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What have your Physios told you about stretching?

Posted , 6 users are following.

LayneTX
LayneTX

I'm wondering what your Physios/Physical Therapist have told you...

When our PMR is most active in mornings, meaning more tight, stiff and painful, should we attempt yoga type stretching then or wait until inflammation subsides a bit?

Same with light weight or stretch bands? 

I prefer morning workouts, but don't want to harm the areas if I'm trying to stretch it or do repetitive motion.

My gut feeling is wait, but I just wondered what y'all are experiencing. 

0 likes, 14 replies

14 Replies

  • EileenH
    EileenH LayneTX

    Posted

    Most of us in the UK won't have seen a physio for PMR and when we do we often meet with lack of knowledge! 

    I used to fall out of bed, straight into my swimming costume and joggers and struggle behind the wheel to get to the gym where I could have a morning aqua class. During that I was stretching and exercising - by the time I got out I could move almost normally, and that was without pred.

    We often used to suggest getting in a warm shower and stretching to get a similar effect. Some people found having an electric blanket on BEFORE getting out of bed meant that the blood flow in the muscles was improved - and of course once you get moving the circulation improves due to that and the stiffness improves. I certainly couldn't do any class in a cool room or aqua in a cold pool - anything below 28C was absolutely not on and it was better when the thermostat was playing up and it got to 30C! I did my yoga and Pilates after the aqua classes and just listened to my body telling me it was stretched enough - but the preparation sequence my instructor did always improved my flexibility dratically.

    Providing the room is warm and you don't push yourself to start with but wait until you are warming up I don't see it matters what time of day it is.

    • erika59785
      erika59785 EileenH

      Posted

      Eileen, I agree with you that physio for PMR does not help.  I tried it -- the therapists do not understand PMR and want to "push to the limit" to get more flexibility.  Even massages caused bruising on the areas they treated..  I gave up on this, althought my GP thought it would help.

      I do gentle stretching every morning while still in bed for about 10 minutes and one more time during the day.  Stretching does help a great deal.

       

    • nick67069
      nick67069 erika59785

      Posted

      I disagree with general statment that all physio dont help with PMR. If I were you I would change the physio... I happen to have a very good one and she has helped immensly in my recovery.  SHe worked with PMR patients before.
    • erika59785
      erika59785 nick67069

      Posted

      Nick, would you believe that I changed physio, and just today I had a very helpful therapeutic gentle massage which is called MLT (Manual ligament therapy) which helped my left frozen shoulder and my back.  I was amazed!  I can raise my left shoulder higher and I almost walk without pain.

       

    • nick67069
      nick67069 erika59785

      Posted

      I am glad that you found one that can help. Work with him/her, ask lots of questions about what you should or should not do on your own.  I see them as a coach and therapist.  What you do on your own every day is just as important. 
    • EileenH
      EileenH nick67069

      Posted

      I have also had good help from a physio - but not for the PMR itself. Physio can't do anything to help with the cause of the PMR pain as it can't combat the inflammation. What physio can do is help with what I call the "add-ons" that occur alongside PMR in many, but not all, patients and the different cause of which it is sometimes difficult to identify. Myofascial pain syndrome comes under that heading, so does piriformis syndrome. Both benefit from physiotherapy if you get the right sort.

      However - normal physiotherapy as is practised within the NHS rarely helps PMR and often makes things worse. So does some massage therapy. It is something that is associated with the NHS system - they have a specific complaint to deal with and they are required to identify the cause and work on it in a maximum of 6 sessions. They teach exercises for the patient to use at home. You are not allowed to arrive and say "today I have this - can you help" because that would require another referral and that means another wait. Many physios have never heard of PMR - and that is when the real problem starts. 

      This is a UK based site, the majority of participants are still in the UK, many of them are retired. Private physiotherapy in the UK is pricey, few people have private insurance to pay for it and are even less likely to be able to afford it out of their own pocket. The advice we provide for those is that physio isn't worth the fight and the wait. You can't just change to another - you get who you get. You might not even get the same person every session.

      What is very useful - we know that - is hydrotherapy. But it is next to impossible to access in the UK. ArthritisUK (I think) funded a hydrotherapy pool in the north of England - but when approached by the local PMRGCA support group they said we couldn't use it too - we didn't need it! 

