Theraband Pacquet Exercise

London's Scoliosis SOS clinic called this exercise the PNF Pacquet, but PNF is short for whatever material a theraband is made of.  Or, as my clinic station-mate called it - that pulley thing.

In my case, I need to exercises both of my lats, so I use two therabands.  Others only used one or the other.  Two therabands are tied to high rungs and I grasp them in my crossed arms, all the while standing in my corrected posture.  Then I straighten our my arms and, at the last moment, twist my hands out so that my lats get a good work out (like trying to squeeze a nut).  Hold for 6 seconds then repeat 12 times - take a break and do two more sets.

This is one of the few exercises that is reasonably easy to manage while on the road.  I put a knot at the ends of each theraband, drape the knots over a door and then shut the door.  Ta-da!  Easy-peasey.

*note that this exercise was prescribed to me for my particular scoliosis, and it might not be appropriate for others.

construction blitz

Ok London, what's with all the building?  On my walks from tube station to Scoliosis SOS clinic, I generally pass huge deep pits with scaffolding proclaiming "luxury flats" or a certain business or hotel.  One morning I counted 6!

These aren't just house-sized pits - these are entire block-sized pits.  And everwhere the pounding and screeching of construction noise, and dust swirling over the wooden hoardings like the smoke from hell rising up.

I had been expecting cautious optimism given the economic climate Britain has been dealing with for several years now. Growth is discerned, albeit minimal.  House prices have started rising again after years of stagnation or depression.  Things in the country and in the EU have stabilised for the time being.

But this boom in building I haen't seen since the Thatcher years of the 80s or the new Millenium years.  It's quite stunning seeing the city changing its skyline before my eyes!

The 5 Stages: #4 - Depression

This was the hardest stage for me to get through.  It's one thing to be sad about something - everyone is allowed to be sad.  But depression is something else.  Western society does not treat mental illness as readily as physical illness and so it is often dismissed or ignored or avoided.  But most people suffer depression at least once in their lives and it is a shame it is so poorly approached.

I had felt depressed twice before in my life, but both times it emerged suddenly from an event that was truly deserving of depression and so I never thought about handling it any differently (i.e., not handling it at all! Just ignore it and be as busy as possible).  But this time it caught me by surprise.

I thought I had a particularly pesky running injury.   I think at some unconcious level my brain suspected my back was really the culprit.  And when I was dropped from a relay team that quite rightly preferred a runner to a walker, I crashed emotionally.  Being kept from my sport was very discouraging, but being dropped from my community was devastating.  Running buddies are activity-specific relationships - fantastic when running but they disappear when you aren't.  There isn't anything sinister in it, it is just the way it is.

Criss-crossed communications and sleepless nights added to the mess and then one day I got a searing pain across the top of my butt, which set up permanent residence for several months.  Nerve pain.  I tried this medication and that treatment - full of optimism at the beginning and then plunged into tears when it didn't help.  12 months later I found a cocktail of medication that allowed me to sleep more than 2 hours (to all you young mothers out there dealing with babies that will not sleep - I totally feel for you!), which helped enormously.  I went to two different psychologists, but nothing turned up amongst all the potential reasons I put forward.  Oddly enough, it was the day when I finally met with a spine surgeon who told me I couldn't run any more and he couldn't do anything for me that, just like that, I popped out of my depression! 

You'd think that would have plunged me deeper, but I think perhaps it was not knowing that fueled the floods of tears.  Depression is a feeling of helplessness, of complete despair and incapacitation.  You look for something to fix the problem (or even to identify the problem) or that will mask it so you can get on during the day, but of course this is never successful because the problem is still there.  You don't talk about it because you don't want to dissolve into floods of tears for no apparent reason.  And you can hardly expect someone who doesn't know what's going on to be able to help. 

Looking back, the only person who was convinced my back was at the heart of my distress was my indominitable pilates teacher SK, who always made me cry just by asking how I was. Now I feel pretty sure it was because my brain suspected the same thing and she managed to connect in to that unconscious thought and that triggered an emotional response. 

