How many steps a day?

After a couple of months of largely rainy weather, local beaches busy with tourists (good for those local businesses reliant on tourism, but the Covid-19 pandemic has brought a new wariness of strangers), my dance mojo still absent and all attempts to get the garden under control and more productive having been thwarted by the excessive numbers of slugs and snails (and rain), by mid-August I had to admit to myself that I was in something of a slough of despond and apathy. 

I noticed some stasis dermatitis on my lower shins, a sign that the circulation in my legs could be better. Realising I needed to take action, I wanted something which would buzz me to move every so often, without having to set alarms, as I can get hyperfocused and end up sitting at my computer for hours. I finally cracked and got myself a fitness tracker watch. 

Not that I am very interested in step counting. The suggested 10000 steps a day is supposed to be roughly equivalent to five miles. However, I can no longer comfortably walk a mile, so I would have to scale back considerably when setting myself a motivational target number of steps. 

In the end, I chose a Fitbit Inspire HR, on offer because an upgraded version was about to go on sale. I didn't need anything very flashy, not being into sports and gym. The HR is the ability to measure heart rate, so I could look at cardio and sleep, and it would give me a little buzz at ten to the hour during the day to prompt me to complete at least 250 steps.

I settled on a target of 3000 steps a day initially, and found that my baseline was around 2000, 2500 on a good day. Gradually I found the number I did creeping up, but my 'crash' days, when my knees really hurt, and I feel tired and generally achy and low on energy, are obvious; I struggle to make 1000 steps on those days.

I saw a few complaints in reviews that there weren't enough instructions on how to use it, and that it was difficult to navigate, not intuitive. I found it easy to set up, and with a certain amount of 'poke it and see what it does', I found my way around quite enough to be going on with. I didn't feel the need to know everything about how it worked, because I was happy not using all the functionality (it can also allow you to record food and water intake, give message notifications and probably more besides, but if it's not going to make tea and cook a meal for me, I don't really care).

I found that if I walk slowly and smoothly with no arm-swinging, the tracker has a problem realising I'm walking and doesn't record steps. The upside of that is that if I do some seated exercise with arm swinging as I step, it still records them as steps. Not that it recognises the steps as part of 'seated exercise'; it's very walk/run/cycle/swim/aerobics focused. I did some dance on the beach when lockdown lifted a bit, and it finally concluded I was swimming. Obviously dance isn't 'sporty' enough.

The sleep function is a bit flaky, sometimes giving a nice graph of light, deep and REM sleep and wakefulness (although you get an error message informing you that the database didn't allow that sleep to be logged. Er, what?), other times just giving some basic measurements. I read from the help/forum that a lot of people have found this, and no one has found a way to resolve it. Fitbit's answer was to subscribe to the app and/or buy the latest watch, which is no help at all. I notice it is sensitive to 'wakefulness', as brief stretching a knee to relieve pain or sleepily stroking a cat means I am awake, however briefly. It usually recognises when I fall asleep again after I get up in the night for a quick trip to the bathroom, but sometimes, it doesn't. I start the 'sleep now' when I decide to turn off the light and sleep, but it sometimes doesn't record my sleep from that time. To get sleep details, it needs to be longer than three hours (I think it's three). I was watching a thriller on TV, very absorbed, and found that the watch had recorded me as being asleep. Despite the excitement, my heart rate didn't increase. She's not moving, must be asleep? I haven't seen a murder/crime programme yet where Forensics download the fitness tracker data to narrow time of death, but it surely can't be long now. 

Recording active minutes is another issue. If you aren't doing anything it can automatically recognise as exercise, it relies on heart rate being up in the cardio zone consistently for ten minutes. I quickly found I could work in the garden until I felt wobbly and light-headed from the effort, but it wasn't recognised as exercise or active minutes, and if I was working in one place, taking occasional rather than continuous steps, not recording steps either. FYI Fitbit, pickaxing bramble and sedge roots really is effort. Maybe I should experiment with recording it as aerobics or something.

it's been three months since I started wearing it. I still cannot conceive of managing 5000, let alone 10000 steps a day and I've found it easy to be so focused on what I'm doing that the hourly 'shift yer bum' buzz goes unnoticed too. It will be interesting to see if continued use changes anything.

Something For Nothing

For the past few years, I have been brooding over the issues of volunteering and the widespread perception that the arts should be free. A while ago, the Universe delivered three items for consideration within the same week: a dancer friend had a well-deserved rant over yet another person who wanted her to put on a show for free, and two Radio 4 discussions, one about whether we have a moral obligation to give a percentage of our income to charity, over and above volunteering or donations to charity shops, and another on whether we owe the arts and artists a living (which was primarily about taxes used to subsidise the arts).

