Feet and the Pelvic Floor

I just finished another foot workshop. I love doing them because they are literally your foundation and also the foundation of all the work that follows, typically the pelvic floor. So yes, next up is a pelvic floor workshop (my second!). I thought I’d write a post about how feet and the pelvic floor are related, and why you can’t really address one without the other.

Let’s establish some very basic anatomical details:
1. Your hip joint is made up of the ball and socket of the femur and the acetabulum. The femur is your thigh bone. It ends in a “ball” which sits in a rather deep socket made up of your pelvic bones.

2. Your knee is in the middle of your leg and this joint is formed by the bottom of the femur (thigh bone, see #1) and the top of the lower leg bones, specifically the tibia. The top of the tibia is like a plateau. In fact, it’s called the Tibial Plateau. Poetic eh? The back of the knee is what we’ll be looking at today.

Here's what the back of the knee of the average person looks like. The red dots are indicating the hamstring tendons. With the feet in turn out, the hamstrings almost face straight back (this person probably walks with more turn out than she is showing here).

Here’s what the back of the knee of the average person looks like. The red dots indicate the hamstring tendons. With the feet in turn out, the hamstrings almost face straight back (this person probably walks with more turn out than she is showing here).

3. Your ankle is at the bottom of the leg, between the lower leg and the foot, and it is made by the two lower leg bones (tibia, fibula) and the top bone in the foot called the talus. The talus is a magical wonderful bone. It has no muscular attachments (the only bone in the body with this distinction!). It supports your whole body like a keystone in architecture. The talus in turn sits on the heel bone (calcaneous).

4. Of course your foot is at the bottom of the leg and is comprised of 26 bones, 33 joints, and basically three arches; one arch on the inside of the foot (often collapsed or “pronated”), one on the outside and another one across the ball of the foot called the transverse arch. (This last one is often also collapsed.) The foot is considerably more complex than the hip or knee.

Let’s get personal. I’m going to introduce you to my pelvic floor. My pelvic floor has done a great job for me over the last 5+ decades. It has birthed two children and held in my internal organs pretty effectively. I’ve not had any really serious issues with my pelvic floor (no prolapses). I’ve had some incontinence following the birth of my kids, but only when I jump around on trampolines (not that often) or laugh really hard (unfortunately not that often) or sneeze really hard (about 100 times a day). I’m willing to bet that most of my female clients have some degree of the same issues and haven’t even mentioned it because “it’s normal.” Most people wouldn’t consider what I’ve just described as a Pelvic Floor Disorder. That has to be more complicated/severe/advanced/painful right? Well, that is incorrect. Peeing when you sneeze or laugh is not normal. It’s common, but not normal. So what if you have the same problems, or perhaps something more problematic, such as a prolapse (unfortunately very common as well) or pain in your pelvic floor? What has that got to do with your feet?

The soles are your connection to the earth, and that fact has many ramifications. For one, there is traction between your foot skin and the ground, unless you are in the nasty habit of wearing those contraptions otherwise known as “shoes.” Then your foot skin is in traction with a sock within a shoe. But whatever. How your foot meets the surface of what you are walking on will affect the joints listed above (ankle, knee, hip). The best biomechanical situation for your feet is with the feet facing straight forward in the direction you are going. This enables the ankle to articulate on it’s correct axis, or plane (which is forward and back, not side to side). But if you walk with your feet pointing out (even a few degrees) the movement that should occur at the ankle occurs below the ankle where the talus articulates with the foot bones, creating an overuse situation that may result in lax ligaments (ankle sprains anyone?).

The foot is made to articulate in all manners of ways with those 33 joints, to accommodate all manner of surface variants, so all these movements aren’t damage making in themselves, but in their frequency of use. Because we walk on flat surfaces pretty much 100% of the time, this turned out position will end up creating the shapes of the bones of the legs, and changing the orientation of the joints of the knee and hip as well as the ankle! Pretty radical eh?

Now the muscles of the pelvic floor are connected to the hip joint (both literally and figuratively) in that the position of the femur in the acetabulum (thigh bone in the hip socket) will change the resting tension of the pelvic floor. Add to that a chronic tail tucking position (which does NOT allow normal hip extension, which would engage the posterior butt muscles and create normal tensile loads on the sacrum – which is a heavy duty pelvic floor attachment site) and we’ve got some major mechanical flaws that will inevitably end up affecting the function of the pelvic floor.

