therapy – a t i s h e h

Guest Post from Lauren Zehara Haas: Bringing the Joy of Movement to Medical Populations

I’m delighted to introduce a guest post from Lauren Zehara Haas, a writer and dancer who is organizing the upcoming Global Hafla for Humanity international fundraiser and building an informational site at www.bellydanceu.net. Lauren is the author of the Belly Dance Journal and of the DVD Stage Presence. I hope you’ll enjoy and share Lauren’s reflections on teaching movement to people going through or recovering from illness.

The first time I taught a belly dance program for breast cancer survivors, I was a bit intimidated. Teaching movement practices in medical situations always feels like both a great privilege and a tremendous responsibility; I hoped I could give this group whatever they wanted from my class.

I arrived early and the director showed me to a carpeted room with chairs around the perimeter. I set up my sound system in one corner, sat on the floor, and started unpacking the veils I’d brought with me. Soon the first pair of women peeked into the room.

“Are you the bellydance teacher?” they asked with a giggle.

“I am, come on in! What are your names?” Turning a room full of uncomfortable strangers into a room full of laughing friends is what a belly dance teacher does best. The more women arrived, the more comfortable I felt.

About 10 women had trickled into the room and we were getting along beautifully when the first truly sick looking participant came in. She had a scarf tied over scalp and deep shadows under her eyes. She entered slowly, seeming very unsure of herself, which immediately alerted me that she was new here, and the others, so much more comfortable in this room, must be further along in their recovery.I got quite a shock when I realized I knew this woman.

“Liz? How ARE you? I’m so happy to see you, I’ve been so worried!” This woman had quietly disappeared from one of my yoga classes six months ago. Liz indicated her headscarf in response; no words were needed. I hugged her gently and told her I was so happy to see her and was looking forward to teaching her a little bellydance. My heart was filled with the honor of being allowed to teach these women who had all so recently danced with death. The purpose of this program was not to teach them to dance, but to help them reconnect with life.

Over the next hour, I gently guided the women in moving their hips and following Middle Eastern rhythms. We kept our arms below our hearts to accommodate their lower energy levels, and when I handed out the veils I taught low, one-armed movements so those who were recovering from mastectomy incisions could adapt to whichever side suited them. We sat down to practice finger cymbals halfway through the hour, so they could catch their breath. We laughed a lot, and they were all smiling when they left the room. No one had a bigger smile than me; mine felt like it was bubbling up from the soles of my feet.

If you’re ever asked to teach a movement class to a medical population, I urge you to say yes. You may never have a more rewarding experience. But you also need to take responsibility for managing these populations responsibly. Here’s how:

Do your homework. Start by asking the person who is hiring you “What should I know about this group’s physical limitations to teach them safely?” but also do independent research on Google. Use search terms like “How to adapt exercise instruction for people with ______.” The yoga literature offers a lot of information on adaptations, and you can usually extrapolate this to other movement forms. Ace Fitness also offers good resources, even if you’re not an ACE certified instructor.
Present yourself as authoritative but open. Tell the group “I’ve done some research, and I’ve brought a lot of ideas. But you are the experts on your recovery and limitations, so please stop me if there’s something I need to know.”
Be awkward. Uncomfortable subjects will come up in medical groups. Push through them anyway. If you avoid talking about body functions and other tough topics, they will avoid it too, so be open and create a no-holds-barred environment for them. Laugh at your own awkwardness. They will love you for it.
Warm up slowly. Give your students time to talk, to laugh. This is a social experience for them even more than it is an exercise class.
Keep it fun. Your job is not to rehabilitate, or even to give them a great workout or teach them how to dance properly. Your job is to help them reconnect with the bodies that have betrayed them. Help them have fun in their bodies. Give them laughter, and encouragement, and lots of success experiences. Measure your success by how much joy you feel in the room.
Encourage adaptation. It’s not enough to start the class by saying “feel free to rest at any time, or adapt the movements to suit you.” You have to prove to the group that you mean it. Humans are social animals, and they will push through pain in order to stay with the group and do what the leader asks. When you see someone sit down for a moment, or change the move to suit them, give a verbal reward like “I really like how you’re taking care of yourself right now” or “That’s a brilliant adaptation, I like that. Would anyone else like to try it that way?”
Continuously offer adaptations. If there are three ways to do a movement, show them all, but then return to the simplest variation for the rest of the drill. Students who feel competent can do the move without a model more easily than people who are struggling. Ask questions like “Would anyone prefer to do this move sitting down?” or “Is this move causing any discomfort for you?”
Monitor their energy level. Keeping arms below heart level and not lifting the feet very high will reduce the workload on their bodies. If the group seems tired, bring them back to a simple drill and talk with them for a while, or offer a water break.
Ask for honest feedback. You are going to love working with these groups, and you’ll want to keep getting better at it.

