When you are suffering from neck, back, hip or shoulder pain, even if you’re just plain tired, Constructive Rest, practiced just 10 minutes a day, is the way to go.

Constructive Rest, pictured below, is a resting position of the body, in which the arms and legs are supported rather than held by the muscles of the neck and spine. By relieving the spine of the weight of the legs at their articulation with the trunk, the pelvis, trunk muscles, fascia and internal organs are also given a chance to rest. As the weight of the arms across the chest presses into the articulation of the shoulders where they meet the trunk, chronically tight and overworked neck, shoulder and back muscles are given an opportunity to reset, too.

Constructive Rest Image provided by Ann F. Cowlin¹

Basic Position: open your feet hip-width apart with the heels outside the toes in a slightly pigeon-toed position. Let your knees fall together so your legs support one another. Cross and drape your arms one over the other, resting them on your chest like empty coat sleeves. Your hands should be relaxed and open, falling off the arms.*

In The Thinking Body, Mabel Todd, who originated Constructive Rest, recommends it for “relieving the spine from strain of leg weights and favoring a return of blood to heart.”² She describes how, throughout nature, cycles of work are always followed by a dynamic pause, or rest. Different from sleep, these dynamic rest periods are intrinsic to life — from the tiniest cells to the heart, lungs, digestive and neuromuscular systems. The moment of rest and silence in the lub dub of the heart is when the heart’s atrial chambers fill with oxygenated blood in preparation for the next squeeze of the heart, which then sends newly oxygenated blood out to each and every cell in the body. It is a dynamic pause.

Lulu Sweigard, a student of Todd’s, wrote in the Human Movement Potential that “the distribution of its structural weight should balance the body so that no muscle work need be added to maintain equilibrium in the position.”³ What we are seeking to accomplish with Constructive Rest, then, is to bring the body into effortless mechanical equilibrium.

Constructive Rest creates an opportunity for the spinal curves, from head to tailbone, from left to right, to relax and lengthen onto the even surface of a supportive ground. Tense muscles, tissues, joints and organs throughout the body can relax and literally unwind from the demands of maintaining an upright position against gravity.

Remember, the point is to be absolutely comfortable and use as little muscular effort as possible to maintain the position. If you don’t find this position comfortable, perhaps another variation on Constructive Rest might work better for you.

Practicing Constructive Rest only 10 minutes a day has delicious effects. By supporting your body in dynamic relaxation, you can unwind from pain and fatigue while you tune into your breath and your body, relax and let go.**

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NOTES AND REFERENCES

* Try not to forcefully bend your arms or hold your arms in place by gripping with your hands.

** Other benefits may be similar to those of meditation and yoga where lowered stress levels, decreased anxiety, lower blood pressure, decreased heart rate, improved mood and energy levels are well documented. However, to discuss these bonus effects is beyond the scope of this article.

¹ Image provided by Ann F. Cowlin, Yale University, and Dancing Thru Pregnancy.

² Todd, Mabel Elsworth, The Thinking Body: A Study of the Balancing Forces of Dynamic Man,  Dance Horizons, Incorporated, 1937, p.290.

³ Sweigard, Lulu E., Human Movement Potential: Its Ideokinetic Facilitation, Harper & Row, Publishers, Inc., 1974, p. 216

Constructive Rest*

In a previous blog post, The Best Way to Relax, I described the many benefits of Constructive Rest. Here, I wish to offer a few variations on the basic position, pictured at left. At different times, or because of your body type, you might find one of these variations more comfortable. And comfort is what we’re looking for here.

• Try placing a small pillow under the head if you have a deep chest (thoracic kyphosis) or forward head. If you notice your chin is pointing towards the ceiling and your head is cocked back, you need a pillow. If you simply feel strain in your neck or back, try a pillow. It should be as small as possible to comfortably support your head and neck. The goal is to support your body’s neutral alignment in a comfortable, balanced way so that you can let go of all muscular holding.
• If the backs of the hips are tight (this is true for many men), try lining up your knees with your hips and ankles rather than trying to force the knees together. Then cross the arms over your chest. If your legs stay in place on their own without drifting to the sides or falling open, this may be the optimal position for your body.
• If you have a large chest, or if for any reason you are simply uncomfortable crossing your arms over the chest, try resting your arms about 45 degrees away from the trunk of your body with your palms facing up. Allow the weight of the arms to release into gravity.
• You can loosely tie your thighs together with a scarf or theraband to keep legs from falling open.
• If the floor feels hard or uncomfortable, try putting more padding down.
• Sometimes a small pillow placed under the pelvis or low back may feel good.
• Another approach to Constructive Rest is to prop the legs, bent 90 degrees at the hips and knees, onto a chair seat or sofa. Open the arms out to the sides, palms up, or cross your arms across your chest as in the basic position.