Starting with the foot position, let’s get those feet facing straight ahead. And then have a gander at the back of the knees. You will notice that the grooves which are your hamstring tendon attachments are not facing straight back the way they should. They face more toward the sides, away from the midline, or laterally. So to get them facing back again, so the knee is also articulating on its correct axis, we need to externally rotate the femurs. This will end up affecting the foot position again – the medial (inside) border will lift off the ground. Only with diligent practice at mobility drills and walking on a variety of unlevel, uneven surfaces will the foot gain back the mobility it needs to evert the forefoot back to the ground – and VIOLA – ARCHES!

With the feet aligned you can see the hamstrings are pointing out to the sides. You can't even see the outside one on the L leg.

With the feet aligned you can see the hamstrings (black lines) are pointing out to the sides. You can’t even see the outside one on the L leg. The feet are flat but pointing straight ahead.

So there you have it, to get the arches back, and the resting tone in the pelvic floor, you need to start with the feet and work your way up to the hips. My foot workshops end with this external rotation, but it’s a concept that is very challenging to do without some guidance – the health of the knee can be compromised if done incorrectly. So please see a certified Restorative Exercise Specialist before you try it. There are also more detailed instructions in Katy Bowman’s books (links in sidebar).

Now the femurs are externally rotated. The feet lift up on the medial side. Eventually, when the feet are more mobile, they will come back down with this hip/knee arrangement: alignment complete!

Now the femurs are externally rotated (the right one needs more!). The feet lift up on the medial side. Eventually, when the feet are more mobile, they will come back down with this hip/knee arrangement: alignment complete!

By the way, it’s been 3 years since I corrected my foot orientation and began walking with correct hip extension. My pelvic floor is a lot stronger. I can sneeze 100+ times now and no leakage. Cool right? And that was accomplished without one kegel. Not one.

Shoe Review: Lems

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I was sent a gratis pair of Lems shoes recently, much to my surprise. I actually thought the email was spam and was about to trash it, but a quick search for company staff led me to believe this was on the up and up. They even let me choose model and colour! I went for the black Primal (called Shade). I’m a size 11 and ordered 44, as per their sizing chart, which was perfect. Of course, they requested I review the shoes on the blog, but my opinions are completely my own and I review honestly.

I have to say, Lems had been high on my list of must-try shoes for some time. Restorative Exercise Specialists™ are quite happy on the whole with this brand and it is recommended among our group highly. But of course, not every shoe works for every foot, and buying a shoe online is always a gamble – especially if you are shipping internationally (Lems is a US company – their shipping rate is 9.95 for one pair domestic and a whopping – unrefundable – $24.95 for shipping internationally). If you are cheap like me, you wait until you are in the States to buy.

My last pair of kicks were Altra, reviewed here. I was happy I started out my zero drop adventures with this brand as it is rather cushy (it’s meant for running) and helped with logging lots of miles on sidewalks in the urban jungle that is Toronto as I transitioned. The soles are starting to wear out so these Lems came in the nick of time. I haven’t logged a lot of miles in them yet, but enough to formulate an opinion.

All of Lems shoes are Zero Drop – industry speak for no positive heel. This is an absolute MUST of any shoe I buy. I wouldn’t even consider anything with a positive heel. If you need to ask why – read this. Or this. How about this. And then get this book. And this one.

Got it? Heels bad!

One of the selling points for this shoe is their wide toe box (also the reason I bought my Altras). If you wear Correct Toes (which the company also sells – and I recommend them highly) this shoe will accommodate your foot + Correct Toes. One cold day I tried toe socks + Correct Toes and this was a bit too much. I have since read that the company suggests removing the insoles if you are wearing Correct Toes but I found they fit fine unless I also tried to add all that extra fabric of toe socks (double fabric between four toes).

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Tracing of my foot with the shoe beside it. The shoe should cover the tracing. If any part of the tracing sticks out, the shoe is not wide enough.IMG_3353

 

 

 

 

 

 

 

 

 

 

 

 

 

Another selling point is how flexible they are. We know the less a shoe does to interfere with the natural movement of the foot’s 33 joints, the better, especially over varied terrain such as a park or hiking trail, rocks at the beach etc. A stiff soled shoe will prevent your foot from moulding to the surface it’s on, and shift the load to the ankle to deal with – which of course is not equipped to move in all those planes and this results in sprains, or worse; falls. So a nice flexible sole like the Lems’ is not just a welcome design feature – it’s a matter of foot health and safety.

Flexible!

Flexible!

Right out of the box I noticed the shoe had a strong off-gassing kind of smell – they are marketed as microfibre and open weave mesh – 100% vegan. Whether this was the result of being in a shoe box during transit…I don’t know, but I left them in a spare room for a few days (it was still too inclement outside) until the smell dissipated.