Of course, as a dancer and crafter, I consider the arts as essential and life-enhancing, although I am aware of a few people (mainly men) who are all about sports and couldn't give much of a stuff about anything else. Don't get me started on the emotional blackmail inherent in most charity campaigns, especially those where you are asked to take a no-make-up selfie or film yourself being deluged in a bucket of iced water, and then post the resulting film/photo having paid a contribution. They raise a lot of money, but I notice many people are doing it under peer pressure, to avoid the adverse judgement of their friends and acquaintances. When I become a multi-millionaire, I shall take great pleasure in subscribing to all of the charities which tug at my heartstrings and will buy lots of arty, crafty presents. In the meantime, I mainly give in kind - I source some materials from charity shops, and give the occasional workshop or performance for 'free'. I admit, I do enjoy the 'feel-good' factor brought on by a spot of altruism, and charity events are often very sociable and fun. However, I earn very little and am not eligible for any benefits. Warm feelings are lovely but they don't pay the bills. A girl's gotta live on something, and to give back, you must first have received.

My brooding was originally triggered by another set of three events: there was a fresh round of waffle about the 'Big Society'  in the media, I attended a presentation by the Ceredigion Association of Volunteers, at which they stressed that volunteers should never be left 'out of pocket' but admitted that many charities, understandably, did not pay travel or parking costs if they could help it, then I received a flurry of requests for belly dance entertainment, none of which would pay even travel costs ('we can't afford to pay you but please bring your dancers, you can do it for the exposure/experience and advertise your classes', etc). I expect all dancers and musicians are familiar with this one. It seems that artists are not the only ones - writers and speakers are also expected to be willing to work for nothing.

Why do people think entertainment should be for free? Answer: Because they can usually find someone, somewhere, who will volunteer to do it for free. Occasionally, that includes me. But there is a difference between someone who wants work done for free because they don't really value the training, skills and experience which lie behind it, let alone the costs incurred in terms of travel, equipment, costume and so on (and when it comes to entertainment, don't regard it as work because, hey, you do it for fun, right?), and the third sector charity and not-for-profit organisations who rely on volunteers to be able to get things done.

It's amazing just how much voluntary work goes on and, in some cases, is utterly taken for granted. Last year, I saw a local charity advertising for a qualified accountant to be a voluntary, unpaid, full-time financial and administration officer. I suppose they might have got lucky and found someone qualified but retired and looking for a new interest in life. I also saw a job ad for a full time volunteer for another charity which would involve a lot of local travel, in your own car, for which they paid rather less than the current tax-allowed expenses rate of 45p per mile. Considering the poor state of many of the local roads and the increased wear and tear this causes, it hardly seems fair.

In fact, many people pay for the privilege of volunteering as they incur costs which are seldom, if ever, repaid.  You may give your time for free, but transport between home and a primary place of work is not an allowable tax expense, so you wouldn't usually get travel costs if you are based in one location such as a shop or office. You make some cakes or biscuits for a charity event for free, despite the costs of ingredients and fuel to cook them. You might perform at a charity event, but have to pay a concessionary ticket price for the evening on the basis that you'll be watching the other performers. If you organise an event, you may make phone calls and extra visits to a venue, create posters to advertise it and print them - for free.  Perhaps you buy cheap yarn or fabrics to make stuffed toys or little hats for premature babies. Most of the data collected on wildlife such as birds, butterflies and moths is done by by volunteers, giving their time and expertise, buying their own equipment, paying their own fuel and parking costs. Sadly, all of this support is not generally considered as 'giving to charity'. You do it for love, so it's dismissed as a 'hobby'. But time is money. It would be fascinating to know the total value of casual work done for charities in the UK.

I believe that money isn't everything and you should do what you love. You never know where these things will lead. I've done a few performances where we dancers were well looked after in recognition that we were donating our services while others were donating money, and we've had a wonderful time. I like to barter my workshops for others' workshops or services; giving and receiving time and services in lieu of paying or being paid seems like a fair exchange. Getting something out for putting something in, rather than feeling used, is what makes all the difference.

Last year, I found a local Age Cymru Over 50s gentle exercise class and joined in just so that I could meet some people in my new area. It was very cheap, huge fun, and finished with chat over tea and cakes. As a bonus, it has led to a couple of engagements to talk about belly dance. I was very impressed that the exercises were mostly seated, so properly low impact, safe and effective. The social side is also important, fostering new friendships and support networks. Then I had the opportunity to train as a LIFT (Low Impact Functional Training) leader for Age Cymru, so I took it. I've completed and passed the 4-day course, and also updated my emergency first aid during a volunteer day. The training course was extremely well put together and delivered, with very good supporting materials. I've already covered a couple of classes for other leaders who are on holiday, although I'm still waiting for my pack of props such as exercise bands. I may not be paid for my time, but I get to do something fun which can make a positive difference to people's lives. It's difficult to put a value on that.

The Joy of Movement

One of the most frustrating things I'm finding about my osteoarthritis (OA) is, amazingly, not the daily pain and limitations on movement (although that's bad enough), but the fine line between doing enough and too much.  It's unpredictable on any given day how much will be too much, but I still the need to move and exercise because I know that without it, I will seize up altogether and that will be even more painful. I had some physiotherapy for my knees, which woke me up to the need to strengthen my quad muscles and pay attention to my knee tracking. The Skinner Releasing Technique (SRT) Workshop last year changed my view of somatics from a word which I read and puzzled over, to something real.  It awoke my curiosity in how I and others move and the links between movement and context, environment, emotional and physical states and the senses.  The realisation of how my OA is going to be a permanent feature of my life started a grieving process, of a sort.  Once over the initial upset, I knew I would have to start to listen to my body and rethink movement, learning to move in a different way.

