Patients

Plantar fasciitis: Oh no! But wait… It’s not as bad as you think!

September 16, 2019 by centeredinmotion

The sole of your foot hurts, maybe at the heel, maybe in your arch. When you get up in the morning or after sitting for a while it feels like knives. It gets better as you warm up a bit, only to get worse again if you walk too much or in the wrong shoes. You turn to Doctor Google and read the dreaded two words: Plantar fasciitis. You remember horror stories of countless insoles, special shoes, painful foot scraping treatments, something involving a frozen golf ball, seasons ruined, no more running.

STOP!

This does not need to be your story!

You see, while the pain is in your foot, the cause of the pain is likely elsewhere in your leg, hip or even core. All it takes is a careful examination to find what’s not working right, followed by focused treatment to correct the issue. Yes, you are going to have to take some time off to let your foot recover, but we’re talking weeks, not months. And during this time we work together to make sure that your pain stays gone for good once you return to doing what you love.

Questions? Feel free to reach out!

Best,

Dr. Claudia

Why you need to stretch your quads, and how to do it right…

May 20, 2019 by centeredinmotion

Have you been battling tight hamstrings? Have you been stretching your hip flexors (psoas) with no appreciable change? Do you struggle with low back pain while standing, walking or when getting up? If your answer is yes to any of these questions, it’s time to check if you have tight quads, and if so, do something about it!

The easiest way to check is to perform the standing quad stretch:

Stand where you have something to hold on to. Bring one knee up toward your chest and grasp the ankle with the same side hand.
With your knee up, pull your heel toward your buttock.
Engage your core. The distance between your hip bone and the bottom front ribs should stay the same as you lower your knee toward the ground.
Lower the knee as far as you can toward the ground. You will feel a stretch at the front of the thigh.

Are your knees right next to each other? If yes, and you didn’t cheat by letting your pelvis tilt forward, then your quad is fine! If not, stay here for 20 seconds, repeat on the other side, then stretch each side once more for 30 seconds. Perform this stretch once or twice daily. Breathe!!!

For a stretch that is even more effective, because it reaches into the attachments right around the hip joint, try the half kneeling version! (This version may not work for people with severe knee problems).

Find a place along a wall. Place a pillow or pad on the floor about 8” from the wall.
Get on all fours, facing away from the wall. Place one knee on the pillow, and the foot up against the wall, toes down.
Bring the other leg forward into a lunge position.
Slightly tuck your chin and engage your core muscles, so that you have a firm connection between your hip bone and the front bottom ribs. With your hands on your forward thigh, raise your upper body until it is angled forward about 20 degrees. If you don’t feel a stretch at this point, you may need to move your knee closer to the wall and the foot higher.
To deepen the stretch, press into the wall with your foot and squeeze the glute muscle.
Lengthen your spine and breathe!

Why are you always so tense? Part III: Fascial Restrictions

April 25, 2019 by centeredinmotion

Sometimes, even after doing all the right things, some tight and tense areas just refuse to go away. This happens when not the muscle itself, but the fascia – or more precisely cells in the fascia called myofibroblasts – have contracted. This happens in response to either severe or ongoing stress of both physical or emotional nature. The body can hold these contractions indefinitely. They are often made worse by too aggressive stretching or exercise. However, when done gently and safely, we can release these tight strings that prevent us from finding balance and ease.

Here’s an example: You are having trouble with your right leg. First it’s the knee, then the hip. Stretches don’t seem to do anything. Exercises just make it hurt. You try PT, massage, get x-rays, nothing. Finally your friend talks you into seeing their myofascial therapist. At first, you’re skeptical because they don’t seem to be doing much. But after the first session your leg feels a bit better. Your therapist sends you home with instructions to perform some gentle yoga exercises, asking you to stay present in your body and observe. During the second session you remember a bad fall off your bike when you were eight. Your right foot got caught and badly wrenched. It almost seems like you are back there, yet at the same time you are present now! You feel a shift in your leg. A lot of the pain is gone! The next time you do your stretches at home, you can feel some remaining tension in your foot and ankle. Now you know how to observe it, breathe into it, and gently allow the tissues to release. You notice that the exercises that used to hurt are starting to feel good! Over time the tightness comes back less and less.

Many of the patients who come to my office have no awareness of how restricted they are. “Wow, I had no idea that that is so tight!” is something I hear every day. The first step in releasing the restrictions is to be able to feel them. This takes quiet patience and observance of our body, which is something many of us have not practiced in years. Sometimes it is even scary, as some restrictions may be tied to painful memories. An easy way to start “self-unwinding” is to lie down on your back on the floor (or in whatever position is comfortable for you), relax, and focus on letting your belly rise and fall gently with every breath. Picture your breath softly inflating all parts of your body and notice areas that feel like they won’t allow this to happen. Turn off all judgement and follow your intuition as you slowly move into a position that lets the air flow into the restricted area.

Thank you for reading! I hope this little series gives you some ideas and tools to address tension in your own body. Of course, if you would like more information, or if you would like help with any of the three challenges, please do get in touch!

Why are you always so tense? You just need to relax! – Part II

April 15, 2019 by centeredinmotion

Just relax! That’s easier said than done, right? We can tense muscles, and we can relax them, most of them on command. But some of them, when left unattended for just a second, seem determined to just hold on. Why?? In my experience there are three main reasons: Habits, stress and fascial restrictions. Let’s look at the second one:

Stress

Why does stress cause shoulder tension? Because tensing our shoulders is part of the “startle response” or “fight or flight reflex”, an ancient, hard-wired reflex rooted in the brainstem. It is meant as a defense mechanism against a sudden threat. Unfortunately our nervous system can’t tell the difference between a real, immediate threat to our life (This tiger is going to eat me any moment!) from an imagined one (If I don’t do this well, I might lose my job!). It is also distinctly unhelpful in the second situation, as along with creating shoulder tension, the reflex also impairs our ability for complex thinking. What can we do? We can remind our nervous system that (at least most of the time) there is no immediate threat to our life.

