Issue #362 – Wednesday, March 16, 2022
Keep on Moving – A Family Affair
by Joanna Fergusson
My mother has always been very active but alas, not so much recently. Four years ago, she underwent treatment for cancer. She already had osteoarthritis that was just about manageable, but the treatment aggravated it further. Due to the cancer, mum would have dizzy spells and would shuffle when walking, with her head and shoulders hunched over. The body changes dramatically with cancer and its treatment, but it’s not just the physical changes that occur, it’s also the state of mind. When mum came out of hospital, we did Pilates together. It was a slow process and although my mother was mentally strong and ready to regain her independence from those lost months, the body was not so willing.
We started with Pilates adapted for the chair as it was impossible for her to get down to (and up from) the mat. We began with breath work and posture alignment – neutral spine and gentle activation of the pelvic floor. We found her sit bones and reviewed her frame: collar bones, shoulder blades, hip bones and sit bones. I got her to envision reaching out of the crown of the head, lengthening the neck and spine.
To start moving, we began with head tilts to either side and chin nods, then gentle lifting of the chin, lifting the collar bones up toward the ceiling. We then brought in arm floats (I like to call them “snow angels”) – bringing arms to shoulder height, then up over the head and sweeping around to open the chest. Still in a seated position, we continued with “dumbwaiters” to encourage shoulder rotation and opening of the chest and to help bring the head and shoulders back into alignment with good posture. We were not only trying to undo four months of immobility but also trying to work with her slight scoliosis.
From the seated position, we concentrated on foot work, finding her pressure points on the feet, heel to toe working through the arches. We added in sweeping moves rotating the ankles in both directions and then rolling the feet inwards and outwards, rotating from the hip joints. We then progressed to sit-stand exercises, with controlled engaging of glutes before powering up from the chair. We used a chair next to a table (to give stability so she could support herself) and slowly moved away from the table so she was just engaging her legs to stand. This progressed to standing glute work, using a wall for stability, forward foot taps, side taps and leg extension work, making sure the supporting leg is stable and glutes engaged. Our goal was to advance this to “step ups”; unfortunately, her hips were causing her immense pain and she was struggling to walk short distances. She was then placed on a waiting list for a hip replacement.
Unfortunately, Covid then hit and the UK went into lockdown. She started using a walking aid to get around the house but was deteriorating rapidly with both hips causing pain. Fast forward a year and she ended up using private medical care and had both hips replaced. The next few months consisted of appointments and scans whereby just getting her in and out of the car was incredibly stressful and difficult, physically and emotionally.
We had been through the emotions of the cancer, the feelings of despair and sadness brought on by the fear of cancer and what it means, to feelings of joy having undertaken the treatment and being told you’re in remission. To have then put in all the rehabilitation work and rebuilt strength and stability, and then suddenly all of that was taken away as her hips completely disintegrated was devastating and overwhelming. Where before my sister and I would look to our mum for guidance and support, as you do when you’re young and growing up, we became the ones providing the emotional support she needed. Our mum had to trust us and to allow herself to be the one being cared for, for a change. While this was incredibly frustrating for her, this role reversal ultimately strengthened our relationship.
When she came out of hospital, my mother had complete muscle wastage. After checking into rehab for a week where she could have hydrotherapy, she came home to recover. After two months of respite, we started working through the exercises we had covered before and started sessions with her physiotherapist to get her mobile again. Her progression is a joy to watch; before her hip operation, she was dragging herself around the house with the help of a walking aid, and now she is walking unaided indoors and able to walk to the shops. It’s the simplest things but until they’re taken away from you, you never fully appreciate them.
Walking indoors for mum has been a lot easier, she feels safer as there is lots of support, furniture to lean on, walls to steer her, but the dizziness still plays its part. When walking outside, she still relies on her walker as it gives her the confidence to concentrate on her footsteps and glute engagement. I’m there to encourage her, to remind her to stand tall and lift her gaze, lift the chest, find and feel her feet and lengthen the spine. I feel lucky that I’ve been able to still support my mum in-person throughout Covid restrictions and throughout this whole experience for her. What I have learnt is that even as our bodies diminish and change with age we need to keep moving; unless we exercise the muscles, we lose them.
My own conditions and limitations have driven me to further my knowledge and apply my own training. I am fully qualified in lower back pain, exercise referral and exercise for older adults. The experience with my mum has enabled me to work with other clients who are also struggling with mobility issues and my goal now is to keep people moving with confidence and to help manage their pain effectively.
My name is Joanna Fergusson and I am a UK, Surrey based, Mat Pilates Instructor and Healthy Back Specialist.
I help people struggling with low back pain. I work with them to build strength and stability, giving them the confidence to do the things they love with renewed passion and determination. I love that I can make a difference in the world by helping people manage their pain and continue being active.
With over 10 years of experience of working with individuals who are in pain, I am passionate about the work I do. I studied with the UK’s biggest governing body for exercise professionals and my biggest accomplishment is qualifying as a Level 4 Back practitioner alongside being a fully qualified bookkeeper.
Life has to have balance, Pilates is not my only passion, I love nothing better than enjoying good food and good wine with loved ones.