Marin Movement Center Physical Therapy Blog

Marion Kregeloh, PT, CFP provides health information for physical therapy, osteoporosis, chronic pain, physical therapy, orthopedic therapy, Feldenkrais, in the Marin Movement Center blog.

Dr Lorimer Moseley on Chronic Pain - part 4 of 4

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Marion Kregeloh
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on Friday, 06 September 2013
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Can men have labor pain? And what about phantom pain after amputation? Thanks to neuroscience we now have more answers to some of the complex and strange events in the world of pain...


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Dr Lorimer Moseley on Chronic Pain - part 3 of 4

Posted by Marion Kregeloh
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Did you know that a famous brand of pain medication is more effective than the exact same medication from a less famous brand? Does this mean the brain is in charge, again....?


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Dr Lorimer Moseley on Chronic Pain - part 2 of 4

Posted by Marion Kregeloh
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The most severe injuries in the ER are the least painful........what does the brain have to do with it?


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Dr Lorimer Moseley on Chronic Pain - part 1 of 4

Posted by Marion Kregeloh
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Did you know that the left little finger of a violinist tends to hurt more when triggered than the right?


Listen more about pain and it's distinctive qualities in this part 1 of 4 interview.

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How the Feldenkrais Method Can Help With Chronic Pain

Posted by Marion Kregeloh
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on Monday, 25 March 2013
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Dr. Feldenkrais created an educational system that consists of movement lessons designed to improve our every day functions: lifting, turning, reaching, bending, sitting, walking and more.

Working with people who have chronic pain, I learned that the Feldenkrais Method is an ideal approach not only for the management of pain but living with more comfort over time.

As a Feldenkrais practitioner I evaluate movement patterns: I observe how movement is organized and where it is stuck or compensated. My goal then is to help restore well-organized movement. When living with pain, the body adapts to various compensation patterns. The result can be stiffness, overuse, forceful movement or hardly any movement at all. This can create endless patterns of dysfunction, creating further deterioration, tension and pain. When working with the client it is as if “peeling the onion”; we want to re-establish natural pathways in which movement can happen easily and without much effort.

A healthy body can feel all the distinctions of sensations when the body changes position, moves or is exposed to pressure. We are in “kinesthetic balance”. When we live in constant pain, the ability to feel subtle changes of sensation is disturbed. Since the Feldenkrais Method works with kinesthetic and proprioception, the individual can re-learn to feel and sense the broad spectrum of sensations that our bodies are exposed to and experience all the time. I find that experience so invaluable since it provides an opportunity to distract from the debilitating pain and focus on other experiences in the body; therefore expanding our awareness of oneself. We become aware again of what the body wants, needs and how it moves. And we realize that pain is not everywhere.

Chronic pain has a big impact on self-image. The individual’s identity is circled around pain. When my clients fill out a body chart to indicate the areas of pain at their first visit, at times there is hardly any area left that is pain-free. When such is the case, we start with very gentle and easy awareness exercises. This includes breathing, one powerful tool of the Feldenkrais Method. Becoming aware of our breathing helps to restore it; breathing fuller promotes relaxation and makes us feel better.

Shifting the focus and finding parts in the body that don’t hurt, including the breath, is often an introduction to the rehabilitation process. One other important part of pain management is to re-learn staying focused, other than on the pain. The brain seems stuck with pain signals and is challenged to think of anything other than pain. The Feldenkrais exercises help to improve thinking and concentration allowing all neuronal connections in the brain to function more smoothly, providing us with greater spontaneity in our thinking and attention.

What makes the Feldenkrais method successful when working with people with chronic pain is its focus on creating a safe environment, making each lesson safe and successful, its emphasis on having choices, inclusion of the mental and emotional being and work in a non-rushed pace. My clients typically leave the session feeling better, surprised that they are not in more pain and that they can move in ways they did not know they can.

Working with people with chronic pain teaches me patience but more importantly, it teaches me that there is no quick fix but rather an endless array of opportunities that help restore the body (and person), one small increment at a time. This is when we have to detach from our cultural background that taught us that “faster, bigger and more forceful is better”.

The message here is “small is powerful”. May be we all need this reminder at times to keep our bodies safe and healthy.

Please contact Marion Kregeloh at 415.479.1765 for further information.

 

Marin Movement Center Physical Therapy in San Rafael and Larkspur

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Chronic Pain May Depend on Emotional Reaction to Injury

Posted by Marion Kregeloh
Marion Kregeloh
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on Thursday, 19 July 2012
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Chronic pain is one of the most expensive health care conditions in the U.S. An estimated 30 million to 40 million U.S. adults suffer from chronic pain.

