More or less

As a physical therapist, I have found that many clients assume that faster recovery is dependent on longer therapy sessions or more vigorous exercise. This is in fact a myth. The truth is that while there are times when the best results come by pushing limits, there are also times when pacing is the key to success. In Scandinavia this middle ground is referred to as “lagom,” not too much, not too little. With attention to known information about disease processes, health professionals are tasked to listen to and observe their patients to determine that “sweet spot” of lagom for best outcomes.

Our world is now consumed by a novel virus that we are still learning about. We do not have a complete picture of the disease processes involved, but our understanding of it is emerging. Thankfully, an array of relatively quickly developed vaccines have been successful in curtailing the spread and severity of COVID-19, but not before many had contracted it. While more than we ever thought possible have succumbed to it, it is estimated that millions of people worldwide live with the aftermath, experiencing a wide range of persistent mild to debilitating symptoms, even after just a light case of the virus. Long haulers have turned to exercise to combat physical deconditioning and fatigue, with inconsistent responses. An editorial in the May 2021 Journal of Orthopaedic & Sports Physical Therapy was co-authored by researchers and by both those who have experienced long COVID and those with prolonged post-viral symptoms from another multi-system virus, myalgic encephalomyelitis/chronic fatigue syndrome. The article brings home the message of “lagom” to avoid relapses, which may take hours or even days to emerge. Their message is simple:

STOP trying to push your limits. Overexertion may be detrimental to your recovery.
REST is your most important management strategy. Do not wait until you feel symptoms to rest.
PACE your daily physical and cognitive activities. This is a safe approach to navigate triggers of symptoms.

How do you find that balance of “not too much, not too little?” The Borg Scale of Perceived Exertion is a good tool to find your personal pace (see March 15, 2017 Ai Chi Plus blog post, “Stretch your limits”). Start off by working or doing daily activities at a “fairly light” level (green range), even if it seems too easy. As your endurance improves you will find that what was “fairly light” initially is now very light and you will be able to do a bit more without ill effect. The Borg scale can be applied to everything from length of time out of bed, to walking distance, to exercise regimes~ even to doing Ai Chi steps that challenge core strength, balance, breath, mobility and reduce stress. Pace yourself to find that moving target of lagom.

If you are patient and pace yourself, you will get there!

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A shell seeker’s guide to pain free beachcombing

I love beachcombing. Walking the beach with eyes wide open, scanning for unusual shells is one of life’s joys. If I find a live one, I’ll take a look at it and maybe snap a picture. If the shell is empty, I may stick it in my pocket to take home to use in my latest shell project or to add to my collection. Each trip to the beach is a new adventure.

Shells come in all sizes~ some are big and easy to spot, and some are tiny. Either way, you have to look down to find shells. But eight out of every ten people experience back pain that keeps them from doing their normal activities, and shell seeking is definitely a high-risk activity for back pain. You can minimize that risk with attention to a few easy steps…

Train for shell seeking! (and general good health)
Strengthen your core. There are many ways to build a strong core~ doing Pilates, T’ai Chi, focused core exercises, and Ai Chi… Do at least one of these regularly!

Make good posture a habit. Sitting, standing and moving with your body in good alignment promotes muscle symmetry and balance that lessens strain and pain when challenges come. Bear your weight equally on both sides of your body~ or shift your weight to the other side after you’ve been in one position for a while. Stand with “soft” rather than rigid knees. Flatten your back slightly. Pull your shoulders back and your shoulder blades down and together. Avoid slumping your head forward~ keep your head over your spine.

Stretch the right way. No bouncing! Bouncing puts muscles, tendons and ligaments at risk for injury. Holding a stretch for 30 seconds to a minute allows soft tissue structures to fully relax and realize the full benefits of stretching.

On the beach~
Pay attention to your posture as you stop to look for shells. Use a wide leg stance with an inward curve in your low back. A flat back will strain soft tissues and makes disks vulnerable. You can even rest your forearms on your thighs for extra support. Try sitting down to sort through piles of shells.

Change it up! Look for shells in short stints, moving from focus on the beach to enjoying the surroundings. Take time to appreciate the fractal patterns of the tide and the patterns of the clouds above. Watch for dolphins popping up between the waves and pelicans dive-bombing for fish. Take in the sights of children building sand castles and shore birds doing their own beachcombing. Breath the sea air in deeply and notice the sounds and smells around you.

Spend part of your beach time walking for exercise. Shell seeking is a slow activity~ balance that time with a fast activity, walking at a somewhat hard to hard pace. Choose a level area of the beach to walk~ or if walking on a slant is your only option, change direction to allow equal time for slant direction.

And finally, have fun on your amazing, ever-changing beach adventure!