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The Bio mechanics, of day to day moves The problems and some solutions |
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Pain is the most prominent symptom of FM, but there are many others, especially when CMP on site link, gets in the picture. CMP trigger points cause muscle tightness, which is an under statement, as they can clench to the point of nearly total oxygen and blood starvation to the muscle in question. Imagine standing there, and clenching your fist. Now, hold it tight ... after a moment or two, you will start to feel the loss of blood to your fingers, if you keep doing it, you will shortly lose the ability to open your hand. And even if you force it open with your other hand, you will find the hand in pain, and nearly useless, as it lays there in your lap. This is what often happens where the muscles join to the bones, in CMP states. In Fibromyalgia, this effect can happen almost body wide. One thing, we all must do, and tend to have the most trouble doing, is just walking across the room, without running into anything. We have become a total klutz, in point of fact, for the simple reason that latent trigger points, meaning ones we are not aware of, until we make demands on them, give way when we do. This creates the "drunken" walk, we are all too familiar with, as we bash into doorways and walls, hit the furniture, trip over dust bunnies :) etc. Now, understand, you are telling the legs, move this way, however, realize that your nerve impulses are telling the body, where your feet are supposed to be going, but in the case of muscles with trigger points ... they lie, big time. The signal they are giving off, does not match what your eyes are saying to your brain. You say, go this way and they go that way and wham, yet another bruise or broken toe. You tend to look down at your legs and ask "will you get with the program here please ! " Which makes everybody think you have lost your marbles, as your talking to your body parts... but anyway, cut the body some slack here, it is trying, but due to scrambled signals, it cannot do the job very well. So, what to do, to try and avoid broken toes, being black and blue or stressing your body into pain or a flare ? ( Please note: That while I was trained in
bio mechanics, specifically for use for persons with disabilities, and
have developed others on my own, understand, I make no claims that they
will suit you, or even be possible for you. And that you use any of the
tactics I outline here, at your own risk
! ) That said, onward.
Heads up ! For almost everything I am going to say here, the first rule is to bring your head up, you will see why in a second. Walking 101: First off, slow down a bit, we tend to go too fast, and the impaired nerve transmitters can't keep up. Walk like a snake would, if a snake had feet. Let the body sway slightly, as you move your feet. A belly dance move I learned years ago, has been a saving grace, called the camel walk, where you glide as you move. Dance your way down that hallway, and you may find yourself in a bit more control over the movements. The normal heel toe walking, can make you trip over your own feet, as I am sure most of you have experienced. Keep your head up and eyes forward, this keeps your back in line and gives you better balance. If, despite all this, you do trip up, and go to fall, my personal advice, as well as the advice of many body workers ? Mind, again, you follow this suggestion, at your own risk, and this one takes practice. Which is, to roll with the flow and just go ahead and go down in a controlled fall, taking the impact on your side. You are better off to let yourself go down, than trying to catch yourself, as the sudden stop and jerk, yanks your entire body, and you can do yourself some seriously painful damage to your neck, hands, elbow and shoulder joints, back etc. The only exception to this, is if you are on the stairs, or if there is hard furniture that you are going to land on if you let yourself go down. In which case, the yanked abused muscles and joints when you grab something to stop that fall, might be preferable to possible impact with things that will do you even more damage. But if it happens in open space ? Then relax, and fold to the ground. If you are going down and you know it, don't tense up and resist it, as you will just hurt more. Practice this, and I mean that quite literally. Drop on the bed, or other soft surface, until you can fold and drop in a controlled fashion. This move is taught in all martial arts classes, and we knew how to do it as small children perfectly, as kids can fall, get up, dust themselves off and keep going. Heck, they do it on purpose in their games. Why don't they get hurt very often? It's not just because they are young. It is because they don't tense up, as they are not yet afraid of falling. Such a move, despite how it sounds, can prevent the dreaded dead drop, where your walking along and wammo, your down, eating floor, with your head ringing, and feeling like you just had a fight with the floor and the floor won. Feel yourself going down ? Take control over that move, and minimize the potential for damage. A note here: If this happens very often, there is bound to be some wise guy, who says you are faking the fall, since it's under control when you go down. Never mind them, it's your bones, muscles and your own pain, you are saving. Getting into or out of a large chair: Now, if you are like most FMers, any chair you favor, has arms on it, if it doesn't, it should. Getting your