After the success of the SRT workshop, a new series of somatic movement workshops started at Penpynfarch studio.  Unfortunately, the state of my knees and the timing of the operation on my foot meant that I have missed four out of the seven so far. Now my knees and toe/foot are improving, I'm driving again, and I need to dance and move!

Somatics refers to the link between the body and mind and its influence on movement. During the 20th Century, it developed into a broad field of approaches to awakening awareness and gaining a deeper understanding of the whole body in motion, using various techniques such as breathing, visualisation and various sensory stimuli. Some of the methods aim to reduce or eliminate chronic pain.  I can see how this could be the case for pain caused by poor movement habits, which can cause imbalances and tightness in muscles over time, pulling the body out of alignment and affecting posture and gait. I'm not sure how effective it could be for pain caused by OA, but it will make me think about the way in which I react to the pain in terms of body movement.

I love serendipitous coincidences!  As I continue my work to try and improve the function of my toes and knees, a fortnightly contemporary dance class started locally through Arts Care Gofal Celf.  It's really more of an extended warm-up and technique session for the youth performance group, but it is taught by a great young teacher who knows my background in dance and is happy for me to work differently at the back, playing with movements to adapt them to my capabilities, skipping those which would frankly be unwise. Each week I can safely test my limitations, explore the limits of my movement and do a little more.  I find that with a hot bath and an extra hour in bad the following day, I get a good 24 hours post-class reprieve from the worst of the OA symptoms and can feel the strength and flexibility creeping back into me, in a way that physiotherapy doesn't supply.

With the somatics workshops and the contemporary dance classes, there's a lot of floor work.  I'm suprised at how much I'm enjoying stretching, breathing, listening to and working with my body.  I've become fascinated with the healing process for my toe. Yes, it is highly subjective and apparently completely self-centred, but doing it with a group also provides insights into how others think about and experience movement. Who knew that rolling around on the floor could be so good for you?

False perspective, toe on window ledge; playing with extension of tree shapes

How to Let Go

I often get stuck during choreography, as I start to over-think the movement and get too caught up in trying to make something work.  Sometimes it's good just to set a few rules, then let go and improvise.
I was flicking through my workshop notes and musing about some choreography (like I do), pondering intent, order, chance, improvisation and mindfulness.  I found my notes from a dance/movement workshop I attended in the middle of nowhere near Llandysul last summer.  Not belly dance (for once) and not just any old workshop either.  I had the great privilege to attend a small workshop on Skinner Releasing Technique (SRT), given by Robert Davidson, one of the seminal teachers of the technique.

I had previously come across a mention of SRT when I was doing some reading into kinaesthetics. It is an approach to dance and movement training developed by Joan Skinner in the early 1960s. The following extract is a very good description from the Skinner Releasing website:

"Skinner Releasing Technique™ is a gentle but powerful system of movement training that encourages a deepened sensory and imaginative awareness of the body. Through its use of improvisatory movement, guided by visualised imagery, music and touch, it also awakens creativity and imagination. SRT teaches the fundamental physical skills and awareness that underlie almost any style of movement and dance.
We're all born dancers, with innate coordination and animal-like grace. As time goes by, we tend to lose touch with this natural ease. Muscles tense unnecessarily, and our alignment goes askew. The Skinner Releasing Technique™ (SRT) lets us practise letting go: letting go of stress, letting go of unnecessary holding in our body, letting go of preconceptions about what is supposed to happen, letting go of fear of awkwardness, letting go of the belief that we don't have the right body for dancing. We let go of habitual holding patterns and habitual ways of thinking in order to let something new happen. Eventually, we find energy and power. We rediscover our natural alignment, improve strength and flexibility, and awaken creativity and spontaneity."

Oh, so true!  I hadn't realised it, but the more my knees and feet hurt, the more I was holding myself, tensely ready to adapt or stop movements when it was painful.  Trying to dance with all that tension wasn't working in terms of avoiding pain; all it was doing was reducing flow and freedom of movement.

We worked with awareness of different body parts and qualities of movement such as sponginess, skating or gliding, leading movement from different parts of the body by imagining puppet strings attached to the head, elbow, wrist, hips and melting down to the floor and up again.  I found that I had let my tension build to the point where I could scarcely relax and release my shoulders and arms on demand! I discovered that if I let go of the tension and used a wall or corner for support, I could flow and melt down onto the floor without hurting myself or my knees.

It came as a shock to realise that it had been 20 years since I did any contemporary contact-style improvisation. I don't remember enjoying it as much as I did during the workshop.  I think I used to be too preoccupied with trying to get it right and create something.  It was still about me, and the revelation, the 'light bulb moment' from this workshop was: it's not about you.

As far as my belly dance is concerned, I've realised that there needs to be an element of release in the movements, as tensing and grabbing for a move often reduces isolation and flowing transitions from one move to the next.  When improvising, it's important not to try to think too hard about what to do next. It's not about you, it's about the music, so let that lead you. The heightened awareness of body and mindfulness in movement can result in self-consciousness and doubts as the inner voice emerges. You have to let go of all the self-talk and just explore your body's movement, and enjoy!