Whichever adaptation you choose, try lying in the same position for 10 minutes a day for a few days. Notice the difference in how you feel.

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* Image provided by Ann F. Cowlin, Yale University, and Dancing Thru Pregnancy.

Have you been taught by your Physical Therapist, Yoga teacher, Pilates teacher or trainer to press your shoulders back and down for good posture?

What if, instead, you were to ease your shoulders up; rotate them slightly back to open the chest; and then allow them to gently drop into place. Then forget about them and move on with your day.

Up and open, not back and down?

Shirley Sahrmann, an influential Physical Therapist, first introduced me to this concept. Her work emphasizes that many, if not most, pain and orthopedic problems are created and maintained by faulty postures and movement patterns.* When I volunteered to be a guinea pig in her continuing ed class, she curtly informed me that I hold my shoulders in an overly depressed position. Really? But wait — I learned to do this as a dancer for good posture. Now you’re telling me that the years-long habit of pressing my shoulders back and down may actually have caused chronic shoulder pain and dysfunction?

Have you never secretly wondered about the instruction to “press your shoulders back and down” — that it sounds, and looks, just a little like the old military instruction “stand up straight, chest out, shoulders back.” Though well-intentioned, it may not be the best advice to correct either internally rotated shoulders or an habitual slouch. Yes, it might facilitate chest opening and elongate tight pectoralis muscles. You may even activate the posterior shoulder blade and postural muscles, like the lower trapezius. Unfortunately, the rhomboids may also become overly activated, too. According to Shirley, shortened rhomboids are not desirable. Besides, you are probably freezing other shoulder blade muscles, like the important serratus anterior, into a chronically tense and overly elongated position. This is NOT desirable. Muscles need to be free and balanced to move bones, especially those of the shoulder blades.

Besides, holding almost any muscle in a static position isn’t usually a good idea. It can create a new host of problems.

Ask yourself, is it possible that pressing your shoulders back and down may actually increase tension in the cervical/shoulder complex and contribute to neck strain and pain? Might it also cause you to press the top of your shoulder, the acromion, down onto the humeral head, creating a moment of impingement within the shoulder joint, contributing to wear and tear of the rotator cuff or a frozen shoulder? The shoulders, particularly in men and women in their 40′s, 50′s and 60′s, not infrequently become problematic through impingement syndromes, frozen shoulder or rotator cuff pulls, strains and tears.

Just for now, try easing your shoulders up, back and then relax them into gravity, easing them into place. You can accomplish the same desired goal of decreasing rounded shoulders, while at the same time creating more relaxation and ease in your neck and shoulders.

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*This may or may not include athletic or other kinds of accidents and injuries caused by sudden impact.  Having said that, even a sudden injury or accident can be contributed to by the habitual strain caused by faulty posture, poor training, conditioning or ineffective movement habits.

At the age of 42, after an MRI, I was diagnosed with Degenerative Disk Disease. I also had two bulging and one herniated disk. I went home, crawled into bed and cried, convinced that my body was aging beyond repair, and it would be all downhill from there.

The Bad News

Yes, your neck or back hurts and you have a condition with the word “degenerative” in it. You can’t even bend down to feed the cat without pain. But, maybe you don’t have any back pain, rather your foot is numb. Or you have pain, numbness or tingling in your buttocks, knee or calf. It’s been going on longer than you care to admit and nothing seems to make it better.

The Good News

Yes, believe it or not, there is good news. You can get better. More likely than not, you can return to a completely pain-free life. With the right treatment and a few targeted exercises, you can restore flexibility to your spine and become stronger than you’ve ever been. You will probably need to learn a few postural adaptations along the way.

