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New Year, New Experience


I have recently been reflecting on the importance of sharing novel experiences with loved ones, perhaps because the pandemic encouraged us to stick to the familiar. Novelty can strengthen any relationship, whether that is with a friend, a family member or a partner, so it is definitely worth planning in. It is also worth bearing in mind that if you feel stuck in a rut, the dis-ease may manifest as physical or mental ill health and prevention is better than cure.


A simple day trip to the coast with my partner at the weekend made me realise just how energising a change of scene can be. It would have been easy not to go, not to spend hours in the car when we had plenty of other things to be getting on with, but as it turned out, nothing was more important than taking the time and making the effort to go somewhere neither of us had been before and to explore.


I love the sea and revisiting favourite beaches, but seeing a completely new stretch of the coast at West Wittering was stimulating to all the senses: the sea mist rolling in with the breakers, that special sea smell, the cool, damp air and the taste of salt on the skin. I even managed to fully immerse myself in the experience with a cheeky dip and rewarmed afterwards with hot chocolate from a flask, sitting on a bench cut into the dunes for shelter. We walked as far as we could in both directions along the beach, enjoying the changing patterns in the sand and the changing views. Afterwards I felt as though I had been plugged into the mains and my battery recharged - all the better for having shared the experience.


It has reminded me to schedule more times like that with loved ones, like discovering historic houses and gardens with my Mum, trying out new walking routes with friends and new eateries with family. And that is the other trick, not just the novelty, but to plan it. If it isn’t in the diary, it can get pushed back to never...


I hope that by sharing this, I have encouraged you to share something novel, whether that is trying a new activity, learning a new skill, exploring a new area or whatever you can come up with. Afterall, to quote Piglet in The House at Pooh Corner: “It’s so much more friendly with two.”


West Wittering Beach_optjpg
Cold Water Therapy

Open water swimming has become very popular over recent years, even chill winter swims, and a lot has been written about it, so my intention is not to recover that ground, but to share my experience of it in case it resonates with you and opens up new possibilities for your health and wellbeing.


I have always been drawn to water - apparently I spent hours playing with it at the kitchen sink as a very young child. I am eternally grateful to my mother for taking me to swimming lessons from the age of six and for introducing me to a sport that has been a lifelong love of mine. Most of my swimming was in pools, until recent years when it shifted more to open water, in fact I haven’t been in a pool for two years now, but I have swum regularly. I do miss the clarity and warmth of a pool, but not the pacing up and down like a caged animal.


I enjoy the community of shared swims outdoors with others: introducing friends to open water swimming or to my favourite swimming spots, and the adventure of exploring new places with experienced swimming buddies. 


I also enjoy the quiet contemplation of swimming alone. I find it difficult to meditate anywhere other than in or by the water. It draws my attention; holds my gaze; keeps me in the present; brings a sense of peace and wonder, of being, not doing. Swimming enables me to enter a flow state, during or after.

I have had some of my most spiritual and magical experiences swimming outdoors, including one winter solstice seeing an otter emerge from beneath the water just where I had been swimming moments before - my favourite animal in my favourite element on my favourite day of the year, and just as I had wished on the journey there, as if I had conjured it.


Swimming regularly in open water all year round literally immerses me in nature: I feel the water warming in March and cooling in September; I see the vegetation greening and fading with the seasons; I hear the bird calls changing; I notice how the smell and taste of the water change too.


The water is also a muse to my creativity and has inspired many a poem, if only to help me capture the moment, the feeling, the experience, like this one:


River shimmering 

as the flow and soft breeze make 

fish scales of water.



I stand mesmerised 

as if I have never seen 

anything like it.


As if I have just 

come up with a new word for 

a new thing: shimmer.


