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Keyboard Hands

The following was written by the author of ‘One Step Ahead of Osteoarthritis’, Frances Ive.

Attention all keyboard users. One day you could  get stiff, painful and knobbly fingers and thumbs, because of osteoarthritis, and one of the contributing factors is overuse of keyboards. No time is too soon to do regular (daily) exercises for the hands, to try to prevent building up problems for the future. Doctors have now been advised by NICE to recommend exercise to everyone when they get a diagnosis of osteoarthritis.

It’s true we use our hands too much and throughout history, those people who reached old age, would have had gnarly fingers, inflammation and pain.  In the 21st Century we are building up even more problems with kids using keyboards from a young age and throughout their lives. Originally, typists bashed their fingers down on to the keys of manual typewriters, but now computer keyboards, phones and tablets are used so much at work and at home, adding even more pressure to our hands.  And, when we use keyboards we put strain on our shoulders and arms as well and the tension radiates downwards to the hands. This results in pain and inflammation and sometimes immobility and inflexibility.

The pressure put on fingers by repetitive typing and key entry is astounding.  Someone typing at 40 words per minute (wpm) uses 12,000 keys per hour and 65,000 keys during an 8 hour day, putting up to 25 tons (25,000 kg) of force each day on their hands. Add to that, using fingers and thumbs to send texts on a phone all the time!   

Trying hand exercises may help to keep your fingers fit as you age. Stretching out the fingers, shaking our hands, squeezing a spongy ball or touching fingers to thumb are all good for keeping hands/fingers flexible and avoiding pain.

You can get osteoarthritis from 40, it is often hereditary, but also results from overuse of joints and the wearing down of cartilage (the protective surface at the end of our bones). Over 8 million people in the UK have osteoarthritis, of whom the majority are women.

Read more in One Step Ahead of Osteoarthritis, by Frances Ive

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What walking can do for people with cancer

cancer

The following was written by the author of ‘Get Your Oomph Back’, Carolyn Garritt.

‘Walk all over cancer’ is an annual month-long fundraising initiative by Cancer Research UK in which the charity challenges participants to walk 10,000 steps every day through March and to raise sponsorship and awareness of issues relating to cancer as they go. There’s information about the initiative, and how you could support it here.

Walking can be a fantastic way to improve our overall fitness and sense of wellbeing, as well as an important part of charity fundraising. What many people don’t realise though, is that walking (and physical activity in general) can also be a powerful part of treatment and recovery for those of us who have had a cancer diagnosis.

Exercise and cancer

Historically when people were undergoing cancer treatment they were advised that ‘rest is best’. It was assumed that physical activity might make patients too tired, particularly as they underwent radio and chemotherapies, which are known to cause fatigue, along with a whole host of other side effects. 

Steadily over the past twenty years or so this caution has been disproved and what has emerged is a powerful body of evidence that shows that exercising, right from the day cancer is diagnosed then through treatment and afterwards, can help cancer patients in many ways and for the rest of our lives.

Being active after a cancer diagnosis (regardless of activity levels beforehand) has been shown to reduce our risk of the cancer coming back. Some clinical studies have shown that risk of recurrence could be lowered by as much as 40%. Yep – four zero. This is significant, so much so that some studies now recommend that exercise should be considered part of the cancer treatment itself.

As well as reducing the risk of (primary) cancer coming back, exercise can help to slow down the development of secondary cancers. It can help alleviate many of the myriad side effects from cancer treatments and can offer some pain relief and mental and emotional support for those towards the end of life.

Increasingly cancer patients are aware of the benefits of physical activity but are often unsure how to start. I wrote my book ‘Get Your Oomph Back’ to explain just how they might, based on my work as a cancer exercise specialist and on my own experience of breast cancer.

Start with walking

For many, myself included, it starts with walking. It’s such a fundamental, functional activity, and it’s accessible and free. Walking can help our heart and lungs to recover their fitness and capacity after a period of illness or inactivity. Walking is a weight bearing activity, so it can help us to protect our bone density – which is often reduced by cancer treatments.

Walking, especially in nature, can help to calm the mind and blow away cobwebs that build up during the weeks and months of treatment. The book contains some suggestions about how we can make going for a walk more mindful, which may help us to feel a little less anxious. 

Walking uses the muscles in our buttocks and legs, which are very often weakened by a period of inactivity. As a result of their cancer treatment, many people lose muscle mass from their limbs, and at the same time they gain fat around the torso. Walking can help offset both.

Now, cancer treatment itself is rarely a walk in the park. As a trainer I often recommend people try to walk a mile a day, if they can, but some people find that their treatment, particularly chemotherapy, can be so arduous that walking becomes very difficult. I have worked with several people for whom walking to the end of their street was a challenge. It’s important that everyone feels they can start from whatever point they need to and build up their activity levels gently.

Meet Sarah

Sarah was diagnosed with stage 4 ovarian cancer in her early fifties and is one of my personal training clients. Her initial cancer treatment was tough going. Immediately after diagnosis she developed blood clots, a complication caused by the cancer, that left her without the breath or energy to move very much at all. At some points early in her chemo, she could not walk to the post box at the end of her street – in fact I remember her showing me a photo of the day she jubilantly made it there and back.