The unconscious part of our person is a lot smarter than we give it credit for, and it really needs to be allowed to reveal itself.  Having a confidante or two who will just listen to you is the best you can hope for until the underlying source is identified and dealt with.  Now I look back at the time my fiancé died in a car accident and I ran away travelling, and the time I realized I would never be a mother and I plunged into stressful work projects, and I realize that I never really did cauterize the wound until years later.  I'm sure I have lost a few days at the end of my life by not allowing myself to heal at the time. 

Knowing this gives me a bit more ammunition in case it happens again, and I know to be kind but stern with myself.  It's no use ignoring it, but instead try to confront the issue and resolve whatever is in the way.  It might mean going deeper into the morass but it will result in rising above it a lot quicker and stronger.  I have learned a little more about myself and how I hande things, and I feel a little bit more empowered to act differently in the future. 

 

 

Unbanded and Left Hanging

The one exercise I, and probably everyone else at the Clinic, must do daily is some form of hanging. 

Long Hanging consists of two elements.  One is to hang your entire body from the top rung or something else that is high enough to allow you to hang with straight arms and without having your feet touch the ground.  The other form has you tractioning your shoulders down and lifting your head and neck up for 6 full seconds, then lower to the long hanging position and repeat, as many times as you can up to a set of 12. 



Half Hanging, or Short Hanging starts with your feet on the ground and in a squat position so that your shins to your knees rest on the ladder/wall.  Find a rung that allows you to sit in this position while taking all the weight on your hands.  Then you traction shoulders and rise as above, but always with your feet remaining unmoving on the floor. This of course is easier, and it is not difficult to cheat and use your feet to move your body upwards, but where's the satisfaction in that? 

Long Hanging was pretty generally felt to be most people's least favourite exercise and more like torture.

Ok, perhaps that is overly dramatizig the situation. I do tend towards the exaggerated don't I?  Apologies.  I blame the medication.

But the first day was particularly humbling as I was unable to do even one long hanging head lift!  (By the end I could manage 6! AND last a whole minute of Long Hanging part 1 - not that I'm bragging or anything of course)

This is where I found out one of the Clinic's rules was for a reason, the hard way.  "No jewellery" is one of the first things we were told and I broke the rules a teeny tiny bit.

Now, I understood why wearing dangly or hoopy earrings would get in the way.  Ditto with chains around the neck and wrist.  I even played along with taking my watch off.  After all, looking at it all the time would make the time go slower, and besides, there is a clock on the wall anyway.  But my wedding rings?  They haven't come off since I I did, or I would, or whatever the wording was I can't remember because it is almost 22 years ago and I was obviously only a child at the time ;)
 
But after only a few stretches of either of the Hangings I had blisters forming at the base of my fingers, with the ring finger in particular looking red and angry.  I realized that I would have to temporarily shed my circle without end.  They didn't go quietly into the night and I had to use a lot of cold water and olive oil to work them off. 

After 4 weeks I could still see the imprint my bands have made on my hand, but at least I accumulated calluses and not blisters from my hanging exertions.  I was not smitten by lightening nor propositioned, so life didn't alter, but I felt more fully dressed when I put them back on.

ring finger remembers
 

On the road I use a hand towel over a door and lift up my feet, which doesn't hurt my fingers any more than before.  I'm not quite sure how I will handle the hanging thing at home but I'll cross that bridge later. As long as my husband knows I still love him!

...were hard won and I wear them proudly!



they may be hard to detect but these calluses...

last Clinic day - the Reckoning (this time it's personal!)

All during the last day of the Scoliosis SO clinic individuals were called out for their one-to-one assessment meetings and final document completions.  I was scheduled to be the penultimate and I tried very hard not to get too nervous (it felt like exam results day!). During our lunch break (at the Minories pub - pre-ordered - what a good diea) I was eager to hear from those who had had their meetings and heard of rising several centimetres, losing a pound or two and, most importanty, seeing a noticable change to their physical profile.

Games, contests, round robin exercises, filling in our booklets, finally it was my turn and I was shown my statistics.

To be honest I was a bit disheartened.  I had worked extremely hard, didn't waste time getting ready, completely extra sets while waiting, always one of the last to finish before breaks.  Without intending to I think I had expected a greater change or had just hoped for it perhaps.  To me it looked like my after photo was my before photo!

the before is on the left.