      I know what to ask for, I know how to explain it to a physio and I know if what they are doing will benefit me - but I'd have to wait for months as it would be classified "non-urgent" and I have no idea who I'd get. Others don't have the same experience or knowledge. If I knew people were using private insurance I would - and do - suggest a trial of physio providing the physio knows what they are doing in PMR. I'd say most don't. But if you look - how many people say where they are from? 

    • nick67069
      nick67069 EileenH

      Posted

      I understand now, it is basically limitation built into UK NHS system. 

      My experience in Japan is exactly the oposite. I don't need referral, I can make my appointments and I can walk into the clinic and ask " today I would like to work on my back, which is a bit stiff from swimming 1/2 time and also work on my sholder flexibility.. One hour session, which is covered by insirance, is very inexpensive, about $10. 

    • EileenH
      EileenH nick67069

      Posted

      Exactly - if I could do that for that price I'd have a couple of sessions a week! But something like 40-60 euros here in Italy for up to an hour or probably £30 for half an hour in the UK is a very different matter. Especially for us retirees who now have a fixed income wink  

      State funded healthcare is not luxury cover - but it is there when you need it and you won't end up bankrupt because you broke your leg and didn't have insurance. I'm lucky here - and Germany is even better - because some very useful things are easily available. Both Italy and Germany see a place for complementary techniques within mainstream medicine. The UK rarely does.

    • erika59785
      erika59785 nick67069

      Posted

      One more question....how often do you see your therapist?

      I was happy with the one who gave me the Manual Ligament Therapy because my alignment from the neck down was out of line.  She said that a damaged ligament compromises the muscles surrounding the area which causes stiffness and pain.

      A different therapy concept which is fairly new.

       

    • nick67069
      nick67069 erika59785

      Posted

      When I got PMR, first 4-6 weeks I saw therapist 2 times a week.  After 6 weeks I had only one session and just now I am seeing therapist every second week, since I really don't have compelling reason for session.

      Pain is usually at the junction of tendon and muscle or sometimes where 2 muscles connect (fasciae).  Damage to ligament ( which connects 2 bones) will cause inflammation in that joint.  Body tries to "immobilize" that joint by keeping tension on the muscle, which eventually causes pain in that muscle ( typical example knee or lower back). Pasture changes and one problem ( hip or lower back) can cause additional load on knee and then it will hurt.  Everything is connected and in balance. When that balance is disturbed, it can cause multiple problems.

       Best to take care of them ASAP.

    • erika59785
      erika59785 nick67069

      Posted

      You explained it well.  Thank you.  Balance and alignment is important.  I am working on it.....kind of late because I did not have a therapist with enough knowledge about it.....PMR.  Now I found one......I have hope, because even a 1 hour session caused a relief of pain in my left shoulder and lower back.

       

  • nick67069
    nick67069 LayneTX

    Posted

    Never stretch cold muscle.  Ideally you would have 15-20 min of activity to warm up before stretching.  My PT suggests. This is the rule with or without PMR.

    Every morning I do 20 min walk, stop to stretch in the park and then walk home for another 5 in or so... Cool down is also important. Last 5 min of walk is easy, slower then before. 

    Move as often as practical during the day.  Make a habit to have several walks or physical activities throughout the day, it helps.

  • Anhaga
    Anhaga LayneTX

    Posted

    I think what you shoose to do should be based on what you have done in the past and your current level of fitness and flexibility.  I entered the PMR journey with a whole suite of yoga and physio exercises to deal with various mechanical problems (mostly maintaining flexibility and strengthening the core).  In fact it was gradual loss of ability to perform some of the simplest of these movements that was one of the main triggers that got me to finally find a doctor who diagnosed PMR.  I've never stopped these exercises, done mornings before breakfast and evenings, and I've added a couple more (from current physiotherapist) to help improve posture.  That being said, if I were you I wouldn't add new things unless certain that they wouldn't hurt!  In my case I don't appear ever to have experienced unusual morning stiffness since starting pred, but perhaps that is as a result of the morning routine that I've followed for maybe 12 years now?
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