Finding a Balance

My consultant's appointment eight weeks post-op revealed how stiff my toe is still, despite my efforts with my foot physio exercises.  As I posted before, I wasn't sure whether I was doing the right thing, and the consultant agreed that I should have some time with a physiotherapist on an urgent basis. After nearly two weeks and several phone calls to chase up my referral, and then chase up the lack of appointment letter, I had my first session last week and my second session yesterday.  It was good, but hard work and painful at times. Before physio, I had no pain when I was just sitting doing nothing.  I was in so much pain by the time I got home after the first session that I took some painkillers, sat on the sofa with a drink and woke up a couple of hours later covered in cats.  There's a very fine balance between doing enough exercise for osteoarthritis and too much, and it's impossible to know where the line is on any given day. The following morning, I felt as though I'd been hit by a truck.  My knees ached, and the scar along my toe had gone from being a healthy, pearly flesh colour to being a dark pinky-purple slash, with a lumpy, shiny pink zig-zag running up it where the internal stitches are and a suffusion of darker greyish purple under the skin on either side.

It turns out that the exercises I have been doing are all good, but don't work the toe and foot hard enough. Also, it might still be early days, and it could be that the lump of bone which looked as though it was limiting the movement wasn't the only limiting factor.

The massage needs to include pulling the toe out to increase the joint space, and gently working it up and down. It feels good when the physio does it and I can't quite reproduce that for myself, probably because it's my foot, so I hold it at a different angle. I was already massaging the tendons involved in moving the big toe, but I should work a bit more where I can feel the stretch and tension when I try to move my toe.  Trying to bend and straighten, lift and lower the toe against resistance is really hard and painful, but it's only for a few repeats.  And I should hold a stretch against something solid (for which I use the end of the bath - the hot water makes it so much easier!).  This seems to be effective in a very small, slow way. I'm still trying to get back the small degree of flexibility I had before the operation, so every millimetre counts!

The real trick with all of this is to find exercises and work to a level which does not cause or increase symptoms of, in my case, pain, stiffness and inflammation, and it is particularly difficult when other joints are also a problem. I also notice that in physio, we only work the 'problem' side, but exercises should be done on both sides to keep the body balanced.

I was given a resistance band to do some leg exercises.  One end is anchored around the leg of a table, the other end has a loop in which I put my 'bad foot' ankle. Standing with my feet together so that the band is taut, I then do sets of 10 repetitions moving the leg out and back in a cross shape forwards, out to the side, across to the other side and backwards.  The resistance strengthens the working side, but also pulls on the supporting side which has to work to balance and to counteract the resistance pull of the working side. It's quite a stiff band, and the table starts to move across the tiled floor.  It is an easy exercise, but I found it really tough on my bad knees and almost immediately, my right knee went into flare. My left knee is better than it was after the flare which started in June, but still not great, so now neither knee supports my weight properly.  It's times like this when I start to become sleepless, partly through pain, and partly through worry that my dancing days will soon be over. But I'm not going to give up without a fight, so if three reps every third day is all I can manage to start with, that's what I'll do. 

The second physiotherapy appointment allowed me to have some fun (and muscles going for the burn) with wobble boards and a rebounder/trampoline (just bouncing a little stretches the toe joints), since I don't have those bits of kit at home. After that, both my knees were truly in flare.  

As physio is not supposed to cause or worsen symptoms, it was decided to switch to hydrotherapy. I had my first appointment yesterday.  The lovely warm pool was very much more gentle on the knees and I had a pinging sensation in my toe (in a good way) when I was doing a gentle jog up and down in the water. Even though I felt good afterwards, by the time I had done a small shop around the supermarket, my knees were agony and I was wiped out for the rest of the day. Just pass me the painkillers. Next week I have a hydrotherapy appointment first thing, then a drive and a somatic movement workshop.  I might be being a bit too ambitious, but I really need to be able to stand, walk and dance again.

The other exercises mainly involve balance challenges, which, I've discovered, are an important component of rehabilitation following lower limb injury or surgery.  They make the feet work harder, but also involve working the whole leg and the core muscles quite intensively. I'm finding them very difficult because of the pain and weakness in my knees. My balance has deteriorated noticeably over recent years. I've decided that I need to do more, and add more balance challenge exercises into my classes. This made me look back on my notes about balance and do some more reading, which will be the subject of another post at some point.

I have a kind of love-hate relationship with these exercises, in that they are useful and effective, but I find them difficult and don't really enjoy them.  In theory, the starting point is 5 minutes, building to 15 minutes, but like the 10 reps starting point, I would start lower.  If you want to do these too, set up a space where you won't hurt yourself or damage anything else if you fall over, although the idea is that you don't let yourself fall - have a chair or stand near a kitchen worktop which you can use for support. Or heap cushions and pillows around you so that if you do crash land, at least it's soft!

Standing on one leg
It sounds simple, doesn't it?  Part of the trick is to start the balance by checking/correcting your posture, then transferring your weight to your supporting leg.  To start with, lift your working foot only a little way from the floor, and lift your arms to the side to help your balance.

