Physical Therapy for Low Back Pain

I know I've mentioned starting physical therapy for my low back pain but with everything else going on I've barely had a chance to write about.  So I met with Kate, the PT, a few weeks ago and we went over the history of my back pain.  It's bothered me off and on for years.  In the past it would flare up whenever I took some time off exercise and then returned, or anytime I did some new hard-core exercise, but it always got better on its own, usually the pain would go away entirely within a week or so.  But when I started back to the gym earlier this year after my bout of pneumonia, the back pain never went away.  After trying to ignore it for a month or so I finally decided to see the doctor.  PT was so helpful for my shoulders last year that I've become a believer.

So Kate asked a bunch of questions about my pain, activity levels, etc.  She's a runner too which is cool.  Then she spent some time having me do various strength demonstrations before feeling around my back muscles a bit.  In the end she said my ab muscles are plenty strong but that the stabilizer muscles in my lower back, the ones that run down either side of my spine (lumbar multifidi?), are not so strong and are over-taxed by all my activity.  So she told me to scale back on ALL my ab exercises for now and do the stretches and exercises she gave me.

Bird Dog (aka Quadruped Contralateral Upper/Lower Extremity Lifts)

Swimmers

Bridge on Swiss Ball (I have to REALLY focus on tightening my core and glutes or else this hurts my back)

Half Kneel Iliopsoas Stretch

Hamstring Stretch

I did my exercises except while we were camping and while I was in Philadelphia.  I know, bad patient.  I think my back is feeling better, although there are still times it hurts so bad ibuprofen barely helps.  Over the weeks Kate added squats and some other exercises that I can't remember right now to my routine.

At my appointment yesterday we got to talking more about running and she ended up taking a look at my stride.  I ran on the treadmill for about 5 minutes and she watched me while chatting with one of the trainers.  I felt like a pro being evaluated, except I wasn't.  In the end she said my stride is notable for one thing, no movement at the hip.  A normal stride would include about 15 percent (or is it degrees?) rotation of the leg moving back, with the rotation happening at the hip.  But in my case all my rotation is coming from rotating my core, suggesting my glutes are not pulling their weight.  Iiiinteresting.  So she's going to add some exercises to help with this too.

When I went to the gym after PT I focused on tightening my glutes with every stride.  Dear me that made running harder.  I had planned to run 3 miles on the treadmill but I was bargaining with myself after only 1 mile, "just make it to 1.5 miles."  Deal.

It wasn't that my legs/glutes felt too tired, the effort just felt increased overall.  So I stopped after 1.5 miles and moved on to chest/triceps/core exercises.  Kate had added planks back into my routine so I did side planks and traditional planks too.  She's against all forms of crunches so I might have to let go of my beloved decline crunches altogether.  I sure hope this works, I got to chatting with a guy at my gym who's had back surgery and the idea of that just scares the bejeezus out of me.  I think I'd have to be immobile before I went that route, which he practically was.

The only other issue is I sit WAY too much.  My job is mostly sitting and a fair number of my hobbies involve sitting (reading, movies, writing, online research of random bits of whoknowswhat).  I need a "get up and move!" app that reminds me to take even the tiniest stroll every half hour to hour.  I saw a headline the other day that said, "Sitting is the New Smoking," suggesting that sitting is just as bad for you as cigarettes. 

Anyway, that's the summary of my physical therapy so far.  Today, Saturday, has been a day with the kids.  We walked to a local garage sale - where I scored an indoor bike trainer for $15!, let's hope I actually use it - and then to a park that has a water feature.  The kids played in the water and spent some time in the swings.  I am so used to wearing tank tops now that you'd think it was my mandatory summer uniform.  The more you get used to wearing less, the more and more comfortable it feels and more clothes just feel so darned HOT.  It's like getting hooked on flip-flops in Hawaii, after a while regular shoes feel like torture.  Aaaanyway, I'm getting way off topic and I need to clean up this mess before Miguel gets home and asks the old "what did you do all day?" question.  He worked today so it's just been the kids and I.

p.s.  Still doing great on my food.  Today, for example, Kashi GoLean with Almond Milk for breakfast, Fage and peaches for snack, Sandwich with avocado and chicken breast for lunch, apple for snack...more to come.  Feeling so good, physically and psychologically with putting good fuel into my system.

