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~Deep Breathing for Pain

Here is a post on breathing from our intern. This is a great technique to control pain and stress.   Marnie

We all experience stress at some time in our lives, some of more than others.  There is no avoiding stress, but learning to manage it can help with our health and control of pain.  We've all heard of the fight or flight response... it's our body's way of protecting us from harm and letting us know when danger is ahead.  Health problems can occur when we have too much stress every single day. Constant, day-to-day stress is bad for our heart and also our immune systems.  Unfortunately, it can also lead to anxiety and depression.  The best thing to do is to learn ways to relax, especially in stressful moments.  Ways to do this are progressive muscle relaxation, meditation, yoga, and deep breathing. 

Deep breathing is also known as diaphragmatic breathing, abdominal breathing, belly breathing, and paced respiration. With deep breathing, the belly should rise when you inhale.  A lot of us breathe with our chests, instead of our bellies, which increases tension and anxiety.  When we breathe with our upper chest only, the lower part of our lungs don't get fully inflated and the diaphragm doesn't fully go down all the way.  This lack of oxygen to the lower part of the lungs alone can make us feel anxious and short of breath. On the other hand, deep breathing  is where the lungs get fully inflated, the diaphragm goes down far enough and lets the belly rise.  This allows oxygen to reach the lungs and actually slows the heart rate and lowers the blood pressure.

Slow breathing helps you focus on your breathing instead of everyday stressful thoughts. First, learn to breathe:  lie in a quiet place, place a hand on your belly and take in slow deep breath and you should feel your hand rise, then breathe out as slowly as you inhaled.  It can help to listen to the sound of your breath.  Try to disconnect yourself from distracting thoughts.  Once you've mastered this part, then you're ready for the next step:  belly breathing while focusing on images or words that relax you. 

Breath focus helps with other relaxation methods like progressive muscle relaxation, meditation, yoga, prayer, and pleasant images.  It's best to have a daily routine of deep breathing, especially right before a stressful event.  Find a quiet place, don't let the breathing be stressful, practice the same time everyday 1-2 times per day, and perform 10-20 minutes each day. 

Melissa Hickman SPT


The material on this site is for informational purposes only and is not intended to diagnose of suggest treatment for individuals.  Consult your health care provider regarding your specific needs.


~TMJ (Jaw Pain) Basics

Here is another post from our intern.  She is learning more about some of the special problems we see.  Marnie

The TMJ (temporomandibular joint) is the joint where the jaw and skull bones meet.  TMJ syndrome occurs when that joint is impaired.  Causes range from teeth alignment to poor posture or even stress. Just like any joint in the body, arthritis (breakdown of the joint and/or bony surfaces) can occur there as well. TMJ syndrome occurs when there is nerve, muscle, or joint damage.  Women are more at risk to develop this issue.  Some of the more common causes are poor posture, grinding teeth, increased stress/anxiety, or even too much gum chewing. 
Symptoms can be severe and may include:
  • jaw, neck, tongue, face and/or shoulder pain
  • jaw clicking or popping
  • ear pain or cracking sounds in the ears / fullness in ears / tinnitus
  • headaches
  • blurry vision, dizziness
  • soreness in neck/face muscles
  • locking of jaw
Many do not know that physical therapy can be very helpful for this condition.  Physical therapy is useful by correcting posture, strengthening jaw/neck muscles, increasing flexibility and jaw/neck motion.  PT can help you learn things to do at home such as using ice packs, eating softer foods, and even reducing stress. 
Melissa Hickman SPT

~Music and Mood

I currently have a great intern that will be writing some guest posts in the upcoming weeks.  Enjoy!    Marnie

Music can have a dramatic effect on our mood.  It can make you really excited and actually feel like your energy level increases,  or it can also have the opposite effect and help relax you when you're mind is racing and going in many different directions.  There are many things we've all heard about music helps you focus, classical music can help you retain information for a test if you listen to it while you study, music can help you sleep, lullabies can put babies to sleep, etc.  Scientists are studing the brain and determining the changes that occure in our brains while listening to music. 