Because her cancer was stage 4, she will probably be on some form of cancer treatment for the rest of her life. She has an impressive attitude towards exercise and how she is caring for herself, that I think we can all learn from – I certainly have. She knows that she may well have to have more drugs, more chemo and she knows how tough they can be. So she is determined, to use her words, ‘to be match fit’ when that time comes. Although it hasn’t been easy, she is currently fitter than she  remembers ever being even though she’s still dealing with significant side effects from the treatment she’s had so far.

From walking just the length of her street, Sarah has steadily built up and a few months ago she walked her first parkrun. She’s currently about halfway to her first parkrun ‘milestone’ – recognition of progress once she has completed 50 of the weekly 5km events. And she’s getting faster. She has gone from post box to parkrun to PB and doesn’t appear to be stopping any time soon. 

Sarah is currently undertaking a challenge to walk a total of 100kms during March, as a fundraiser for an ovarian cancer charity. More info here: www.justgiving.com/fundraising/sarah-winmill

How walking can be even better – add poles

Nordic walking (walking with poles that you use for momentum) is an incredibly useful form of exercise for everyone and has particular benefits for people who’ve had a cancer diagnosis. I teach Nordic walking at two of London’s Maggie’s Centres and it is as likeable as it is effective. Adding the poles means that we use the muscles in our top half as well as bottom, and Nordic walking has been shown to help us build strength and range of motion in our arms and shoulders – helpful after breast cancer. 

Walking with poles burns more calories than without and so it’s useful for those trying to lose weight or body fat. It works the muscles around the torso in a way that’s gentle and doesn’t bend the back or squash the bladder – which is good for those who have back problems or cancer in the bones, and after prostate cancer and/or pelvic surgery and radiotherapy. The poles can help people whose balance has been affected, and the poles can reassure those with peripheral neuropathy in the feet, a common side effect of chemo.

But over and above, Nordic walking is an enjoyable form of walking. It is often done in groups and surrounded by nature. At Maggie’s it provides an open space for people to talk – about their cancer but also about everything else – whilst exercising. Juliet is one of my regulars who walks with me on Hampstead Heath. She refers to our Nordic walks as her ‘Monday medicine’.

There’s a step-by-step guide to Nordic walking technique in my book.

Parkwalk – habit forming

Parkrun is a global movement in which volunteers host timed 5km events in designated parks on Saturday mornings. They decidedly are not a race, and participation is welcomed across the ages and across abilities. You don’t have to run them – plenty of people walk. I tend to do a bit of both.

Parkrun events are friendly and non-competitive. Last year this intention was reinforced with the introduction of ‘parkwalk’, a campaign that provides encouragement and support to anyone who is walking and ensures that everyone feels part of the parkrun community.

This community building can really help anyone to make walking become a habit. Saturday becomes ‘parkrun day’. I highly recommend them to anyone who’s trying to walk more. They are usually at 9am on Saturdays and by 10 o’clock, you feel fabulous. More information here: www.parkrun.org.uk 

Take part now

By taking part in Walk All Over Cancer, people are helping to raise funds and awareness that might ultimately benefit Sarah, Juliet and me to live and thrive as people with a cancer diagnosis, through future cancer research. 

The impact is bigger than that though. By promoting walking as a form of exercise, cancer charities and organisations like parkrun are helping people to walk more and to gain the often unrealised benefits of this utterly simple, natural form of movement. 

Happy walking, folks.

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What does Get Your Oomph Back include?

Blog post written by Carolyn Garritt, author of ‘Get Your Oomph Back – A Guide to Exercise after a Cancer Diagnosis’,  now officially launched.

 

There are many tools described in the book. Often the best starting point is simply to walk – outdoors if possible. Walking mindfully and seeking out nature (in an urban environment as well as the countryside) can feel really soothing and, as long as the walk is brisk, it can help to restore physical fitness as well as a sense of wellbeing.

If you’re not able to stay on your feet for long, then marching in a chair, and chair-based exercises in general, can elevate the heart rate more than many people imagine. You can get properly out of puff at home if that’s what you need to do, for now. There’s a chair-based cardio routine in the book.

In the book I also talk about Nordic walking – using poles – which I boldly describe as ‘perfect exercise’. It is very clever – it elevates the heart rate, gives the lungs space to work, improves the posture, protects the joints, strengthens the bones, supports the balance (pain and numbness in your feet is a common side effect of chemo). It helps reduce the risk of, and manage, a condition called lymphoedema, helps rebuild upper body strength and uses 95% of your body’s muscles.

And yet – perhaps most importantly – it feels really nice. The poles propel you along, so walking can feel more manageable. The fact that it’s outdoors, in nature, it’s low-cost and highly sociable, just seals the deal. Possibly my most used and useful type of activity.

Strength training

In the book there’s a lot of information about strength training – often overlooked, and definitely one aspect of exercise that folks are unsure about. Strength training – using weights, resistance bands or our own bodyweight – can help us to feel less tired after cancer treatment. Most people feel they lose some strength while they’re on the injury bench, and if we’re out of action for a while we can lose muscle mass.