Getting Paid to Do What I Love.

It has been another very busy 5 days since my last post.  Too busy to really write, which makes for a potentially looong blog post to update you on everything.  But instead of potentially boring you with too many details (what, me?), I'll try to stick with mostly a pictorial blow-by-blow...as much as I can anyway.

My last post left off with me about to tuck into bed in Philadelphia on Sunday evening (I think I left off the large number of chocolate kisses I ate while writing that post, whoops!) and a promise that, "tomorrow I'll exercise for sure."  Did I?  Do you have to ask.  But a quick recap of Monday.  I bypassed the hotel buffet breakfast (nice job, Michelle) and had an order of oatmeal with all the fixings before heading off to my training - the first day of a two day workshop on Cognitive Behavior Therapy for Weight Loss and Maintenance.  Rather than attempt a summary, I'll just share their description...

Led by Judith S. Beck, PhD and Deborah Beck Busis, LSW, participants will learn how to use a cognitive behavioral treatment plan for weight loss and maintenance through an experiential two-day workshop designed for individuals who work with dieters. In this workshop, which is based on The Beck Diet Solution and The Complete Beck Diet for Life, participants will learn evidence-based strategies aimed at facilitating change in their clients' thinking and behavior so they can make permanent changes in their eating. Participants will learn how to conceptualize the difficulties their clients face and plan strategies to handle them effectively.

I learned so much I was practically on the edge of my seat the entire training.  Two days chock full of applicable and entirely relevant information.  Deborah in particular had many experiences to share as far as challenges dieters she's worked with have faced and how she's helped them deal with them.  Good, good, good stuff.

I think I've been sort of hush-hush on my blog about this but I started a private practice several months ago working with people much like myself - people who want to lose weight and keep it off, people who have tried in the past, lost weight and regained it, or who struggle to manage their food intake even if they don't want/need to lose significant amounts of weight.  I'm only seeing people who can come to my office but soon I'll be experimenting with Skype so I'll be sure to keep you posted on that in the event you're interested.  It's all very exciting and I can't tell you how much I am enjoying the work.  Teaching others how to do what I've done is so inspiring for me.  I love seeing people start to really get it and change their eating slowly but surely.

Speaking of food...During the lunch break I and another workshop participant (Hi Susan!) lucked upon Honeygrow, a "small footprint Whole Foods with a focus on noodles and stir-fry and higher-end salads."  I would DIE to have one of these in my town.  I've actually been fantasizing about contacting the owner about a franchise.  So far there are only two of them owned by the same guy in Philadelphia but this thing is cutting. edge.  Fresh, local ingredients made either into a stir-fry or a salad or, if you prefer to drink your food, shakes and smoothies with the same fresh, local stuff inside.  Day one I had the Coconut Red Curry...and would have died happy had it been my time.  When you order you choose from light, regular or on-the-side sauce.  Love that.

carrots, red onions, bell peppers, thai basil, tofu, rice noodles, coconut red curry sauce

After the workshop a group of us women made plans to hunt down a Philly Cheesesteak for dinner.  But before that...I had that promise to exercise.  So I went back to the hotel and changed into my workout clothes.  Debated an outdoor run vs the treadmill and decided that no matter how hot and humid it is when one is in a new city, one MUST run outdoors.

I left the hotel and ran for 1.5 miles before turning around.

3 miles in 32:41, full Garmin stats here.

 The best part was the elevation...mostly a slight uphill for the first mile or so, yes, I was dying.

