Support yourself for better sleep and a healthy spine.

   
    A lot of people complain about waking up with pain that they didn't have when they went to bed, saying that "they slept wrong". As someone who truly appreciates the value of a good night's sleep, I don't believe that there is a "wrong" way to sleep. However, there are ways that you can support your spine in a neutral position by using pillows at night to decrease the incidence of waking up with musculoskeletal pain that you didn't have when you went to bed. Here are a few suggestions:

    1) If you sleep on your back.

        Use a pillow under your knees to support your low back in a neutral position. Play with different sizes until you find the one that is the most comfortable for you. Be sure that the pillow you use under your head is the correct size to support your head in a comfortable position.

    2) If you sleep on your side.

        Place a large pillow between your knees. This eliminates the strain on your low back and hips by putting your lumbar spine (low back) and pelvis in a neutral position. You may want to support your legs all the way to your ankles. Put another pillow in front of your chest and let your arm rest on top of it. This takes stress off of your shoulders and puts your cervical spine (neck) in a neutral position. Again, make sure that the pillow for your head is properly supporting you in a comfortable position.

    3) If you sleep on your stomach.

         Body pillows are great for stomach sleepers. Place the pillow in front of you so you can position yourself over the pillow as if you were lying completely on your front. You have the sense of being on your stomach, but your spine is being supported in a more neutral position. This eliminates the strain and pressure to your low back caused by excessive extension as well as neck strain from lying on your stomach for prolonged periods of time.

            I recommend using traditional pillows that you already have in your home. You can spend a lot of money on special therapeutic pillows and be disappointed in the results. You already have pillows in your home, so put them to good use and save your money.

          Don't worry if you position your pillows and wake up to find them on the floor or thrown across the room. It takes a while to get used to the pillows, and we all move around and re-position ourselves a lot during the night. Your body will become accustomed to the pillows and you will subconsciously readjust them in your sleep as you move.

Wishing you good nights, good sleep, and good health!
Cheryl Ilov, PT, GCFP

Stormy weather, cucumbers, and neuroplasticity.

    I love storms. I love the way the sky darkens and the wind starts to build. I even love the clap of thunder and the lightening strikes (as long as they aren't too close). I love to sit outside and watch them, but of course I go inside when things get a little too intense. Why am I not afraid?

    When my sisters and I were small, a particularly violent thunderstorm started developing. Terrified, we cuddled together in the kitchen with my mother, who kept trying to distract us and keep us calm. Suddenly, my mother opened the refrigerator and pulled out several cucumbers. She started slicing them, and we all sat around the kitchen table eating cucumbers and playing games. Although we still jumped at the closest lightening strikes and the loudest thunder, we kept talking, playing and eating cucumbers even after the power went out.

    Later, my mother told us that she didn't want us to be afraid of storms. You see, her mother was terrified of storms and would cower in the kitchen, tremble with each bolt of lightening, and cover her ears against the sound of thunder. Her father, on the other hand, would sit on the front porch, watch the storms and happily bellow out songs in Serbian. So, my mother had a choice. She could cower in the kitchen with my grandmother and reinforce the pattern of fear, or, she could face her own fear and sit on the porch with my grandfather and witness the storm. She chose my grandfather. The result? She lost her fear of storms.

    What my mother did for us and my grandfather did for her was a simple but brilliant example of neuroplasticity. They both created an environment where we could learn new patterns of behavior in how we respond to the experience of a thunderstorm. Each one of us were able to process our own individual learning experience, not in a cognitive (thinking) way, but in a visceral, organic way. Even though we were frightened, a safe, comfortable environment was provided. The natural flexibility of our nervous systems (which is present in all of us during our entire life time) took over and showed us new and different ways to respond to the scary situation.

    Life is full of unexpected storms. Sometimes the lightening can be blinding, and the thunder deafening. The sky can become so dark we feel that we may never see the sun again. But, now we know we have choices.We can cower and try to hide from them until they're over, and live in fear of the next one. We can find someone to sit next to, and listen as they sing through them, and learn from their courage. We can have someone guide us through with grace and dignity, allowing us to learn our own strategy for weathering the storm.  Trust the intelligence of your nervous system to figure out the right strategy for you, and realize that you have many options rather than being stuck in a pattern or habit that may not be serving you well.

