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stroke & neurological physiotherapy

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Exercise

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Life during lockdown is certainly a massive change from our normal life. Maybe you would normally attend an exercise class, go to the gym or for a swim as a way to keep fit and active. It may be that you also have a specific programme of exercises recommended by your physiotherapist to work on at home.

As therapists we often see that patient’s general fitness, muscle strength and endurance can diminish over the winter months as we are generally not as active. Therefore, it is even more important during lockdown to keep as active as possible and work on those home exercises and maybe that regular walk.

Motivating yourself to exercise regularly is for many people an ongoing challenge.

Here are a few top tips to help you to keep motivated. Through lockdown …and beyond!

  1. If it is a daily exercise programme try and do this at the same time every day so that it becomes part of your daily routine. If it’s a programme several times a week, allocate a day and time and add in to your calendar for the week ahead and try to stick to it.
  2. Break it up into bitesize chunks. Some people prefer to do their full programme in one go. For others this is too much so you could break it up into 2-3 10-minute sessions. Do what works best for you but try to keep to the same routine.
  3. Record your exercise for a while on a chart or tick it off on your calendar until it is established part of your daily/weekly routine.
  4. Reflect on how you feel when you have completed your exercises. How did your body feel? How was your mood? Did you enjoy the sense of achievement?
  5. Set goals for yourself. If you can link doing exercise to achieving what is important to you it can boost you to keep going. Discuss your goals with your physiotherapist.
  6. Anything is better than nothing. If for whatever reason (and this happens!) you don’t do so well one day, don’t beat yourself up. Get back on track as soon as you can. Start afresh the next day.

You can do it!

And remember that at Heads Up we are here to guide, support, and encourage you to achieve your goals.

We also have a new online exercise group for patients that have been assessed by us. It is a weekly class in standing and sitting aimed at improving general mobility, strength and balance.

Please speak to your physiotherapist or give us a call on 01306 888171 if this interests you and you would like to find out more. We would love you to join us.

 

 

 

Standing up and sitting down as a leg strengthening exercise

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If you are not doing as much walking around as you would like to after suffering a stroke or being in hospital then it doesn’t take long for your body to become de-conditioned and your muscles to lose some of their strength.

Any neurological condition such as cerebral palsy, stroke, spinal cord injury, multiple sclerosis or Parkinson’s will affect the ability of muscles to activate strongly and consistently and in a co-ordinated way.

One good simple way of strengthening your legs is just to practice standing up and then sitting down and then standing up again. If you make this a habit so that when you stand up in the mornings you incorporate three to five repetitions of simply sitting down again and then standing up, this is a convenient and easy way to get all the leg muscles working.

As we get older we tend to use the arms of chairs more to help us get from sitting into standing.

This is normal. However, if you have had a stroke then often one arm will become accustomed to pushing on the arm of the chair and the body then becomes twisted towards that side so that more weight is put on that leg, the stronger leg, and less on the other leg which has been more affected by the stroke.

It is important to have the feet fairly level and about hip width apart and this will help to give both legs the opportunity to take equal weight so that they both get the benefit from the sitting to standing to sitting exercise.

Familiarising yourself with your feet

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Familiarise yourself with the exercises in the previous blog “getting ready to be active”.

If you have muscle stiffness and reduced movement after a stroke or because of Parkinson’s, cerebral palsy a brain injury or other neurological condition regular small movements will help reduce discomfort from stiffness.

Priming the legs for standing up

Once you are feeling more alert and are more active in your body in sitting then firing up your legs in preparation for standing is a good idea. Firstly rub your thighs with your hands and then gently step one foot forwards a couple of inches and then back then the other foot forwards and then back. Do these small steps forwards with each foot five times and then take three or four really deep breaths in and out, making the out breath last for as long as you can.

Repeat five small steps forwards and backwards and then bring your nose forwards over your knees as far as you can. Keep your head up and choose a spot on the wall in front of you to keep looking at so that your head doesn’t drop down. Do this movement slowly three times. Repeat once more the five small steps forwards and backwards with your feet.

Now your body and legs are primed so that you are ready to get up and go. Before you get up check that your feet are level and hip width apart and focus your attention on your feet as you stand up.

Sitting less – moving more

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Winter 2016 – 2017

In this series of simple exercises and advice about keeping mobile during the winter months, there are some that people will find easy and also there are some people that will find everything hard.

As we are all different and have individual ways of moving, there is no substitute for the specific advice and individually tailored exercises which are given during a treatment session with one of our clinical specialist neurological physiotherapists at heads up!

If you are in any doubt about the suitability of any of the exercises suggested then please do not do them. Ideally the first time you do them it would be helpful to do them with another person. All the exercises suggested are best performed as part of a daily routine, for example after brushing your teeth in the morning so that you do them regularly and consistently.

Although we are unable to give specific advice over the phone, we are always happy to talk to anyone who feels that an individual assessment would be useful.

If you are stiff after suffering a stroke or because you have some other neurological disorder affecting your muscle stiffness such as Parkinson’s or cerebral palsy or multiple sclerosis then some simple daily exercises can help alleviate stiffness. Regularity is key and making exercises a part of your daily routine.

Getting ready to be active

It is said that sitting is the new smoking. Sitting for prolonged periods is especially detrimental to health. It is often difficult for people who have neurological disability to move around and standing up may not be easy.

It is difficult for anybody to go from being very inactive to being active so if you have been sitting for a long time, it will be easier to get up if you wake your body up a bit first. So sit up as tall as you can to begin with, then take three or four deep breaths in and out, bigger each time and keep sitting up tall as you breathe out. This wakes up the muscles of the back and the tummy.