No, wait...the best part was the weather.

58% humidity...that's when the air does the sweating for you.  I finished my run feeling as good as anyone else who makes good on a promise.  And then hit the hotel gym for some weight training before readying myself for our Philly Cheesesteak quest.  Susan and I were lucky to have Ginger along for the evening festivities...not the least of which was because she provided the wheels and doubled up on the Southern Charm. Vroom, we were off on our adventure to South Philly.

I know, you just want pictures...ok, so here.

wit onions, mushrooms, peppers and cheese whiz (whatever the heck that is)

Cheese Fries

We had to order a second order of fries and got "pizza cheese fries" the second time - because one order of fries amongst three women is just asking a little much.  I had a great time chatting with Susan and Ginger but let me warn you, socializing with psychology types is never about exchanging recipes, we got into some heavy discussion.  Fortunately we were all better off for it, especially after our post dinner "snack", washed down with a glass of wine, of course.

Peanut butter bomb, creme brulee cheesecake and chocolate lava cake with ice cream.

We shared all three deserts while making jokes about being at a weight loss training - hey, we ate mindfully at least - and I went to bed with the idea that it might be a good idea to set my alarm for 5am and get in a workout in the morning.  And then I changed my mind.

7am came plenty early.  Packed my bags and again bypassed the buffet for a bowl of oatmeal.  I love oatmeal, I really should eat it more often.  Day two was just as good as Day one, if not better, and I again went to Honeygrow for lunch, this time Ginger joined us...another fabulous meal.  This time I got the Pork with Smoked Oyster Sauce stir-fry.  Triple yum!

scallions, naturally raised pork, shitake mushrooms, egg noodles, bok choy, eggplant, smoked oyster sauce

In the late afternoon we were lucky enough to have a Q&A with none other than Aaron Beck, the inventor of Cognitive Therapy.

Aaron Beck and his daugher, Judith Beck.

Neat!  I asked him a question about how he felt about the classification of disorders in the DSM these days...good, but getting to be too many of them is the extremely short summary of his answer.  I tend to agree with him, I'm afraid we're over-pathologizing...but that's a different blog.  Group pictures were taken, here I am with about a quarter of the class since we all couldn't fit in one picture.

I'm on the far left, next to Susan (who is next to Deborah who is next to Judith).

I am hoping to get back to the Beck Institute in November for a 3 day training on PTSD.

After Day two ended I was off to the airport for a 6:40 flight...except upon arrival I found there was a delay until 9:40pm.  Ugh.  Dinner was 12 chicken wings at a place called Chickie and Pete's in the airport. There were much worse things on that menu I could have eaten but chicken wings sounded good.  The plane didn't take off until 10:40pm and by the time I hit the sack at 3am I had been awake for 23 hours.  Good thing I didn't get up at 5am to exercise!  Oh, and I resisted the very strong urge to buy chocolate both in the airport and on the plane.  Kept reminding myself I was tired, not hungry.

Back home and back to it.  Fortunately my mom was over on Wednesday so I was able to sleep in until 9:30.  I had Physical Therapy and client appointments in the afternoon.  I was so excited to integrate some of what I learned into my work with them.  I don't know if I will eventually plan to make CBT for Weight Loss my main gig but it's sure moving in that direction.  It's great to get paid for something you love to do.  Social Work has always been that way for me but this is even more so.  I'm so passionate about it!  And I asked Judith what she thought about clients knowing about my history with weight loss and she thought it could be great to disclose it, depending on the client.  Bam!  Loving it.

Thursday was back to my regular gig and back to a routine day of eating.  I've sort of forgotten about my plan to finish up my 7 day realignment so I need to get on that.  But my eating has been so on track that it's not feeling like a huge priority to tell you the truth.  We'll see.  I went to the gym after work and did a 25 minute ride on the upright bike that was SO HARD and followed that up with back/biceps/core.  Whew, I've weakened a bit in my chicken-without-a-head routine of late.