Swimming outdoors can be many things: community, challenge, solitude, meditation, spirituality, inspiration… It is far from just being a means to keep fit, and in winter it isn’t about that at all. If this has inspired you to give it a try, our local West Berkshire Open Water Swimmers group is very friendly and welcoming, or there is the aptly named Blue Tits Chill Swimmers group. Many of the commercially run local swimming lakes such as Caversham Lakes and Reading Lake offer open water swim coaching for beginners and the more experienced. I started my outdoor swimming adventure with Swim Trek, who run trips in this country and abroad, including introductory ones. Or if getting in doesn't appeal to you, just walk by water and allow it to mesmerise you…

Plantar Heel Pain

Pain in the heel on the underside (the plantar aspect) of the foot is quite common and can have several causes, but the most common of those by far is the one that you are most likely to have heard of: plantar fasciitis. Other possible causes are fat pad syndrome, fracture of the calcaneus (heel bone), neurological problems and rheumatoid arthritis. The correct diagnosis of plantar heel pain depends on several factors, including whether the onset was sudden or gradual; whether pain is felt under the heel on weight bearing; whether it hurts when there is no weight on that foot; whether there are any other associated symptoms, such as weakness or numbness; what makes it worse and what makes it better.



Plantar Fasciitis


Plantar fasciitis is inflammation of the plantar fascia, which is the connective tissue that connects the heel to the toes. The plantar fascia is between a ligament and a tendon in character; it connects bones, but behaves like a tendon. Plantar fasciitis is caused by a strain on the tissue, often from a recent increase in volume of walking or running or from spending more time than usual standing. It can also result from inadequate cushioning for the sole of the foot. One in ten of the population in the Western World develop plantar fasciitis at some point in their lifetime and it is the most common cause of heel pain.


The pain of plantar fasciitis tends to be felt more on the inside of the heel than in the middle of it and it tends to be worse on the first few steps of the day, walking off during the day and returning after sitting rest. If the condition persists for more than three months, it changes from being an inflammatory condition to a failure to heal and is then known as plantar fasciopathy.


Initial management of plantar fasciitis may include:

  • Wearing firm, low-heeled footwear with cushioned soles, which can help relieve the discomfort by taking some of the pressure off the plantar fascia.

  • Applying an ice pack to the area and/or taking non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammation.

  • The use of strapping or taping to support the area.

  • Firm, off-the-shelf orthotics.

  • Stretching the calf and plantar fascia.

  • Massage to relieve tension in the plantar fascia and to promote healing.

  • Steroid injection is another option and is about 50% successful.


Longer term management options include:

  • Stretching as above.

  • Gait retraining (because the pain may have caused changes to the way that someone walks or runs, which could lead to other problems).

  • Warmth over the affected area to stimulate the circulation and healing, rather than to reduce inflammation at this stage.

  • Custom orthotics if the arches of the feet are particularly flat (pes planus) or high (pes cavus).

  • Massage as above.

  • Shockwave therapy, which can be provided by a physiotherapist or osteopath.

  • Ultrasound guided steroid injection, performed by a medical professional (ideally one experienced in treating plantar fasciitis).

  • Platelet rich plasma (PRP) treatment, which is now also available on the NHS.



Fat Pad Syndrome


One in ten people with heel pain have fat pad syndrome, so it is the next most common cause of heel pain after plantar fasciitis. Fat pad syndrome is experienced as a dull ache in the centre of the heel. The pain is only and always felt on weight bearing, is worse barefoot, is usually only in one heel and doesn’t walk off. It is due to age-related atrophy of the cushioning (fat pad) under the heel and so is most common over the age of forty. It can also occur in people with high arches because the pad may be displaced by the one-sided pressure on it. The pad can also be damaged by traumatic injury. A heel spur (a bony lump also known as an osteocyte) can aggravate an irritable fat pad.



Calcaneal Fracture


If the heel pain is caused by a fracture in the calcaneus (heel bone) it may have come on suddenly after a fall or an unusually long walk or run. Being underweight can cause bones to weaken and so will make calcaneal fracture more likely, as can being overweight, which puts the bone under more strain. A stress fracture can also occur in the calcaneus from increased load of impact exercise. Calcaneal fracture results in heel pain even when not weight bearing and there can be pain at night. Heat may make it worse.



