J. Who Loves Walking Her Dog: A Case Study
A couple of weeks ago, I saw J. who had complaints of pelvic pain: her pain originally started on the right side, but now is affecting both sides, and on the left, it even goes down her leg. J. has been seeing her physiotherapist twice a week and finds it helpful, but feels that there is more. She sometimes goes to the gym for a workout but thinks that this can potentially trigger her pain. She loves walking with her dog and can walk for about 25 min without too much pain.
First, we had a conversation about pain as an alarm system and how with persistent pain this alarm gets more and more sensitive. We also spoke about choosing the right movement strategy and agreed that J. would try some more gentle movement, as well as slowly increasing the time she walks with her dog. She’d love to be able to do one hour walks as this would be beneficial for both herself and her dog.
Then I watched J. walking. One of the things I noticed was that J. was hardly moving her shoulders during walking.
When J. was lying on my table on her back, I noticed how her chin was directed more towards her right hip, and there was some tension in her neck muscles on the left side. I thought this was interesting: trying to find out more, I asked J. whether she had anything to say about her vision but according to her, there was nothing to report.
I moved on exploring the movement of her shoulders and found that her right shoulder was moving easier towards her left hip than her left shoulder towards her right hip. This diagonal movement is an important part of efficient walking. I asked more questions and we figured out that J. was always holding her dog’s leash in her left hand: she used to walk two dogs with both hands having a leash; while another dog was not there any longer, the habit of having the remaining dog on its usual side remained.
I suggested J. swap hands holding the leash from time to time and see how this would affect her walking and pain, but also notice where she looks while walking her dog.
When J. stood up and started walking, I invited her to observe how her shoulders and hips were moving in relation to each other. She found a new way of walking that felt light but unusual.
With help of observations and touch, J. got a new experience of carrying herself through life and she’ll keep noticing things she used to be unaware of, continuing developing a sensitivity that will allow her to make further adjustments on her own.
With help of pain education and pacing, J. will be moving more in the ways that work for her.
Notice that this time I didn’t do too much about J.’s pelvis, the part that hurts. I was trying to see what happens elsewhere and how this can contribute to the pain.
“The part that hurts is the most innocent. ”
We caught up with J. one week later. She told me that she already increased her dog-walking time to 35 minutes: she can be a bit sore but she knows she’s safe. She also noticed that while walking her dog she usually looks down. Now when she is aware of this, she can start changing this habit and this will positively impact her walking “posture” and release a good amount of tension in her neck. We’ll continue creating more small but important changes and over time this will make a big difference.