Stress-Free Exercise for People With Arthritis
Wednesday, June 7, 2017
by: David Zemach-Bersin, GCFP & Mark Hirschfield, GCFP

Section: Chronic Pain





“...the Feldenkrais Method® can undo many of the aches and pains that plague us, and I currently recommend it to patients whose movement has been restricted by injury or chronic pain. I also believe the Feldenkrais Method can help older people achieve greater range of motion and flexibility, and help all of us feel more comfortable in our bodies.”

—Andrew Weil, MD 


Many people with arthritis find it challenging to get enough exercise. You know that it is important, and you know that you’ve got to keep moving to maintain joint health. But as much as you might like to run a marathon, the fact is, many physical activities cause discomfort. How can you enjoy doing something that exacerbates your arthritis symptoms instead of making them better?


The Feldenkrais Method is a sophisticated form of sensory-motor education, which interacts with the brain in a special way to improve the comfort and function of the body. It may be of special interest to people with arthritis because it is so different from other forms of exercise. While conventional exercise typically involves the repetition of strenuous movements, the Feldenkrais Method takes a very different approach.

Feldenkrais® exercises involve no stretching or straining and require only minimal muscular effort. They use slow, easy-to-do movements that are designed to engage the brain’s ability to change in response to stimulus (its neuroplasticity) to improve the body’s underlying neuromuscular and skeletal organization.


Safe, easy exercise

The Feldenkrais Method bears little resemblance to conventional forms of exercise and works on entirely different principles. It improves the way in which the brain coordinates posture and movement. By engaging the brain’s ability to relearn and change, the Feldenkrais Method improves the exchange of relevant information between the nervous system and the muscles, and as a result, movement becomes more comfortable. Although Feldenkrais exercises are not aerobic, they provide many of the benefits commonly associated with exercise, including increased production of the synovial fluid that acts as a lubricant inside your joints, increased flexibility, better circulation, improved respiratory function, better coordination and balance, and an overall sense of well-being. For people with arthritis, the Feldenkrais Method can help to reduce friction, swelling, and inflammation in the joints, and can interrupt cycles of pain and tension. In addition, once a person is able to move more comfortably, he may be able to start engaging in more strenuous aerobic or strength-building exercises. 


In a study done with 21 people with rheumatoid arthritis (RA) who engaged in a series of Feldenkrais exercises, participants experienced both a significant improvement in muscle activity and a decrease in their perceived effort, or the amount of effort they felt they needed to exert to perform certain tasks. Two years after the study ended, a follow-up was done, and a large percentage of the subjects reported improved mobility and higher levels of function than before participating in the study. In addition, a large percentage of participants continued to use the skills that they had gained from doing the exercises, and reported that the Feldenkrais Method had taught them new ways to reduce pain and discomfort before their RA could progress to long-term deformity and disability.


Improved “organization”

Over time, everyone develops habitual ways of holding, carrying, and moving themselves. Although some of these habits of posture and movement may be physically stressful and limit a person’s freedom of movement, people are usually unaware of them. They don’t realize that they have options and can make choices about the ways in which their brains “organize” and coordinate their bodies.


If you have arthritis, improving your body’s underlying neural and muscular-skeletal organization may make a significant difference. When your skeleton is aligned, and you are able to use it in a functionally efficient manner, force is transmitted through your joints in a way that is more comfortable and less damaging. Better organization can also help you protect the health of your joints by reducing wear and tear, friction, and inflammation.


With carefully designed sequences of simple movements, Feldenkrais exercises provide a detailed sensory-motor learning experience similar to what an infant experiences when first learning to move. Feldenkrais exercises give the nervous system a chance to sample and select better options for the body’s movements. And when you learn to move in a more efficient way, the result can be greater flexibility, better posture, and pain-free movement.


Reducing muscular contraction

Most people share a common response to the sensation of pain: To protect an injured area, the nervous system tries to limit movement in that area. Although arthritis is not technically an injury, the nervous system responds to arthritis similarly to how it would respond to a broken arm or leg: It sends messages to the muscles located near the inflamed joints instructing them to contract in an effort to prevent movement. While this is a natural and often useful response, it can have serious drawbacks for people with arthritis. In addition to restricting movement, excessive and prolonged muscular contraction contributes to cycles of tension, pain, and loss of function.


Research has shown that when pain persists over a long-enough period, certain neural pathways can become hypersensitive, giving one’s perception of pain an autonomous, self-perpetuating quality. The Feldenkrais Method can be used to interrupt cycles of pain and tension and to reduce the neural links between pain and muscular contraction. With less muscular contraction, the nervous system and muscles have an opportunity to recalibrate and become better balanced.


Margaret Fletcher, MD, is a retired surgeon and former spokesperson and educator for the Arthritis Foundation who has had RA for 45 years. She says, “The Feldenkrais Method has totally changed the way I see myself, especially in relation to pain. Physically, I went from using a wheelchair to walking two miles almost every day. Most of my mental energy was formerly focused on how to live with pain, [but] now I have extraordinary mental freedom as well. I have found new skills that I never knew I had such as oil painting and writing poetry.”