legs under you to rise, can be a challenge, so here are a few tips on ways to minimize the strain. Make like a queen on her throne here. Go slowly, don't rush yourself, the chair should be the right size, and by that I mean, if you cannot put both feet on the floor, it's too high for you, and you should not be using it. The same goes for the infamous "vampire" chairs and sofas, that swallow you, if you have any like that, get rid of em. To get up, first off, look up, as that act, tightens the muscles in your back and helps you to lift yourself up. Use your arms to start the process of rising. As you come up, lean the back of your legs against the chair and push off with them ( this tactic does not work with light or armless chairs, or ones on wheels, more on those in a second ) at this point, both feet should be on the floor, your legs pressed against the chair for leverage, and your arms are just for balance at that point. To sit down is much the reverse, keep your head up, as this keeps the back straight, then back up to the chair and put your legs against it, this gives you a cue that you really are close enough to sit down. As if you don't do this, what can end up happening, is you think you are close enough, ( as recall, the nerves are lying to you here) and you end up flopping down in the seat. Not good, as you can jar everything that way. Use your arms for balance as you go down. Now, if the chair can move, like your desk chair, or a light armless kitchen chair, use either the desk or the table... to push yourself away slightly, then use the desk or table as your support to rise, as you shove the chair back with your legs. To sit down, pull the chair in as close as possible, stand in front of it, and use the desk/table as your support as your going down, and again, putting your legs up against the chair, so you are certain where it is. To get in close, grab the table or desk and pull yourself forward. Do not reach down and grab the chair bottom, and try and hitch it forward, with your body weight in the chair. Put small gilding furniture movers under the legs if need be, say for the kitchen chairs, but make it mobile. Those with wheels, be sure there is a full space behind you, to shove the chair back as you rise. If the wheeled chair has arms, use them. Sofas: By and large, you will want to avoid them, simply because, as I am sure you have found out, getting into or out of them, can be a pain. However, if you find it's comfortable to use one. Some ways to make it easier. Getting down: Pick one end that has an arm, again, don't flop, head up, back up to it and lean into it with your legs. Use the side arm to balance as you go down. To get out, this is trickier, given how deep a sofa is, compared to an average chair. Use your legs, hook your lower legs into the front of the sofa, grab the arm on the side, and pull with the one arm, and push with your legs against the sofa, at the same time. You are basically throwing yourself into a standing position. Better however, is to have someone help you to rise. The proper way to have someone help you: One, do not have them grab your hands. This will just hurt you, and you can easily lose such a grip. Reach beyond the hands and grab each others forearms. Have them stand directly in front of you, slightly away from the sofa and lock themselves into position, ready to lean back slightly. Do not let them pull you up, you pull yourself up, using their body as a stable leverage point. Their job is just to stand there, leaning back slightly against the pull, and let you control the movement. This can take practice, and the helping party has to be able to withstand your weight, otherwise, they are gonna wind up on the sofa with you, on top of you generally speaking. While this might be fun if it's your mate, them falling on you is gonna spoil any mood you might get going here, so make sure they can handle the weight, before you attempt this. No one in the house can help, or there's no one home ? Plan B and C. Plan B, is to put a simple short chair near the sofa, and move the chair into place, and use the back of the chair, as your second chair arm, to rise. It's much the same as getting out of a chair that way. Plan C, worst case, is to roll off the sofa, and on to the floor, and then use the sofa itself to rise. Again, head up, back straight, lean both arms and hands on the sofa seat and use it to lever your body up off the floor, pushing off with your legs. Going up or down stairs: This one can be a major challenge for any of us. First thing, if the stairs do not have hand rails, get some ! Keep your head up. I know, we tend to look down at the stairs, but this just puts you more off balance. Lumber like a bear as you go up, meaning, holding on to the rail, sway a bit and bring up one foot, then sway the other way, and bring up the other foot. Remember how you took stairs as a child ? By bringing up both feet to the step before moving to the next riser ? This can be very helpful. But even if you can do one foot per stair motion, keep a hold of the hand rail, for balance. The muscle signal problem, is very likely to cause you to lose your balance, as you are not only on just one foot, you are at an angle as well, which is almost more information, than the over stressed muscles can handle. Going downstairs, can be even more challenging, as you often feel like your about to fall down. Again, head up, back straight, the same moves you used to go up.. is how you go down, but keep your eyes forward, not looking down, as when you look down you tend to pitch the body weight