Posture Fitness

Oh how the mighty have fallen

2012-02-03T12:51:00.000-06:00

Got a bit too cocky for my own good. Last week, for the first time in over 3 months , my knees were as problematic as they have ever been. But just for two days. As soon as I got back on my exercise program, the pain was resolved as the joints became better positioned. Once again, I had been feeling so good, I forgot to do my daily Posture Fitness routine.

I see this happen with my clients all the time and i have always wondered about their choices. The two things I do know and feel very confident about are that 1. I can make the pain go away all by myself with no drugs or surgery and 2. The only problem is time.
We just have to make that time the most important in our daily agenda and keep it there.

The club I was on the verge of joining is filled with people who see their pain as a distraction to be dealt with as quickly as possible -- Cut it out or turn off the symptoms with drugs. They are not interested in expending any personal energy on resolving the cause of the pain. They just want to pay someone to make it go away.

Our pain tells us a huge amount about how we are living our lives. We should listen to it. It is telling us something is wrong. I have decided to give my knee pain the time of day it deserves. Everyday, for at least the next 6 months, maybe longer. Can I find the time to do that? No, we never find the time; we have to make it. Carve it out and hold it sacred. This determines our quality of life after all, for goodness sake!

I am working with a client who has experienced excruciating pain for over a year. Last month, he told me when he did his exercises every day, he was totally pain free. But he said that 45 minutes a day was too much time on top of everything else he had to do. I question the logic in that thinking. For myself, I will get back on the wagon and invest that hour a day toward reaping the reward of a painfree knee without the trauma of surgery or the cost of prescriptions and doctor visits. We really are in control here. We just have to accept responsibility.

Great Progress!

2012-01-10T08:04:00.001-06:00

OMG. My knees have felt so good for the past weeks since I have been following a PostureFitness corrective exercise plan that I have been able to be much more active. Thus I have not been sitting at the computer so much and totally forgot to update this blog over the holidaze. These days I hardly even think about knees or limitations. The recurrance of pain or fatigue is very infrequent now and almost assuredly associated to periods of inactivity. I'm still happy that I did not choose Total knee replacement surgery (yet). Keep moving people! But be sure you are moving in the right way. I'll get into 'the right way' next post - Postureal dysfunctions and compensations. Eye-opening stuff!!

Client Comment

2011-11-21T08:20:00.002-06:00

I'm not the only one benefitting from practicing the Egoscue method® for knee pain. Here's what one of my clients sent me this morning:

"Thanks for checking in. I have been doing the e-cises you gave me daily and am happy to report that my knees are feeling great. In fact, I'm planning to go to the Y today--- first time in three months! So they have paid off for me in a very good way. I'd love to come in to see you next week for my next installment of e-cises. "

~ It's a good thing and NNC is happy to help.

Inflammation

2011-11-16T08:00:00.000-06:00

My knees are not happy today. It's not the sharp grinding joint pain that made me schedule TKR surgery; but rather the discomfort of inflammation. I recognize all too well that those of us with joint pain and arthritis are not well-served by consuming sugars, carbs, or alcohol (same as sugar). For the past two nights I've enjoyed dinner with friends and there was wine and pasta involved. But today I am paying for that with stiff sluggish knees. Plus I wore a shoe yesterday with a bit of a heel. Never good for knees.

The TKR surgery promises to eliminate any arthritis pain because there would no longer be any nerves in the joint to transmit pain, nor would there be any natural joint surface to become inflamed. But my goodness, why would I want to put myself through such a major surgery, when I can control this inflammation simply by avoiding certain foods and shoes which create my discomfort.

So at least for today, I'm still choosing to control the situation by lifestyle modification. My experience predicts that I will feel much better after doing my Egoscue routine this morning.

Egoscue and My Total Knee Replacement - The process

2011-11-14T07:57:00.005-06:00

Yesterday I walked for exercise for the first time in years. Not even a full mile, mind you, and my cardio was not up to par, but I had no knee pain and was not limping. That's a victory for me!

When I began my dedication a few months ago, to change my posture and avoid bilateral total knee replacement surgery, I could not walk from the house to the end of the driveway to pick up the newspaper without limping and wincing with pain in one or both knees. Walking down any incline was ridiculously painful, and when I walked back up the slight incline to the house, I noticed I kept my left leg stiff and straight; it would not propel itself with the quadriceps. The muscle simply would not fire to let me walk properly. It was obvious to me that my gait was 'wonky' and the left leg just wasn't working right. My foot hit the ground with a wobble, but I could not for the life of me see where the dysfunction was. I walked toward many mirrors for months trying to assess my own gait. I asked many physical therapists to assess my gait and see what I was feeling. Why weren't my quads and glutes working? I saw many professionals in my attempt to figure out how to turn them on (the quads, not the professionals!) and where in my gait dysfunction was the key to correction. I did lots of quad and glute strengthening work with no change in outcome.

