead to injury, and that will not get the kinds of changes people want to see. The fact that you are so interested in changing means that you don't have to accept those limits as a long term thing.  When we question why those limits exist, and we gradually work up to them and challenge them, the limits will change, and they may change more than you think.

Tomorrow I will try to put up a post with more of the actual movement things that you are looking for, but for now I have one assignment for you. For the next 30 seconds, stand up and move. I don't care what movement you do, you can wave your arms around, do squats, jump up and down, cheer, dance across the room, do jumping jacks, whatever the heck you want.  Just move. Starting... Now!

Sunday, February 15, 2015


If you or someone you love has had to talk to me or read anything I've written in the last few months, you've probably had to put up with me getting overly excited about body mechanics and movement. You are probably entitled to an apology, and if I work up a little contrition for it, I'll get on that. I am a little carried away right now, but it's been so much fun. I have had my own thinking challenged, and it as allowed me to challenge others (specifically my patients). The best part for me is seeing my own nagging injuries improve, as well as seeing patients get better. It really feels good to move better!

The downside to all of this studying is that I can't turn it off. I see people standing or walking, and I want to run up to them and excitedly tell them some simple things that they could do to move better and decrease adaptations that lead to restriction and injury. My dad suggested that I could do a PTWB kind of thing "PT Without Borders", to which I said, "It's more like PT Without Boundaries" and nobody wants that! It's kind of frustrating to see some simple fixes that people aren't doing, and knowing some of the problems they are creating for themselves both now and later.

There are several things that are keeping us from moving like we should. The primary one is that we don't know what some of the things are that we could be doing to move better. The second one is that they do take some work. As Chesterton might say, it's not that moving better has been tried and found wanting; it's been found difficult and left untried. Initially, there is work, yes. But in the long run, it opens up opportunities that people don't even know are out there!

All the time I hear, "Well, I reached (whatever age) and I'm just falling apart now" or, "I'm older, so things don't work like they used to." Argh! I think that is a load of crap. Not horse crap, elephant crap. We're talking huge mounds, people! We don't fall apart and stop working well because we get older, we fall apart and stop working well because we move badly, and even though our bodies do a great job of putting up with our poor movement, eventually it catches up with us and injury happens.

One thing that I have noticed in my own personal work that I have been doing is that each of the steps I've taken has led me to be a little more grounded, often in some very literal ways. I'm thinking that's what I want to do for Lent, is to keep working on being more grounded physically as well as spiritually. Physically, I think I will give up the chairs in my house for Lent (but I won't be the weirdo that sits on the floor in public). Spiritually, that's going to mean getting more connected with a faith community, and putting a renewed emphasis on daily Mass and confession at least monthly.

Here's the other thought that I've had, though. Is there any chance that any of you are interested in some posts a couple of times a week about different things that you can work on to move better? Like I said, one of the biggest obstacles to moving better is knowing what to do and where to start. I'm more than happy to share some of the more simple things as well as links to other resources if you're interested.

Saturday, February 14, 2015

Happy Valentine's Day!

You know what I realized this year? I don't dislike Valentine's Day. There have been years where I would have said that I hated it, but in recent years I have been a lot more ambivalent about it. Now? I realize that it is a very good thing, and that I like it. I don't always like the feeling of having it rubbed in my face that I'm single (TOTALLY my own issue and not that anyone is purposely trying to do that). Nor do I like the idea that in order to be a good Valentine, someone has to buy roses, chocolate, and dinner. Too cliche and boring for me. But I do like the idea of celebrating love. Romantic love first, as it is a wonderful thing and SHOULD be celebrated! Especially those of you that are married and have been for a while. That is a wonderful thing, and any excuse to celebrate it is great. That doesn't mean that you have to go all out, just celebrate the fact that the two of you are, whatever that means to you.

However, I do also want to argue that maybe all the kids have it right, handing out Valentine's to everyone in their class. It is also a day to celebrate all different kinds of love and the people in our lives that mean something because they are there. This simple little post is my celebration of you all reading this! Have a wonderful Valentine's!

