How I do know whether I need a knee replacement or not? Can the Feldenkrais Method help prevent a knee replacement?

“I have a severe arthritis in my knee.  Will I need a knee replacement or can I avoid a surgery with the Feldenkrais Method or any other modalities?”

 

This is a very common question I receive from my clients and friends.  I believe that the amount of information you can get on the internet is overwhelming, and it is not easy to differentiate reliable information based on good research from information based on personal opinions without a scientific basis.

 

My intention for this article is to clarify a reasoning for a surgical intervention and the Feldenkrais Method (TM) for some conditions such as arthritis, degenerative joint disease (DJD), and degenerative disc disease (DDD).

 

The diagnoses mentioned above are all chronic conditions that result from repetitive use over many years vs traumatic acute injuries.  It is important to remind you that degeneration of joints, discs is normal aging process, and that should not intimidate you.  No matter how well you use your body and move you will have some wear and tear.

So how do you know if you need a surgery or when you need a surgery?

 

Here are two important questions you need to ask yourself:

 

1) Is your condition causing pain/discomfort?  How severe?

2) Is your pain/discomfort compromising your daily activities?  How badly?

 

Notice I didn’t ask you about the severity of degeneration based on imaging studies (MRI, X-rays, etc).  Why didn’t I ask you that question?

 

Whether you will need a surgery or not depends on the severity of your pain experience, not necessarily based on the severity of arthritis, bone/joint degeneration.

 

* There are other factors: age, other medical conditions.

 

Research shows that the severity of pain is not really correlated with the severity of arthritis. In fact, many people experience little or no pain in the presence of severe arthritis, or vice versa.

 

It’s not uncommon for some people in their 90’s to have no joint pain.  I bet x-rays would show quite a bit of joint degeneration in most joints including knees, hips, and spine.

 

Does it make sense for them to have a surgery if they are not having much pain and their functions aren’t affected?  A surgery may not be necessary if a person is experiencing little or no pain regardless of the severity of arthritis/degeneration.

 

I’d like to clarify that I am not suggesting that you don’t see a physician, nor that imaging studies are unnecessary.  I believe it is important that you consult with your physician regarding your condition(s).  My point here is that the presence of degeneration does not necessarily determine whether a surgical intervention is warranted.

 

Can the Feldenkrais Method (TM) reverse my joint degeneration?  How can it help me?

 

The state of the joint integrity cannot be reversed with the Feldenkrais Method.  It is important to realize that your habitual movement patterns create uneven use of your body.  You use certain parts much more than others.  There is a very good chance that to some degree uneven use has contributed to increased joint degeneration in some areas.


Proportional distribution of effort and movement is one of the Feldenkrais Method’s fundamental principles.  We, Feldenkrais practitioners teach you how you can redistribute your movement effort more evenly and efficiently, which will reduce stress at the affected part, and you can move more comfortably and easily.

What is unique about the Feldenkrais Method is that we don’t work with the affected part in isolation.  We, instead look at its relationship with other parts and improve the whole relationship, as you cannot influence one part and not influence the rest.  

 

If one part is affected by any condition, your nervous system will find a way to compensate in an effort to protect the affected part.  While compensatory mechanism is helpful and necessary for a short period of time, it will have consequences in a long term.

 

That said, the Feldenkrais Method can improve the relationship between the affected part and the rest of the parts and can recreate a new experience and sense of how you use and move the affected part of yourself and change your pain experience as well.

 

Thus, whether you end up needing a surgery or not, the Feldenkrais Method can benefit you. You cannot go wrong with improving the quality of movement. It will benefit you tremendously even if you have a surgery.

 

In summary, the severity of joint degeneration is not directly related to the severity of pain.  Whether you’ll need a surgery (a knee replacement in this case) or not depends on the severity of pain experience and how much pain is limiting your activities (plus other factors such as age and other medical conditions).  Ultimately your physician and you will decide the best option for you.  The Feldenkrais Method can benefit you whether you pursue a surgical intervention or a conservative treatment.

 Get help to move more comfortably and be more comfortable in your body.

Movement is essential to our life. Improving movement quality is directly related to quality of our life. Teaching people to move well is my passion. Sign up for Trans4Move Newsletters that will teach you how to improve your movements, functions, and your life!

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My name is Taro Iwamoto. I am a Feldenkrais practitioner and movement expert. I help people develop new and more efficient movement patterns and expand movement options in order to overcome injuries/pain and move beyond limits. Feel free to post in the comments section below and feel free to share this with your friends!

Mindfulness Exercises For Stress Reduction, Balance, Focus

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I teach mindful movement class based on the Feldenkrais Method (TM). Mindfulness practice is about practicing how to be in the moment and how to bring your attention to the moment.

Mindfulness practice combined with movement makes it even more powerful, and in my opinion, it makes it very real because our body, thoughts, feelings are all constantly changing and moving. Thus, I teach mindful movement class called Awareness Through Movement.