Review of Zayna Gold’s Healing Through Movement

Zayna Gold introducing Healing through Movement pilates and weight program

Zayna Gold’s workout, Healing Through Movement, was designed to help patients with IBD or other digestive disorders such as Chron’s and Colitis, and Celiac. I don’t have any digestive disorders, so I can’t judge the workout from the perspective of its target audience. However, I am very interested in workouts and programs aimed towards people who are not in perfect health. I think you can keep moving even when you are a bit sick, and sometimes it’s one of the best things to do. But it requires a bit of guidance.

Healing Through Movement is essentially a strength-training workout consisting of four parts. Cycle One: Upper Body is a standing series of basic arm exercises using light hand weights. Cycle Two: Lower Body gives you classic lower body moves such as squats, wide plies, and lunges. Cycle Three: Full Body Workout combines moves from both of the first two sections, so you might do arm lifts while squatting, for example. Finally, the Core Workout is a pilates-based mat series, with exercises on your back and from plank position.

For people who have done any exercise at all, most of the exercises will not seem particularly new — though there were a number in the Core Workout section that were indeed new to me. What’s really outstanding about this program is the quality of Zayna’s guidance. For every single exercise, be it ever so simple, she gives you detailed cues to move your body in a safe way, to use your breath to guide the movement, to work from the core. Even though I was working on my own, with only the DVD and a mirror to guide me, I felt very much in control of my body during the exercises, because they were never rushed, and always thoroughly explained. Zayna has a pleasant, matter-of-fact manner, so it was never grating to hear her talk me through an exercise — rather, it felt like I had a teacher right in the room.

Throughout, Zayna offers modifications and options for people who find a particular position (say, lying on the back) uncomfortable. The cycles are designed so you can repeat them if you want a tougher workout in a particular part of the body. I can imagine, for example, doing Cycle 3 and the Core Workout twice as a mini circuit.

I really liked that this program was just so doable. In forty-five minutes, you have done strength training — enough to sweat — for most of your body. You don’t need fancy equipment, because even the mat and weights are things you can do without. And you don’t need a lot of space, because everything is utterly stationary. It’s the perfect travel workout, in other words. The next day, I felt a light, pleasant muscular pain in my entire body, and if I’m not mistaken, I was standing a little taller too.

What I think could have been improved: First, Zayna’s counting was often very different from what she actually did, which was occasionally confusing. Second, I think there really should have been a stretch at the end. I wound up doing my own series of yoga moves to stretch everything out, which felt wonderful, but I think with that kind of weight training a guided stretch should be included. That said, it’s a workout I can see myself returning to. I like how efficient it is, how careful the instruction is, and the core workout is simply great.

I received a review copy of Healing Through Movement. You can get a copy directly from Boston Body Pilates. It’s also currently available on Amazon, but at three times the price.

Review of Chantal Donnelly’s Pain Free at Work

Although I’ve dedicated this blog to activities that make me feel physically wonderful, like dance, and yoga, and pilates, the truth is that I spend enormous amounts of time in front of the computer like everyone else. It’s not just work, though it is also work. But many things I love to do, like writing creatively (and like, well, my work) require the computer.

This means that I can reliably count on one thing: pain.

I was recently sent a review copy of Chantal Donnelly’s Pain Free at Work. The funny thing is, I’ve often wanted something just like what this video includes, namely a short stretching program that can be done in my office chair. But first things first.

