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Managing bad joints with exercise

I had my first appointment with an osteopath in my early twenties, for sciatica and lower-back pain. This, I learned, was down to my habit of íslouchingí, as my mother called it - standing with my hips forward and my spine in an exaggerted íSí shape. I lived with periodic bouts of very severe pain for years, and then things changed. While I was íputting my back outí regularly, I had more-or-less pain-free periods in between. Then I started to have fairly constant nagging pain, but without the really severe bouts - mostly.

Sometime back in the í80s I had a standing spinal x-ray done by a chiropractor (why donít the hospitals do that?). This revealed that three of my discs were quite badly damaged - one in the lower back, one bwteen my shoulderblades and one in my neck.

A bit later I started getting bouts of severe pain and muscle spasm close to the inner edge of my right shoulderblade. My chiropractor put it down to my neck and treated it solely by cracking the neck joints: a waste of time - and money at £18 a go. I went to a private physiotherapist, who - for the price of a ten-minute neck manipluation - gave me an hour of massage, reflexology, heat treatment and good advice. The core of the advice was: donít rest - exercise. Thatís been my rule ever since, and although Iíve had to resort to surgery (a brilliant success) for my collapsing right ankle Iím still exercising to control the pains from the discs, one knee and a joint in my shoulder, all of which have quite severe osteoarthritis - a posh name for wear-and-tear leading to inflammation of joints.

While I was pretty well chair-bound waiting for my new ankle to heal I got incredibly stiff, but I restarted my neck, shoulder and back work-outs as soon as I could and felt the benefits within hours, particularly in terms of comfort in bed: when I awake in the morning - or in the dead of night - I can really luxuriate in the comfort, rather than struggling to find any position in which I can relax. So hereís the routine...

My neck, shoulder and back workout

Iíll try to describe this adequately in words, and maybe get round to some pictures in due course.

Please note: I offer no guarantees that this will work for anyone except myself. It is very important to approach these mobilising exercises cautiously - try them out very slowly and if you feel real pain go no further - there are no prizes for heroes. The idea is to loosen your joints up slowly and gently and then to maintain the mobility you achieve by regular repetition of the routines. I often donít do any of this for weeks and then, when I get stiff, do a workout before bed - and sometimes another during the day.

Neck 1
Stand comfortably with your feet some distance apart and your arms hanging loosely by your sides. Turn your head to one side as far as it will go in reasonable comfort to one side - slowly with no jerking. If, like me, you hear a noise like someone crumpling cellophane, donít panic: be guided by how it feels. Turn to the other side. Return to centre. Repeat about four times to begin with, gradually increasing the number of repetitions - I usually do 10.

Neck 2
Push your chin down onto your chest and then tip your head slowly back as far as it will go - again in reasonable comfort and without jerking. Repeat the same number of times as for the first exercise.

Neck 3
Tip your head to one side and then to the other, repeating as before.

Neck 4
Push your chin as far forward as you can and pull it as far back as you can, repeating as before.

Neck 5
Finally, drop your chin onto your chest and roll it up to one shoulder, then round to the other shoulder, and repeat - donít roll it right round: I was advised very strongly against this.

Shoulders 1
Still standing in the same position, hold your hands facing forwards with the tips of your thumbs touching your shoulders. Push your shoulders down, then reach up with both hands as far as you can go - really reach for the sky. Repeat as before

Shoulders 2
Put you arms out to the front, holding them loosely and slightly bent with your hands palms-down. Push your hands forwards as far as they will go, straightening your elbows and pulling your shoulders forward. Return to the relaxed position. Repeat as before.

Shoulders 3
Put your hands together, overlapping them with the backs of the hands against the small of your back - but donít clasp them. Pull your shoulders back and your elbows towards one another, using your back muscles - donít grab hands and pull with your arms. Repeat as before.

Shoulders 4
With your arms hanging loosely by your sides, rotate your shoulders up, forwards, down and backs. Repeat as before. This and the following exercise sound quite easy but can send pains shooting up your neck and into the back of your head, so go carefully and listen to your body.

Shoulders 5
Repeat but rotating up, back, down and forward. Repeat as before.

Shoulders 6
íWindmillí your arms out, up and in, crossing them in front of your body. Donít hurl them around but keep the movement slow and controled. Try to alternate the way they overlap, left in front of right and then right in front of left. Repeat as before.