Listening to music not only feels good but can also have some physiological benefits.  For example, we all know surgery can be scary.  A study was done where patients either listened to music or took anxiety medications prior to surgery.  The anxiety levels were lower in the ones who listened to music than the patients who took the medications!  Listening to music is also related to our body's ability to fight off germs!  Researchers have found that our brains can be changed depending on the genres of music we choose throughout our lives.  The more of one genre we listen to, the more we appreciate that particular style.  The attention, planning, memory and movement centers of our brains are all activated while listening to music. we all hear the same thing?  Music is the same as with other life experiences.  We can all be present and share the same experience, but do we interpret it the same?  We actually DO have similar experiences.  Our brain activity is the same in different kinds of people with very different personalities. Think about attending a concert for a minute.  Did you ever stop to think about how it blends all different kinds of people.  It doesn't matter the age, race, or gender; but they're all there because they share a common bond.  
Further research needs to be done to find out the parts of the brain that are activated with music and how it affects each of us differently.  In the meantime, listen to music that makes you feel good and puts you in a good mood!


Melissa Hickman SPT

The material on this site is for informational purposes only and is not intended to diagnose of suggest treatment for individuals.  Consult your health care provider regarding your specific needs.



~ 10 Free (or Cheap) Things You Can Do To Control Pain

Pain is something that grabs your attention. Our bodies are designed this way to protect us. Unfortunately, sometimes the system goes haywire and pain takes over your body, mind, and life.   This is especially true of chronic pain or nerve related pain (think toothache or sciatica).  Fortunately, our body has some work-arounds built in so that we can "hack" the sensation of pain.  Essentially we must give the brain something else to think about.  In time the brain can even "rewire" itself to be less aware of the pain sensation.  

There are many ways to work around the brain's perception of pain that are easy to do and are either free or cost very little.  Pick one (or all 10!) and get started soothing your pain. 


Any kind of exercise is beneficial for controlling pain. Many studies have found that exercise is very useful especially with chronic pain and fibromyalgia. All exercise qualifies including aerobics and weightlifting,  but walking is one of the easiest activities for people to do. Most people are able to start a gentle walking program at some level, even if they have pain or are unfit.  While it is important for health to work your way into a regular fitness program that may include activity for at least 30 minutes most days of the week, even short bouts of walking can be beneficial for pain. The key is to do what you're able to do within the limits of your pain on a regular basis and increase your time as you are able.


Taking slow, relaxed breaths deep into your belly is another way to calm your nervous system.  This method of breathing is called diaphragmatic breathing.  Most people in pain tend to breathe more with their upper chest.  Breathing harder and faster than you should into the upper rib cage leads the brain to perceive pain more easily. In contrast, allowing the breath to slow down into expansion of the abdomen sends relaxation signals to the brain and allows the nervous system to quiet down. This can be very helpful for people with pain. See my post here on how to do this type of breathing.


Meditation is also a well known activity for decreasing stress and helping relieve pain. In involves quieting the mind and focusing on the breath.  Often though this is one of the hardest things for people to do. Our minds tend to go a mile a minute, and this is even more difficult if you are in pain. Traditionally meditation is done sitting crosslegged position and focusing inward on the breath.  However, another way that can be easier if you have a difficult time quieting your mind down can be doing a repetitive task such as walking or washing dishes. This gives the physical body something to pay attention to while you focus on slowing your breathing and quieting the nervous system.


Yoga is another form of activity, which typically includes stretching and flexibility moves.  It consists of holding positions that  focus on breathing and paying attention to the body. This can be beneficial for pain. Yoga not only  taps into the same avenues that meditation does, but also give the body gentle movement and stretching at the same time.  Look for restorative forms of yoga such as programs for pre-bedtime, relaxation and breathing, or even specifically for pain. 


Laughter is another great way to tap in to the body's own pain relieving mechanisms. When you laugh, your body releases natural painkilling chemicals inside the brain. So not only do funny things give your brain something else to think about, but they send out your body's own self-made drugs to combat pain. Tell a joke, watch a funny movie, or hang out with your best friend who always makes you laugh.  


Any craft activity from quilting to painting can be helpful in dealing with pain. Knitting or crochet a can be especially useful as they typically involve a  soothing, repetitive action that can be performed in a comfortable sitting position. (note: this type of activity may not be good to do for long periods of time if your pain is in your hands or upper body).  This repetitive movement taps into those meditative pathways and helps calm the nervous system. Sit back and relax while making gifts or clothing and knit your pain away.