Another intriguing benefit of the Feldenkrais Method is that over time, the user’s kinesthetic awareness—or awareness of his bodily position, weight, and movement—is clarified. This can come in handy during episodes of acute arthritic discomfort because it enables a person to use and benefit from the Feldenkrais Method without moving at all. That’s because simply imagining a movement can bring about as big an improvement as actually doing the movement. Scientists have found that for certain movements, the same networks of neural pathways are activated whether a person actually moves or only visualizes moving. Imagining pain-free movement can also help to calm and soothe the nervous system, and decrease the brain’s association between movement and pain. On the other hand, trying to actively do the exercises while pushing through pain hinders the brain’s ability to learn and is counterproductive to healing.


In a study involving a group of adults with chronic pain, some of the participants took a six-week course of Feldenkrais exercises. The people who took the course had a significant improvement in mobility and a significant decrease in pain, both immediately following the course and one year later. Researchers also noted a reduction in anxiety in the people who took the course, as well as an increase in their ability to relax. Although the participants in this study did not have arthritis, the success of the Feldenkrais Method in the reduction of chronic pain is likely transferable to those who do.


Improving mood and well-being

Many people with arthritis know that unless their discomfort is managed, it can take an emotional toll. Pain is exhausting and can gradually diminish a person’s sense of what is possible for him. The experience of improved posture and movement offered by the Feldenkrais Method can improve a person’s mood and sense of well-being. In a positive and empowering way, the Feldenkrais Method provides people with any type of arthritis an opportunity to focus on their abilities, rather than on
disability.


A SHORT FELDENKRAIS EXERCISE

Now, try this short Feldenkrais exercise to improve your body’s ability to turn comfortably and easily. The results of doing this simple exercise may surprise you, as turning is an important aspect of almost every movement you make, including walking, reaching, and bending. By improving your ability to turn, you can improve your body’s comfort and function in a wide range of situations.

When you do a Feldenkrais exercise, it is important to remember the following:
-Do each movement in a way that is easy and comfortable.
-Use as little muscular effort as possible.
-Do each movement slowly.
-Make each movement small.
-Relax and exhale as you do each movement. 
-Do not stretch or strain.
-Rest between each movement.

Now let's begin!

1. Sitting on the forward edge of a chair with a flat seat, slowly turn your upper body, as if to look to the right a little bit. Then return slowly to face forward and rest for a moment before doing the movement again. Keep your feet flat on the floor, and repeat this movement 6–10 times. Notice exactly how far to the right you can see easily, without feeling any strain.

2. Focus your eyes on an object or spot straight ahead of you. While your eyes continue to look at the spot or object, slowly turn your head and upper body a little bit to the right. Then slowly return to facing forward and pause. Repeat this movement 6–10 times. Don’t stretch or strain, use force, or turn farther than is truly comfortable. Notice how keeping your eyes fixed restricts your turning. Relax your neck, jaw, shoulders, chest, abdomen, and legs. 

3. Do movement #1 again: Slowly turn your upper body, as if to look to the right. Then slowly return to facing forward and rest. Repeat this movement 2–4 times. Is there any improvement in your ease of movement as you turn? Can you see a little farther to the right? Rest in the middle, and notice whether your left shoulder and the left side of your neck feel more relaxed.

4. Now do the movement again, but keep both your head and eyes facing forward. Repeat this movement very slowly 6–10 times. As you turn, notice how your left shoulder moves forward, and your right shoulder moves back. Relax your face, neck, shoulders, and stomach. Try to reduce any unnecessary muscular effort.

5. Do movement #1 again: Slowly turn your upper body, as if to look to the right. Then slowly return to facing forward and rest. Repeat this movement 2–4 times. Is there any improvement in your ease of movement as you turn? Can you see a little farther to the right? Rest a moment and notice: Does your left side feel more relaxed than your right side?

6. Keeping your feet flat on the floor, simply move your left knee forward slightly. Repeat this movement very slowly 6–10 times. After each movement, let your knee return to the starting position and rest. Relax your leg and reduce any unnecessary muscular effort. Notice how your left buttock and hip move forward a little. Feel how your head, eyes, and shoulders turn slightly to the right as the left knee moves forward.

7. Move your left knee forward while turning your head, eyes, and upper body to the right a little bit. Repeat this movement very slowly 6–10 times. Reduce unnecessary muscular effort and notice how your left hip moves forward as you turn. Do you feel any improvement in your ease of movement while turning? Can you see farther to the right? For comparison, turn to the right and then turn to the left. Feel the difference?

8. Standing up, turn toward the right, and then to the left. Is turning to the right easier? Do you feel other differences? You can achieve the same improvement in your ease of turning to the left by reversing directions in the instructions above.


Note: This exercise is adapted from the book, Relaxercise: The Easy New Way to Health and Fitness, by David and Kaethe Zemach-Bersin and Mark Reese, published by HarperCollins, New York, 1990.



David Zemach-Bersin, GCFP, is the Cofounder of the Feldenkrais Institute of New York.





Mark Hirschfield, GCFP, is the Creative Director and a Faculty Practitioner at the Feldenkrais Institute. The Feldenkrais Institute can be reached by visiting
 www.feldenkraisinstitute.com.


Reprinted with permission of Madavor Media. Originally published in Arthritis Self-Management, now known as Pain-Free Living in the January/February 2013 issue. For more information, visit www.painfreelivinglife.com

Post a Comment

Name
Email
Comment

Comments (1)
Peggi Honig
6/9/2017 5:59:40 PM
This is wonderful and I am forwarding this to the Tennis and Fitness Club I teach at as well as many of my clients so thank you David and Mark.


Pages:  1