As you get better, you can make this more of a challenge by:

• Closing your eyes.
• Lifting and lowering your arms.
• Passing a small ball around your body.
• Lifting one leg and passing the ball under your thigh.
• Bending and straightening the supporting knee.
• Moving the working leg to the front, side, back (away from the centre line of the body).
• Standing on a cushion or something spongy.
• Rising onto the toes of the working foot.

Any exercise done on one leg involves some degree of balance challenge, but sometimes it's good to play with being deliberately off-balance, extending and moving legs and arms around while tightening the core muscles and trying to find counter-balances.  It doesn't matter if it looks ungainly, you are working hard!  I used to do this in contemporary class and was reminded of it in a workshop by Galit Mersand at Fantasia last December.

I don't think I've ever truly appreciated ballet barre exercises until now.  The barre is just there as a light assistance to balance.  The exercises work the legs and feet intensively. I use the kitchen worktop as a barre, and do just a few demi pliés and battements various, an odd stretch and feeble rise here and there. Just a few, until my knees start complaining that they would be so much more comfortable were I to lie down. I can currently cope with about five minutes.  Still, it's better than nothing and good to start low and build gradually, however depressing it may be that I feel so utterly and pathetically puny. This month is going to be physically tough!

Getting Back on My Feet

When I had the cheilectomy operation on my foot at the end of July, I was warned that the success of it would be largely down to me.  After the first two weeks, where I was advised to keep the weight off it but do plenty of point and flex exercises (as described in a previous blog post here), I was told I should get onto it, mobilise it, use it even though it hurts, and it should start to respond. I don't normally hold with the 'no pain, no gain' method of doing things, but accept that movement will hurt at the moment and it's okay.

It healed very well in the initial two weeks, and I had high hopes that I wouldn't need to go back. Since then, despite doing my daily physio exercises, it's not really making a difference except in terms of producing pain (lots, as well as throbbing, stabbing, stinging, prickling and other strange sensations which I dismiss as part of the healing), stiffness (quite a bit) and swelling (a little). I wonder if I'm being too aggressive, or not working it hard enough. Or perhaps I'm just being impatient; after all, the other tissues will be tight as well after years with a limited range of movement in the big toe.

I am hoping that I shall be able to start dancing and teaching again from the beginning of November, which means I have a lot of belly dance rehab to get on with now that I am back on my feet. It still depends partly on how well my knee supports my weight, but that's a different story.  So, as part of the occasional 'use it or lose it' series, here are my foot and ankle exercises.  I do each exercise at least once a day and I don't do all in one session as it takes too long and after a certain point, I can't cope with the pain.

I find as I get older, my feet need warm-up exercises before I go into any sort of pulse-raiser warm-up with involves stepping, otherwise my feet quickly start to hurt. A selection of these exercises work well as a warm-up and are also very useful if you suffer from plantar fasciitis, which used to be one of the banes of my life until I started dancing regularly again.

Some of these exercises are best sitting or standing, and some can be done any old how - I like to lie on my back with my feet in the air for the point and flex and foot circles. Do feel free to join me and comment on them. These may not be good for you if you have pinned, fused toe joints. Remember the rules (if in doubt, leave it out and ask a medical professional first, stop if it hurts, go for quality, not quantity - and so on).

Humps
This exercises the tissues of the arch.
Sit comfortably with the feet flat on the floor.
Tense the underside of the foot, as if you are trying to make the balls of your big and little toes meet your heel. You should see your arch lift a little.
Relax. Repeat, alternating feet to work both feet equally.

Pencil Pick-Up
This isn't the exercise for you if you have long or slender toes and find it easy to use them to pick up a pencil on the floor. (On the other hand, use it or lose it! Do it anyway, occasionally, just to prove you still can!)  I've got short, plump toes and have never been able to pick up a pencil, so it gives me a lot of exercise trying (and failing) to curve my toes around the pencil enough to lift it!
Pencil (or pen) on the floor. Use your foot to turn it and then try to curl your toes over it to pick it up.  Keep trying with both feet.
I have to say, I get bored after a few repetitions and find the next exercise rather more interesting ...

Scarf/Towel Drag
This is a great one for doing while you're sitting watching TV, because apart from using each foot alternately, it doesn't really need any thought.  Place a scarf or towel stretched out lengthwise on the floor in front of your feet.  The aim is to use your toes to grab a bit of the scarf or towel and drag it towards you, trying to keep your heels more or less in place, until the length has been scrunched towards you. For me at the moment, a tea towel is enough!

Roll-a-ball
I have a smallish ball (about twice the size of a tennis ball) which I roll around under my feet, bending and stretching my toes as I work it around. Also a good one for sitting in front of the TV.

Point and Flex/Good Toes and Naughty Toes
Stretching the ankle to point the toes away from you, then bending it to bring the toes towards you, the full sequence explained here

Foot/Ankle Circles
I like this range of motion exercise very much and do it frequently. It was one of my standard exercises along with point and flex for the couple of weeks when I had my feet mostly up. Seated or standing, hold the foot off the floor, circle both clockwise and anticlockwise a number of times, drawing a circle with your big toe. Repeat for the other foot.