The popularity of adult coloring books is fairly new with many titles popping up on book bestseller lists. Any type of craft or art can also tap into the meditative pathways in the brain. However, not all people feel that they are particularly artistic. Coloring books allow people to relax and destress without worrying about having to be crafty. Coloring can allow you to unplug from pain and get into a relaxing state of mind. These coloring books come in a  variety of patterns so there is sure to be options for everyone.  They even come in in “color by number” versions for people who would stress about choosing colors for their picture. This is a great activity at any time but especially for those who have difficulty sleeping due to pain. 


This is another type of low energy activity that engages the brain in relaxing ways. Any puzzle will do including Sudoku, crosswords, word find, etc…. When the brain is actively engaged in figuring out puzzles it has less resources available to dwell on pain signals.


Another way to actively engage the brain so that it does not focus on pain signals is to try something new. Find something that you've always wanted to do and take steps to learn it. This could be almost anything from cooking, learning a new language, picking up an instrument, or even as simple as driving a different way to work. All of these activities force the brain to use energy in focusing on new connections instead of pain.


Most of the other activities engage the body's built-in pain relieving systems in the brain. When you help someone else, you're able to take the brain's attention away from focusing on yourself to focusing on someone else's pain. Not only does this give the brain something else to think about, but it can help remind us of things that you have be grateful for. It is very easy when suffering with pain to get caught up in your own internal feelings on a regular basis. Helping someone else helps to get you out of your own head. Activities can be as simple as assisting a child with homework, writing a nice letter to someone who is ill, or volunteering.  


Fiber and Pelvic Pain

Guest Post by Katherine Beverage, SPT


Everybody has likely heard about the importance of fiber for good digestive health. Fiber has been known to help alleviate some of the symptoms of irritable bowel syndrome, constipation, Crohn’s disease, and ulcerative colitis. These diseases, particularly constipation, can be sources of pelvic pain and pelvic floor dysfunction. When stools are irregular and difficult to pass, the pelvic floor muscles can get stretched out and tense, causing pain. Getting on a good fiber and bathroom program can help prevent some of the issues associated with chronic constipation and these other issues. However, do you actually know how much fiber is enough?  Should you focus on soluble or insoluble fiber? There are many questions that come up when discussing fiber.

 The average American takes in roughly 15 grams of fiber a day. According to the Mayo clinic, adults should be taking in anywhere 25-35 grams of fiber a day to promote good bathroom habits. That’s almost twice the amount that we are averaging! For most people, sources of fiber can be hard to identify. There are two main types of fiber: soluble and insoluble. Soluble fiber dissolves in water and can be found in foods such as oats, psyllium, apples, carrots, and barely. Insoluble fiber binds to water which helps bind the stool together and move it through the large intestine. It is found in bran, whole-wheat, beans, and cauliflower.

So what are some ways that you can up your fiber intake? A leading expert in the area of fiber and constipation is Dr. Wes Jones who works at the Cape Fear Center for Digestive Disease in North Carolina. He has written a book called “Cure Constipation Now” which outlines a general fiber program to help people begin their fiber routines. A good place to start is by adding a supplement to your daily routine. The easiest supplement to start with is synthetic fiber such as Citrucel® or Benefiber®. Although these supplements usually have a “honeymoon” effect, they are usually the easiest to tolerate if you are starting out.

One of the ways you can tell if your fiber is working is if you are developing good bathroom habits. Adults should produce 3-5 non-smelly stools a day. Another way to tell is if your gas production is down. Gas is a waste product and if it trapped inside of you then likely you are constipated in some way because you can’t get it out. According to Dr. Jones, once you have developed good bathroom habits, you can usually start switching to more classic fiber sources, such as bran, apples, etc. A bowl of bran flakes in the morning or using high fiber bread is a nice addition to your daily routine or you can add a non-synthetic supplement like Metamucil® in a similar fashion as step one. And once you get on a good fiber routine, the benefits are well worth it.  Fiber has been shown in various research studies to promote good bowel movements and health, lower cholesterol, control blood sugars levels, and attain a healthy weight.

The material on this site is for informational purposes only and is not intended to diagnose of suggest treatment for individuals.  Consult your health care provider regarding your specific needs.