 

The physiotherapist took great pains to tell me otherwise, pointing out that my back profile was flatter (primarily due to holding my shoulders back instead of rounding them forward, I think), there is now a tiny indented waist on my left side (primarily due to shifting my hips left) and secondary indents on my right side have lessened (primarily due to shifting my ribcage up and to the right).  In my head, all the gains I made were due to better posture, and not any change stucturally.  But lumbar curves (I was told) take longer to change, (especially after they have been in situ for awhile, I think!) and given that it takes 6 weeks to get a muscle 'activated', the work done in 4 weeks is good stuff. But all I kept thinking was that the gains I had made were due to better posture only.

The other diagrams and stats indicated some but little change, although all the changes were for the better so that was a relief.  I was booked for my follow-up appointment, given my menu of exercises, and that was that.


Scoliometer scans - the after one (right) shows a lower profile (a good thing)

my back's "mountainous" regions are closer to being "hills"

the only one that didn't get better was my weight!

the middle blue (side on profile) image is the one of interest I was told -
it shuld be a bit like an "S" - a kyphosis curve to the right at the top
and a lordosis curve going the other way at the bottom -
my after image on the right shows a positive shift

I was very thankful that I had been scheduled at the end of the day so that I could avoid going back up to the class and take a little time to settle my mind before they all trooped down.  I got trapped with an enquiry by one of the loveliest ladies in the group, who responded to my lacklustre response by saying that I had such a strong core compared to all the others that my gains could never expect to be as big as everyone else's!  In the end we all got dressed, hugged those that had to catch trains and planes, and went to the pub for a drink with everyone else, slowing peeling off with hugs all round as our time to leave came.

As I walked back to the station I reflected that the clinic itself may be over, but it's clear that the work has really only just started. I have 3 months of travelling ahead of me before I get home - how the heck am I going to do 30 minutes of work every day on the road?  Adapting my surroundings to fit?  Am I really going to be hanging off doors or lying on a bed kneeing the mattress as hard as I can? I think I see some rather amusing blogposts ahead.  (you are either promised, warned or threatened depending on how you see it!)

Mean Streets and Emapthic Architecture

My most common path from station to clinic passes a cruel part of London.  The streets bully and taunt me on my journey and I must pass through them with brisk pace and head held high.

 

But I receive support from new friends, the architecture that is emerging from old blocks of square, straight-lined, unbending structures that have dominated this City for too long.  As if to stress that humanity needs to incubate an Age of Empathy right now, constructions rise with curvatures of their own.  I feel more empowered and confident just seeing them as they expand into their scoliosis-like profiles with strength and purpose, and encourage me on my own way.

A journey is a journey whether it's physical, emotional, spiritual or metaphorical.  This is a bit like wearing your heart on your sleeve, but wouldn't it be fun to have a twisted version of this? 

 

Exercise Modifications - Stretches

One of the talks we had on the final day included how we handled our exercise schedule while away from home and our exercise station.  Given that I will be visit friends around Britain before spending a month in Turkey and two months in Africa (blogs to come!) all before I return home, this was one talk that attracted my attention.

The stretches will be easy enough to do with minimal equipment.  The pectoral stretch known in the clinic as "The Titanic" (from Kate Winslet's pose and Celine Dion's song of the movie):

can be easily done one side at a time against a door frame:   

Other stretches for the pierformis, the adductors, the traps, and the hamstring are easily done anywhere there is a bit of floor (and I hasten to say that the photographer snapped me too early while I was getting into position for my hamstring stretch and that I was not in fact cheating by bending my leg!)

 

The most difficult one to replicate without my trusty wall bars is the Ballerina stretch.  Although I am to do all other stretches on both sides, I am only meant to stretch my right side on this one. I have had a go on a few door frames and I think that will work nicely.  As long as I don't lose my focus and fall on my patoot.

 

*note that these stretches were prescribed to me for my particular scoliosis, and they might not be appropriate for others. 

Week 4

There is a definite change to the atmosphere this week.  Weeks 2 and 3 were pretty much the same; we warmed up, we stretched, we exercised together, we exercised on our own. 