They have a slight toe spring (I believe .5″). This is an angle where the toe end of the shoes rise upward from the ground. I’m not sure why this is part of the design of this shoe – it’s slight enough that it’s not a deal breaker for me, but I’d like to see it go. The toes are meant to lie on the ground, and lifting them up places an unnatural load to the ball of the foot (metatarsal heads). Of course most shoes have a tremendous amount of toe spring, so this shoe is a step in the right direction and certainly better than most out there. And the soles are flexible enough that when the foot is in them, the toes spring less.

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Reflection on my dining room table showing the toe spring.

I’ve worn these barefoot now and really like the feel of the shoe in bare feet. It’s comfortable right out of the box. Remember when you had to “wear shoes in?” What a ridiculous concept! Yesterday I wore them sans socks in 18 degree weather (64F) and found them to be a little sweaty, so in super hot weather I’ll probably go with a thin pair of socks.

I think these shoes are good looking design wise. I’ve had lots of compliments on them already. Not everyone loves the white soles but I do. I would recommend them with no reservations to anyone ready for a fairly minimal shoe. The company also offers zero drop, minimal, flexible dress shoes (great for the office) and a great looking boot (that’s next on my wish list). I’m going to enjoy wearing these shoes this spring/summer! They are perfect for my foot and my current urban environment. Thanks Lems!

OH! One more thing – my cat wanted to thank you for the box. It was very tasty!

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Transitioning to a Minimal Bed

All my friends know about my penchant for things Japanese. I love the stores Muji and SouSou and this song. I love their rain boots and Japanese literature old and new. I love anime movies, Tamagotchi…the list is long.

So when I found an importer of real Japanese Tatami right here in Toronto I was ecstatic! Tatami are rice grass mats, used as flooring in traditional Japanese homes and often in martial arts studios. Apartments and rooms are described by how many mats they hold, for example, a “seven mat room” is approximately 10’x13′. To see pictures and learn more, link here.

There are many importers and makers of mats but the real mats are unique. They are 5.5cm high and no wood filler or styrofoam goes into their making. They are made with rice grass all the way through so they are all natural and smell lovely. They are quite heavy and don’t fold. They are meant to sit on the subfloor and be the wall-to-wall flooring in the room.

The showroom at Tatami Imports (note dining tables - one in back with the legs unfolded, and the one in front legs folded ready to be moved against the wall)

The showroom at Tatami Imports (note dining tables – one in back with the legs unfolded, and the one in front legs folded ready to be moved against the wall)

As well as the mats, Tatami Imports also carries the traditional Shikibuton, or futons. They are different than the futons you get at the futon store. Thinner and stuffed with soft cotton, they are no more than a layer of comfort between you and the floor. They fold up when not in use and can be stored away.

Kitten Soetkin tries out the Shikibuton (futon)

Kitten Soetkin tries out the Shikibuton 

Unlike North American homes with many rooms, each dedicated for a specific purpose, traditional Japanese rooms were multi-purpose. So the dining table legs would fold up, the table leaned against the wall, and out from the cupboard would come the futon and bedding. Thus one room could serve as living room, dining and bedroom. I love that idea – that a room could be devoid of permanent furnishings and could morph into whatever you need. Once you try living in a room that is not filled with “stuff” you quickly realize how wonderful it is to have space around you, and only the things you need at hand, nicely organized.

Of course this fits into the whole Restorative Exercise™ paradigm of natural movement, less furniture, floor dwelling to eat and work and relax. So I was hell bent on getting myself some tatami and a futon and making over my spare bedroom into a room that would be multi-purpose – both a studio for private clients, and a second bedroom.

That dream finally became a reality and I have my peaceful beautiful room. During the day I fold my futon and sheets and store them away and have a big space to do my exercises in or teach clients.

My studio for private or semi-private lessons

My studio for private or semi-private lessons

I started sleeping on the futon as an experiment to see how sleeping on the floor would feel. Readers of Katysays.com will know why. (Read this post for more information.) A mattress is essentially a cast, something that allows you to maintain a position for a long period of time that would not be comfortable otherwise. I tend to sleep on my left side about 95% of the time, since my first pregnancy. The first night on my futon, I woke up sore and turned over uncomfortably to my right side. The fact that I didn’t have 10″ of foam under me meant that I felt the weight of my hips and shoulders on the floor. The mats have more give than hardwood, but they are still harder than a mattress. Then invariably, I would get sore on the right side and flip back to my left. This went on all night and in the morning I was tired, cranky and sore! But I was not about to give up, because the thing was – I moved all night long and didn’t stay stationary on that left side.