     I remember that day every time a storm comes up or I make a cucumber salad. It's also another opportunity for me to silently thank my mother for the many gifts she gave us. Here's the funny part: years ago I asked her, "Mummy, why cucumbers?" She replied, "It was the only thing I could find in the refrigerator!"

                                      
Be healthy! And look for the cucumbers in the storm.
Cheryl Ilov, PT, GCFP

The balance challenge continues....

     So, what would happen if you did fall? How would you respond? What would you do? I remember skiing with my father and my husband about 20 years ago. My father (who was an excellent skier as well as a martial artist) took a very bad tumble.  My husband witnessed the fall, and quickly skied up to him to offer assistance. My Dad was laughing as he got up, and my husband was stunned that he wasn't hurt. He said, "George, you fell like a 30 year old!"  And he got up again like a 30 year old. At the time, my father was in his early 60's.

     My Dad knew how to fall. Most of us do not, which leads us to develop a fear of falling. After all, most of our activities as adults are performed in an upright posture: standing, walking, running, dancing, sitting, etc.  As a result, we lose our connection with the ground, we don't trust our balance, and we also lose the  flexibility (both physically and emotionally) to get back up. So, what can we do about it?

       1) First of all, spend more time on the floor. Get down on the floor at least once a day and just lie comfortably for a few minutes. Allow yourself to get familiar with the floor and how it supports you. Try rolling side to side. Explore rolling to one side and gently spiral up to sitting. Play with crawling around the floor, and just notice what it feels like to be on the ground.

       2) Practice getting down and up from the floor. Don't make it a big deal, just play with it a little bit. Notice how you choose to do this. How can you make it easier, more comfortable and less effort? Let the floor be your friend, your teacher and your guide. Don't be in a hurry to get up, but play with different movement patterns to get down and up from the floor.

     3) Practice controlled falling. For this activity I highly recommend getting assistance from a Physical Therapist or Certified Feldenkrais Practitioner. If you have ever considered taking a martial art class, perhaps now is the time. The practice of falling, rolling, and getting back up is a huge part of the training. Some martial arts such as Tai Chi is an excellent way to connect with the floor and improve standing balance and is offered in many senior centers and well worth looking into.

    If you currently have balance problems, a neurological condition, history of falls or osteoporosis, do not attempt these exercises, but do consult with a licensed physical therapist for assistance.

    Remember, at some time in our lives, we all fall: physically, emotionally, spiritually. Having the confidence that we know how to land is crucial to being able to get back up again.

                     
       My Dad at age 77, skiing with the confidence of someone who knows how to fall. And get back up.

 Be healthy!

Balance, perturbations, and neuroplasticity....

    A lot of people are concerned about losing their balance and have a fear of falling. So, what can we do to  improve our balance? Let's start with some basic exercises in standing.

    1) Single leg standing:

       Stand in front of a counter top or other stable surface. Gently place your hands on the counter top for safety. Lift one foot off of the floor so you are standing on one leg. Don't rest the lifted leg on the standing leg, just let hang relaxed in the air. You can lift your hands off of the counter, but it's there if you need it to steady yourself. See if you can balance on one leg for 30-60 seconds.You may feel your ankle or hip wobble a bit, but that's fine....you are actually training the nerve endings (proprioceptors) in your feet, ankles, knees and hips how to adjust to maintain your balance. Don't look down at the floor; instead, keep your head up and look staight ahead.  Hold for 30-60 seconds. Stop. Repeat on the other leg.

    2) Progressing single leg standing:
    
         Once you are able to maintain your balance on one leg for a duration of 30-60 seconds and it feels easy, place a small pillow under your standing foot. This adds a "perturbation" into the challenge of balance, because now your standing surface is less stable. As a result, the nerve endings have to work harder to adjust to the changing environment (neuroplasticity). Hold for 30-60 seconds. Stop. Repeat on the other leg. Once this is easy, add another pillow under the standing (supporting) leg. This further decreases the stability of your standing surfaces and gives more information to your nervous system about balance.