This week we are being retaught all our exercises, with us adding notes in our own words to ensure we will be able to get into the right position with the right props and make the right movements when we are on our own at the end of the clinic.  Equipment pieces that have been ordered are arriving like Christmas parcels.  More questions are being asked of the physios. and they are extremely solicitous of every enquiry no matter how repetitious or banal.

The weather has been less than fair this week; cold and windy.  Rather than sit and eat all crowded in the tiny changing rooms, I leap off to St. Olaf's for its lunchtime concerts.  A few of the others have joined me, and it's so lovely to let the body relax and the brain take over, allowing the music to seep into my now strong core.  It is so quiet in their and everyone so intent on the musicthat eating is pretty well impossible.  I did manage a banana and a yogurt without making any noise, but veggies and hummus were scarfed down either on the way there or on the way back, along with noisy apples and rustling packets of granola bars.  I learned to avoid doing "iliopsoas on a ball" too soon after lunch, as it involved lying on my stomach a large yoga ball, with predicted results.

On our last day we were taken out one by one for our individual assessments and we had forms to fill out and reflections on the clinic itself to make.  There were contests: I came 3rd in the Long Hanging competition but 1st in the Sit Skiing and the Plank competitons!  However, it was only when I finished that I realized one of the instructors had been doing the plan as well and was still in position when I stopped. I had been under the impression (not looking up) that there was only one other student still planking with me and when I heard him let go I knew I could do so as well.  I like to think that if I had known I still had a co-competitor I would have hung on and beatern him senseless but in reality I doubt it to be true,  Still, I feel victorious if only for have gone 4 1/4 minutes which was the longest plank I'd ever done.  It was then that I realized that I really do have a stong core.

I had not been able to achieve one shoulder lift while long hanging at the beginning of the clinic, but now I can manage six.  I can also stay hanging for almost 2 minutes, which is another complete surprise.  I truly hope I can mantain such arm and lat strength.  Having a bump of muscle on my forarm is like a badge of honour for a girl of my vintage!

Equipment List

We have been given a list of all the equipment we will need to have in place when we return home in order to continue working on our own.

At this point my cynical head said "Here we go, the sell job."  It was hard not to listen to that cynical head as most of the items seemed quite highly priced for what they were.  Now to be fair it could be that I was looking at prices as a Canadian, and as a lotus-land Canadian at that.  As a couple, yoga and Vancouver go way back, and there seems to be a yoga place next to a sushi placeon every block.  Prices are pretty good compared to Britain in general, but on something so ubiquitous.  It's no surprise that the yoga cloithers "Lululemon" started in Vncouver.

The list I was given reads as follows:

• 2 poles (8')
• wooden bar
• 3rd pelvis correction bar
• 2 wooden blocks
• large PVC cylinder
• 2 small PVC cylinders
• webbing strap
• webbing yoga belt
• 2 foam wedges
• 2 bean bags
• 1 Deuser band
•  exercise mat
• 1 large ball
• 1 large stool
• 1 small stool
• 2 purple therabands

for an estimated total of`324 pounds stirling (about $520)

Oh - and a set of wall bars overlaying a full length mirror which would cost approximately 300 pounds - plus shipping and installation!

 

Once I'd recovered a bit and took a longer look I was happy to see that I already had about half the items at home in my basement room, or what my husband lovingly calls my "Wellness Centre".  Over the years of doing yoga and pilates I have attained a large ball, a mat, various balls and weights and bands, and body rollers of different lengths and strengths.  I can see my large ball will get a lot more use, but I particularly love my pink roller, upon which I can lie full length and complete core strength and stabilizing balance exercises.


Those of us who had come from far afield were given a spec sheet of the wall bars (i.e., "the rack" - it has a nice ring of torture about it), which is really just a frame of 2"x4"s with wooden rungs placed at varying distances, and a full length mirror behind.

Most of the items I do not already have I think I could easily cobble together qite cheaply - poles and wooden rods cut from doweling, and different sized PVC pipes all from a building supplier, and therabands, plastic stools and blocks from the yoga section of a good-sized pharmacy, such as London Drugs.  I could probably even make a beanbag or two, and cover a wedge of foam to complete my trousseau

Which is a relief as I can't imagine continuing with my summer travels holding a couple of long wooden poles and a large plastic stool!