The other good news is that this is a wake-up call while you are still fairly young. Once you learn new postural patterns, you will sit, stand and walk taller. With the appropriate Core strengthening exercises, you might find that not only do they make your back feel better, you look better, too. Another plus is that with a stronger Core, you might find you have more energy.

Who Can Help?

A Physical Therapist with skills in McKenzie’s Techniques, Manual Mobilizations, Neural Glides, Yoga, Feldenkrais, Alexander or Pilates can help you. A Physical Therapist who has healed from her own back pain, and there are many of us out there, has a unique perspective.

Don’t try to go it alone. Certain things that well-meaning friends or teachers think might help — like forward bends and intensive hamstring stretching — may make the situation much worse. I would avoid twisting exercises until you know more about what’s going on in there. Backward bends, like sphinx and cobra poses help many people but make others worse. It might be best to avoid abdominal crunches or other heavy-duty abdominal exercises at first. There are many wonderful and effective Core strengtheners that involve little to no spinal flexion.

Holding On vs. Letting Go

Just for a moment, think about what you are doing right now. Feel your body. How are you sitting? What muscles are you using? Are you sitting still? Are you relaxed or are you holding tension in your body?

Next, let’s move to thinking about the concept “holding the body.” First and foremost, we hold our bodies upright against gravity. How effectively we do this is a major determining factor in the efficiency of our everyday movements. Not only that, but we need to hold tension in our muscles. And, for the most part, this is normal tension. A muscle has to tense — or contract –  to lift a weight or to carry out a task, like when we sit down or stand up.

But sometimes we hold too much tension in our bodies. When you are learning a new movement skill, whether dance, tennis, yoga or learning to play the cello, there is a pronounced tendency to hold excessive tension globally, all over the body — in your face, jaw, neck, fingers and toes. This excess tension translates into extra effort. To complicate matters, the tension could also be psychological in origin. If you are apprehensive or anxious about learning this new skill, chances that this psycho-emotional tension is being held in the muscles of your body, too. It takes practice to let go of this extra tension, whether in the mind or the body.

Practice Practice Practice

Until the motor pathways are well established in the brain, new movements and skills are inefficient and require a lot of extra effort. But, when we practice an activity, neuronal pathways are laid down in the cerebral cortex, one over the other, again and again. Over time, practice being key here, the movements become easier. You use less tension to accomplish them. You are able to do more. You have more fun. The movements become more refined.

We often think of it as kinetic or muscle memory. Really, what you have done is to establish motor pathways in the brain. Further, if you have aptitude and a good teacher, these movements over time will be increasingly efficient and effortless. Think of the best dancers or musicians. They seem to throw away all technique and move/play effortlessly.

This is especially true after an injury — you have to learn how to move again, perhaps to learn new postures, in addition to restoring strength and flexibility.

On the other end of the spectrum, what happens when the brain itself is injured, like after a cerebral vascular accident, a stroke? We often see varying degrees of recovery after a stroke. The primary factor is the severity of the stroke and its location in the brain. Another, in my experience, is that those people who have a good fitness level before the stroke tend to do better. Is it because they have developed more in terms of quantity and diversity of motor pathways in the brain? That when the brain was damaged in the stroke, they had a head start on recovering function. Maybe the motor pathways are deeper, cut in deeper grooves and more plentiful.

Speaking of practice, might something similar occur in psychological terms? The more we practice anger, say, the better we get at it. Might it be that thought pathways develop through axons and neural synapses. Is this because we have deeply embedded the neuronal processes and pathways in the regions of the brain that spark anger? Is this why cognitive-behavioral therapies have such a good track record with depression, because they teach the patient how not to just keep repeating the same old patterns — cognitively, emotionally or behaviorally — but to establish new ways of thinking and behaving. In essence, beyond the mystical and mysterious results of seeing the changes in one’s thoughts, emotions and behaviors, are we simply establishing new neuronal pathways?

I did it my way.
-Frank Sinatra

Why I prefer Intentions over New Year’s Resolutions 

Creating an intention is about finding out what I’d like to do or have happen in the New Year. It is a gentle process, one of tuning in and listening to the still small voice within. It’s a taking stock of where I am with my life today, and where I’d like to steer towards tomorrow. Am I heading in the desired direction? Do I want to tweak it here and there, or are we talking major changes here?