Why is being stationary a bad thing? Well think of side lying – your spine is dropped on one side in the lumbar (low back) and cervical (neck) areas, all your weight is compressing one hip, one shoulder is displaced and one arm is pinned and getting less blood flow. Not to mention what’s going on internally (organs and circulation). Often those shoulder and hip pains are so stubborn because you spend so much time in one position all day and night. And I’d been lying on that left side 95% of the time for over TWENTY FIVE YEARS! I was not about to give up after one night!

So I persevered. After a few more nights, I didn’t wake up to turn over, or only slightly so. I woke in the morning with no aches and pains. I started using more sleeping positions that the one or two previously. I slept better and longer. I started really looking forward to going to bed. Maybe it’s memories of sleepovers or camping, but it feels child-like and fun to sleep on the floor. Plus my cat thinks it’s awesome (my husband probably less so but I’m hoping to convert him). There is one surprising thing that I didn’t foresee: getting up in the morning is literally getting UP in the morning – from the floor one must fold one’s creaky old limbs and push yourself up to standing, unlike before when all I had to do was to swing my legs over the edge of the bed to the floor and be half way to standing already. Ah, the benefits of getting up and down from the floor!

My cosy room all made up for bedtime.

My cosy room all made up for bedtime.

Thinking of Airbnb’ing my new room – how much would you pay to sleep on the floor? 😉

One of my friends works on the computer all day. She asked my opinion on a video going around that had a nice upper body loaded/twist exercise as a 30 second quick fix-it for the desk bound. While the exercise felt pretty good to me, I doubt whether a lot of people who spend all day in a chair would be able to actually accomplish it without possible injury (specifically to the shoulder – see my last post), so if you really wanted to do this exercise, it should be taken in steps. (As an aside, would you do this in the middle of your office? I would but I’m the person who squats on the subway platform).

So what is the quick “fix it” solution for the desk bound?

Of course you already know the answer – the quick fix it for years of being sedentary is to stop being sedentary. You’re welcome! Next!

Ok I know, that’s not a very helpful answer. But here’s the thing: we’re still thinking that “not being sedentary” equals “exercising“. We replace our desks with treadmills and bicycles in the hopes that exercising more will offset those hours of sitting. This belief starts at a young age, when we expect our kids to sit quietly for schooling, offset with brief interludes of recess (unstructured play) and “exercise,” i.e., gym (structured play). So all you need to do to offset those hours in front of the computer is 30 seconds of stretching recess, right? I do think any break in sitting is well worth it, but it helps to start to broaden your scope of movement opportunities.

My flippant answer above is really the truth – stopping being sedentary is something you can do right now, this very minute. Sitting in and of itself is not the problem. Sitting in the same position all day is the problem. If you were to stand, before long there would be a rash of standing injuries – if you were to stand immobile all day. The answer is to move – and movement can be small and varied. For example, change your chair to one without back support. (Keep in mind these suggestions might be extreme for extreme cases, and should be transitioned to appropriately.) “Outsourcing your muscles’ work to furniture” is a line that Katy Bowman uses to describe the fact that we don’t use muscles to sit just because we are sitting – most of the time our muscles are turned off and the chair is supporting us passively.

Set your computer up on something (a couple of boxes) and stand sometimes, interspersed with sitting. Change your position a lot. If you are lucky enough to work from home on a laptop your opportunities are endless. I’m writing this squatting on a yoga bolster with my laptop on a stool. If you can stand for part of the day, place something under your feet such as a half dome (calf stretch) or Yoga Tune Up balls or tennis balls, a cobblestone mat (my favourite – and you can buy a boot tray or jelly roll pan and fill it with river rocks from the garden store – or the beach – for a cheaper and wonderful alternative).

Think of the joint positions your feet, knees, hips, spine, shoulders, neck and head experience the most and start varying them. Most of our work is done with the arms in one position all day long, with very little movement at the shoulder. The fingers are almost always in flexion. I see many people who spent their working lives at a desk who can no longer straighten their fingers all the way. Start stretching your fingers! Raise your arms above your head now and again. This video by Daniel Vitalis shows his workspace, it would be a great goal to integrate one or all of his ideas. I especially love his hanging bar but you could use a door frame and you don’t have to lift your feet off the floor to gain shoulder health.

Another thing we don’t move very much is our eyes. Daniel shows one way to vary our focal point by moving a remote keyboard far from the screen, but you can achieve a varying focal point as easily as looking out a window often and focussing on the furthest point you can see.

Think of these ideas as giving your future self a gift. If only we could look into a crystal ball and see ourselves at age 65, 70, 75 – that would probably be motivating. A lot of the ills that we consider a natural, inevitable result of aging are actually the result of years of mechanical mis-use. And it’s never too late or too hard to start moving more.

ps something to look forward to is the Katy Bowman/Mark Sisson collaboration – a comprehensive multimedia course called Don’t Just Sit There! Together they tackle the public health problem that is the sedentary office environment.

