Strategies to Improve Occupational Performance and Reduce Pain
By Rachel Gottesman, OTR/L
Occupational therapists are healthcare professionals who help their clients return to or improve upon their daily living skills. While the profession has been thought by many to only help people find jobs, occupational therapists can help people across many settings prevent injuries as well as provide strategies to promote a healthy lifestyle. From office ergonomics to therapeutic exercises or activities, occupational therapists can help those afflicted by issues that affect office-based workers and those who suffer from modern day conveniences such as extra screen time. These ailments include, but are not limited to, neck and back issues, headaches, tendon inflammation and fatigue often caused by physical or emotional stress/trauma, poor posture and repetitive stress over time.
It is important to note that pain can come from many different sources. Pain can be an indication of a medical condition in which a primary care physician will need to be consulted. This is particularly true if the pain has been persistent for an extended period of time. The purpose of this article is to help prevent or alleviate pain that is due to physical tension, stress, strain, or pain that has been diagnosed as musculoskeletal. This article is not meant to replace or represent medical advice.
The American Academy of Pain Medicine reports that 100 million Americans and 1.5 billion people worldwide suffer from chronic pain. Chronic pain is pain that persists well beyond an initial injury or trigger. Chronic pain can develop over time, especially from lack of activity, poor posture, physical or emotional stress and repetitive strain. Pain signals from the nervous system continue to fire for weeks, month or years. Unfortunately, chronic pain can trigger a pain cycle in which exercise, sleep or a balanced mental state becomes difficult, thus continuing the cycle keeping one in pain. While chronic pain can affect any age, it is most prevalent in older adults.
The following strategies may help to decrease pain and tightness in day to day activities. Applying some of these principles can help create more ease in one’s occupational performance by improving sleep, increasing concentration in work or leisure activities, maintaining flexibility for family roles (parent, grandparent), and continuing a healthy work/life balance by creating comfort in movement while exercising or performing sports activities.
1. Stretch Effectively
LENGTH OF TIME – We have all heard of the importance of stretching. However, the LENGTH OF TIME a stretch is held is key to effective long-term pain relief.
When we stretch, we are not only stretching the muscles, but the FASCIA, the soft connective tissue that surrounds and penetrates ALL THE MUSCLES in the body. Fascia responds best to slow, prolonged holds in order to release or open up.
Think of a rubber band – you can change its length by pulling on it, but what happens when you let go too quickly? It snaps back to its previous length. Stretching the fascia is very similar.
HOLD THE STRETCHES FOR A MINIMUM of 90-120 seconds (1 ½ to 2 minutes). That is the amount of time it takes to get an initial release of the fascia.
This is a good start!
However, to keep the area open and loose after the stretch is over, you should hold the stretch an additional 2-3 minutes. Holding the stretch for a total of 3-5 minutes will start to make lasting changes in the body. Of course, the longer you can hold, the greater the chances that the fascia will stay open to its new length.
DON’T FORCE – Just remember to wait at the barrier, or where you feel a stop. If you don’t force past that barrier you will not injure.
You may feel a temporary soreness as the fascia adjusts to its new length. This type of soreness usually last for a few hours to a few days.
2. Give your FEET some love!
Our feet are our “foundation.” They take much of the brunt of day to day life. Often times, other areas of the body talk to us and we attend to those areas first. However, the feet often get neglected. We want to care for our feet and make every step as easy on the rest of the body as possible. Proper foot care is essential! Here is a way to get started.
Sink into those soles!
You can use a golf ball, a tennis ball, a small knobby ball, or a tool called a nola rola. Of course, feel free to be creative in what you use.
Sit on the couch or any comfortable surface and let gravity help your feet mold into whatever device you choose. Once you find a pressure spot you let your feet ‘melt’ and ‘soften’ into that spot for the 3-5 minutes. You don’t want to roll the device all around the bottom of your foot because you are simply gliding along the surface and not creating any softening or length changes.
