spasmHave you ever twisted your back or neck suddenly causing a severe pain and then not been able to move?  “Throwing your back out”  is a common term often used.  When we have a sudden pain in a  muscle,  joint, or nerve resulting from a sudden twist or strain, the muscles around that injury often spasm or contract to protect the area. This results in a decreased range of motion and often a complete immobilization of the area.  It is common for soft tissue to impinge nerves.  The impinged nerves and lack of mobility oftentimes creates more pain and is then evolved into what is known as the Pain-Spasm-Pain cycle.  This occurrence often happens with areas surrounding a herniated disk or inflamed nerve condition such as sciatica or carpal tunnel and thoracic outlet syndrome.

The Pain-Spasm-Pain cycle is what happens when we have an injury then subsequently feel “stuck” and finally, more pain.  That spasmodic reaction is the bodies response to the shock of the injury.  Our bodies have natural defense mechanisms in place so we do not cause further injury to these areas.  Think of this spasm or immobilization as a “Natural splint’  such as one would have placed near a bone that had been broken.  The splint is placed near the injury to restrict its movement so it can heal properly.

The tensing of the muscles around the area to immobilize it is very useful up to a point.  In chronic issues, massage therapy and other forms of bodywork are very useful in helping to “break” the Pain-Spasm-Pain Cycle.  As mentioned above this reaction (of contracting and immobilizing the injury) is generally very purposeful, but when it continues for a prolonged period and becomes a chronic condition it is best to seek help.  Consult your Doctor as to what the prescribed treatment should be (physical therapy, massage therapy etc).

There are so many reasons why this occurs:  incorrect sleep positions, lifting a heavy object, or a repetitive motion injury are just a few examples.  The more we can train our muscles to be toned and physically aligned the safer from injury we can become.  Usually we injure ourselves when we are rushing or tired.  This often happens with elderly people as their brains can still think quicker than their bodies’ reactions and reflexes.  New parents may find it challenging to keep up good body mechanics as they are chasing after a toddler (or two) going in every direction.  So if at all possible try to slow down and be mindful of your body mechanics to avoid injury and the dreaded “Pain-Spasm-Pain” cycle.

sandwich21So often in life we need to communicate something difficult to someone and we don’t know how to say it. The communication could be to a close friend, family member or a work colleague. The subject may be trivial but important enough that there needs to be a resolution around the topic that continues to arise. The challenge is how to be tactful and speak one’s truth. We may feel, “‘how can I possibly say this in a kind way that will not alter or damage the dynamic of the relationship”? We all know words have resonance and we cannot take them back. Being on the receiving end of an ill spoken criticism hurts and tends to make a person want to shut down or get defensive. Most of us have learned to forgive but we never really forget. Words are powerful.

This technique of giving constructive criticism is called, “the Sandwich Technique.” I am sure some of you may have heard of it.

Before you begin speaking your truth imagine what it will achieve (your intention). Ask yourself “how will my words “land” on this person. We all hear things differently and though it is not possible or even healthy to completely imagine how someone may receive you. Set your intention for saying what you need to say. This will help to keep your thoughts clear and maintain speaking from a heart centered perspective. An example of an intention may be to have a deeper and clearer connection in my relationship with this person.

Begin with a genuine compliment (after all you would not bother to communicate your criticism unless you cared for this person). Be sure that it is a genuine compliment otherwise you and the recipient will not be open to the growth that will take place once a resolution has occurred. If it is not genuine it will feel like false flattery and that is pointless and surface.

Now, the challenging communicative part where you speak your constructive criticism. Be mindful of your original intention and keep it simple.

Finally end at a positive, genuine place. This could be your original and genuine compliment re-stated with something spoken from the heart about your investment in the relationship. This can even be your intention spoken clearly and kindly out loud. This will be the last thing they hear so the value of it lingers. Remember when you speak this last part it will come directly after the constructive criticism so be mindful that they are in a more vulnerable or possibly defensive place.

This may seem like a lot of work to simply speak your mind/truth. You may feel that you prefer to speak your mind, tell it how you see it or tell the truth and be honest. All of this (your truth) remember is your point of view and the person you are speaking to may hear your words/critique/suggestion completely opposite of what you mean. Consider how your words “LAND” on someone. Literally the way they will receive them from their perspective. You may not get the desired effect you are looking for if you simply blurt out your truth.