Alternate heel lifts
This can be done standing, with the full weight on the feet, or sitting to take some of the weight off. With the feet in parallel and flat on the floor, lift one heel and push the ankle forwards so that you are on the toes. Be careful not to sickle the foot (i.e. allowing the ankle to curve out sideways, putting more weight onto the little toe). Lower the heel and repeat with the other foot. Work alternately and speed up as the feet feel warmer, switching feet so that there is a moment of suspension when both feet are on the toes and only ever one heel on the floor.

Working through the Foot
Dancers in my classes will be familiar with this one. Again, it can be done sitting, but it is more effective standing up.
With feet parallel, lift one heel so that you are on the toes (as in the previous exercise) then push off with the toes to lift the foot slightly.  Note, it is not a kick, and be careful not to cheat by lifting the foot.  Place the toes back down, then the heel. Repeat on the other foot.
You are aiming to peel the foot off the floor from heel to toes, then smooth it back onto the floor from toes to heels.When it gets to peeling the toes off, imagine that you are going from a low heel to a very high heel, then onto ballet point (but without putting any weight on the toe, very important!), and reverse from high to low heels as you stick the foot back down.
You can repeat this in first turnout and second positions, and speed it up so that you are padding from foot to foot with the knees bent. One of my lovely contemporary dance teachers, Erica Stanton, taught me this as an effective warm-up for the legs and feet and it really is!

Bends and Rises
This is a standing exercise with two levels of difficulty.  In both, there is a balance challenge as well, so remember to check your posture!
In the simple version, you stand in parallel, bend both knees, straighten them, then rise onto your toes, and back down again. Bend and stretch. Simple.
The more challenging version has a circular feel to it:
Bend both knees, lift your heels, straighten knees, lower your heels.
Repeat a few times, then reverse:
Lift heels, bend knees, heels down, straighten legs.
Repeat a few times.

Well, I'd better go and do some instead of sitting here writing about them ....

Best Laid Plans ...

Anyone following this blog (all two or three of you!) will have noticed that the series on salads stopped abruptly about half way through with a couple still in draft, and I haven't been on here for about 6 weeks.

Well, the best laid plans, as they say .... My knees were already feeling a bit sore and creaky by the second week of June, and then suddenly my left knee flared up and would not take my weight properly.  I started to take my painkillers, then worked up to the maximum dose without the desired effect.  When I ran out, I went to the GP and got more, stronger, and had an interesting discussion with the pharmacist.  As she put it, 'once the pain door opens and you step through it, it's very difficult to shut it again'.  In other words, you have to take the maximum dose in anticipation of the pain in order to get on top of it and stay there while you rest, ice, elevate, compress, apply heat, etc to the joint and carry on doing range of motion exercises.  It rather begs the question about how you know when to stop taking painkillers. At the time, I had a month's worth of dance classes to give before the summer holidays, and the Essential Skills course I was attending to finish. I rested as much as I could, cancelling workshops and haflas which I had intended to go to (curses!), and taking a higher dose of painkillers than previously, which left me feeling a bit woozy. Everything else pretty much went on hold until I could stand to stand.  No work on the garden, no sorting out, cleaning and redecorating, little cooking, the bare minimum of housework. The weather has been outstanding - I don't remember it being so hot and dry for so long since I've lived here, but I could not enjoy it. To my mounting frustration, the flare would not switch off and still hasn't.

I have found a new friend in a physiotherapist/Pilates/aerobics teacher who works in a local community centre where I teach. She has been giving me some physio and Pilates exercises, in exchange for belly dance lessons. The physio helps, but only temporarily, in the same way that doing my range of motion exercises in a hot bath leaves my knee feeling great - until I put my weight back onto it the following day. We seem very much on the same wavelength with regard to anatomy.  I love the peer-to-peer sharing and that I can explain belly dance moves in terms of the muscle groups being engaged, and we have interesting little discussions, like the possible role of the iliotibial band in patellar tracking.

Last week, I had my long-awaited operation to help with the osteoarthritis in my right foot.  When I was 17, I came down hard and with a horrible click on my right big toe in gymnastics class, just before the summer half-term holiday.  The joint swelled up, but the usual advice at school was to run it under the cold tap, take an aspirin, stop making a fuss, stiff upper lip. There were signs that the joint had been damaged and movement was limited by my late 20s.  (My GP at the time told me it was gout, and that if I didn't accept his diagnosis, we had nothing further to discuss.) Thirty five years later, and the bone around my big toe joint had grown so much over the years that I could scarcely bend the toe - hallux limitus/rigidus. When walking, I could not use my foot properly, and it was affecting my gait.  Dancing was painful, as my foot would 'sickle', my weight transferring to the outside of the foot and causing pain in my foot, ankle and knee and back.  I persuaded the consultant to do a cheilectomy, cutting away the excess bone with a view to restoring range of motion in my big toe.  The joint shows severe osteoarthritis, and this may only be a temporary measure; normally they would pin and fuse the joint, which would be sufficient for walking but not really for dancing, and could still affect my gait and create knock-on effects for my other joints. Unfortunately, I'm not yet a candidate for surgery on my knees.