forward, which will put you off balance. A side step move, like a crab walks, is also a good alternative. Carrying things: Keep the head up, and your back straight. Holding whatever it is, close to your body, using both hands, even if it's small, or both arms if it's larger, not dangling down at the end of your arms. Hug the item to you, even if it has handles, like a laundry basket ( the worst, as they are heavy ). The reason being, your arms can handle the weight, a lot more than your hands can, and you are not hunched over in the process, pulling your shoulders out their sockets, with your body off balance by the weight at the end of your arms. Bringing in groceries: Don't rush, and don't over load yourself. Hook the bags onto your forearm, not your hands, and carry it close to your body. Even better, is to use a stick or cane to thread bags on to both ends, and grab the middle of the stick, just like the over the shoulder carry sticks used for water buckets. Use both hands, not one, as one handed, puts you way off balance, as it's all on one side. Use both hands and carry it in front of you. Hooking it over your elbows, rather than your hands can be useful, as it keeps the weight closer to your body. Besides which, your elbows are stronger than your hands. If the house has just a few stairs to get in, put the bags down at the bottom, hold on to the stair hand rail, and lean over the stairs, and one bag at a time, place the bags on landing. Anything non breakable, like paper towels and such, just toss it up there. This avoids having to go up the stairs with all that weight. This tactic works very well, if there are two of you, one to get them out of the car, and the other to take them off the landing and bring them inside. This way, neither of you, has to carry them up or down stairs. If you have a chair with wheels on it, drag it over to the door and load the bags into it, and then wheel them into the kitchen. You can use both tactics, even if it is just yourself doing it. Try and avoid carrying the bags, and yourself, up the stairs, at the same time, if at all possible. If this is not practical, hug your arm with the bags close to your body, and use the hand rail to rise on the stairs. Use the hand that does not have the bags on it, to balance yourself. Getting onto or off of, the porcelain chair: Now, they don't build them with arms, ( mores the pity ) but, you can either A: buy one of the toilet surrounds that does have arms and get up and down, just as you would a normal chair or B: if there is a counter top within reach, attach a towel bar or other handle on it, to use to hang on to, to lever yourself up and down. If neither of these is possible, use your hands on your own knees, with your legs slightly splayed outward, as a means to balance your weight as you go down or rise. As with all else, keep your head up, and your back straight. Getting in and out of the tub: Rails, rails and more rails, make the tub area look like a railway switching station if you must, but put in a rail for any move you plan to make. First is to get in, have a rail either on the wall, or attached to the tub, or both, so that you are balanced getting in. And yes, again head up, back straight. ( You are getting tired of me saying that by now, aren't you ? :) Place one at the rear of the tub, so you can lever yourself up and get your feet under you, to rise from the floor, and or, as a place to put your feet to wash them, or bring your leg up for shaving, during a shower. Likewise on the side of the tub, on the wall, for the same reasons, yet another place to grab and steady yourself. If you have one of those tub enclosures, where it is impossible to attach any rails. As some are made in a cast thin fiberglass shell, with no way to attach anything that would hold weight, even using the suction cup varity. Then the clamp on rails that go on the edge of the tub, becomes paramount. A bath chair might also be wise, for those days when you are just wiped and you don't have the energy to even stand there. This commands the need for a hand held sprayer as well, as you sit down to bathe. Many bath chairs have short hand rails, use the rails to rise up, just as you would from any other chair. In and out of the Car: Depending on how far your vehicle is from the ground, getting out of the car is much like getting in and out of the tub or out of a chair, it's a bit of both really. The typical stance of one leg out and shove off, as you drag the other leg out and stand, with no support, is asking too much of the muscles. As it is too many things, going on at once. So, option one, getting in, open the door all the way, turn and face away from the door opening, and grab hold of the door, and then sit, as you bend your head under. This takes some practice to do well, so you don't hit your head, since you cannot see. Once your buttocks on are on the seat, let go of the door, and grab the wheel, use that leverage to swing both legs around, at the same time. Still holding the wheel, reach out and grab the door to close it. Use your grip on the wheel to draw the door to you, so you whole body is part of the process, not just your left arm. Option two, the most common. Door all the way open, hold on to the top of the door, and the right or left hand side door opening, meaning the car body, reach one leg in, and let the body ease down into the seat, using your grip on the top opening of the doorway, to control the move. It also saves you from hitting your head, as remember what your eyes see and what the body will tend to do, is not always