Notes on Shoulder Health

This post is in response to a reader request for more details on the RE™ approach to shoulder health. In order to have this discussion, it is necessary to talk first about shoulder anatomy.

Shoulders and feet are pretty much my favourite topics anatomically. They both have a lot in common: they are complex structures that are both fundamentally underused and overused! We can stand on our feet all day, or run a marathon (overuse) but we can’t spread our toes or lift them individually (underuse). We type/hold a steering wheel, carry bags and lift weights (overuse) but we don’t have the strength to hold up our own weight, nor can we achieve full range of motion (ROM) in the shoulder without spinal distortion (underuse) leading to friction and wear of the spinal discs. There is huge potential to increase the health of the tissues in both feet and shoulders from their current state.

I’ve had a lot of problems with my own feet and shoulders, so I’ve spent years trying to understand and rehabilitate them. I was successful at it (ongoing) and look forward to having not just pain free feet and shoulders, but really incredibly strong structures with full ROM.

If I ask you to point to your shoulder, you’d point to the area where your arm meets your body. This is the glenohumeral (GH) joint, where the humerus (upper arm bone) sits in the glenoid fossa. This is a concave or dish-shaped structure on the side of the shoulder blade, or scapula. Our arms don’t hang on our ribs, they hang from the scapula, which sits on the ribs. Thus, the position of both the ribs and scapula will need to be assessed for proper shoulder mechanics.

GA205 (1)This is a picture of the L scapula from the side, the bean shape of the glenoid fossa is the socket part of the ball&socket jt. Please refer to the wikipedia page for some more pictures/animations.

The nice thing about RE™ is that we have alignment points or markers; objective placement of the bones that allow us to see just what is going on. So we would start with placing the rib cage in a position that would allow for a correct relationship between the rib cage and the scapula…

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and then we would put the scapula in anatomical neutral. At first this is done with some difficulty, because the resting muscle tension in 99% of us precludes our ability to do this easily. (I’d go so far as to say 100% because I’ve never seen anyone with a neutral scapula on a neutral rib cage but they might exist.) NOW we can see what the arm is doing!

One of my favourite exercises for assessing all this in the RE™ repertoire is called the Rhomboid Push Up. Don’t get caught up in what it’s called. It should be called “Full shoulder assessment allowing us to see residual tension residing in all structures from the trunk to the fingers in a partially loaded position” but that’s an awfully long name. The nice thing about RE™ assessment tools, is that they are also the prescription. If you can’t do it, do your best until you can do it better, which might take a while but I think it’s the only thing you can do to really truly get to the bottom of what is keeping you from optimal health of the shoulder (or whatever body part you are addressing, and in RE™ there is no isolated body part – as a matter of fact, if you came to me with a shoulder issue I’d start at your feet and lower legs!).

The ball part of that Ball&Socket joint is of course, the head of the humerus.

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This is a L humerus. The ball part articulates with the socket part on the scapula, but the scapula has other structures that the head of the humerus can rub against, particularly in a situation where things aren’t residing where they should be. There are muscles, tendons, ligaments, nerves and bursa also residing in the spaces around the head of the humerus that in an ideal situation slide around without impingement. It’s this impingement that can be a creator of many problems, pain and torn tissues.

So getting this bone to be optimally situated within its socket is key. Typically the humerus lives a little too far forward and rolled inward (called internal rotation) than it should. This changes the orientation of the ball and socket articulation and can create problems for those structures I mentioned before.

Try this: stand up and face a mirror. Let your arms dangle by your sides. In the most relaxed state you can achieve, where there is no muscle engaging to hold your arm in the socket some way, where does your elbow “pit” face? This is the crease on the inside, opposite the pointy bit of the elbow joint.

Now look at your hand – which way is the palm facing? Is the back of your hand in view?

In an optimally placed humerus, the elbow pit faces front – towards the mirror, and the thumb faces forward. Can you move your arm so that this is the case? Can you do that without moving your scapula also, or did it move too? How much work are you doing to keep your arm in that position? It should be there by default, in a relaxed state.

Now turn to the side and still looking in the mirror, start to raise your arms to the front and see how high you can reach them, all the while keeping your eyes on your spine. At what point does your spine have to extend in order to get your arms higher? Back down to the point just before that happened: this is your true ROM in shoulder flexion. Oops, are you using your abs to hold your ribs down while you raise your arms? Stop doing that, and see if you can raise your arms without creating tension anywhere else. My bet is that you don’t get very far.