The Sandwich Technique works for small things as well as large and complex ones. Remember your genuineness and the intention with which you have set (before you begin). Is the Sandwich Technique manipulative? Well, you are still saying what you need to convey hopefully without harming yourself or others. It is a kinder approach and it is a smart technique in improving how to think before you speak.

knee-anatomyThe knee joint is the largest joint in the body. It takes three bones articulating with one another to create it: the lower portion of the femur, the upper portion of the tibia and the patella. As a result of it being a large and complex joint (due to a variety of ligaments, tendons, and cartilage to support and protect it) it takes a lot of wear and tear.
There are so many varieties of injuries and conditions of the knee all of which can be helped and prevented by working on strengthening the optimal tracking of the patella (the shield-shaped bone in the front of the knee). Imbalance in the tracking of the patella can lead to conditions such as; chondromalacia patella syndrome, patella tendinitis, and patella misalignment. The improper tracking of the patella can create bad alignment in the entire knee joint which can result in injuries including: Meniscus Injuries and ligament tears ( Anterior Cruciate Ligament-ACL, Lateral Collateral Ligament-LCL, Medial Collateral Ligament-MCL, and the Posterior Collateral ligament -PCL).
Imbalance in the Quadriceps muscle is a major contributing factor to poor tracking and alignment issues in the knee joint that can cause knee strain and knee sprain. Patella subluxation (dislocation) can be a result of the Quadriceps muscles, retinacula, or patella tendon being pulled too hard. Overuse or over excessive loading of the knee joint can also result in patellar and quadriceps tendinitis (inflammation). Knee issues are very painful and can take a long time to heal so it is of great value to take care of and strengthen them.
The Quadriceps muscle is made up of four muscles (vastus lateralis, vastus medialus, vastus intermedius and rectus femoris). This is the large outer muscle group in the front of the upper portion of the leg. It originates at the hip bone and inserts via the patella ligament to the tibia and is used in extension of the knee joint. In many people (mostly women) (see high heel article) the outer quadriceps is overused and the inner quadriceps is weaker. This imbalance is what creates the poor tracking issue. The patella is literally pulled outward and upward more frequently. This constant outer pulling effects the meniscus (cushioning and shock-absorbers in the knee) as well as the tendons and ligaments. This creates an instability in the knee joint. The inner Quadriceps need to be strengthened to keep the balance of the Qaudriceps muscle and the tracking of knee in alignment. Imagine … pulley system imagine one rope pulled much tighter than the string on the other side eventually it would teeter off
Even though Vastus Lateralis is not used to flex the ankle joint, it is used in the action of extension of the knee. This next exercise is really an isometric contraction of the muscle(it does not move but is toned and used to stabilize).
Place a pillow under your knee to avoid hyper extension of the knee joint (see article on pillows and bolsters for joint support for more tips). Gently flex and point your foot letting the toes relax and go along for the ride. There should be no excess tension in the foot. The focus is on the inner Quadriceps muscle (just above the knee toward the mid line of the body). One should see this area of the muscle slightly bulge or at least feel some sensation there. This is an indicator that it is being done correctly. Do up to ten repetitions on each side. If that feels like enough then stop there. Feel free to repeat a second set. This simple exercise is very effective in helping the balance of the Quadriceps muscle and subsequently in the tracking of the patella. It is great to have an “exercise” you can do on the couch!
Biking (done in a moderate level) is also an effective way to help in the strengthening and tracking of the patella and subsequently the entire knee joint.
This exercise is meant as a preventative measure for enhanced health and does not substitute for personalized physical therapy or medical advise. For acute or chronic knee pain please visit your doctor.

highheelsBad shoes (high heels with pointy toes) negatively effect not only your feet but each joint and muscle above them by throwing them out of a natural alignment.  Over time this poor alignment can lead to a lot of wear and tear  on these joints and muscles.  Imagine yourself talking to yourself as an 80 year old woman and tell her how important those heels were to you .  Your point of view will seem very pointless to her as she (you) is dealing with a multitude of injuries and maybe even painful surgeries such as toe and hip replacements because of high heels.

According to Dr. Michael Coughlin, an orthopedic surgeon who reported on all his toe surgeries over the last fifteen years which included bunions, bunionettes, hammer toes and other types, eighty five percent of them were performed on women.  This is linked directly to tight fitting and ill fitting shoes.  And the main culprit-high heels.  It is a sobering statistic to find out that 85% of all foot surgeries are a result of bad shoes.

The foot issues mentioned above are just a few examples of how high heels can damage your feet.  A good way to feel how they can hurt the rest of your joints is to stand with bare feet on the balls of your feet (as though wearing high heels).   Notice the great pressure created at the ball of the foot-the beginning of the problems.  Feel how the ankle is weakened because of its lack of mobility and zero contact with the floor.  The muscles of the calf are shortened affecting  the balance of your knees, hips, spine, shoulders and neck.  Now, try walking!

High heels also throw off the center of gravity (known as the plum line).  So, instead of your body being stacked above the center of your feet it is pitched forward.  This creates tension and strain in your muscles and joints and can create spinal misalignment such as lordosis (sway back) and kyphosis  (hunch-back).  They also exacerbate other conditions like herniated disks and sciatica.

I worked at Haven Spa in SoHo for five years.  We had many clients from the fashion industry and I understood their plight because that was their business to wear the latest fashion.  If you absolutely have to wear heels at least try to balance some time off work to wear comfortable shoes for your bodies sake.  A podiatrist once told me that it was really ok to wear a low heel as long as the toe-box was wide enough to give adequate space for them.  This way your toes will not be smashed and the rest of your joints which are stacked on top will be less affected.

*source:  The foot and Ankle Sourcebook by M. David Tremaine M.D. and Elias M. Awad PH.D.