predictable. Once the derriere has landed, again grip the wheel or the dashboard, and gently pull your other leg in, still holding the wheel or dashboard, reach out to grab and close the door. Reaching back for the belt: It's habit to try and look at it, but don't, you know where it is, you do not need to see it. That extreme crank of your head to look at such an angle, is likely to be painful. Reach with your right or left hand, over your body, grab the belt and pull it over. Now, you can look down, to hook it up if you have to, but again, by preference, do it blind. You don't want to pull your head that far out of neutral. Getting out of the car: Option one: Fully open the door, grab the wheel or dash, and get the body turned to face the door, swinging your legs out. Then grab the door and the car body, and push off with your legs to stand. Watch your head as you rise. If you have doors that do not lock into postion strongly enough, another optoin, ( the one I use most myself ) is to put out both arms, once you get your feet out and grab the door jam itself on both sides, and pull against the car frame, to stand. This also puts your hands in equal postions. Option, two: Fully open the door, get one leg out, grab the wheel or dash and use it to slide your body sideways, towards the door. Do not try and use the leg that is now outside the car to drag you over. Then reach up and grab both the door and the car body, or both edges of the door frame, and use your arms to lever the body upwards, until you can get your other leg out, to stand on. Computer work: This is one where most of us tend to mess up, since we get rather absorbed in what we are doing. However, ways to ease the strain. First off, where your monitor is, is of paramount importance. If you have to dip your head up or down to see it, it's not in the right place. Put as many books or what have you under the monitor as needed, but get it to where most of what you do, is at head up, eye level. As otherwise, what you tend to do, is hunch over, your body, head, or both. Or, you are hyper extended and your neck or back, are leaned out like a giraffe. Keyboard: Optimal placement, is to where you can pull your arms in to your sides, and just extend your hands out to type, preferably with somewhere to rest your wrists. Most find that an underdrawer set up that you can pull out from under the desk, works best for this, rather than have the keyboard on the desk itself. Mouse use: This one can be hard to get right. First off, get a large mouse pad. Don't even bother with those things the size of a postage stamp, get one that covers the entire front of the desk space. ( they sell these at most office supply places ), and get the mouse set to where you can use it from any position. Use a wireless mouse, you want free range of motion here. Re-set the mouse movement to fit you. How you do that, is go to your control panel, find the mouse set up and fiddle with the adjustments, until you find a movement, speed, and tension, that fits your needs. Avoid short repetitive movements with the mouse. Set the adjustments to where you need to move it more to get action, than what are its default settings, this makes you have to move it further, to get the cursor to move. This might seem like extra work, but it forces you to use a wider move, instead of short tiny ones. Most of us have carpal tunnel, and using the mouse with tiny moves from just the wrist, is a promise of numb hands. ( this is also true for those without FM, as the tiny movements, court carpal tunnel, so make the mouse run its little feet off, to spare your hands ) Watch the body postures: A great many of us, due to pain, will contort ourselves, without even realizing that we are doing it, until the muscles we have put under strain, scream at us. Pay attention to your entire body interface here. Listen to the messages, and make whatever adjustments you can, to avoid stressing them out. Take breaks: Get up, walk, stretch, drop your hands into your lap when your not using the mouse, instead of sitting there with your hand on it. Come on, we all do it and we know it :) but for the sake of your hands, get out of the habit. Center everything: What tends to happen, is we are off center, especially with the mouse off to one side, which is why the large mouse pad and getting the keyboard off the desk. Place whatever you commonly use, in easy reach, build pigeon holes over the top of the monitor if need be, to have what you use all the time, handy. If you are having to lean over the side of the chair to get something, it's not in the right place. Moreover, absolutely do not lean over the side of the office chair, if it has arms, can you say owww ~ In the case of drawers, stop, move the chair over to it, then pull it open or turn the chair to face it, again keeping the body level and not twisted sideways in the chair. Use the scroll bar: Get the part of the page you are reading or looking at, level with your eyes as much as possible. Do not fall into the habit of reading the entire screen, down to the bottom, before you pull it up. Your head should not dip down, until and unless you are forced to, as there is no more page to pull up. Using a laptop: This is a bit more of a challenge, as ordering where everything is, is next to impossible, and due to their size, we can and do tend to use them almost anywhere. Set up the lap top to where your arms are supported, while your hands are on the keys. Fully open it, even to it being hyper extended, so you don't have to dip down your head so much, to see it. Use larger fonts