So far we’ve addressed the arm in its position as it hangs down from the body, but our arms were made for more than just swinging by our sides. If you study the muscles that attach the arm to the trunk, you will notice that they are proportioned and positioned to organize the trunk and lower body weight as we hang from our hands. We are primates, and hanging and swinging is part of our birthright. We will reflexively grasp and hang on as infants when given the opportunity. It is the traction that is provided from hanging our body weight from our hands that provides the opportunity for optimal positioning of the scapula and optimal length in the chest and trunk musculature. You can stretch your pecs till the cows come home, but only with a hanging practice will you enjoy the real state of health that your shoulders are capable. As mentioned in this post, hanging will encourage remodelling the bony and ligamentous structures of the scapula to provide more space and thus decrease or eradicate impingement.

It is important to progress slowly and carefully when it comes to hanging. Start by hanging from a door frame with your hand at shoulder height (or lower if necessary) only partially leaning away from the hand. It is traction you are after, or a pulling out of the humeral head. After a slow progression you might eventually hang your full body weight with feet off the ground. Eventually you work towards a one arm hang and swinging from bar to bar. That might never happen for me with the poor shoulders I started with, but I can go as far down that road as safely possible and still reap untold health benefits, and so can you.

P1030674Try hanging like this from your doorframe or bannister post several times a day. The closer your feet are to the post, the more weight on your arm. Step out and come in gradually. I usually start people mid-way from the wall and vertical.

Using my affiliate link to the right, you might want to try a Shoulder themed Alignment Snack or two. Let me know how it goes.

ps in Episode 13 of the Katy Says podcast (14:19), she answers a listener question about hanging and a torn labrum. Her answer: “It’s not helpful and it wouldn’t be the appropriate step.”

Homecoming in Ventura


P10508901st Class of 2015 (click on it to enlarge)
I’m in the back with the hair all over my face :)

I just returned from a second RES™ week in Ventura with Katy Bowman. The first time I went to the Restorative Exercise Institute (now “The B.E.A.C.H.”) was my certification week, two years ago. This time I went as an active observer, taking part in all the classes and lectures but watching the private lessons with new certifying RES™.

I went with my two colleagues and one new friend from Toronto and we all rented a sweet house a few steps from the real beach. This was our commute – seriously!

Every morning started with a class with Katy Bowman – how awesome is that? We studied the art of bolstering, discovering your physical boundaries, hanging, squatting, with two classes held outside. As well, there were seven other classes with Master RES™ teachers including a special class on the concept of how the top of foot displaces relative to the bottom of the foot, dragging the rest of the leg (and thus the entire body) with it. Even though I’ve studied this for three years now, I achieved a deeper understanding of many concepts this week, with three personal breakthroughs in understanding some of my own issues.

One was the fact that I am actively plantar flexing in the toe off phase of gait (walking) instead of generating forward momentum during the flat foot phase. A second was a sense that my lumbar spine is hyper mobile in some areas, but hypo mobile in others. And the third is about squatting. It’s a whole new ballgame folks!

Squat class on the beach:

P1050875 Katy demonstrates an enviable squat while the rest of her family plays in the sand

Using the sand as a “bolster” to enhance the Double Calf Stretch resulted in this scenario:

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Gait lesson on the beach included phases of gait and role of arm swing. With lots of racing for good measure:

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Who needs a stinkin’ stroller? Master Teacher Michael Curran demonstrates the Double Kid Lift:

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Someone needs to give this guy the 1A protocol (spot the alignment fault):

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Of course I returned home with more enthusiasm about my work and my role in passing on this important information. Having a week in the sun in January was a huge bonus!


P1050791Pictured L-R is Mina Van Brunschot, Katy Bowman, Tim Harris, Breena Maggio,
teachers at the Restorative Exercise Institute

— All pictures are my own

2015: A Year In Balance

Happy New Year from the Alignment REScue! 

I’ve been telling my clients for a few weeks that this is going to be the year of Balance and Independence. This came about because of an event in my family that I will share here.

A senior member of my family recently fell and broke her arm. It was a simple break and did not require a cast, just a sling. This was tough in and of itself of course, but it wouldn’t be a terrible  hardship for most people. It wasn’t her dominant arm for one thing. It’s mostly an inconvenience pulling on your clothes, doing up buttons, making a meal, etc.

I know from previous client experience though, that having one limb immobilized can seriously hamper your confidence in walking around. You are afraid to fall because now you only have one arm to break your fall, and if you break that one too, you’re screwed. As well, the idea that someone could knock into your “bad arm” in a crowd is enough to keep most people safe at home on the sofa for the duration of their convalescence.