    3) Adding more perturbations:

        If you choose to further challenge your balance, you will need a partner. Stand with both feet on the floor and have your partner gently push you. Be nice to each other! The purpose is not to knock each other over, but to gently perturb your partner's standing balance. Try pushing from different angles and directions. This gives your partner different messages into their nervous system for the purpose further challenging and fine tuning their sense of balance.

    If you currently have balance issues, a neurological condition, a history of falls or osteoporosis, don't attempt these exercises. Consult with a licensed physical therapist or Certified Feldenkrais(R) Practitioner for assistance.  

    Here is Giovanni practicing his balance, perturbations and neuroplasticity while his buddy Bruno offers encouragement. Giovanni was unable to stand or walk after being diagnosed with a neurological disorder. After 6 weeks of balance training, Giovanni was standing, walking, running and even jumping on the bed, much to his delight!

Be healthy!

From fear of falling to fearless falling.

    Most of us are afraid of falling, especially as we get older. Why is that? Of course, we don't want to get hurt, and many of us either know someone or have heard of someone falling and experiencing long term injuries. But it doesn't have to be that way.

    As babies and small children, we lived, played and crawled on the floor. As we grew, we continued to frequently get down on the floor. The occasional spills we experienced were no big deal, and we would bounce back up and be off on our next adventure. But as adults, we keep ourselves upright. We stand, walk, sit in chairs and lose our intimate relationship with the ground. As a result, we develop a fear and distrust of the ground, of our ability to fall safely (yes, there is such a thing) and gracefully get back up.

    My last hiking trip to the mountains included maneuvering through glacier fields. It was a challenge going up, and in the back of my mind I was a little concerned about the trip down, knowing that it would be a slippery descent. I, myself, have never been a huge fan of falling and used to avoid it at all costs. Oh, well. I was already pretty far up the trail, so I knew I would have to figure a way to get down.

    It was interesting to observe some of the other hikers and the strategies that they were choosing to get down the mountain. One group of teenagers took a running start and then slid down the glaciers as if they were skiing on their sneakers. An interesting technique, considering the huge rocks, large trees, sharp drops into the canyon as well as the fact that most of them were carrying large, pointed sticks for balance. I envisioned a few trips to the ER.

    One woman chose to walk behind her husband, holding onto his waist for support. She was bent forward with her center of gravity behind her base of support, staring at the ground, tentatively and cautiously placing her foot on the snow with each shaky step.  I watched her fall twice, once with her husband hanging on to her arm. I was more concerned about him dislocating her shoulder as he tried to "help" her than her injuring herself with the fall. Another family had 2 small girls that looked terrified as their Dad tied a rope around their waists. Yikes! What if Dad was the one to fall and take the little ones down with him?

    Without even thinking, I found my strategy. I set my weight down into my pelvis, lowered my center of gravity directly over my base of support, kept my upper body flexible and shifted my weight side to side. I quickly and confidently scampered down the mountain. Even if I did fall, I intuitively knew that I would not get hurt. My center of gravity was so low and close to the ground that I didn't have far to fall. Of course, I have the advantage of having studied a martial art where we learn how to fall. I also have the advantage of spending a great deal of time on the floor with my Feldenkrais practice. As a result, I am no longer afraid of falling, and am able to trust my instincts to know how to land without getting hurt.

    The physical therapist, Feldenkrais practitioner, teacher and ultimate caretaker in me was tempted to teach the other hikers how to safely get down the mountain. But the truth is, we all fall; literally and figuratively. Life often pulls the rug out from underneath us and we go tumbling down. It's up to each one of us to develop a strategy that not only allows us to fall safely, but also to be able to get back up again. We can hold onto someone else, and hope that they can support us as we fall, without causing more damage than the actual fall itself. We can tie ourselves to someone else, and hope that they themselves don't fall and take us crashing down with them. We can throw ourselves down a slippery slope littered with dangerous obstacles and hope for the best, and that somehow we will survive.  Or, we can figure out a safe way to fall, take care of ourselves, and get back up again.

    Recently someone asked me "Who catches you when you fall?" My answer was immediate and honest: "No one. I learned how to fall so I don't get hurt".

Be Healthy!
Cheryl Ilov, PT, GCFP

Sense of smell. How neuroplasticity saved the day.