I was so nervous when I went into hospital, but there was no need. The orthopaedics unit at Prince Philip Llanelli seem to have it all worked out. I wouldn't say I enjoyed it - that would be a bit strange, but I think it went as well as it possibly could have. The nurses were nice, efficient with their rounds of observations and concerned for our comfort. I was in a ward with other lovely ladies, all in there as day or overnight cases for foot related problems. We had our details checked, saw the anaesthetist, physiotherapists, consultant/surgeon and one by one had our pre-ops and went down to theatre. I had a spinal anaesthetic, and meant to take an interest, but with a sedative and some headphones on, I went to sleep and woke up in recovery, with a brief snatch of Dire Straits' 'Sultans of Swing' before the headphones were removed by someone asking if I was awake. I suppose I must have been, but was enveloped in pink fluffy clouds of deep relaxation and don't remember going back to the ward. I woke up properly being transferred to bed with my foot encased in a big, padded bandage and resting on an extra pillow. I had a late lunch of a tuna sandwich with a cup of tea, dinner was a potato, almost baked to oblivion, with a plain salad, and drank an entire jug of water. A friend came at visiting time and I went home at the end of visiting time with her, the only one on the ward to go home the same day.

The idea was that I would have sorted out the garden and put up my swing seat, so that I could easily potter out there and lounge in the sunshine, and make it easy to do some moth recording.  As it is, everything has exploded into growth in the six weeks where I couldn't work on it, my swing seat is still in its box, and anyway it keeps raining! I did manage to pick up a couple of bolster cushions from a charity shop, did my best to tidy up a bit and remove the main trip hazards, and found a couple of extra pillows for the foot of my bed.  So now I can lie comfortably on the sofa, with my foot raised higher than my hip, or lie comfortably in bed, and the maximum dose of painkillers sends me to sleep, with the added bonus that my knee is being rested too.  I have to keep my foot clean and dry at least until I see the consultant 2 weeks post op, staying at home with the weight off and the foot up as much as possible, but doing my range of motion exercises for my knee, and various exercises lying down with my legs up to promote circulation (and work on my lower abs 'zip').  The cats have realised something is up, and are a bit worried by me clattering my way around on crutches and lying around sleeping.  They keep bringing me voles and are quite put out when I put the poor, dead, furry things back outside, repeating that I don't eat that sort of thing.

My foot is aching a bit, so I should stop sitting at the computer and go lie down again, although it's not possible to do anything creative in that position. In fact, it's time for bed. Sometimes, you just have to go with the flow.

Good Toes and Naughty Toes

I was looking back over this blog (and through my posts in draft) and I realised that I had started the 'Use It or Lose It' thread, then hadn't started adding exercises.
So, here is the first exercise, bringing back happy memories of early ballet classes, where it was called 'good toes and naughty toes'.  I remember much later doing this in contemporary class as well, although there it was called 'point and flex'. In ballet class, the 'good toes' were pointed with a beautiful arch to the foot, and the 'naughty toes' were flexed.  As you advance in ballet, you realise that the flexion has its place too and there's nothing 'naughty' about it.  I sometimes use point-and-flex in class as a warm up while standing, so that it has a balance challenge element to it. But for starters, let's do it sitting on the floor, so you can see what you're doing.

Remember the rules!

• I'm not a medical professional.  You are responsible for yourself.  If you're not sure whether you should be doing this, for example because of injury, recent surgery or long-term health issues, ask your GP/doctor, consultant, physiotherapist or other healthcare professional for advice.
• If it hurts, stop!  It's okay if the movement feels strange, or you can feel a slight pull, a bit of muscle ache or burn, but sharp pain in soft tissue or joints is not good.
• Be patient and gentle with yourself. Start with the easy exercises and work up to the more difficult versions.
• Remember that everyone has different strengths and weaknesses and that you are unique.  Don't compare yourself to anyone else.
• Work slowly, carefully and mindfully; concentrate on good form and don't rush the exercises. Quality, not quantity!
• Work both sides of the body equally, even if it's more difficult on one side or perhaps only one side feels as though it needs it.
• If you feel as though there's no challenge in the exercise, do it anyway, just to prove you still can.

So, sitting on the floor with your legs out in front of you.  No slouching, now!  Sit up straight, supporting your back against the edge of the sofa or an armchair if you prefer, or lean back, using your arms to support yourself.
How does it feel?  If you aren't used to sitting on the floor with your legs out, just doing this can be quite strenuous. You might want to sit on a cushion.  Are you warm enough? Floors can be chilly, so you might want a blanket, an extra jumper and keep your socks on. (I wonder what happened to my leg warmers?)  Easy?  Then sit up straight, using your core muscles to support you.  
 
In this position, you can see your legs.  Look at your knees and how they line up with your ankles and toes.  When you are relaxed, your feet may well flop inwards, and your legs may roll in so that the knees face each other.
Roll the legs out from the hips so that the knees face the ceiling, and then straighten the foot so that you could draw a line down from the knee to the centre toe.  This is 'parallel position'.
How does it feel?  Is it an effort to get everything lined up?