In this person’s case however, she had had both hips replaced within the past few years. She did her PT, healed, and was for all intents and purposes “good as new.” However, what is not apparent to most people who undergo these types of procedures, the environment that created the osteoarthritis in the first place is still there – the tight muscles, the chair bound hips.

Bones regenerate constantly; this is what allows them to heal and knit together after a break (bones are amazing!). But the same thing is happening all the time. Your bones (and other tissues) literally mould themselves according to their use. This is called ADAPTATION. Your tissues adapt continuously to how you use them most often. Thus, if you sit in a chair for hours a day/years/decades long, your bones and muscles are literally formed to make that the most energy efficient position. While heads of the femurs are replaced and sometimes the socket part (acetabulum) of the joint too, the muscles of the hips are still tight, in some cases underused, often not in the right plane or alignment. In the instance of my family member, I believe the confidence of walking was never fully established post-replacement, but this was masked by the fact that she could rely more heavily on the arms to make up for this lost motor skill.

This is something that the body will do quite naturally, and we might not even be conscious of it. For example, if going up stairs is difficult, we can depend on arm strength on the rail to pull us up the stairs. We can use canes or walkers to lean on (effectively giving us more ground support in lieu of strong hips). We can use our arms on the kitchen counter or various furniture as we navigate our surroundings to help us balance.

The problem only becomes obvious if the remaining limbs become incompetent. Although my relative has the use of two legs and one arm, only one of her four limbs is really functional (and who knows at what percentage that arm is really functional – most of us don’t use our arms to their full range of motion and our shoulder girdles are for the most part operating at a low percentage of their potential). In fact, she did fall again, just walking through a room with nothing to hold on to.

At the same time, another relative had a long-awaited knee replacement. Standard PT in both hip and knee replacement focusses on strength, and getting back a functional range of motion. Unfortunately, the operation was a bit of a shock to this relative and she had a hard time recovering and performing her PT. For some time after the replacement, the pain was too great for her to want to move. So she spent a bit too much time sitting comfortably and well…we know that that leads to more of the same – tight hips/knees, weak muscles, loss of bone density, chair bound joints.

It’s sad to see this happening to people I know, but an important lesson is the fact that this all started years and years ago. Can you get up from the floor unassisted (by either hands or knees)? Can you get down to the floor at all? Are your hips strong enough (and not in that weighted knee extension kind of way) to hold you on one leg during a normal gait cycle with everything in alignment?

What compensations are you making – right now – that will inevitably end up being your downfall?

This is why I dedicate 2015 to a year of Balance and Independence work. I will be focussing my classes and privates lessons to ensure that we age as gracefully and independently as possible. It is NEVER too late to start this work! Each lesson will incorporate something that we can work to improve as the year progresses. Hopefully by 2016 we will have completely new hips and knees and shoulders – now isn’t that a nice thought?

Have a safe and happy New Year – may your bones be aligned.

Off the Beaten Path

On Katy Bowman’s Facebook Page she is posting daily advent walking and movement tips. This week one of the tips was:

Get off the beaten path. For at least 10 minutes today, walk OFF that flat and smooth ground and let your ankle joint complex participate fully. Don’t have wild terrain nearby? Just walk on the stuff right next to the path.

This reminds me of a part of my commute to work that goes through a park. Over the years I’ve explored enough to make most of my 5km walk to work on surfaces other than sidewalk. I go through dog parks, ravines, through community gardens…and one of the parks is part high school’s sports field/part city park. Along side the park runs a laneway (Toronto is full of them!). Here’s a shot:

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Needless to say, I walk through the park, usually barefoot. There’s a big rock at the other end where I can sit and brush off my feet and put my socks and shoes back on. Here’s a shot of the high school kids:

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Hordes and hordes of them, all walking on the asphalt of the laneway, while I walk through the empty park all by my lonesome…

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…barefoot, in December, in Toronto, because….well:

Today you’re going to walk and get a little COLD, WET, or DIRTY. No, you don’t have to throw your immune system under the bus, but our over-zealous relationship with “clean, neat, and comfortable” has left our immunity and metabolism a bit compromised. Don’t go outside naked and roll around on an ice pond, just shed a layer or two. Expose some skin. Allow the strength of your tiniest parts to strengthen relative to the environment you’ve chosen as “home.”

The other thing I take off on my walk is my glasses. I keep my peripheral eyesight scanning the ground for possible dog poop and focus on a tree at the other end of the park, because…well:

Your peripheral vision uses different areas of your eye; parts that go unused in the all-day tunnel vision utilized in screen work. Today, pan out while walking and see if you can keep checking in with a wider view of the world. Bonus points for distance-looking now and then (even more unique eye-work!).