Today was more of the same...work, physical therapy, gym.  I have so much to share about physical therapy but this post is getting way too long AND I'm tired as heck so I'll wrap this up and share all the PT goodness next time.  I'm not even going to proofread so sorry if there were typos :)

ps - one last shout out to Susan, Wendy and Ginger, some great women I connected with at the conference who have their own amazing journeys of changing up their lives, their bodies and their minds. 

4 Miles, a 4th of July Parade, Camping, Philadelphia & 3 Days Starting Wednesday

I can't believe how much I've packed into the five days since my last post!  Let's see...Wednesday was my day home with the kids.  We spent the morning at home and then I took them along to my PT appointment.  I was given some additional exercises, including one I was already doing - the bridge - which hurt my back.  The kids were a challenge, they thought the giant PT room was a playroom.  As an aside, we took Myra's diapers away and she got the whole potty training thing all but down within a couple days.  My little rock star!

After PT we went for frozen yogurt.  And by "we" I mean them, I had tea.  Then we met up with my buddy Michelle and her kids at the library for Lego playtime.  The library has tons of legos and the kids get to build to their heart's content.  Fun!  Then back home for dinner with Michelle and all the munchkins.  Michelle and I enjoyed a salad, some of my red beans and avocado.  It was a satisfying dinner.  After they left I prepped my gear for the Four on the 4th Fun Run the next morning.

Up and at 'em and ready to face the miles.  I wasn't quite sure how the run would go, given that I'd barely run even 1.5 miles in the last few weeks.  But I reminded myself it was a "fun" run and to just enjoy myself.  As soon as I got there I ran into a slew of mommy friends also doing the run.  Now we're really talking fun!

Mira and I pre-race

Erica, Danielle, Me, Jackie and Laurie pre-race

Check out all those runner moms...so cool.  Danielle and Jackie are both still nursing and working on partial nights of sleep.  Hard core runner moms is what they are!  Before we knew it, it was time to line up for the start.  And, as has been my habit lately, I forgot to start my Garmin.  So I walked up to the starting line and waited for my Garmin to find satellites. Unfortunately, I think I got too close to the starting line and the timing chip on my shoe thought I'd started the race.  Lost about 30 seconds on the official clock but that's ok because I know my "real" time.

Anyway, once my watch was ready I hit start and started running.  I didn't have a goal pace in mind, just planned to see what felt comfortable for my body.  I remembered from last year that there was a nice little hill around Mile 2 so I just took it easy and prepared to face said hill.  It was already pretty warm out with the morning sun beating down on us pretty good.  Laurie and I ran together for a while and then we separated and then together and separated, playing leap frog as we have done in past races.  My first couple miles were just under 10 minute miles so I decided to have that be my goal, to keep it under 10.

Things were going well.  I ran up the last small hill and a volunteer yelled, "It's all downhill from here," which was just at the start of Mile 3. The next couple miles were a cruise with Mile 3 coming in at 9:18.  Then early on in Mile 4 I looked down and saw 9:03 as my pace.  I can break 9 minutes for my last mile!  And finish strong, something I really enjoy.  So I dug deep, focused on keeping up my pace, and pushed on toward the finish line, which couldn't have come soon enough.  Mile 4 came in at 8:54 - woot!  Boy was I happy to be done. 

Full Garmin stats here.

My final time was just over 38 minutes for an average pace of 9:28 minute miles.  I'll take it!  My "official time" was 38:33 but I know that's got an extra 30 seconds or so tagged on because of my dawdling near the starting line.

Elevation profile for 4th run. 

So the run was done and it was off to the 4th of July Parade!  I've walked with the kids every year with my mother's club and it's so much fun.  I wish I had a picture to share but I was too busy handing out lollipops and keeping my kids hydrated to take any.  And man-oh-man it was friggin' hot out!  After the parade we headed over to Baskin Robbins for some promised post-parade ice cream.  I decided to make ice cream my afternoon snack.  Makes sense, right?  This was pretty much the beginning of the end of my 7 day realignment, which still had 3 days left.  More on that in a bit.