    A few weeks ago I was hiking in the mountains with my husband. I was in  a terrible mood. I was irritable, sad, depressed and feeling sorry for myself. It was Father's Day, and the first Father's Day without my Dad. This was only 6 short weeks after going through the first Mother's Day without my Mom. Trying to hide my bad mood, I did what I do best....I put my head down and stubbornly forged ahead, placing one foot in front of the other and forced myself up the mountain, oblivious to the spectacular scenery around me.

    After about an hour we stopped to rest. The wind shifted, and  I caught the indescribable fragrance of clean mountain air, pine trees, melting snow and damp earth. As I stood there soaking in that incredible smell, my mood immediately began to shift. My spirits rose dramatically. The heavy burden of grief, sadness and self pity melted away as effectively as the sun was melting the snow. I felt myself smiling. I was suddenly aware of the sensation of the cool air against my skin and the sun on my face. I heard the birds singing, the wind in the trees, and the sound of running water. I couldn't get enough of the breathtaking scenery. All of my senses were acutely awakened and I was enjoying a truly embodied somatosensory experience. So, what happened? What drastically changed my mood and saved the day?

    I got my love of the mountains and the snow from my father. I got my incomparable stubbornness and sharp wit from my mother. The smell of the mountain air triggered a flood of emotional memory stored deep in my brain in an area called the amygdala. Emotional memories are usually associated with traumatic and/or negative experiences, and unfortunately they get all the attention. But, positive experiences and happy memories are stored as well. The smell of the mountain air filled me with the memory of the many ski trips growing up, the smell of our fresh cut Christmas trees, the smell of the trees in our yard after a storm, the visits my parents made out West to visit us, the hiking and even horseback riding expeditions we had (especially fun because my Mom was more of an indoor girl, but she sure was adventurous)! It was not the specifics of "Oh, I remember that", but more the "felt sense" and the feelings of happiness related to all of those experiences that went through me at lightening speed that day.

    The plasticity (flexibility) of my nervous system did a huge favor for me that afternoon. It was able to automatically switch from my cognitive ruminations to my emotional brain and as a result to fully embrace the pleasure of being in the moment on that mountain and the life long journey (and the parents) that got me there. What a gift!

    The point is, we all go through difficult times, but we also have joyful memories that we may not fully appreciate, especially during the tough times. But your brain remembers. Trust the intelligence of your nervous system to help bring these positive and nurturing emotional memories to you, especially when you need them most.

    Be healthy!

Cheryl Ilov, PT, GCFP

A very happy hiker!

                                                       
                                  

So....why Pilates and how can it help you?

     

Have you ever wondered what Pilates can do for you? Here are a few examples:

1) The Pilates reformer provides a supportive environment which is very important for people who are recovering from injury, surgery, trauma, or are deconditioned (out of shape). Springs provide resistance (instead of weights) which more accurately simulates natural muscle activity. The springs also provide assistance for you in the early stages of physical rehabilitation.

    2) The reformer provides immediate feedback to the client in a partial weight bearing position to allow for postural corrections and healthy movement patterns to develop. Clients experience changes in their movement patterns in a stable environment, without trying to fight their habits in full weight bearing against gravity.

    3) The stable and secure environment of the reformer combined with the skills of an experienced and knowledgeable therapist makes it safe for people with chronic conditions including injuries and illnesses to participate. Pilates promotes and supports functional movement such as walking, standing, and balance.

    4) There is a natural progression from rehabilitation to strengthening and conditioning. Using the reformer bridges the gap between passive movement and resistive movement, which is often a missing element in traditional rehab programs. Pilates helps you progress through a continuum of gravity eliminated movement and movement against gravity.

    5) The positive psychological benefits are frequently overlooked and not addressed in the clinical setting. They  include (but are not limited to) increased self confidence, increased body awareness and improved self image. Pilates helps people get "out of their heads and into their bodies" by truly embracing the mind-body connection.  There is also something incredibly comforting about the rhythm of the reformer and the ability to move against light resistance for someone who has been  injured or deconditioned.

Pilates reformer and trap table combination unit at Ilov Integrated Arts, LLC

So.....that's what Pilates based rehabilitation can do for you!   

Be healthy,

Cheryl Ilov, PT, GCFP