So just think of all the health I got on in that one little section of my walk! Check out Katy’s Aligned and Well Facebook page for giveaways all this month!

It’s that Time of Year!

It’s the time for rampant consumerism, greed and gluttony otherwise known as Christmas! So I’m going to jump on the bandwagon and add my gift list here. So you’ll know what to buy me.

I live in an igloo and I’m cold for 9 months of the year (June, July and August are okay). So I would like to be wrapped in this blanket from Toronto’s Dear Lil Devas. You can tie it around your waist for added warmth and also use it as a regular blanket/throw.

DLD blanket

Also, check out their Haramaki – core warmer. I have one of these already and I’d like another (in size small please). It’s really very comforting to wear this. I have become very attached to mine.

haramaki

I also own their fleece yoga pants and highly recommend them. COZEE! I live in mine. Check out this Christmas colour:

fleece pants

I discovered Vauxhall Gardens, a woman owned/operated natural products company at my local farmer’s market this year and she’s become a big favourite around here. We use her soaps and shampoo and conditioner and face lotion….you get the idea. There are a lot of great products out there now but what makes Adele different is that she is a trained horticulturist who grows all her own ingredients. She’s amazing! Her packaging is gorgeous too. Each purchase comes with an information sheet.

 vauxhall

One exception to Vauxhall products is this strange little website selling various products. I discovered this lady selling her wares with her husband in a farmer’s market in Bancroft Ontario this past summer. I bought a little jar of their Harmonia cream for $20 and they assured me that the same ingredients and size of jar would cost hundreds of dollars elsewhere, and that she went to Germany to learn how to make it. And well…I love it! It will last a long long time, as you only use a little. She warned me over and over that if it appears greasy, you’ve “used too much!” She made lots of health claims too and you just never know.

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One of my favourite stores just opened in Toronto – MUJI! So exciting! I went on opening day and turned around and went home when I saw the 3 hour long lineup to get in. I managed to get in a few days later and many of the items are sold out. But – I managed to snag a pair of toe socks and they are GREAT! I’ve tried lots of toe socks and these are the best of the lot. There was no pic of the toe socks on the website, but all their socks are cool:

socks

Last year I got a handmade Squatty Potty for Christmas! It’s the best present EVER. Bed Bath and Beyond in Canada now carries the Original Squatty Potty! I think you should have one delivered for every toilet in the house.

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Do you have this book yet? Why not?

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While you’re ordering that, throw this in the cart too, it is at a special introductory price so don’t dally!

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and then buy some of these in every size. If you live near a Yoga Sanctuary in Toronto they carry them. Otherwise, order here:

balls

My butcher has started a supper club! For 55 bucks you get a FIVE COURSE meal. BYOB – no corkage! What the what!? These kids are ex-chefs so they know their way around a kitchen. If you are in Toronto you need to check out this butcher. Great quality, all grass fed and pastured meats free of hormones. They’ll even brine your Christmas capon or turkey for you!

Meat

If you need a new backpack or a great t-shirt, check out this company. Everlane uses the same factories as the high end designers but doesn’t mark up 8x like the designers do. Great quality at a great price. I bought a backpack from them and it never fails to get compliments, most recently from the cool kids in the Muji lineup! Everybody loves this backpack!

backpack

I spend roughly half my life in the kitchen (the other half sleeping) so this list wouldn’t be complete without a kitchen implement. So I give you: The Danish Dough Whisk! I bought mine from Lee Valley but I’ve seen them in the odd kitchen store. I love this crazy thing and I find myself reaching for it a lot. They come in two sizes, get the smaller one, it’s plenty.

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doughwhisk

* I don’t receive any kickbacks from any of these websites, dammit! They’re just my favourite things that I thought you’d like too.

December Advent Calendar, RE™ style!

Just a quick visit to the blog today, things are heating up in freezing Toronto and I’ve been busy! The Pelvic Floor workshop was a blast to teach, and many participants shared their history with me. I hope they will get in touch as the weeks progress to let me know how the exercises are helping. Many of them expressed a wish to experience the foot workshop – so maybe in January 2015 we can start at the beginning (because that’s a very good place to start) and do the Foot workshop again. I’ll be in Ventura for more training mid January so it will be an end of month event most likely.

Katy Bowman over at Katysays.com is holding a December Advent Calendar, with short alignment tips every day! Here’s the first one (yesterday):
http://www.katysays.com/24-day-walking-advent-calendar/
(it’s a longish one but today’s is much simpler).

Join me in this event and make sure to “like” Aligned and Well over on Facebook for giveaways!