Neurological Causes


A problem in the lumbar spine can cause sciatica, referring pain down the leg to the heel. Tarsal tunnel syndrome in the foot (similar to carpal tunnel syndrome in the hand) can cause heel pain because of the restriction of nerves around the ankle. Usually if there is a neurological cause there will be pain elsewhere in the body and associated neurological phenomena (e.g. shooting pains, pins and needles).



Rheumatological Causes


If heel pain is caused by a rheumatological condition, it will usually be in both heels, with stiffness as well as pain. There will usually be a family history of rheumatoid arthritis or other enthesopathies (pain where a tendon inserts into a bone), so those over the age of thirty will usually have been screened for the condition or diagnosed already.





If you experience heel pain, no matter the possible cause, it is advisable to consult with your GP as soon as possible for a diagnosis and for advice on the most appropriate treatment for your condition. They will also be able to refer you on if necessary for the most suitable ongoing support. And if you are heel-pain free, I hope that you have learnt something here to help you stay that way.

The Top Ten Principles of Qigong

There are several principles of qigong, and in class I tend to focus on one per session, although all of the principles are involved in every class, as one principle feeds into another. The top ten principles that I am going cover here are:

  1. Relaxation
  2. Concentration
  3. Alignment
  4. Coordination
  5. Breathing
  6. Centring
  7. Soft and gentle movement
  8. Balancing
  9. Duration of exercise
  10. Practice.

Relaxation

One aspect of relaxation is to notice tension in the body that we can feel and consciously release, whether that is by sequentially scanning through the body, top to toe, one joint at a time or as we work, regularly checking in with the body. The shoulders can be particularly prone to wander up towards the ears.

Another aspect of relaxation is known as ‘sung’ and is the sense of sinking the weight down through the body, as if hanging from a bar. Peter Wayne in The Harvard Medical School Guide to Tai Chi describes it as the opposite of being uptight “The Chinese character or pictogram for Sung depicts hair contained in a tight bun letting go and hanging freely.”



Concentration

In qigong, concentration should be relaxed, not forced. It is about observing sensations in the body and having moment-to-moment awareness. As such it is a mindful practice. It is through concentrating on what we are doing that we develop body awareness and improve our practice.



Alignment

Alignment is all about minimising effort in any given posture or movement so as not to waste energy or strain the body. This is epitomised in the standing meditation known as wuji, which roughly translates as extreme nothingness. In wuji we imagine hanging from a thread attached to the very top of the head; jaw relaxed; shoulders relaxed; arms relaxed with a natural, slight bend in the elbow; shoulders balanced over the hips; a slight bend in the knees as we feel the weight sinking down through lightly flexed ankles and evenly distributed across both feet. I think of it like pebbles balanced one on top of the other on a beach.



Coordination

I often feel like a puppet on a string when practising qigong and I love the sensation, for example as a wrist and ankle lift together or an arm and leg circle simultaneously. We can coordinate a sense of sung with movements, for example we can feel our weight sinking down through the body as we lower our hands from overhead, either to the side of the body or in front.


Breathing

When we are focused on other things we can forget to breathe, which is why coordinating movements with the breath can be helpful. It can also help keep movements slow and smooth. As Kenneth Cohen explains in The Way of Qigong “One of the ancient names for qigong, tu gu na zin, ‘expelling the old, drawing in the new,’ sounds like a modern description of the gaseous exchange that occurs during respiration… One of the goals of qigong is to maintain the balance and efficiency of this exchange, so that the entire body receives the energy it needs.”



Centring

In qigong we work with three energy centres in the body: the lower dantian in the abdomen between the navel and pubic bone, the middle dantian in the chest near the heart and the upper dantian in the head between the eyebrows. The lower dantian is the most significant of the three in qigong and is the body's center of gravity. “The dan tian both stores qi in the body, like an energy reservoir, and propels qi through the body, like a pump. Dan tian means, literally, the elixir (dan) field (tian), the field of the elixir of long life and wisdom. The qigong master learns to cultivate, nurture, and harvest qi by concentrating on this energy centre,” Kenneth Cohen.