Resolutions connote differently. I RESOLVE TO sounds, well, like a legal document. Or the beginning of my Last Will and Testament. It’s a do or die proposition. It sounds authoritarian. Parental. Since I have issues with authority — who doesn’t — when faced with a directive like this, I tend not to listen. Or, if I’m in a particularly self-defeating mood, do the exact opposite. Besides, I don’t think that I ever kept even one New Year’s resolution. Have you?

Last year, my intention was to write morning pages* every day. It took me 4 or 5 months to get there. First I only wrote them at night once or twice a week. Then I started writing them more frequently, but still only at night. Maybe the late afternoon. For seven months now, because I want to, I write them just about every morning.

It took time to get here. I didn’t do it because I thought I should or because I obeyed an inner dictate. It came from a deeper, lighter place within. This process of daily writing grew into an activity I look forward to every morning. It grounds me deeply. It helps me to find the cheer and energy to face the day.

Check that one off the list.

This year my intentions are to meditate 10 minutes a day, and to write for this blog 10 minutes a day. Not publish, just write. Only 10 minutes. I’ve only been successful two days so far. It’s just something I want to do. I don’t have to.

Won’t you join me?

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*The concept of morning pages was developed by Julia Cameron in The Artist’s Way.

DanceNYC.org 2010 Bessies Highlights

Click on above to see video footage from the Bessies.
Issac Mizrahi MC’d. It was a night of fun, shouts and tears devoted to choreographers, dancers and the usual suspects in New York’s vibrant dance scene.

Say no more . . .

Bacon and cheesecake ‘alter brain like heroin’

Obstructive sleep apnea syndrome (OSAS) is caused by a disruption to the breathing cycle, often for 10 seconds or more at a time, when you are sleeping. Contributing factors vary — from narrow or clogged airways to the tongue falling back in the throat cutting off the air supply. If you snore, keep your partner awake at night and wake up tired every morning, you might have sleep apnea.*

Since sleep apnea is a common breathing disorder, and since your breathing is controlled by your brain and breathing muscles, wouldn’t it make sense to use breathing exercises as a front-line treatment? After all, Physical Therapists and Yoga Therapists use exercises all the time to restore balance to the body’s neuromuscular systems. And, Yoga provides the best system I know of, hands down, for exercising the breathing apparatus — muscles, lungs and brain.

Can we then apply this same treatment logic — of restoring balance to the body with exercise — with years of documented success, to sleep apnea? It seems we can. Two randomized studies have recently been published in support of using different forms of breathing exercises to successfully treat obstructive sleep apnea.

The first, published in the British Medical Journal February 4, 2006, showed that didgeridoo playing is an effective treatment alternative for moderate sleep apnea. Here 25 patients were randomized between a control group of 11 people and a treatment group consisting of 14 participants. The treatment group practiced didgeridoo playing for 25.3 minutes for 5.9 days per week for four months.

The didgeridoo players showed significant improvements in terms of daytime sleepiness and snoring. The sleep apnoea-hypopnoea index (a measure indicating the severity of the disease in terms of sleep disruption and decreased oxygen saturation in the blood) significantly decreased. Happily, their partners also reported less sleep disturbances.

The second study was published February 20, 2009 in the American Journal of Respiratory and Critical Care Medicine. It was a randomized trial of 31 patients with moderate OSAS. For a period of three months, 15 patients received sham therapy and 16 patients received a set of exercises for the mouth, soft palate, face, tongue and throat.

Not surprisingly, the exercise group showed significant decreases in snoring frequency and intensity, a decrease in daytime sleepiness, improvements in sleep quality and a significant decrease in the severity of the measure of OSAS.

Doesn’t it make sense that yogic breathing exercises might have the same desired effects?

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* To get a good diagnosis, please consult with your primary care doctor, who can refer you to a sleep clinic for evaluation.

References and Resources

Guimarães K, et al, 2009. Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome. American Journal of Respiratory and Critical Care Medicine Vol. 179: 962-966.
Puhan M, et al, 2005. Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial. British Medical Journal, 332(7536): 266–270.
http://www.mayoclinic.com/health/obstructive-sleep-apnea/DS00968
http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea

http://www.nlm.nih.gov/medlineplus/sleepapnea.html

Check out this article on the science of touch