From the moment I had scheduled the bilateral TKR surgery, I was committed to being in as good a shape as I could to deal with it. I immediately began doing the pre-op knee program twice a day:

Elevated ankle pumps
Knee Press Downs
Straight Leg Raises
Supine isolated Glute contractions
Heel slides
Sitting Quad Extensions
Seated Hamstring Stretch

A few of these were quite painful for me. But I kept reminding myself that it was not as painful as it would be after the surgery, so Just Do It! (that simple Nike slogan has really helped me with so many things over the years)

Just from doing these simple exercises, I was amazingly better within a couple of weeks. To the point that I first began to think maybe I could get by without the surgery for another year. I decided then to give it a couple more weeks and told myself that if I maintained the improvement, I would postpone the surgery and give myself even more time to get in better shape. By the end of the next month, I was beginning to believe that I might actually be able to avoid the surgery altogether if i walked my talk, did the work necessary to get my total body posture back in the postion it should be for proper knee joint functioning. And I put together my first Egoscue menu based on what I saw in the mirror and what my colleagues had seen in their evaluation of my posture.

Now, the only question in my mind was "is it too late?" The cartilage is gone and that's ultimately the reason it hurts, right? But how can it be then, that I am without pain for these recent days and weeks, when the cartilage situation is the same that it has been for years? Hmmmmm?! Could it be that it's the position of the bones of the joint that are grinding and if I can move those bones into a better postion, the joint will move smoothly and the pain will abate? Bones do not move by themselves, so I will have to work on the proper muscles to stretch and strengthen specifically to repostion the joints.

Here are my 2011 xrays. I In a few months I will take another set and we'll see definitively what has changed from my efforts.

Next I will take you through the E-cises and the reasoning behind the process, and share my weekly ups and downs in the process to date.

Egoscue and My total knee replacement -- The Cobbler's children

2011-11-13T13:49:00.002-06:00

As a neuromuscular clinical massage therapist and corrective exercise coach specializing in relieving pain by restoring posture for over 20 years, I have been implementing the exercises of the Egoscue Method for quite some time. I am certified as an Egoscue Posture Alignment Specialist (PAS1). My certification as a Posture Alignment Specialist (PAS2) will be formally completed in a couple of months.

But it is challenging to evaluate and assess your own body. I had been helping everyone else but myself. There's an old saying, "The cobbler's children have no shoes." And I really needed to supply myself with the same care I took of my clients. When I went searching for an Egoscue therapist several months ago , looking for someone to help me in my quest to avoid bilateral total knee replacement surgery, the Egoscue people who came enthusiastically to my aide were Rick Mathes at the Egoscue Clinic in Austin, TX, and Brian Bradley at the Egoscue clinic in San Diego. Since I have family in Austin, I decided to make the magic happen with Rick at Egoscue Austin.

Egoscue and My Total Knee Replacement - Rehab or Prehab?

2011-11-13T13:23:00.003-06:00

I have a few months to catch up on, and then I hope to go forward in real time. From my daily notes I can report that from the first day I decided to committ to putting myself first and follow the advice I would give to a client, and with the same effort I expect from them, I began to get better -- significantly better. From the first week I began to employ my self designed Egoscue Menu, I began to see biomechanical and gait improvements I had not seen with any other past attempts. And when I added the Egoscue Menu prescribed by my mentor, Rick Mathes at Egoscue Austin, my improvements were heightened....AS LONG AS I DO MY WORK EVERYDAY. I had to take responsibility for my own condition and be disciplined enough to really commit to getting better, no matter what it took. This has become my priority. Has this been a miracle moment straight-to-the-top result? NO! But the overall trend on the graph of improvement has continued to be a rather consistent upward gain. And with the Egoscue e-cises I see profound improvements in other areas of my body -- better hip and shoulder range of motion, etc.
Having read all the pre-op literature about the total knee replacement surgical procedure and the rehab period and what to expect in therapy post op, one thing became clear to me: The necessary rehabilitation effort was going to be the same regardless of which path I took. The only difference was this:

if i had the surgery, I would be unable to work, generating no income for 2 months, and be in excruciating pain for several weeks while I made physical therapy my life's focus for several hours a day. I would be dependent on other people to drive me to and from the therapy and do all the other errands I needed in the course of daily living.
if I postponed the surgery, I would be in moderate pain while doing my own physical therapy at home for an hour or more every day, but still able to work and pay my bills and I would remain independent and able to drive and ambulate without narcotics.

Now almost everyone I know who has opted for the TKR, either single or bilateral, has had good outcomes, and is very happy with their decision. But something about cutting the ends of my bones off, just makes me think twice. I decided I had very little to lose by choosing to see if my own "Pre-Habilitation" could keep me out of the O.R. and that brutal post-op rehab. And thus my journey began.