Let me just pull up a seat…

Pain Free at Work is a mixed-genre DVD, made up of both informative lecture segments and sets of practical exercises. It’s about forty minutes long, and divided into multiple sections:

Pain Free Sitting
Training for Marathon Sitting – Phase 1
Training for Marathon Sitting – Phase 2
Ergonomics in the Work Place
Exercising at Your Desk
After Work Workout
Handling Pain: Elbow, Wrist and Hand Pain
Express Stress Relief

The lectures:

In Pain Free Sitting, Chantal demonstrates how to sit correctly so as to minimize the curvature of the back, and reduce pain. She uses a live model and anatomical charts. As much as I am easily bored during this kind of lecture, the truth is that I realised how much I am doing wrong when I sit at a desk. (Just right now I was sitting back with my legs crossed on the chair!) I’ve always known I was sitting poorly, but having it spelled out somehow helps me to check my own posture. (Now I am sitting up straight, abdominals in. Aren’t you proud of me?)

This is the secret to good laptop mojo!

I found Ergonomics in the Work Place very useful. Again, this is the kind of thing I’ve read dozens of articles on, but I’ve rarely been able to control my work space to the extent needed to have an optimal setup. What I liked about this section is that Chantal and ergonomics expert Brad Hutchins deal with laptops, which I never have seen before. The assumption tends to be that you have a huge desk computer. The other thing I liked was Brad’s point that even making one improvement is better than nothing. I don’t have to have the perfect setup at work, but changing one thing is still good.

Express Stress Relief was really express. It is a short conversation between Chantal and Dr. Jeff Gero, and includes a few strategies on dealing with stress. Mainly deep breathing, meditation, and positive thinking. Honestly, I think each of these take enough training to do them right that having a short segment on them is not particularly helpful.

The lectures with some exercises:

Training for Marathon Sitting – Phase 1 is basically an introduction to connecting with your transverse abdominal muscle. Chantal provides some strategies for strengthening it while doing everyday tasks. Again, simple, but good to have the reminder. I do think that people who have not had training in accessing this muscle might benefit from even more detailed instruction. (I found Helen Byrne’s postnatal conditioning workout to be particularly focused in this respect.)

Handling Pain: Elbow, Wrist and Hand Pain is another brief segment, including two self-massage techniques for dealing with elbow and hand pain that were completely new to me. Short, but very worth while.

The exercise programs:

The real gem of Pain Free at Work for me is Exercising at Your Desk. This is a compact set of exercises you can do at your desk that will gently stretch everything from the feet to the head. The thing I particularly like about this is that the exercises do not look weird — that is, you don’t have to get into any funny or embarrassing positions to do them. You could do them around your coworkers and no one would bat an eye.

This is just a delicious inner-thigh stretch

Training for Marathon Sitting – Phase 2 is a gentle yoga and pilates-type workout for stretching the back and building strength in both abdominal and back muscles. Chantal suggests you watch it through before doing it. This is a good idea, as the cuing is minimal. (I would have liked for everything to be cued.) That said, she does give good prompts on form and using the abdominal muscles for support. And she has one of the demonstrators show modifications, sometimes using a Swiss ball.

Finally, there is an After Work Workout that uses a thick foam roller for stretching and relaxation. I didn’t have the prop, so I didn’t do it! I can say that the other two workouts are simple but definitely relaxing.

In short, I think Pain Free at Work can be very useful to anyone spending a lot of time at a computer. Watching the lecture segments is not as much fun as doing the exercises, but I did get some good tips out of them. I think the best way to use it is to keep it in your office and do the stretches and self-massages on a regular basis, once or twice a day, as a preventative measure!

Review of Annette Fletcher’s Perfect in Ten: Stretch

[Note: Don’t forget to enter the giveaway for Annette Fletcher’s Prenatal Stretch & Strengthening before June 1, 2012!]