Anyway, Miguel met us for ice cream and we started again kicking around the camping idea.  We'd been discussing it for days and not settling on a plan.  I'd looked up campgrounds the night before and it seemed every site in the state was booked.  But I found one spot for one night in Mendocino County.  I called and asked what the chances are of them finding a spot for us for night #2 if we drove up, "pretty good," the campground lady said.  Pretty good is good enough for us!

We headed home and packed up our camping gear and the kids and got on the road going north.  Several hours later we arrived in Westport, just north of Fort Bragg.  And just in time for an ice cream social.  That's my kind of campground!  We had a great time with the kids.  Smores, a beach day, wine, plenty of adventure walks, fireworks, chips and snacks galore, making new friends and generally living it up.

The blurriest pic ever of Myra and I sitting by the campfire.

Come Saturday after all the junk food I'd been eating I begged Miguel to hang with the kids while I go on a quick 30 minute run in the morning before our drive home.  Thankfully he was on board with the idea.

I was so excited for my very first beach run.

Running along the beach in Mendecino (wearing my See Jane Run race shirt)

I ran for 3 miles along the 1/3 mile strip of beach adjacent to our campground.  At first I'd wished it was longer but then, when I experienced that beach running means running on an angle, I was happy to be reversing course every 1/3 of a mile.  Here's the satellite of my route from my Garmin stats.

Isn't that cool?!  I ran 3 miles in 32:55, just a hair shy of 11 minute miles.  Running along the surf was surreal and I felt so grateful for that moment in time.  I wish I had some camping pictures to share but we were too busy having fun to take any pictures!  After my run we decided to head to Fort Bragg to check out the Salmon Festival that was going on.

World's Largest Salmon BBQ

Cooking up some corn

Grilled salmon, corn, garlic bread and salad. 

There were about 10 of these massive bbqs going at once!

I think the pictures do our afternoon justice.  The only thing missing is the massive waffle cone of ice cream I had after my lunch.  I told you my 7 day plan went a bit astray.  We headed home but ended up stopping about an hour from home for some last minute playtime in the Russian River.  It was about a bazillion degrees and the kids were happy for the diversion.  From there we headed to In-n-Out for dinner before making the final leg home.  Back at base came we unpacked our gear and then I got to packing for a trip to Philadelphia.  I had a 9:30am flight out of SFO.  I was shocked to learn a plane had crash landed there earlier in the day. 

Up early and on the road to Philadelphia, it seemed my flight was scheduled to leave on time despite the tragedy from a day prior.  I logged my morning weight, 142.8 pounds. Nice.  I packed some string cheese and a bag of whole, plain almonds for the 5+ hour flight.  At the airport I bought a Greek Chicken Salad to eat for lunch on the plane.  I did my best to nap on the plane, which wasn't easy given I'm a terrible napper and I was on a plane.  Landed in Philly and boy is it hot here!  But honestly, I like the heat here, the AC in the airport and the shuttle bus had me freezing.  I briefly entertained a trip to the hotel gym but in the end I was too worn out.  So I had a beer and a burger with fries for dinner and called it a night.  It's super late here, midnight  as I'm wrapping this up.  I have to get up at 7am so I'm hitting the sack.  Tomorrow I'll exercise for sure. 

So here's my plan.  Once I get home from Philadelphia (late Tuesday night) I'm going to resume my 7 day realignment as if this holiday/camping/travel glitch didn't happen.  I have 3 days left so that will be Wed, Thur, Fri.  Doesn't that sound like a good idea?  I think so too.  Well, I'm sure I left something out but there you have it, the busiest 5 days I've had in a while.  Good gosh I'm tired.  Night all!