With your knees relaxed, flex (that is, bend) your ankles and bring your toes up to point at the ceiling. Try to keep the feet flat, as if they were pressed against a wall.
Now point the foot, first stretching the ankle, then down the front of the foot with the toes still flexed as if you were wearing high heels. Lastly, point your toes, stretching them away from you, without curling your toes under and keeping your middle toe aligned with the centre of your knee.
Work slowly, without sudden movements, and gently, stretching only to the point just beyond where you start to feel the pull.
How does it feel?  One of the things I noticed was that it felt as my skin was being stretched, it was so dry.  Slathering my feet with moisturiser really helped.
Notice how this movement also works the calf muscles.

The next stage is to repeat this with a straight knee. Pull the thigh muscles up and keep them tensed (contracted) while you repeat the point and flex.  You may find that your heels lift away from the floor as your calf muscles move. Practise one foot at a time and then both together in the same direction, and then with one foot flexing as the other points.

Ready for more? Flex (bend!) the knee as you flex the ankle and foot and straighten the knee as you point.  It's very important to keep the knee aligned with the centre of the foot, so watch as you bend the knee and the ankle that they are in line.  Bending the knee moves the foot towards the body.  Keep your heel in light contact with the floor.  Don't aim for a big bend in the knee. Again, start with alternate legs, one at a time, and then both at the same time in the same direction, then both in alternate directions.

Still easy?  Rotate the legs out from the hip joints and repeat the exercises in turn-out rather than parallel.
Then sit with the legs wide and repeat the exercises in parallel (knees and toes to ceiling) and turn-out.

Other variations:
You can do this sitting down and it is a very useful exercise if you have to sit for a long period of time, either at a desk or as a passenger during a long drive or flight, as the movement of the calf muscles aids circulation by helping to pump blood back up the legs (the 'venous return').
Standing up, on one leg.  If the balance challenge is too much, use a chair, wall or ballet barre as a support.  (Really, it's not cheating.  Wobbling all over the place and risking falling over defeats the purpose of the exercise!) 
Do it in the bath or the swimming pool (the flex and point is at the core of  the frog kick!)
Do it lying down with one or both legs raised, still paying attention to the alignment of knees and toes.

And do let me know what you think of the exercise and how you get on!

Use It Or Lose It/Belly Dance Rehab Exercises: The Rules

So, in preparation for posting the first set of exercises under the 'Use It Or Lose It' theme, here are some 'rules' for anyone wishing to join in (and for me too!).  These also hold true for dance in general, whether you are in class or practising on your own:

• I'm not a medical professional.  You are responsible for yourself.  If you're not sure whether you should be doing this, for example because of injury, recent surgery or long-term health issues, ask your GP/doctor, consultant, physiotherapist or other healthcare professional for advice.
• If it hurts, stop!  It's okay if the movement feels strange, or you can feel a slight pull, a bit of muscle ache or burn, but sharp pain in soft tissue or joints is not good.
• Be patient and gentle with yourself. Start with the easy exercises and work up to the more difficult versions.
• Remember that everyone has different strengths and weaknesses and that you are unique.  Don't compare yourself to anyone else.
• Work slowly, carefully and mindfully; concentrate on good form and don't rush the exercises. Quality, not quantity!
• Work both sides of the body equally, even if it's more difficult on one side or perhaps only one side feels as though it needs it.
• If you feel as though there's no challenge in the exercise, do it anyway, just to prove you still can.

Use It or Lose It!

Use It or Lose It

I had the strangest dream the other night, and it's one I've had before.  I was dancing (I often dance in my sleep) and I did the splits.  It was a vivid dream; I remember feeling the cool floor under my thighs and the stretch in my groin and hamstrings.  It's amazing how muscle or body memory persists - I haven't done the splits since the early 1990s.  Sadly, having a body memory doesn't mean I can still do it.  I don't know why I stopped practising the splits, but I know now it would be very difficult to work towards doing them again. And there are all sorts of other things I can no longer do. I wish I had taken the advice to 'use it or lose it' more seriously.

This loss of flexibility is seen as a natural part of ageing and it might well be, but it probably has more to do with everyday habits; use, abuse, misuse and lack of use.  It's not just use, but proper use which makes the difference.

I've had a problem with the big toe on my right foot since my late 20s, when it started stiffening up and the joint started to grow.  I came down with rather a 'snap' onto that toe in a gym session when I was 17 and although it was bruised and sore, it was just before half term, so it got a few days rest.  Now it doesn't bend enough for me to wear more than a lowish heel, and extended dancing makes my foot ache as I know I compensate for the lack of flexibility by allowing the ankle to sickle (curve outwards). I've had stiff knees for ages; they seemed to get really bad when I was driving for a few hours to commute here from Berkshire at the weekends. The X rays prompted by my sore right knee show that I have severe osteoarthritis in the knee and the toe joint.  On the other hand, it's not stopping me dancing as it seems better once I'm warmed up and dancing than lying in bed at night, even though I can't bend it very well.

While I try to lose weight and pop painkillers while waiting for my consultant's appointment, (which could be 3 or 4 months away), obviously I need to use and maintain or hopefully improve on any flexibility and strength I have. I haven't been offered physiotherapy - perhaps they think as a dance teacher I can provide for myself, although I'm not a trained physio!  So I've decided that I shall carry on with some careful exercises and record them here. Watch out, the first one (or more) will arrive soon!

Please feel free to join me, but be careful and gentle with yourself!  Your body is your responsibility!