Yes, we are connected

skeletons

Though I’ve been focusing on the feet these last few weeks, if you’re having problems with your feet you may also want to make some other connections. Yes, similar to what we’ve been exploring there are things you can do physically that will help. But our feet are connected to our leg bones, our leg bones are connected to our hip joint. Our hips are connected to our spine and further it goes, up the whole body.

We tend to look where pain expresses itself… and think we will find the solution there.

Some people may have knee problems and look to ‘fix’ the knee when really what’s happening (or not happening) is at the hips or at the feet. Or elsewhere.

Imagine you have a cast on your ankle and how it might feel when you walk. How your body might compensate. You may end up with a sore back or shoulder muscles as you try to move as best you can with a stiff, unable to bend, ankle. We’re not usually walking around with a cast on, but many people don’t really use a lot of their ankle flexion for a whole host of reasons. Shoes, patterns of movement, previous injury, etc. Pain may be expressed in your back or shoulders when what’s really going on is down at your feet.

People will often say, “yes but I had an x-ray or ultrasound and they found this (insert condition here) is wrong with my feet”. Yes, I’ve been there too. Diagnosed with chronic plantar fasciitis in both feet, osteoarthritis in both big toes. Basically, I was told to wear rocker shoes, orthotics, and live with it.

Orthotics absolutely serve a purpose in many cases but I’m not sure of any other body part we are willing to cast or brace for a lifetime. We might need a collar brace, but not forever. We may need to wear a special boot to help with a foot injury or after surgery. The point is we work hard, physiotherapists and others work hard with us, to remove these external or artificial supports. Our feet and some orthotics, in my opinion, should be no different.

After my own diagnosis and subsequently learning that our body will most often adapt to what’s asked of it, I figured there must be another way. I have put some effort and focus on my feet in many of the ways shown last month but what was happening in my hips (lack of strength and stability) also played a part.

There are often many pieces to the puzzle of long-term, persistent or chronic pain.

For instance, why was it my feet didn’t always hurt? Why only sometimes? Some days?

Paying close attention I came to notice that when under stress, under too much ‘load’, my pain was likely to arise or increase.  If I was out enjoying myself, not a care in the world, doing something fun or even necessary perhaps, I didn’t seem to have pain. But at other times, it most definitely kicked in.

The biggest a-ha for me now is to realize that structural degeneration or tissue damage is likely to show up for me and everyone else at some point (Note: Brinjijki et al 2014 study as shown in the table below). Particularly by the time you’re my age (56). I need not ‘fear’ this, or fear making things worse, but rather utilize all the things I know I can do, that might help with the pain I sometimes experience in my feet.

  • Strengthening
  • Stretching
  • Keeping my feet soft, supple, agile
  • Adding load, good stress, to keep the bones healthy
  • Wearing appropriate footwear; allowing for space, mobility, flexibility
  • Keeping my overall ‘weight’ in a manageable range
  • Knowing that my levels of stress, fatigue, diet and a range of other factors may also play a part.

degenerative spine issues

In the month of November, we’ll explore our HIPS (Yes, I switched my focus this month from shoulders to hips. We’ll get to shoulders in December). This is where load and/or gravitational forces are primarily distributed through the body so how well we manage this, matters.

Along the way, I’ll throw in a few morsels about chronic pain that might help you make sense of your own personal experience with persistent pain in the hips, or elsewhere.

I hope you’ll join me.

 

Great programs but why the disconnect?

disconnectAfter receiving basic information about the University of Ottawa Heart Institute’s Heart Wise Exercise program, presented at my yoga therapy training, I wanted to go back to learn more so paid them a visit earlier this week. Theirs is a program that helps to connect patients who have been through initial rehab programs after diagnosis, illness, surgery from heart disease, to community-based exercise programs and fitness professionals. It served primarily Ottawa but over the years has expanded in/around Ontario and a little into Quebec.

I mentioned a program in Alberta that I’d found on the internet a year or so ago. In Alberta the Prescription to Get Active Program allows you to visit your doctor, receive a ‘prescription to get active’ and then find a facility in your community offering all kinds of activities from walking, strength training, yoga, cycling, swimming, dancing, etc. The ‘prescription’ allows for free access (often a series like a 10-pass visit, free month, etc.) to get you started.

I often reference the excellent program the province of BC provides to health care providers and those living with chronic pain. The Pain BC program is one of the of the best (well, the only one of its kind I know of) in Canada in terms of information, resources and programs.

It’s too bad all these programs are rather piecemeal and for the most part unknown across Canada, rather than being coordinated. I give great credit to the people and work done to provide them.  It’s just our government or overriding systems that seem to be unable to provide the coordination, or funding or whatever might be needed so everyone can access them.

Regardless, for my Canadian friends and followers, feel free to check them out!

Links above, but for easy reference click on any of these links: