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Personalized Movement Therapy for Chronic Pain

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DrBonnie360 shares her 30 plus year journey in coping with chronic musculoskeletal pain, secondary to her chronic autoimmune condition. She explains why there has to be more than PT and offers alternative movement modalities that you can try out to help with chronic pain.

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Personalized Movement Therapy for Chronic Pain

  1. 1. FOR CHRONIC PAIN PERSONALIZED MOVEMENT THERAPY
  2. 2. @DrBonnie360 @DrBonnie360 @YourAutoimmunityConnection linkedin.com/in/bonniefeldman +1 310 666 5312 drbonnie360.com drbonnie360@gmail.com Bonnie Feldman, DDS, MBA DrBonnie360’s mission is to create a connected world of personalized care for patients with chronic diseases using the best of conventional, functional, and digital medicine. We consult to entrepreneurs and others who are developing new products and services to improve chronic disease research, diagnosis and care.
  3. 3. DISCLOSURE I have no financial disclosure or conflicts of interest with the presented material in this presentation.
  4. 4. LEARNING OBJECTIVES 1 2 3 Why physical therapy is not enough to manage chronic musculoskeletal pain and improve mobility. How to create personalized movement therapy programs that enhance your patients’ mobility. Find and explore different kinds of movement therapies.
  5. 5. DRBONNIE360’S STORY • Family history of several autoimmune diseases. • 35 years of chronic musculoskeletal pain. • Diagnosed with Fibromyalgia 30 years ago. • Weekly physical therapy for over 30 years.
  6. 6. LIMITATIONS OF PHYSICAL THERAPY Reactive not proactive Temporary benefits Need long term alternatives
  7. 7. WHY WE EXERCISE? REDUCE MORTALITY PREVENT & REDUCE MORBIDITY IMPROVE CHRONIC PAIN & IMMUNE FUNCTION Hoffmann, Tammy C., et al. "Prescribing exercise interventions for patients with chronic conditions." Cmaj 188.7 (2016): 510-518. Sharif, Kassem, et al. "Physical activity and autoimmune diseases: Get moving and manage the disease." Autoimmunity reviews 17.1 (2018): 53-72. Vina, Jose, et al. "Exercise acts as a drug; the pharmacological benefits of exercise." British journal of pharmacology 167.1 (2012): 1-12.
  8. 8. BONNIE’S EXERCISE PROGRAM ON PAUSE • Bar Method • 3-4 times per week for 10 years • Shingles outbreak • Post-Shingles Chronic Fatigue
  9. 9. EXERCISE INTOLERANCE Noakes, Timothy David OMS. "Fatigue is a brain-derived emotion that regulates the exercise behavior to ensure the protection of whole body homeostasis." Frontiers in physiology 3 (2012): 82. What is exercise intolerance? Why does it happen? Why are autoimmune patients & certain other populations more likely to suffer exercise intolerance?
  10. 10. ONE SIZE DOES NOT FIT ALL Varied symptoms of chronic musculoskeletal pain Conventional care may not be enough Individuals have different symptom clusters Hoffmann, Tammy C., et al. "Prescribing exercise interventions for patients with chronic conditions." Cmaj 188.7 (2016): 510-518. Vina, Jose, et al. "Exercise acts as a drug; the pharmacological benefits of exercise." British journal of pharmacology 167.1 (2012): 1-12.
  11. 11. FUN REBUILDIN G MUSCLE MEMORY HYDROSTATIC PRESSURE DULLED SENSE OF TOUCH IMPROVED CIRCULATIO N RESISTANC E MASSAGE MUSCLE RELAXATI ON Becker, Bruce E. "Aquatic therapy: scientific foundations and clinical rehabilitation applications." Pm&r 1.9 (2009): 859-872. Mooventhan, A., and L. Nivethitha. "Scientific evidence-based effects of hydrotherapy on various systems of the body." North American journal of medical sciences 6.5 (2014): 199. HOW AND WHY POOL THERAPY WORKS
  12. 12. BONNIE BECOMES A FEARLESS EXPERIMENTOR • I realized a need for mind & body exercise • So I became a fearless experimenter: Yoga therapy Pilates Gyrotonic Feldenkrais
  13. 13. INTEGRATING MIND AND BODY VIA SOMATIC PRACTICES UNDERSTANDING HOW BODY WORKS PAIN RELIEF GREATER BODY AWARENESS
  14. 14. YOGA THERAPY WHAT HOW TYPES Arora, Sarika, and Jayashree Bhattacharjee. "Modulation of immune responses in stress by Yoga." International journal of yoga 1.2 (2008): 45. Büssing, Arndt, et al. "Effects of yoga on mental and physical health: a short summary of reviews." Evidence-Based Complementary and Alternative Medicine 2012 (2012). Gothe, Neha P., et al. "Differences in brain structure and function among yoga practitioners and controls." Frontiers in integrative neuroscience 12 (2018). Empowers practitioners to progress toward improved health & well- being through the application of yoga teachings Gentle to vigorous movements Breathing techniques Meditation & visualization practices One-on-one private coaching Small-to-large group classes
  15. 15. YOGA THERAPY VS PILATES YOGA PILATES Flexibility, endurance, stretch Core strength, stretch, posture A variety of breathing techniques Breathing in through nose & out through mouth Poses/Asanas on mat with props or not Dynamic exercises on mat with machines
  16. 16. PILATES THERAPY Core strength, muscle balance & postural alignment Low-impact flexibility, strength & endurance exercises Mat Machine Group classes & one- on-one coaching WHAT HOW TYPES Wells, Cherie, Gregory S. Kolt, and Andrea Bialocerkowski. "Defining Pilates exercise: a systematic review." Complementary therapies in medicine 20.4 (2012): 253-262.
  17. 17. PILATES GYROTONIC 2-dimensional Uses spring resistance & own weight Teaches control & alignment Requires careful attention to form & breathing BOTH Help elongate muscles & build strength Teach how to move fluidly & create greater body awareness 3-dimensional Uses a pulley and weight system Circling, spiraling & undulating motions to strengthen all of the body's internal support structures
  18. 18. GYROTONIC/GYROKENESIS METHOD A holistic movement system that supports the energy opening of pathways by stimulating the nervous system Increases range of motion and improves strength and movement efficiency through circular movements Gyrotonic uses proprietary machines Gyrokenesis |uses mats and chairs WHAT HOW TYPES Seo, Hye-Ran, and Tae-Ho Kim. "The effects of Gyrotonic expansion system exercise and trunk stability exercise on muscle activity and lumbar stability for the subjects with chronic low back pain." Journal of exercise rehabilitation 15.1 (2019): 129.
  19. 19. QI GONG A mind-body-spirit practice to improve mental & physical health by integrating posture, movement, breathing, self- massage, sound, and focused intent Slow, gentle standing movements More vigorous in martial 3 types: Medical Martial Meditative WHAT HOW TYPES Jahnke, Roger, et al. "A comprehensive review of health benefits of qigong and tai chi." American Journal of Health Promotion 24.6 (2010): e1-e25. Wang, Chong-Wen, et al. "Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials." BMC complementary and alternative medicine 14.1 (2014): 8.
  20. 20. TAI CHI Sometimes described as meditation in motion & body Improves muscle strength, flexibility & balance A series of gentle standing exercises & stretches Each posture flows into the next without pause 5 Types: different styles, Yang is the best for beginners WHAT HOW TYPES Jahnke, Roger, et al. "A comprehensive review of health benefits of qigong and tai chi." American Journal of Health Promotion 24.6 (2010): e1-e25.
  21. 21. FELDENKRAIS A practice, a process & a system of self- improvement. Curiosity is the underlying driver A philosophy or way of life Uses gentle movement & directed attention based upon physics & biomechanics to help people learn new & more effective ways of moving Private Functional Integration Instruction Awareness through movement classes WHAT HOW TYPES Hillier, Susan, and Anthea Worley. "The effectiveness of the feldenkrais method: a systematic review of the evidence." Evidence-Based Complementary and Alternative Medicine 2015 (2015).
  22. 22. WHAT I LEARNED
  23. 23. CONSIDER 4 MAIN FACTORS WHEN EXERCISING WITH AUTOIMMUNE DISEASE Frequen cy Duration Intensity Type Wool, Andrea. “The Four Factors You Need To Consider When Exercising With Autoimmune Disease.” Autoimmune Strong, https://www.getautoimmunestrong.com/blog/four-factors-exercise-and-autoimmune-disease.
  24. 24. WELL-BEING TEAM FOOD AS MEDICINE TEAM INDIVIDUAL GROUP FAMILY FRIENDS CHURCH YOGA MEDITATION PSYCHOLOGISTS BIOFEEDBACK COACHES NUTRITIONISTS COACHES MUSCULOSKELETAL INTEGRITY TEAM PHYSICAL THERAPY ACUPUNCTURE MASSAGE CHIROPRACTIC BIOFEEDBACK
  25. 25. MODALITY TARGET POPULATION EQUIPMENT CLAIM TO FAME Pool exercise Older pool, floats low impact Yoga Therapy All ages mat and props flexibility Pilates Women 20s-80s mat to machines core strength Gyrotonic Women Proprietary machine strength, flexibility Qi Gong All ages none simpler to learn than Tai Chi Tai Chi Old folks, groups none great for groups Feldenkrais All ages mat, chair, massage table meditative, slow EXERCISE FACTORS TO CONSIDER
  26. 26. HOW TO GET STARTED Personal Preference = Motivation Poses vs Flowing Movements Cognitive Benefits Complexity/ Intensity of movements Need for Equipment Meditative/ Breathing Benefits Need for Coaching Social Aspects Factors to Consider
  27. 27. Sherry Brourman Yoga Therapist Jessica Zarins Feldenkrais Practitioner Nichole Beeks Gyrotonic Instructor Tricialee Friedman Pilates Instructor Dr. Bonnie Feldman DDS, MBA drbonnie360.com John Chao Physical Therapist MY TEAM
  28. 28. NEXT STEPS
  29. 29. 30 VIDEO CREDITS Ann Swanson AnnSwansonWellness.com Living Healthy Chicago wgntv.com GAMEPLAN TV @GAMEPLANonline AQUA THERAPY YOGA THERAPY PILATES Trifecta Pilates Trifectapilates.com GYROTONIC Gyrotonic Headquarters gyrotonic.com
  30. 30. Dr. Kien Vuu, Kienvuumd.com Tomm Voss qiwithin.com Mayo Clinic mayoclinic.org Andrea Wool getautoimmunestrong.com MD Anderson mdanderson.org VIDEO CREDITS TAI CHI QI GONG FELDENKRAIS AUTOIMMUNE STRONG
  31. 31. WORKS CITED AQUA THERAPY Becker, Bruce E. "Aquatic therapy: scientific foundations and clinical rehabilitation applications." Pm&r 1.9 (2009): 859-872. Mooventhan, A., and L. Nivethitha. "Scientific evidence-based effects of hydrotherapy on various systems of the body." North American journal of medical sciences 6.5 (2014): 199. YOGA Arora, Sarika, and Jayashree Bhattacharjee. "Modulation of immune responses in stress by Yoga." International journal of yoga 1.2 (2008): 45. Büssing, Arndt, et al. "Effects of yoga on mental and physical health: a short summary of reviews." Evidence-Based Complementary and Alternative Medicine 2012 (2012). Gothe, Neha P et al. “Differences in Brain Structure and Function Among Yoga Practitioners and Controls.” Frontiers in integrative neuroscience vol. 12 26. 22 Jun. 2018, doi:10.3389/fnint.2018.00026
  32. 32. WORKS CITED PILATES Wells, Cherie, Gregory S. Kolt, and Andrea Bialocerkowski. "Defining Pilates exercise: a systematic review." Complementary therapies in medicine 20.4 (2012): 253-262. FATIGUE Noakes, Timothy David OMS. "Fatigue is a brain-derived emotion that regulates the exercise behavior to ensure the protection of whole body homeostasis." Frontiers in physiology 3 (2012): 82. GYROTONICS Seo, Hye-Ran, and Tae-Ho Kim. "The effects of Gyrotonic expansion system exercise and trunk stability exercise on muscle activity and lumbar stability for the subjects with chronic low back pain." Journal of exercise rehabilitation 15.1 (2019): 129.
  33. 33. WORKS CITED AUTOIMMUNE DISEASES Sharif, Kassem, et al. "Physical activity and autoimmune diseases: Get moving and manage the disease." Autoimmunity reviews 17.1 (2018): 53-72. Stojanovich, Ljudmila, and Dragomir Marisavljevich. "Stress as a trigger of autoimmune disease." Autoimmunity reviews 7.3 (2008): 209-213. FELDENKRAIS Hillier, Susan, and Anthea Worley. "The effectiveness of the feldenkrais method: a systematic review of the evidence." Evidence-Based Complementary and Alternative Medicine 2015 (2015). Paolucci, Teresa, et al. "Improved interoceptive awareness in chronic low back pain: a comparison of Back school versus Feldenkrais method." Disability and rehabilitation 39.10 (2017): 994-1001. TAI CHI & QI GONG Jahnke, Roger, et al. "A comprehensive review of health benefits of qigong and tai chi." American Journal of Health Promotion 24.6 (2010): e1-e25. Wang, Chong-Wen, et al. "Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials." BMC complementary and alternative medicine 14.1 (2014): 8.
  34. 34. To learn more, download our free ebook A glance inside Visit drbonnie360.com/movement-guide

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