Next look over to the right side and then to the left, moving your head gently and slowly to each side, three times each way. Next sit up as tall as you can then blow to the left and then blow to the right and do this twice each way. Then repeat moving the head from side to side slowly turning as far as is comfortable each way.

Place your hands together or support one wrist with the other hand and gently reach both hands forwards over your knees, gently bringing your back away from the back of the chair and do this five times. Take another three deep breaths before you take both hands forwards and then over to the left and then over to the right side three times each way.

These exercises prepare the body for activity and are a useful way to get ready to stand up after you have been sitting down for some time.

3 tips: improving the quality of your standing practice (advanced)

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Create a checklist

Have a checklist in your head about the quality of your standing. The aim is a good posture, which allows a relaxed standing position, with weight evenly distributed on both feet and the back in a neutral position.

Everybody is different and people find individual reminders useful. Some common ones are “feet level, hip width apart, knees soft, bottom tucked in, tummy strong, ribs gently down but breast bone up, shoulders relaxed with soft arms and head up with chin gently tucked in and back of the neck long with crown of head up”.

2. Create and develop sense of your posture

Developing your own personalised checklist (with the help of a neurological physiotherapist ideally) and using a mirror if this helps you. A mirror may help to create and develop your sense of your own posture. Keeping still in your “best” posture and closing your eyes to enhance your appreciation of where your body parts are in relation to each other will help this improved posture to become more familiar and natural to you.

3. Joining posture with movement

Thinking about posture and movement is the next stage and developing strength in the trunk muscles. An easy way to do this is to take something with both hands from a shelf in front of you, or simply touch the wall in front of you or stand in a door frame and touch the frame either side at about shoulder height and then squat down and touch the floor with both hands or put an object on the floor, then pick it up again.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

3 tips: improving the quality of your standing practice (intermediate)

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Standing and using your arms

Think about HOW you stand up. Ideally weight should be evenly distributed on both feet and although using hands on the arms of a chair is something we would often do, if we take a lot of weight through the hands to push up then we are not asking the legs to work as hard as they might, so we may miss out on opportunities to strengthen the legs.

2. Stand up tall

When you are standing up make sure that you stand up as tall as you possibly can before you start doing anything in standing. Think about having strong legs and your hips forwards, chest lifted and head up with shoulders and arms relaxed. Say to yourself “stand up tall”, or “heads up! bottom in!”

3. Weight on each leg

Having checked that you are standing up tall, gently take more weight over to one leg so that you are putting 75% of your weight on one leg and 25% on the other. Hold this position for three seconds and then change so that there is more weight on the other leg.

Do this five times on each leg. Try to keep your body up tall and hips facing straight forwards.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities.

3 tips: Increasing the time you spend in standing

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

  1. Identify a daily activity

Identify an activity you can do in standing as you become more confident on your feet. Examples of this may be brushing your teeth, washing your hands or brushing your hair.

2. Listening to music and watching TV

If you listen to the radio or watch television, stand up either during a news bulletin or during the advertisement breaks. If you listen to music, identify a particular song you like and try to stand up for the duration of the song. You can then build up the time by adding other songs.

3. Build on your confidence

As your confidence improves in standing, increase the number of times you stand up in the day. If you cannot stand for long then try and stand more often. This will build your confidence and strength.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

3 tips: improving the quality of your standing practice (introduction)

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Foot control

If you are able to move your feet forwards and backwards with reasonable control, then do this a few times with each foot if possible, whilst you are sitting down, before you get ready to stand. This warms up the leg muscles and gets them ready for action.

2. Distributing body weight

When standing up try and get the weight transferred evenly over both legs. Think “is my weight even? How much weight have I got on my right foot – press a little into the floor with your right foot if you can as you think this, then do the same on your left foot.”

3. Turning your head

Stand up as tall as you can, bring your hips forwards, raise your chest – imagine a light on your breast bone shining straight in front of you. Lift up your head and if you feel stable enough, slowly turn your head to look over to one side and then the other side. Do this three times each way.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

3 tips: preparing for standing practice (intermediate)

by Leave a Comment

This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Slow breathing

Take three slow deep breaths, sitting up as tall as you can, as you breathe in through your nose and out through your mouth. Do this five times.

2. Sitting tall

Sit up as tall as you can, imagining a very strong elastic band through the top of your skull pulling you gently but strongly towards the ceiling. Stay sitting up tall for ten seconds. Do this five times with a short rest in between.

3. Working your tummy muscles

Place your hands in your lap and think about where your shoulders are in relation to your pelvis. If your shoulders are behind your bottom, try to sit forwards (without using your arms if possible, so that your tummy muscles do the work, not your arm muscles) so that you are sitting in your best sitting posture. Imagine a torch light shining from your breast bone and slowly turn your body to shine the torch to one side and then to the other. Do this three times to each side keeping your best posture all the time. Try to lead the movement with your tummy muscles rather than shoulders or head. Do this five times each way.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

3 tips: preparing for standing practice an introduction

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Breathing

Take three slow deep breaths, breathing in through your nose and out through your mouth. Pause for a minute or so and then repeat.

2. Sit up tall

Sit up as tall as you can, imagining a very strong elastic band through the top of your skull pulling you gently but strongly towards the ceiling. Stay sitting up tall for three seconds.

Do this five times.

3. Posture

Take three more slow deep breaths, this time concentrating on your tummy button and imagining the area behind your tummy button filling up with air and your lower ribs going out to the side as you breathe in. As you breathe out concentrate on your posture, trying not to slump downwards as you breathe out. Do this five times.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities.

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