were possible: If the font size is too small, what you will tend to do, is lean forward, bringing your eyes closer to the screen. Bad move, as it pulls on your back, neck, and rubs your tail bone raw, from how often you move in and out, to read. Windows is, by default, set to a medium font in your browser, however, you can change this. On your browser itself ( in IE and Fire fox. Google ) look up to the top row, the stuff above everything in the window and find the word view. Click that and you should see something that says, text size. In IE, this means setting it to large or largest, ( default is med size) and on sites where they have not frozen the font at a given size, everything will get bigger and therefore, easier to read. In Fire fox the settings just says increase or decrease, just hit that until things are a size you can read, without leaning into the screen. Most of us who have FM, are at least middle aged, and it's common to reach a point, where your arms just are not long enough to read things, as you are near sighted, so bump it up. Another means to do this on most modern systems, is to hit the control button and then move the wheel on your mouse. This will bring the font up or down, depending on what direction you wheel the mouse. Learn to touch type: By that I mean, learn how to type, know where the keys are, so you are not sitting there with your head cranked down at a steep angle, looking at the keys. There are many programs available, to teach you how to do this. Lighting: Place lighting to where it only lights up the area you need to see, like on the keys and in front of the monitor where the mouse is. You do not want an over head light, or window light, glaring on the screen. As again, this will force you to lean in, and squint, to see clearly past the glare. So lose the over head lights, and block out the light from whatever window is behind you. ( this is also true for TV's ) A small hint but important, clean the screens. While it might not seem like it just looking at it, they get dirty rather quickly and if the screen is dusty, greasy, has streaks and such like, it is going to be harder to see things. In the Kitchen: If your face is close to the freezer door, as you reach in, your doing the move correctly. Now, for things on the lower shelves, and buried in the back, use the same sumo wrestler move, to get down, holding on to the top of the door or the body of the refrigerator, for stability if needed. Getting Into and out of Bed: Believe it or not, there is a right way and wrong way to do this, for anyone, much less, for us. If you have leg use, that way goes like this: Getting out: Roll your body until you are facing the edge of the bed. Drop one leg to the edge of the bed, and hook it. Pull with that leg, while at the same time, push upward with your arms to bring up the rest of the body. Once the second leg is within reach, you can use it to pull as well. You want the body to remain in line, at all times, no twisting, no turning, and yes head forward and back as straight as possible. At no time do you want to stress out your lower back, hips etc, by trying to force your entire upper body, bolt upright in bed, using just your back or tummy muscles to rise up Getting up from the bed is the same as for any armless chair, with no table handy, or rising off the commode. Legs spread, hands on knees and lean forward at the hip, letting your own body weight, pull you forward, then tighten the thigh muscles as you straighten your legs, to stand. If you do not have leg use, to rise, a possible way is a cotton rope, ( no nylon, it will burn your hands ) of a large diameter so it does not cut into your palms, with knots in it, to give you pull points, about one foot apart, tied to the foot of the bed rail. Position the tie down to the bed rail, about centerline of where your body normally is in the morning, then hook it somewhere behind you so it will be in postion, in the morning ( a hook on the wall near the edge of the bed works fine ). This rope will give you a way to raise up the body, even if the legs cannot be directly used. Preferred however, is the roll over bringing your legs with you, face the edge of the bed and use the arms and the same on your side move as outlined above. Once upright, lift your legs down to transfer to your chair or other conveyance. Getting into the bed is much the reverse. Check your distance with your legs, to be sure you are close enough. Sit down, then fold the body down on your side, using your arms as support, until your head hits the pillow, drawing your legs up, as you go. Otherwise, what you can wind up doing is the more typical, get in, get your legs in and covered, then sitting bolt upright, do a controlled fall into the pillow, using your back and stomach muscles to control the move... well, I think you can see the problem with that idea, for us anyway, for yourself ... especially if your muscles or back gives out, which at the end of a long weary day, is much more likely. Not to mention, what we think we see, is not always how things are with FM, as how close you think you are to the wall and how close you really are, might be two different things, entirely... which means if you do this drop onto the pillow routine, you are going to misjudge that distance at some point, likely on the same night the back and stomach muscles give out on you and BAM.. The contact of your head with the wall might solve your sleeping problem for the night, but I think it would make for a very lousy morning. :(
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