Soft and Gentle Movement

As well as coordinating movements with the breath as mentioned above, we can use visualisation to ensure soft and gentle movement. We can imagine moving through something with more resistance than air, like water or even treacle. It also helps give grace to the practice.



Balancing

When balancing on one leg, whether fully or partially, we employ sung to sink our weight down into the supporting leg, bending the knee and ankle a little more (like a spring being compressed) so that our centre of gravity is lower and our position more stable. We also play with shifting our weight around so that the body gets used to rebalancing even from random or unexpected movements.



Duration of Exercise

All things in moderation as they saying goes and that applies to qigong too. “Each practice should be done over a long enough period so that the body can relax into it - but not so long as to exhaust the physical or mental energy,” Karel and Eva Koskuba.


Doing one practice, whether that is a standing meditation like wuji, a breathing meditation or a moving exercise for 10 minutes has value. You don’t have to spend an hour doing qigong if you don’t have the time or inclination for that. Probably more important is regular practise, ideally at the same time of day. And play around with that to find what time of day works best for you.



Practise

The variety of practices in a session can seem bewildering and impossible to remember, but if you remember just one or two exercises from each class and practise it or them for just a few minutes each day, you will soon build a repertoire and improve over time. You will find that you recognise them in class and pay close attention to them, which will help refine your technique.    




All of these principles are inextricably linked, like organisms in an ecosystem. If this has piqued your interest and you would like to put these principles into practice, you are welcome to join one of my classes, details of which are on my website. Call me on 07528 708650 or email wendy@rookeholistic.co.uk to register your interest.


How to Maintain Safe Levels of Vitamin D All Year Round

In my previous blog post in July, I talked about staying safe in the sun. As mentioned in that post, here I will talk more about vitamin D and how to maintain healthy levels safely.


Vitamin D is important for bone health and muscle strength. It is also linked to immune function. Very low levels have been associated with health conditions such cancer, diabetes, dementia, heart disease and multiple sclerosis.


As SKcin (the Karen Clifford skin cancer awareness charity) explains “Exposure to UVB radiation is the most efficient way for our bodies to boost our vitamin D supply. So, whilst some sun is definitely good for us, over-exposure to UV is a serious health risk, it’s therefore important to strike the right balance.” The sun emits three types of ultraviolet rays: UVA, UVB and UVC. UVA can reach the middle layer of the skin where they can cause skin burn, skin cancer and premature ageing. UVB rays (often referred to as the ‘burning rays’) affect only the outer layer of the skin and are the main cause of sunburn and skin cancer, but also stimulate the vital production of vitamin D in the skin. UVC rays do not reach our skin unless there is damage to the ozone layer.

From the end of September until the end of March, UVB light ray levels in the UK are insufficient for us to make healthy levels of vitamin D in our skin, so we need to supplement with the vitamin, unless our diet already provides adequate levels. It is worth checking labels because a lot of plant milks, margarines and cereals are fortified with vitamin D now, as well as some juices. The NHS recommends that 10 micrograms a day of vitamin D should be sufficient for most adults and children over the age of four. Some health conditions can affect the safe dose, so it is worth checking with your doctor if you are unsure, as too high an intake can be harmful.


From April until September most of us can produce sufficient vitamin D in our skin from unprotected exposure to daylight: from 10 minutes for paler skins and up to 45 minutes for darker skins (the important thing is not to burn). Don't worry, you cannot overdose on vitamin D from light exposure. People unable to ensure adequate sun exposure over the spring and summer are advised to supplement with vitamin D as above.


For more information about vitamin D, you can visit the NHS Choices website or listen to the ‘Get Some Sun’ episode of Dr Michael Mosley’s Just One Thing podcast. Keep well and do get in touch on 07528 708650 or email wendy@rookeholistic.co.uk if I can support you with your health and wellbeing through holistic therapies or qigong.