Being a new mother means suffering through all sorts of aches and pains: lower back, shoulders, neck (from looking down adoringly at my son, of course), you name it. The natural answer to this should be, of course, yoga. And I have several postnatal yoga videos to work with, but so far, I’m still not really ready to take on a proper yoga workout. So I decided to give Annette Fletcher’s Perfect in Ten: Stretch a go.

I was particularly motivated by the fact that the video is split up into ten-minute segments. I don’t have enormous chunks of time to myself these days, so I wanted to start something I could do in bits if I happened to be interrupted. (And of course, I was.) The video is broken up into the following chunks:

1. Upper Body, Back and Hips
2. Hips and Legs
3. Sedentary Lifestyle Relief
4. Sports Stretch
5. Intense Stretch

Chapters 1 and 2 really flow into each other — do them back to back and you’ll have some decent stretching for your entire body. Chapter 3 stands well on its own, as it has you do stretches while sitting in a chair. This would be perfect as a quick ten-minute stretch to do at work.

Chapter 4 contains stretches targeted for particular sports, such as tennis, golf, and running. However, it’s not a full stretching program on its own, so you’re best off learning the stretches useful to you and then doing them on the field. Finally, Chapter 5 has some deeper, mostly yoga-based stretches.

When I do a program like Perfect in Ten: Stretch, I typically ask myself several questions: How effective is the program, especially in ten-minute segments? How new to me are the moves? And, if the moves are not particularly innovative, is the way they are sequenced particularly interesting or good?

Effectiveness: When I’m really tense, ten minutes of stretching doesn’t do very much. It’s better than nothing, but won’t get me really relaxed. I think Chapter 3 is good on its own, as it is easy to do in one location and is perfectly designed as a little break. The other chapters have you move between standing, mat work, and wall-based work. (There is plenty of time for these changes, but I don’t have a lot of spare wall space, so I tend to be frustrated by extensive use of wall space in exercise videos.) Doing 1 and 2 together is good for basic, head-to-toe stretching. I did the entire video, with an interruption, and I found that doing all 50 minutes or so really was effective, deeply relaxing, and relieved all sorts of pain.

Novelty: Most of the stretches, especially in the first three segments, are ones I recognized, though there were some surprises. Annette uses a lot of gentle twisting moves, which I also liked. I thought the sports stretch and intense stretch chapters were the most interesting. Sports stretch has a shoulder stretch (pictured) that a former yoga teacher of mine had us do, and which is truly wonderful if done right — I’m glad to have it on video.

Sequencing: Despite the fact that the chapters are themed, Perfect in Ten: Stretch works as a whole. It starts with super gentle stretches, continues to slightly more intense one, and builds up to deep stretches. If you have a regular yoga practice, you will probably not find Perfect in Ten: Stretch challenging enough. But if you don’t, or you’re trying to build up to yoga but are inflexible or suffering from pain, you might find the video just the thing for slowly easing into yoga-type stretches.

I’ve previously reviewed some of Annette Fletcher’s DVDs for World Dance New York here and here. The more I work with her stuff, the more I like her. She has a calm, matter-of-fact demeanor I find soothing. Her cueing is detailed, precise, and allows you enough time to move from one position to another. (I noticed one missed cue in the whole video.) And I feel better and stronger once I’m done working with her videos. They’re just plain solid.

First workout with Helene Byrne’s Bounce Back Fast! Post Natal Core Conditioning

My mother’s day gift to myself? Starting to exercise again.

Even though there are many people who exercise before hitting the six-week mark, it’s my nature to have a sense of fearful respect towards any process that involves cutting my body open and rearranging my organs. So I was really careful to toe the line before I got my doctor’s ok: I didn’t lift heavy things, I didn’t exert myself too much — at least not two days in a row — and I did absolutely no exercise. Not even the lightest movements. None.

But man, was I ever dying to. So to ease into it again, I decided to start with my review copy of Helene Byrne’s Bounce Back Fast! Post Natal Core Conditioning. There are two workouts. “Gentle First Moves” can be done early in the postpartum period, and is all I’ve worked with so far. Then there is “Bounce Back Fast!”, with an “Abdominal Separation Program.”