Here’s a simple mindful exercise you can try:

Sit on the front of a regular chair with both feet on the floor. Close your eyes. Shift your attention to your feet and notice how your feet are touching the floor (are feet flat, turning?), how close/far apart they are. Notice your sits bones. Can you feel which sitbone you are leaning more on? Are you sitting more the back of your sitsbones or front? Slowly and gently shift your weight on pelvis forward and back several times (10~15 times) and pay attention to notice how your weight shifts on your sitsbones. And, slowly and gently shift your weight on pelvis side to side so you shift onto one sitbone and onto the other alternately. Do this several times (10~15 times). When you are done, notice how you are sitting now. Do you notice any changes in how you sit on your sitsbones? Has your posture changed?

What happens when you pay attention to your body and movement is that you direct your attention to yourself in the moment so your brain is fully engaged. When you are fully attending to yourself, you’ll begin to notice the way you use your body (the way you breath, sit, stand, walk, etc). This is the moment when subconsious becomes conscious.

To become mindful, you have to slow down what you’re doing so you can pay attention to what you’re doing. Then, you will really know what you’re doing.

Once you really know what you’re doing with your body, then you can pay attention to other things and people and will start to notice things you really haven’t before.

This practice helps reduce stress, improve balance, and focus because you’re shifting the brain’s attention to this very moment from other distractions. This calms the brain and nervous system. This balances autonomic nervous system. As a result, you feel more relaxed and less stressed.

 Get help to move more mindfully and feel more calm and balanced.

Movement is essential to our life. Improving movement quality is directly related to quality of our life. Teaching people to move well is my passion. Sign up for Trans4Move Newsletters that will teach you how to improve your movements, functions, and your life!

Taro photo2.JPG

My name is Taro Iwamoto. I am a Feldenkrais practitioner and movement expert. I help people develop new and more efficient movement patterns and expand movement options in order to overcome injuries/pain and move beyond limits. Feel free to post in the comments section below and feel free to share this with your friends!

How to Be "Grounded" Physically and Emotionally

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I am sure you all injured yourself once or twice, or too many to keep track of. Recall the last time you were injured and in pain. Can you describe your feelings as you were going through your recovery?

Upset? Disappointed? Helpless? Sad? Scared? Depressed? Anxious? Nervous?,…. what else?

It is very apparent that what happens to your body directly affects what happens to your mind. Can you use this fact to your advantage?

What do you do when you are feeling very unstable for whatever reasons? How do you regain your stability?

Because physical stability and balance are closely related to emotional stability and balance, the benefits of exercise and movement extend into both physical and emotional aspects.

When you are feeling emotional wobbly and unsteady, instead of thinking or worrying about “it”, start working on your physical stability and balance then you will regain your "ground" from which you can move into any direction with ease and confidence!

Watch the video below (about 12 minutes) to learn how you can improve physical stability, which will help you feel more stable and “grounded.”

Before you do this exercise, observe and notice your emotions as well as physical sensation of your body, and after you finish the exercise, observe and notice your emotions again. Did they change? How?

 Get help to move with stability and confidence and feel stable and grounded in your body and mind.

Movement is essential to our life. Improving movement quality is directly related to quality of our life. Teaching people to move well is my passion. Sign up for Trans4Move Newsletters that will teach you how to improve your movements, functions, and your life!

Taro photo2.JPG

My name is Taro Iwamoto. I am a Feldenkrais practitioner and movement expert. I help people develop new and more efficient movement patterns and expand movement options in order to overcome injuries/pain and move beyond limits. Feel free to post in the comments section below and feel free to share this with your friends!

Toe Dexterity and Balance

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How well can you move your toes? I bet you can't move your toes as well as your fingers. Your feet used to get a lot more sensory stimulation from the ground when you were a child as you probably walked in barefoot than you do now.

Notice how babies use their feet and toes and use the feedback from the ground to develop movements. Your brain gets so much information from your feet and toes.

Imagine how little freedom your feet and toes have in your shoes. Sensory feedback your feet receive from the ground help you develop balance.

Start activating your toes once again like when you were a child with "Monkey Toes Exercise" and improve your balance!


Get help to improve your balance and movement.

Movement is essential to our life. Improving movement quality is directly related to quality of our life. Teaching people to move well is my passion. Sign up for Trans4Move Newsletters that will teach you how to improve your movements, functions, and your life!

Taro photo2.JPG

My name is Taro Iwamoto. I am a Feldenkrais practitioner and movement expert. I help people develop new and more efficient movement patterns and expand movement options in order to overcome injuries/pain and move beyond limits. Feel free to post in the comments section below and feel free to share this with your friends!

What can you do to prevent the problems associated with sitting too much?

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Are you getting sore from sitting too much at work?  Wondering what you can do to prevent the problems associated with sitting too much?  


This seems to be a very common issue for many people, perhaps including you.  Proper ergonomics definitely helps, but that’s not enough, right?  Paying attention to your posture, but you can’t think about your posture all the time, can you?  So what can you do??

 

While sitting in itself is not bad and it is necessary, a lack of movement or less movement variability that sitting for a long period of time creates can be problematic.  I believe we, human-beings are designed to move.  Less movement means less muscle activation, less bone stimulation, less brain stimulation, less blood circulation, etc.  Your brain and nervous system will get your attention by increasing muscular tone and/or producing pain/uncomfortable sensation in your body, which is a cue that you need to move.  