Here’s an example: You’re at work. You’ve got a deadline looming. The in-laws are coming and the house is a mess. And there’s that doctor’s bill… I bet that just reading this you can feel your shoulders creep up to your ears! But wait. You’re sitting at your computer, at your desk, in your office. People around you are going about their business. It’s warm. Your coffee is sitting right there. Nothing is trying to harm you RIGHT NOW. In this moment, you are SAFE. With practice and repetition, reminding yourself of this simple fact, RIGHT NOW I AM SAFE, you can calm down the startle response, and keep your brain functioning in a way that allows you to better solve the issues at hand.

All too commonly we have inadvertently trained ourselves to live in a constant state of fight or flight to survive. This not only feels bad to most people, but it is also harmful to our health. The constantly elevated levels of the stress hormone cortisol increase blood pressure and blood sugar while impairing our immune system and digestive system. This puts us at risk for anxiety, depression, digestive problems, heart disease, sleep problems, weight gain and memory/concentration impairments to name a few.

Here are a few more ways to calm your body and lower your cortisol:

1. Regular exercise such as kickboxing, weight lifting or a good match of tennis will give your “fight” response an outlet. Or you can let “flight” out with a run, bike ride or other aerobic endeavor.

2. Spend time with friends! Social isolation feeds the stress. Personal connections on the other hand will help your and your friends’ nervous systems calm down.

3. Mindfulness practices such as yoga, tai chi or meditation are great ways to help your system switch off the “fight or flight” response.

4. So you find meditation boring or can’t tell if you’re doing it right? You can learn to control and over time train your body’s response using biofeedback such as HeartMath’s InnerBalance app (easier) or the Muse meditation headband (more challenging).

5. If you are struggling with depression, anxiety or insomnia, a CES (Cranial Electrotherapy Stimulation) device such as the Alpha-Stim might be helpful, and comes with fewer risks or side-effects than commonly used medications. These devices require a referral from a healthcare professional, so if you would like to pursue this further, you will have to get in touch with your provider.

The next time you feel stress coming on, remember to ask yourself: Is there really a “tiger”? Or can you reassure your mind that there is no imminent threat to life, and that you can take a moment to calm down and figure it out?

The best time to start a new diet or exercise routine!

December 11, 2018 by centeredinmotion

“After the holidays I am going to lose weight/ start going to the gym/ never eat carbs again!”

Sound familiar? Gym membership statistics show that the highest number of new memberships are purchased in January of every year. Sadly those same statistics show that 80% of the new members drop off within the first five months. It’s not the lack of good intentions that makes people quit, but rather that all the energy that was saved up for the “big change” fizzles out – until next year.

So what can you do if you want to lose weight, start going to the gym or never eat carbs again, and stick with it?

You know what you want to do! Why wait? Start TODAY!

It doesn’t matter that it’s Tuesday, that you have a trip coming up, or that the holidays are just around the corner. So you’re going to fall off the wagon. It happens! But it’s no big deal, and definitely not a reason to beat yourself up and quit. Falling off is quite normal. I bet that you’d be hard pressed to find anyone who hasn’t. So fall off, dust yourself off, and get back on!

Plus: It helps to plan ahead and choose what is worth falling off for. Start now, and you only have to keep it up for two weeks before you can plan to cheat at a holiday dinner – and practice doing it completely guilt-free, because you know that you’ll go back to your plan afterward. You can do that! It will also take pressure off starting again in the new year, as you’re not doing anything new and different. No figuring out how to do it. No falling for some high-pressure sales pitch aimed at “resolution seekers”. Just getting back on the wagon and taking care of yourself.

Why are you always so tense?? You just need to relax! (Part One)

December 5, 2018 by centeredinmotion

That’s easier said than done, right? We can tense muscles, and we can relax them, most of them on command. But some of them, when left unattended for just a second, seem determined to just hold on. Why?? In my experience there are three main reasons: Habits, stress and fascial restrictions. Over the next three posts, we’ll look at each one.

Part one: Habits. Most of us have habits that cause tension, usually related to posture and repetitive movements. And as you probably know, changing a habit by sheer force of will is incredibly difficult. The reason for this is that a habit solves a problem. It is currently, or at one point was, the best thing to do to cope with a situation. The key to overcoming a “bad” habit then lies in recognizing the problem and helping your body find a better solution!

Here is an example: No matter how hard you try, you always end up slouching when sitting at your desk. Why? Because that is the position of least effort in your current environment. One major factor that makes sitting tall hard is that most of our chairs are too short. By simply raising your chair (and desk) you can make it easier on yourself to sit with better posture.

The next time you notice tension, take a moment to look at your position, at the way you are performing your task and at the equipment you are using. See if there is anything you can tweak, such as the angle of a keyboard, the size of a grip, the stiffness of a pedal or the position and flow of the things you are handling. Ask a friend or co-worker to observe you, or hire a professional such as a trainer to help you find a better way.

Thank you for reading! I hope this little series gives you some ideas and tools to address tension in your own body! Of course, if you would like more information, or if you would like help with any of the three challenges, please do get in touch here!

Yours in Health,

Dr. Claudia