Another effective self-treatment strategy is to sit on the floor or bed with you back up to the wall. Place a tennis ball, golf ball or knobby ball under your calf and search for those tender pressures spots. Once you find one, feel your leg sink into that spot for the 3-5 minutes (or as long as you can tolerate). It is important to relax your body as much as possible and breathe as you do this to encourage softening and change. You should feel the sensation start to change during this time and you may feel sensations in other areas of the body. That is not uncommon as the fascial system is connected, like a spider web or sweater from head to toe.
3. Remember Your Arches
Where is your weight distributed when you stand? Most people typically place their weight too far back, putting undue pressure on the back of the body, including the lower back.
Stand with your weight back on your heels. If your balance is off, hold onto something for support as your try this. What do you feel?
Now stand with your weight forward, on your balls and toes. See if your body guards to keep you from falling forward
When your weight is back on your heels do you notice pressure up the back of your legs onto your lower back and spine? Stand there for a minute and try to get a sense of how this position effects your lower back and spine
Now place your weight in the middle of your foot, over your arches. Imagine that you are “floating” over them. Notice how it feels – your toes are still engaged in the ground but not doing all the work. You may feel some of the pressure taking off you calves and lower back.
You may need to explore this exercise a few times to “find” and then “float” over your arches. You may even feel like you are leaning forward. Try this when you are standing in line at the store, pumping your gas or at a social event talking to people. Practice keeping your weight over your arches and your back will thank you!
4. Find a Good Way to Sit
DO YOU SIT A LOT DURING THE DAY?
You can probably guess that getting up at least 20-30 minutes to stretch and move is a good idea. However, I would like to add a way to effectively sit to avoid undue pressure on your lower back.
We went over strategies for standing and taking some pressure off your lower back. You can use similar strategies for sitting.
FIND YOUR BUTT BONES, or ISCHIAL TUBEROSITIES. They feel like points under the flesh of your gluteal (or rear end) muscles. Stick your hands under your behind and see if you can find them.
Now lean forward slightly. Do you feel how the bones move backwards? Picture your pelvis as a bowl and those bones are the little feet at the bottom of the bowl. When they move backwards, the bowl is tipping forward. Now try it again and see what parts of your body are tensing. Do you notice how your legs and front of your body are engaged or working extra hard?
Now keeping your hands on your ischial tuberosities lean back. Imagine that pelvic bowl tipping backwards. Feel how that effects your body? Do you notice more tension in the back of your body, especially lower back area?
Ideally while you are sitting you want your pelvic bowl to not tip over – forward or backwards. Keep your feet engaged in the ground and make sure your chair is a comfortable height. This will keep the strain off of your lower back while you are sitting for work or watching TV.
5. Take Care of the Front of your Back
Tight psoas, or lower abdominal muscles, can contribute to lower back pain.
We sit a lot in our day to day tasks – riding in the car, sitting at a desk, sitting on a couch to socialize or watch TV. All of these positions shorten the lower abdominal muscles.
Give them a prolonged stretch! There are many ways to do this. Here is one example:
Take a 4” rubber ball and find a comfortable position on the floor. Find a spot between your belly button and your hip bone.
Place the ball in an area that feels ‘tight’ or ‘tender.’
* Make sure you do not have any medical conditions such as pregnancy or aneurysms before doing this. *
Allow the ball to sink into that area for a minimum of 2-3 minutes. Feel for what other areas in your body are holding or tense. Send your breath to those areas and allow them to relax or soften.
Repeat on both sides of the abdominal area.
The weather is getting warmer and now is the perfect time to explore a park or plan a weekend getaway. Hiking does not have to be strenuous. Local parks usually have trails that fit all abilities, from flat smooth surfaces to more challenging terrain. Pick a time of day that is cool enough to enjoy the weather and remember to stay hydrated. Come prepared with plenty of water and make sure you are wearing supportive footwear. Make this a season of renewal by applying some of these techniques at work or in your daily activities. Change your scenery by finding new places to explore in nature.
These suggestions can help decrease or eliminate pain caused by muscle strain or injury. As pain decreases, activities levels can increase. Your body and mind will thank you.
Rachel Gottesman, OTR/L has been in practice for over seventeen years. She has been incorporating myofascial release (MFR) into her practice and has performed MFR techniques on clients ranging in age from 3 to 95 years with a wide variety of conditions and diagnoses. Learn more at www.bodyeasetherapy.com
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