 

Ideally you want to get up and move around every so often, but when you are at work or driving, it’s not very realistic to do that.  My guess is that this is a dilemma you are facing.  So, a real question is: What is a solution?

 

Solution:  Create more movements in sitting.  Sitting on an exercise ball or a dyna disc (shown in the video below) can help create more movements due to an unstable sitting surface.  I need to mention to you that you will want to start sitting on an exercise ball or a dyna disc for a short period of time and gradually increase time if you have never used it as a chair.  As it is unstable, it will require you to use muscles you haven’t used a while or you don’t use all that much, thus will require you to adapt to new physiological demands.


While an exercise ball or a dyna disc can be helpful in terms of creating more movements in sitting, they are not absolutely necessary.  You can also create more movements in sitting with simple exercises.  I suggest you try these exercises to improve comfort in sitting at work.

 Get help to improve comfort in sitting at work.

Teaching people how to move well is my passion. Sign up for Trans4Move Newsletters that will teach you how to improve your movements, functions, and your life!

Taro photo2.JPG

My name is Taro Iwamoto. I am a Feldenkrais practitioner and movement expert. I help people develop new and more efficient movement patterns and expand movement options in order to overcome injuries/pain and move beyond limits. Feel free to post in the comments section below and feel free to share this with your friends!

Applying the Feldenkrais Method in Working with People with Dementia

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I have been fortunate enough to have had many opportunities to help individuals with dementia including Alzheimer’s disease as a Feldenkrais practitioner and a physical therapist assistant in the past several years.  Although people’s diagnoses would not change how I work with people, working with people with dementia brings unique challenges.  

I’d like to share a few things that I’ve learned over the years and how I use some principles of the Feldenkrais Method to help those individuals.  I understand there are several types of dementia and they all present different symptoms, but what I am sharing here applies to people with all forms of dementia.



Principle #1:  Be present and meet them where they are at

 

This principle is not unique to the Feldenkrais Method,but is such a fundamental one to keep in mind.  Even if they don’t understand what you are saying, they can intuitively sense whether you’re giving them your attention or not.  It is very important to be able to  recognize all of their cues (verbal or non-verbal) that can suggest their needs because they may not have the ability to express them verbally.  Being present is a pre-requisite to notice those cues.

 

Principle #2:  Let go of expectations  

 

You teach them something, say, teach them how to get out of a chair more efficiently, and there is a very good chance they will forget what you teach and you will end up teaching the same thing again next visit.  We, Feldenkrais practitioners know that we should not expect any particular outcomes/results from our clients.  This is especially important when you’re working with people with dementia.  

We may guess and speculate what might happen, but it’s not our job to decide their outcomes.  It it their nervous system’s job to decide.  Just observe and notice their responses/changes.  The nervous system will take what it can take at that moment and will not take anything if it’s not ready.  Knowing this will greatly reduce pressure/stress on practitioners as well as clients.

 

Principle #3:  Developmental Movement Patterns

 

It’s not uncommon that people with dementia decline in motor functions as well as cognitive functions as they tend to work together.  A beauty of being a Feldenkrais practitioner is that we help improve people’s functions through movement.  Based on my experiences people tend to regress in their motor functions in the very similar development sequence except in reverse.  

I find it very helpful for them to practice developmental movement patterns such as rolling, crawling, scooting, all transitional movements, etc.  Development movement patterns are fundamental building blocks for more complex movements such as walking.  Thus, when complex movements become more difficult, it’s beneficial to go back to earlier movement patterns.  

I had a client in her 80’s with mild dementia, and she was declining in all her functions.  It was getting harder for her to get out of a recliner chair, bed, toilet, get in/out of shower, walk, and more.  She was working on some strengthening exercises, which were helpful, but didn’t seem to improve her functions significantly.

 I started incorporating developmental movement patterns, which she had not done for years.  After a few weeks, she started to show significant improvements in all her functions.  It was getting much easier to get out of her recliner, bed, toilet.  She was walking faster.  She was much more confident in her balance.  I am not describing specific movements here as what is appropriate will depend on each person.  

What I’d like to emphasize here is that practicing developmental movement patterns can affect their functions so significantly.  However, please don’t be shocked if you don’t see any improvements or carryover from one session to next.  As I said earlier, it’s not our job to decide their outcomes.  Our job is to facilitate their learning by creating such conditions.  Then, we’ll just need to let their nervous system do their job.  Observe their responses and adjust what we will provide next time accordingly.

 Here’s a video that shows a few examples of developmental movements I use with my clients.

While there are more Feldenkrais principles that I apply in working with people with dementia, I wanted to select a few that I find particularly helpful.  I hope you find this information helpful.  Whether you are a Feldenkrais pracitioner or not, you can use these principles to help people with dementia.  

 

Get more information:

How to Improve Your Posture

How to Improve Your Posture

Have you tried to change your posture consciously and tried some stretching/strengthening exercises to correct your posture yet you find yourself with the same posture? Why is it so hard to change posture? Here, I talk about posture from a different perspective.

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