Researchers found that the state of the brain at the time of the injury determines if someone will suffer from chronic pain; they could prognose the likelyhood of developing chronic pain with an 85% accuracy. These outcomes will have profound impacts on treatment. You can find out more at this site....................http://health.usnews.com/health-news/news/articles/2012/07/02/chronic-pain-may-depend-on-emotional-reaction-to-injury

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Back Pain and the Brain

Posted by Marion Kregeloh
Marion Kregeloh
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on Sunday, 08 April 2012
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50 million Americans suffer from chronic pain. Many of them experience depression, anxiety and memory problems. New studies have shown that the brain loses its grey matter when suffering from chronic pain. The longer the pain lasts, the more likely the brain will suffer. While some people give up hope and adjust somehow to a life with pain, others are actively involved to find the treatment that will finally bring relief from disabling pain.

The good news is that the brain can reverse its losses and rebuild the cortical layer of the brain. Once the effective treatment reduces or eliminates the constant pain, the changes in the brain reverse themselves. I highly recommend to anyone with chronic pain to not give up but keep searching for the treatment that will work best. Chronic pain is never a quick fix and as a physical therapist working with chronic pain, I have to be creative and reinvent my own professional experience over and over again. Body awareness and sensing, proprioception, breathing, relaxation and gradual progressive movement exercises are helpful to allow the body to learn and tolerate movement again. Some people require surgery or invasive procedures or pain stimulators for pain management.

When comparing the brains from patients with chronic pain to a peer group without pain, the studies have shown that six regions in the brain are thinner and less densely packed in the brains of those with pain. Three of these areas are part of the frontal cortex and are responsible for attention, judgment and reasoning. Other areas affected help process mood and pain signals. Six months after getting spinal surgery or injections, subjects who underwent challenging cognitive tests showed no difference anymore compared to their healthy peers.

With the loss of density in brain areas such as the prefrontal cortex, mood, memory, higher-order thinking and social judgment are affected and explain why people with chronic pain experience problems with some or all of the above.

Treating chronic pain successfully needs to be the top priority for the medical team of each patient. Once the pain is gone or reduced significantly, patients not only experience physical comfort but cognitive, mental and emotional wellbeing.

For more information contact Marion Kregeloh at Ext. 36 or at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 

Marion Kregeloh, PT, CFP

 

If you have any questions regarding exercise routines or want more information, please contact Marion Kregeloh, PT,  at 415.479.1765.

Marin Movement Center - Helping Your Body Thrive

Your source for physical therapy in Marin

Locations in San Rafael and Larkspur

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How to Retrain an Orchestra

Posted by Marion Kregeloh
Marion Kregeloh
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on Tuesday, 30 August 2011
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Chronic Back and Neck Pain---------or How to Retrain an Orchestra


Chronic pain is about making changes: the way we think, feel, move and breathe. Healing from chronic pain is about transferring control back to the individual who is in pain as opposed to pain being in control of the patient. 

Pain occurs when the body’s alarm system signals to the brain that there is tissue damage. In chronic pain, we can use the metaphor of an orchestra:  it is as if the orchestra in the brain plays the same pain tune over and over again. It lost the ability to find its entire repertoire of tunes. And this is the source for more dysfunction and more pain and so on.

Movement is essential for the health of all body systems and processes. When dealing with pain, movement is the key function that is affected. While movement is always therapeutic for the tissues and aids healing, many people with chronic pain feel “trapped” by pain. Movement can even make their pain worse.

The approach to getting out of the “pain trap” includes following key steps:
1.    Understanding pain and its physiology and source: Once pain is understood, it is given less power and the individual can engage more efficiently in her/his recovery.
2.    Understanding the fact that hurt does not always equal harm. This is a very important piece of information for anyone who is recovering from pain and/or enrolled in physical therapy as part of a chronic pain management program.
3.    Understand the principles of pacing and gradual exposure: a) choose one activity that you want to do more. b) determine your baseline of that activity, such as how long you can walk without flaring the pain. c)  plan how to progress: if your baseline walking is 10 minutes, plan to add ½ minute each day, to 10.5, 11, 11.5 etc d) stick to your plan. Know that flare-ups are part of the natural response of the nervous system. e) include pleasurable activities into your daily life since they have positive effects on the brain-pain cycle.
4.    Here are some of the fundamental criteria that are needed for restoring healthy and pain-free movement:
•    Imagine movements.
•    Introduce different orientations for the same movements.
•    Include balance tools such as gym ball or roller for the same movements.
•    Include exercise in the water.
•    Play with different speeds, qualities, or break the movement into different components.
•    Include distraction such as music, art or visualization; let your mind create new ways.
•    Allow movements in different emotional states. Just because you feel down one day, does not mean you need to put your movement routine on hold.

This list for movement restoration retrains the orchestra so it can play its full range of tunes, harmonious notes, revive old tunes and prepare new masterpieces, eventually.

After all, who wants to hear the same tunes over and over again....and remember: “You own your body, medicine doesn’t”.

To find out more about chronic pain, please contact Marion Kregeloh, Physical Therapist and Feldenkrais Practitioner, at 479.1765 or at 924.6226, Ext. 36.

Marion is part of a renowned chronic pain management program in Marin County, California.

 

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