Thursday, February 5, 2015

Ahh, Thursday

How is your week going? My sister is not loving this week. She said today feels like the fourth Monday of the week, and she's ready for it to be over. I've had a great week. Not perfect, but at the moment I am enjoying having a chance to sit down and chat with you, and nothing that is absolutely begging for attention.

Budgeting is still going well. I just made it through my first 2 week pay cycle on the budget and I love it. I adjusted some things along the way, but in the end, I have $0 overspent. I did spend more on continuing education than I wanted to in the last couple of weeks, but it's for a conference that's important for me to attend for several reasons, so it's one I had already worked into the budget when I first set it up. I love being able to see what I have, and if I need to make an adjustment, I love the feeling of knowing exactly where it's coming from so that I can make an reasonable judgement about whether it's a good decision. I can't tell you how beneficial it is for me to have it all divided up into categories instead of looking at one pot of so many dollars and trying to figure out if I have enough for a certain thing that I may be spending money on.  Love it! I'm such a nerd that I'm excited for pay day tomorrow so that I can do some more budgeting, and figuring out how to make my money work best for me.

Yesterday was kind of fun, too. I was able to challenge several people with some different thoughts about how we move and what some of the best ways of movement are. I was also able to study some things that challenged me. I love those kinds of days! I actually read one article, and then yelled at my computer for a while. The article was talking about sleeping positions of tribal cultures, and how it helps correct certain musculoskeletal problems. It made a lot of sense, but it was crazy to think that I have spent so much time learning how to treat these problems that people could potentially fix automatically by different sleep patterns!  However, most of these involve sleeping without a mattress, so my job will not be obsolete any time soon, but it's interesting to think about. The article did quote a doctor from Kenya that mentioned that as certain populations got more affluent and adopted more Western ways (think: beds and chairs), they have started to see an increase in hip and knee osteoarthritis. Interesting, no? Also, learned a stretch for people with bunion problems! I was excited about that one, because there are few stretches that people can do for long enough to make them worthwhile, but this one could help.

Then today is Thursday, which is my day off. I was able to get taxes done with only minimal blood and no tears. (Seriously, I got a paper cut that really stung! And, yes, I am a big baby.) I was also able to get several other things done, and it's great to sit here in the evening without huge things hanging over my head. Tomorrow will be busy, but busy is good, and I'm feeling rested and ready. Saturday should hopefully mean cross country skiing, and I can't wait! How's your week going?

Friday, January 30, 2015

7 Quick Takes Friday

1) It's Friday! I'm excited for Friday, just because. I hopefully should be out on a great hike with friends this weekend (though weather might make the plans change; this is life.) I think I'm also more excited because I feel a little less overwhelmed with life. There's a lot going on, but I'm chugging through, you know?

2) One of the things that I think is helping with feeling less overwhelmed is the whole budgeting thing. I've been at it one week and one day, and it's not like there have been any magic new savings in that time. In fact, I actually had to spend a lot more money than I expected to this week. But it was okay, because I knew exactly what I had, I knew where it was coming from, and I felt like I had control of things. It was a decision that I made weighing all of the reasons for it, I had the money for it, and it was worth it. I kind of like love the feeling of being in control of my money rather than wondering if I'm doing the right thing or if I'm going to put myself in a world of hurt.

3) I should really be in bed by now, but I'm not. If it was just the blog keeping me up, I'd like to think that I would have canned it by now. Instead, I was working on the never ending paperwork that is part of my job. It's done now, and I can not think about it for 2 whole days. I'm finally learning to suck it up and do it the night of. Since I'm a morning person, sometimes I wait to finish the morning after, but then it sucks some of the joy out of a day off. This way, I don't have to do any of it until Monday. It's a great feeling! You know what that means? Maybe I can start on taxes this weekend. Joy!

4) Okay, my paperwork's done, so now I'm getting tired, so I'm just going to skip this one.

5) And maybe this one, because I'm a big huge cheater.

6) I heard an interesting assignment the other day, where people were given an essay where the topic was "If you could talk to a million people what would you tell them?" I think it's a fascinating question, and I want to know what your answer would be.

7) A couple of weeks ago, I got a chance to be out for a pretty fantastic sunrise.

Sky's on fire!
Head over to Kelly's for more Quick Takes!