Shoulders 7
Repeat the previous movement in the opposite direction: inwards, crossing in front of your body, up, out and down. Repeat as before.

Spine 1
Spread your feet a little wider apart - say around 18 inches, to give you a solid base for the next exercise. Put your hands flat on your hips or the outside of your thighs, depending on how long your arms are. Now bend sideways, sliding one hand down your thigh as far as it will go and letting the other one ride up. Reverse direction. Repeat as above. This opens up the joints between your vertebrae and helps with sciatica, which is caused by the nerves that serve your legs being trapped between the bones of your spine.

Spine 2 Sit on the floor with your legs straight out and spread at a comfortable angle. Reach forward with both hands and slide them down one leg as far as they will go comfortably, keeping the leg straight. You should feel the pull behind the knee as the hamstring stretches. Slide your hands back and sit up straight. Repeat as before. Switch to the other leg and repeat. You may find it easier to bend the free leg, even pulling your heel up towards your body. Finally, put one hand on each leg and push towards both feet. Repeat as before. With luck, you should eventually manage to touch your toes, but it may take some weeks of regular workouts.

Spine 3 Kneel with your hands on the floor, arms straight and parallel with your thighs. Arch your back upwards, pushing your head down. Then arch the other way,.pushing the small of your back downwards and lifting your head. Repeat as before.

Spine 4 Still kneeling, sit on your heels; put your hands on the floor and slide them as far forward as you can, hopefully getting your forehead on the floor even if you have to lift your bum off your heels in the process. Lift up, using your arms rather than your back muscles. Repeat as before. Eventually youíll be able to open your feet wider, sit further down and still get your head on the floor.

Spine 5 Lie flat on your stomach (you can get there directly from the previous exercise) with your hands, palms-down, under your shoulders. Press up on your arms, but keep your pelvis on the floor - you?re not doing push-ups! Life as high as you can to arch your back to the maximum. Then lower yourself back to the floor. Repeat as before. This too opens up the joints in your lower spine to help relieve sciatica - I sometimes use it in bed if I get pain in the legs at night.

Spine 6 Finally, lie on your back with your legs bent and your knees raised and together. Dtretch your arms out to the sides, palms flat on the floor. Roll your head to one side and simultaneously rotate your knees to the other, keeping them tight together and allowing your hips to rotate and the upper foot to come off the floor. I can get my thigh flat on the floor and my head rotated nearly 90 degrees in the opposite direction, but Iíve been using this exercise for years. Rotate your legs and head to the opposite sides. Repeat in a smooth, rhythmic motion. I find this incredibly soothing, like a massage, and I do twice as many repeats as for all the other exercises.

Finally... Lie still for a few minutes with your knees still raised and your hands by your sides or on your stomach. Breathe slowly and rhythmically. Then roll over and get to your feet carefully - you donít want to undo all the good work!

Exercises for the legs and feet

Once my knees and ankle began misbehaving, I started working on them, too. This lot are best done before getting out of bed.

Kick off the duvet and lie flat on your back with your legs together. Keeping your legs straight, lift one until the hamstrings pull, then bend it, using your hands on your shin to keep the leg fully bent and pull your knee onto your chest. Release the leg and straighten it, keeping it as high as possible, and lower it to the bed. Repeat as with the neck, shoulder and back exercises. Do the same with the other leg.

With your feet together, straighten your feet in line with your legs as far as possible, then pull your toes up towards your knees, maximising the movement of your ankle joints. Release and repeat as before.

Rotate one foot, clockwise and then anticlockwise. Repeat with both feet as before.

When you get out of bed, do the same number of repeats rising onto tiptoes with your legs a foot or so apart, balancing with a hand on the wall or a dressing-table if necessary.

Warning

Iíll repeat: be guided by the pain and donít strain or jerk. The idea is to increase the mobility of your joints gradually. If any of these moves causes particular discomfort, donít risk doing it - just leave it out and maybe try again in a week when the others might have done some good. Be alive to what your body tells you and be creative. Use my suggestions as a starting point and try variations until you have built a routine that works for you.

Good luck, fellow sufferers!

Personal site for Paul Marsden: frustrated writer; experimental cook and all-round foodie; amateur wine-importer; former copywriter and press-officer; former teacher, teacher-trainer, educational software developer and documenter; still a professional web-developer but mostly retired.

This site was transferred in June 2005 to the Sites4Doctors Site Management System, and has been developed and maintained there ever since.