Bounce Back Fast! begins with a series of informational segments on beginning postpartum exercise, using kegels to recondition the pelvic floor, dealing with Diastasis Recti (I didn’t have this so I skipped watching this segment), and ways to work the abdominals so as to pull in the stomach. I think it’s really worth watching through these at least once for two reasons. First, Helene introduces the postures she later calls on in the workout. And second, the tips on keeping the abs engaged during movement have made me much more aware of how I hold myself when walking, holding the baby, breastfeeding, and so on.

Now, let’s be frank here. This is not an exciting video. It’s filmed in a very plain studio, though the shots are very clear and professional. Helene enunciates everything slowly, explains in detail what the postpartum body needs, and doesn’t use cutesy words for body parts the way exercise video instructors sometimes do. There’s no “tushy” here. When Helene means “anus,” she says “anus.”

Nor is the workout exciting. If you were simply to watch it, you would probably think nothing is happening. And this, my dear readers, is why I always insist on doing the videos I review. Because this plain 30-minute workout, with no music and no flashing lights, is ridiculously effective.

I’ve done it three times so far, and each time I was suffering from upper and lower back pain before I began it. The first time I worked with the program, I felt pain relief the following day. The second and third times, I had no more back pain immediately after finishing the program. I am serious. One moment I was in lots of pain, and exactly half an hour later, I felt good.

How did this happen? The exercises themselves are fundamentally basic stretches, the kind I know from physiotherapy and from pilates/yoga type workouts. They remind me quite a bit of the Viniyoga back therapy videos I love so much. However, Helene cues them with precise attention to which muscles should be tensed and which relaxed. And each of the exercises has something just a little bit different about them. One focused on pulling in the abdominal muscles uses breath work and hand spotting to get those loose muscles working again. (Incidentally, this particular exercise would be great for belly dancers looking to isolate lower from upper abs!) A hamstring stretch uses the included elastic band to do a gentle but powerful variation. These are just a few examples.

The other thing I want to note is that while these exercises seem like nothing from the outside, doing them correctly is very difficult, especially postpartum. While my strength and flexibility have improved with each repetition of the workout, I’ve also come to see more and more how much concentration they need to be done according to Helene’s instructions.

I’m looking forward to working with the second part of the workout. But I’m also looking forward to returning to dance and yoga instructionals, to say nothing of other postpartum exercise programs, with the increased awareness of my abdominal muscles taught in Bounce Back Fast!

Bounce Back Fast! is also available on www.befitmom.com.

Review: Gary Kraftsow’s Viniyoga Therapy for the Upper Back, Neck & Shoulders

I bought Viniyoga Therapy for the Upper Back, Neck & Shoulders and its companion for the lower back shortly after having a debilitating back spasm that put me out of commission for several weeks. I went to physiotherapy, and although it did help, I find the exercises excruciatingly boring, which of course means I don’t do them as often as I should.

So, what was the result? These DVDs are quite simply a godsend. (I’m only writing a review of this one now because I haven’t yet used all three segments of the lower back DVD.) Kraftsow says in his introduction that doing the yoga exercises should be like brushing your teeth, and I find that the program is designed to make it just as easy to keep the stretching going as brushing teeth would be! Knowing that I have a choice between segments of different lengths, and that I can do just 20 minutes in the morning (before I get too hungry!) and still be doing something for my back, makes it so much more realistic to keep up a yoga program.

That, and the fact that the exercises work. I am sometimes so tense that the neck & shoulders movements don’t relax me completely, but they do help, and I generally feel the difference the following morning: they can be better described as preventing future, worse pain than easing current pain. I might add that several of the exercises are similar to what I learned in physiotherapy, which gave me some confidence in the system.

I spent more on these DVDs than I usually do on exercise videos, but I also use them several times a week, much more than I use anything else. They offer variety in type of exercise and duration of program, and they’re set up so that I can do a light program when I’m suffering from pain and a harder one when I want to build strength. I’ve also noticed a difference in my core abdominal strength from using the two videos. Finally, I should add that the DVDs also include mp3 files of the practices, in case you just want to work out with the sound and don’t need the video any more.