Wednesday, 3 July 2013

Kicking kyphosis

Whatever, whenever, however you like, 'cos this is good this is cool this is nice and tight. I mean, I like it when the vibes make my stress flow free, and keep me calm and in my centre, like a sanctuary
Whatever, Whenever - Groove Armada

11 months of severe back pain left me with substantial deformation of my spine. Locked muscles meant I couldn't straighten my lower-mid back (couldn't lean flat against a wall, for example). And my shoulders were pushed forward, restricting the movement of my neck. As someone who has a very low personal tolerance of physical imperfections (as a teenager I once cut some warts of my elbow with a pair of scissors), I'm greatly troubled by this. I've built up quite a routine of back straightening and loosening exercises (having consulted no less than 5 physiotherapists). I thought I'd post up what I've learnt, since I know posture is a not uncommon problem with myeloma. I do a combination of these, each day.

Each of these exercises should be repeated 10 times. Do them in a sequence that suits you. And do the ones you think help your posture most - I don't do all of them all the time. If you can't do them all at first, start with the ones you can do. If you can't do them fully, or can't do them 10 times, do what you can. Over time you'll be able to do more. Exercise to the point of stretch - which will make your muscles ache a bit - but not to the point of pain. I'm a work in progress myself: I'm better at some of these than others.

I am not a physio expert, just a patient. I have found these exercises helpful, but you must make your own judgement, reflecting your own situation, at your own risk. Be sensible. Myeloma bodies are fragile.

Ex1: Arm stretch
Helps open up the chest muscles
Either: standing, raise the arms forward in a circle until they are (if possible) above the head. Hold and release.
Or: lying on your back, raise the arms in a circle until they are behind you – if possible flat behind you. Hold and release. If you can't reach the whole way, simply reach as far as you can.

Ex2: Windmill
My latest permutation of Ex1 - a more pronounced stretch
Lying on your back, rotate both arms out to the sides like a windmill, until they meet behind your head, keeping your hands on the floor as far as possible, and then as near to it as you can, with elbows straight, until they meet. Then bring the arms up in the air and over until they are by your sides again.

Ex 3: Chest extension
Helps open up the chest muscles
Standing, hold both arms straight out in front of you, palms up. Bend each elbow 90 degrees so from shoulder to elbow stays horizontal but from elbow to hand is pointing upwards. Move the elbows apart, as far as you can so that each arm is moving round to the side of the body. If possible, move your arms so that your elbows are level with or behind your shoulders. If you can't go that far, go as far as you can. Hold it there for a few seconds and release.

Ex 4: Chicken head
Helps loosen the upper spine
Standing with your shoulders and arms completely relaxed by your sides, move your head forward, keeping your chin level, so that only your neck is moving. Then move your head back, again keeping your chin level and shoulders relaxed. Then release.

Ex 5: Resistance band
Strengthens the muscles between the shoulder blades
To do this, you need a resistance band – like a big rubber band – attached to something strong (such as round a door handle), so that you can pull on the other end.

With arms so that elbows are by your side and hands out in front of you, hold the free end of the resistance band in both hands, with the band taught. Pull your elbows back, so that you are stretching the band. Hold and release. The trick is to keep your shoulders loose and down, so that the pulling is happening from the muscles across the middle of your back between the shoulder blades (you can feel it when it's right)

Ex 6: Lumber roll
Helps loosen the lower spine - one of my physios said we should all be doing these
Lie on your back. Raise your knees up so that they are directly above your pelvis. Your feet should be off the floor but pointing downwards. Keeping your pelvis reasonably flat, rock your knees to one side as far as is comfortable. Hold for a few seconds, then rock your knees to the other side as is comfortable. Hold for a few seconds, and release.

Ex 7: Restricted rotation
Helps open up the chest and loosen the mid spine
Stand in a door way, facing into the room, with one arm out to the side, raised and bent so that elbow is level with shoulder and the hand is pointing upward, with arm from palm to elbow resting against the outside of the door frame. Rotate your upper body away from the arm that is against the frame, keeping your pelvis stationary. Your arm will therefore be unable to move because it is restricted by the door frame, and so pull the shoulder back and open the chest, as you rotate. Hold and release. Repeat for other arm.

Ex 8: Arching the back
Helps regain lost lordosis (curve of back)
Lie on your back with your knees raised but feet still on the ground. First gently raise your bum off the ground – this rotates your pelvis forward. Hold and release. Then lower your bum and gently rotate your pelvis backward so that you arch your back – lifting the small of your back off the ground. Hold and release.

Ex 9: Pelvic rotation
Helps loosen the pelvis - similar movement to Ex 8, but potentially easier to achieve
To do this, you need an inflatable exercise ball that you can sit on.

Sitting on the ball with both feet flat on the ground, rotate the pelvis forward gently so your bum moves forward on the ball – but keeping your back stationary. Then rotate the pelvis backward, so your bum moves backward, but still keeping your back stationary.

Ex 10: Doggy style
Another way to practice rotating the pelvis
On hands and knees, alternately rotate the pelvis forward, raising the middle back upwards, and then rotate the pelvis backwards, lowering the middle back downwards. The trick is to try to isolate the movement so that only the pelvis and spine are moving (you are not trying to do press ups). A physio friend long ago told me you know (as a man) when you are doing it right because the motion is similar to sex!

And... relax!


Anonymous said...

Hi Alex,

We had a good laugh last week when my parents were here, Phil and I were doing the chicken head and they joined in and no matter how hard he tried my Dad couldn't do it! Phil can't do all the excersises yet due to the pain he still has sometimes but his back is getting straighter so thanks again for posting them.


Alex Bicknell said...

I've recently found myself being able to do the chicken much more dramatically - really tucking my head back. It just takes time doesn't it.

I maybe should have said in the post, that for me its still a slow process. For example, I always start by lying on the floor on my back. And I still have to do this in 2 stages. First with a pillow under my head, and then once I've relaxed into that position I remove the pillow. Otherwise I can't get my head down, and my muscles lock up.

I found another new exercise today. It involves lying on your front - which is something I'm only just beginning to be able to do (until now I've found my head pushes down on the floor so hard it's painful...) So it's one to add to the regime at the right time.

Ex 11: Breast stroke
Strengthens the muscles between the shoulder blades, but without the need for a resistance band
Lie on your front. Push your pelvis down as low to the floor as possible - and keep it pushed down throughout. Raise your head and shoulders so you are looking straight down at the floor and stretch your arms out in front of you. While keeping your arms a few inches above the floor, slowly pull your arms back and to the sides, while bending your elbows - like a frog, or swimming breaststroke. Keep your head and shoulders raised, and your pelvis pressed down. Repeat 10 times. On the final time, hold in position at the end of the "stroke" for a count of 10.

I can't do this properly yet. I can't get my arms really straight in front of me, and I can only do it about 5 times before collapsing! But I will persevere

Alex Bicknell said...

I originally posted these exercises on a forum in the Myeloma UK website. What pleased and surprised me then was to receive a number of messages - from people in the UK and elsewhere - along the lines of "thanks, really helpful". It's what made me post again here, and I've found the same response this time.

Obviously, I'm absolutely stoked if I can pass on some tips to help battle one of myeloma's more troublesome symptoms.

But I'm also a bit freaked out. It doesn't say much for the medical establishment's concern for us as individuals (rather than simply as tumour hosts), that we aren't all getting this information, as a matter of course, from our doctors. There's something wrong.