Egoscue and My Total Knee Replacement

2011-11-13T07:46:00.005-06:00

My story begins:

I scheduled TKR this year for both knees. My surgery was scheduled for November 1, 2011.

My quality of life had diminished to the point I could no longer hike with my friends or even walk far enough to call it a walk. Doing simple house work had become a real chore because my legs and knees would fatigue and ache long before the job was done. There are several flights of stairs involved in my daily life and I had begun to dread them all. The laundry would simply pile up because it was too challenging to navigate the stairs to the basement. My yard and garden suffered from profound neglect because I could not even stand long enough to water everything much less bend and kneel and tend to the outdoor tasks I used to love so much. The thought of going on vacation was not exciting because I knew I could not get around well enough not to be a complete bore to my travel companions. I stand in my job, and everyday when I left my office I would literally limp to my car and couldn’t wait to sit down. Which is all I did after getting home in the evenings.

Now, I should explain that I am a Professional Posture Fitness Specialist who has great success with my clients in keeping them pain free and out of the Operating Room on a regular basis. But I had not been walking my talk for several years. An extraordinarily stressful business relationship had taken its toll on me and when the dust finally settled, I found myself forty pounds heavier. Amazing that all this fat had been accumulating without me really acknowledging it at the time. I had become much more sedentary as I focused on protecting the business reputation I had worked so hard to earn over the years. At the same time my elderly parents were declining in physical and mental health. Since they live in another state, instead of my activity level increasing as I tended to their needs, I became even more sedentary as I sat at the computer or on the phone helping guide them toward the best resources available in their area. This is the same thing that happens to so many of us – perhaps different scenarios, but the same resulting stress levels and with the same destructive increase in the time we spend sitting.

My knee joints deteriorated with all that sitting and weight and were diagnosed as 'bone on bone' 6 years ago. The pain changed over the years , sometimes managable, sometimes crippling. During that period, I sought out Physical Therapists, Fitness Trainers, other NMTs, and anyone I knew about nationwide whose opinion on anatomy and biomechanics I respected. I was keenly aware that my gait had become dysfunctional and my muscles were not firing correctly, but I needed help to determine where the source of the dysfunction actually resided in my body structure.

My colleagues at NNC were invaluable in giving me an accurate postural assessment and great soft tissue massage which helped greatly to alleviate the pain when it became too much. It was my associate at NNC who confirmed my suspicions that I had an anatomical leg length discrepancy -one leg is longer than the other- *( I will discuss anatomical vs functional leg length imbalances elsewhere in this blog. It's quite a controversial topic among bodyworkers) But this condition was unquestionably confirmed by an xray of my full standing posture. And when I put a full foot lift on my shoes, my gait improved to the point that I no longer waddled like a duck and some of the pain in my left leg was reduced. Thank you Bethann and Paul St. John! But leveling my pelvis was not the answer to all the resulting compensations that were now causing me trouble.

So I made the decision to have my knees replaced in an attempt to regain a better quality of life. And I began to acquire all the paraphernalia necessary for the long and brutal rehab – walker, toilet seat riser, shower transfer seat, lining up people to drive me during the 8 weeks I would be out of work and unable to drive. But in one week’s time, my inner alarm went off. This went against everything I taught and said that I believed about posture and pain and the ability to change joint pain.

So I knuckled down and worked all the traditional exercises in my clinical repertoire to strengthen glutes, quads, hams, calves and abs to improve the strength, position and support of my knees. When I was not making significant improvement, I reached out and took the advice of other trainers and therapists, and worked their prescribed programs. To my great surprise and dismay, things only got worse instead of better. The weight continued to pile on as I became more fearful of trying any form of cardio or lower body strengthening.

I had all but stopped giving exercise protocols to my clients because I was unable to demonstrate them myself and I’ve always held myself to the standard that I will not ask my clients to do anything I cannot do. Plus I was no longer confident that my knee protocols were going to provide the results they were paying me for. Plus my physical image was no longer conducive to my professional status. (you can read more about that at "confessions of an overweight fitness trainer")

I needed another trick in my bag of knowledge and decided to get serious about learning more about the Egoscue Method of Postural Alignment. Having used bits and pieces of Egoscue menues for quite a long time in my practice, I had not really worked the menues as they are meant to be used. I began the rigorous study on the path to becoming certified in Egoscue. But even after I began my education, I was not actually implementing it for myself, but rather spending more time at the computer and on airplanes and in lectures --- SITTING!

When I finally hit myself over the head with the realization that knowing and doing are two different things and I was not going to change my body by knowledge; I had to act on that knowledge. No one could to do it for me. Or if I insisted on someone else 'fixing' me, it would be a surgeon. And thus I finally set about treating myself as I would a client with these same challenges and utilizing the Egoscue Method the way it should be implemented.

I am using this blog to journal my experience toward my goal of avoiding total knee replacement surgery.