In the end I bought two items I did not have and thought might be difficult to find.  I no doubt could get them cheaper over the internet, but I won't be at any fixed address for shipping until I get back home in September and if I am to follow this journey through I really do need a few items that will facilitate my prescribed exercise programme while on the road.  I had packed a theraband and small ball with me, and can get Martin to bring over my yoga belt and another theraband with him when he joins me.  The blue webbing band (through which I can thread my yoga belt and thus attain traction) and the super-stong Deuser band (which will work me harder than will my theraband) will be like extra percussion instruments on the road tour, not vital but adding a lot more colour and versatility to the performance.

*note that this equipment was prescribed to me for my particular scoliosis, and it might not be appropriate for others.

Foot Notes

One afternoon, we were sent up to the gym room on the 3rd floor, one by one.  There, I (and presumably each of the others) found a large square pad placed on the floor.

I was first of all asked to stand normally directly on the pad, which would measure how my feet bear my weight.

Then I was to walk normally over it, pacing myself so that my right foot walked over the pad going one way and the left foot passed over it when going the other way, 3 times in all.

A few days later I received an image of my walking performance.

It was no surprise to hear I have flat feet, nor that my right foot rolls inward, as I had discovered my right knee pronates in a few years ago. But it was still quite interesting to see it in living colour.

The static image isn't too bad.  It indicates I have fairly equal weight on both heel and ball of foot, with toes getting in on the party a bit too.


But the dynamic image is not quite so positive. 

The black line indicates weight transfer, which is supposed to start in the middle of the heel, roll forward along the outward edge of my foot and then move from little toe to big toe before pushing the weight off as the next foot takes over.  As you can see, my left foot is a bit more successful at this than my right.  In fact it looks like my right foot has completely lost the plot, despite my awareness of its inward habit.

I, like about 5 others of my company, were recommended to get orthotics.

My general practitioner had me resisting the call for orthotics a few years ago, when my pronation was first detected. His take was that unless absolutely necessary, wearing orthotics means muscles in the foot that need to be strengthened are let off the hook and not worked sufficiently. Given that orthotics seemed to be like flavour of the month for every runner I knew made me a little wary myself.  I am always a bit susicious when everyone has or uses the same thing - I am not a first adopter!  Call me old fashioned if you will but there I am.  And when the podiatrist I had been referred to concurred and recommended an off-the-shelf shoe insert (with the action-packed name of "superfeet") I thought I was sorted. Especially when my running shop and trainer also recommended them.  http://www.superfeet.com/activity/running-walking.aspx

So I questioned the Scoliosis SOS recommendation, and the physio. very kindly listened and offered to do the test again with me in my trainers (with said insole).

Which I did.

Well, as expected, the left foot is adjusted quite well, but the right foot still indicates incorrect weight transfer. 

I was gently told that yes, foot muscles must be worked absolutely, but a "mechanical fault" (I swear he used those exact words!) requires more assistance as other parts of the body are also impacted (e.g., pronated knee).  In other words a structural as opposed to an operational fault. And, big surprise here, my scoliosis was at the heart of this structural, mechanical fault.

Nerts.

Still hestitant given that they are not inexpensive, I put the word out to my peeps to hear their thoughts, and I received some very interesting feedback, all of course quite individual, but I did sense a couple of themes.  Those that had 'lazy feet' didn't enjoy the orthotics, whereas those who had experienced pain found them to be very therapeutic.

I bit the bullet, and my scepticism was finally tested two weeks later when I received my orthotics in basic black (I had a choice of colours, and was tempted with red or lilac but decided I would regret my choice.  One of the 14 year-olds got the lilac and as fun as it looked, I think my reasoning was sound).

$320 would have bought shoes much cuter than these!

After a week of breaking them in a few hours at a time, they now feel just fine.  And when I am conscious of it, I notice both my feet move from heel to the outside of my foot and along my row of toes to come off the big toe like they are supposed to - hey magic!  I also notice my right knee doesn't brush along my left leg as it often did while walking, but bends over feet in a straight lone like it's supposed to.

I've been wearing them in my trainers and my sketchers and my boots, and I feel like Nancy Sinatra strutting down the road now, regardless of whether I happen to be wearing boots or not at the time, but whatever they are, they are made for walking. And that's just what they'll do. .
http://www.youtube.com/watch?v=SbyAZQ45uww

Week ending

Clinic staff told us our weekend homework was to relax, walk a bit, and do our stretches, but not anything physically strenuous.  So I shall exercise a different kind of muscle and recount my 3 weekends in rhyme.

a-hem!

Weekend #1
Friday night I walked for an hour
I drink a pint and hid from a shower
Then I saw a play by Alan Bennett
That can't be bad now really can it?
Sloane Square next day to shop for a dress
Got shoes as well so a great success
Had dinner that night with friends up the road
And a lovely Sunday with kids who have growed
I drank champagne and ate way too much
And was driven back home - that was a nice touch!

Weekend #2
Dashed to a train in a Friday rush
Sun in my eyes in a coach all crushed
Got to Petersfield and was met at the station
Than proceeded to begin a 2 day conversation
A high point was at my favourite pub
The Harrow has such delicious grub
Skyped a cousin-in-law who has just bought a house
(Cannot think of a rhyme here except for 'mouse')
My body's a bit achy so nice to stay in
A friend's Clapham flat as neat as a pin

Weekend #3
Friday night in and tried to get work done
But a 2 hour skype was a lot more fun
Had to rise very early to make my train
But I still almost missed it - a right royal pain
My in-laws met me and took me to lunch
And a walk round the market 'cuz I had a hunch
That Bury was a good place to find a kettle
As a gift for a friend who's tested her mettle
It rained and it blew and the sun tried to shine
So I nestled right in with the in-laws, mine.

a city still with cobbles

beautiful Bury

a rare sunny morning walk into town past the butts

I haven't got a thing to wear!

Ok, that title was a bit of an exaggeration for theatrical effect.  I actually do have a lot of things to wear.  The question really is: Are they the right things?

Once accepted into the Clinic, I was given some direction as to what and what not is appropriate vestments for the physical work we are expected to do. 

1.) Exercise pants, leggings or shorts with no zips or loops or buckles.  There are some exercises that require a cinched, woven belt tight tightly around our hips that is connected to another belt that is connected to a ladder-like affair that is connected to the wall  (connected to the knee bone...) intended to provide traction as we elongate our bodies away from the wall.  So anything that can interfere with this activity is not good.

So, pack two of my long yoga leggings and two stretch capris.  Check!

2.) Men to be barechested - Women to wear bra tops.  The physios. need to watch the muscles of our backs while we exercise and work in our attempted corrective positions.   Well that's just dandy if you are a buff young man or a slim young woman but, not being either, this put me in a meditative mood.  Do I really want to bend and stretch in my bra?  I felt a little coy about this, so went off in search of an exercise bra that would provide good coverage and support but allow the practitioners with the view they require. This is not as easy as it sounds. My first stop was to Lululemon, an obvious choice.  While trying on various cute little numbers I made a discovery.  Not only is it impossible to squeeze into a 34D yoga top with any grace whatsoever, but in order to move with enough support the top in question is often designed with a racer back or several  thick straps crisscrossing the back, obscuring the spine too much. So, what about a swim suit top?  I dug out a few options to find they had decent coverage, and the halter in particular displayed my spine admirably, but I'm not sure they would be up to the rigours of the clinic every day for a month.  My local running store (Raquets and Runners) fortuitously invited me to a " 'Girls' Night Out" event.  Food, wine,  an expert on running bras - perfect.  I found out that no actively worn bra should celebrate a birthday.  that just made me feel sorry for my nice little Elle MacPherson - it was so looking forward to turning 5.  I gathered some options to try on, determined I like adjustable straps, prefer encapsulation-type bras to compression-type bras, and want covered hook enclosures that allow for adjustments but that won't get caught on any of the clinic equipment. I found two different styled bras in two different styles that both fit and looked good.

Pack two Moving Comfort sports bras - Check, Check!

3.) No shoes to be work inside clinic rooms.  Easy-peasey.

Assorted socks - Wright double-layer, blister-free socks (my old running fave) for walking to and from and basic wear, Wigwam marinos for warmth, and my fluffy panda socks I bought in Soeul last year for fun - Check!.

And of course my Twisted Outreach Project tee-shirts - Check!