Building (or rebuilding) stronger muscles is known to reduce our risks of cancer returning. It can also make everyday activities seem more manageable. Many of the people I’ve worked with (regardless of their age) have found that they can’t climb stairs as easily as they could before. There’s some specific information in the book about how to tackle stairs.

Do what you enjoy

One important theme throughout the book is that we should, I believe, do what we love when it comes to exercise. If you don’t love any type of exercise at all, there are some suggestions about how you might find acceptable, even likeable forms of activity. In my mind, nothing is out of the question – I’ve trained people to play croquet and to tackle ultra-marathons. And pretty much anything in between.

There’s definitely scope to get into, or return to, team sports, such as football, rugby and/or basketball, after a cancer diagnosis, and there are now organisations that run group-based activities specifically for people with a cancer diagnosis, such as the wonderful Active Ostomates.

Parkrun

In the book I also talk about parkrun which is, in my view, community, grassroots exercise at its very finest.

Running (slowly) is without doubt the exercise I love most. There’s a ‘couch to 5k’ running or walking programme that incorporates a monthly trip to parkrun.

Boxing

Boxing features too because it is a superb stress-buster. It helps sharpen our hand-eye coordination, which can be a bit foggy after treatment, and if done properly it works the whole body. (You don’t have to spar or hit actual people – I’m talking about using pads, mitts or a punchbag.) You do have to really think on your feet and stay light on your toes, yet it can be for anyone. My oldest trainee boxer is 84.

Combining boxing with using a skipping rope is one way to push ourselves and strengthen our hearts, lungs and bones as we go.

Yoga

Yoga, particularly restorative yoga, is another tool described. It’s important for people to find ways to relax (not easy, I know) and also to stay flexible as this can help deal with some of the aches and pains associated with taking cancer drugs.

Making time

Too much? I know that the idea of exercising can feel overwhelming. Fair enough. If you know you’re short of time or energy (or enthusiasm), then the book contains several cunning ways to incorporate movement into your daily routines. It can be as simple as getting off the bus a stop early and then walking, or taking the stairs rather than the lift. These actions can all add up to a more active day.

How am I doing?

And so, 18 months down the line, how am I doing? I know I’m not as fit as I was before, but I’m working on it and I’m doing my own strength training rather relying on what I do for a job to keep me strong. I’m less anxious about the cancer coming back, for sure. The drug I’m going to take for 5-10 years (tamoxifen) does make me tired and achy but I’m figuring out ways to minimise that.

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How to Get Your Oomph Back by Carolyn Garritt

Blog post written by Carolyn Garritt, author of ‘Get Your Oomph back – A Guide to Exercise after a Cancer Diagnosis’, launching on 25th November. Available for pre-sale now. 

At the start of the pandemic, I was working as a personal trainer specialising in exercise for people with cancer, a job I had adored for more than seven years. I was fit, and mostly worked outdoors, one-to-one or with groups. As the realities of coronavirus became clear I knew I wouldn’t be working much, but I imagined I’d use the time to update my website, do the bookkeeping, and finish that book (about exercise and cancer) that I’d been writing for, well, ages.

And then, three weeks into lockdown, I found a breast lump. Quite by accident, after I had been shadow boxing, holding weights, with a couple of clients online. I thought I had just inflamed one of my pectoral muscles.

I was wrong.

 

The diagnosis

Going through a cancer diagnosis felt odd, almost dreamlike. Doing it at a time of global crisis just made the whole thing even more surreal, and it felt incredibly strange to be facing decisions as a cancer patient after years of working with them. It was suddenly happening to me too.

I was very lucky as I already had a network of support through my work. I was also fortunate because I knew a great deal about the side effects that I might encounter, and I knew what I could do to promote my own recovery.

 

Why exercise is so important

Research has shown – convincingly – that being active after a cancer diagnosis is really, really helpful in aiding rehabilitation and in improving our outlook for the future. In fact, exercising after cancer can help reduce the risk of it coming back by between 30% and 40%. That’s huge, and it has often been said that if exercise was a pill, it would be prescribed to every patient. For those living with secondary or advanced cancer, exercise can help to slow down the cancer’s progression, again, just as drugs can.

More immediately though, exercise can help us to feel better. Clinical studies have shown that exercise can help combat most of the commonly experienced side effects of cancer treatment:

Fatigue – Anxiety and depression – Hot flushes and night sweats – Weight loss / weight gain – Pain and joint stiffness – Bone thinning – Lymphoedema

 

Exercise to improve treatment side effects

Cancer treatment can be completely debilitating, and the side effects often drag on for months. Research shows that 95% of people find that they experience fatigue. For those living with cancer, life can become cyclical, as you go through endless treatment cycles and experience the associated ups and downs.

There’s also the anxiety – will it come back? Did the treatment really work? Will my next scan be okay?

 

Why my new book?

The reason I started to write my book was because I found in my work that increasingly people knew, or had been advised, to try to be more active after a cancer diagnosis, but they were often unsure what to do. What would work, what was safest, and when, during their cancer ‘journey’, could they start? Get Your Oomph Back aims to answer these questions and more.

There is a solid and growing body of evidence to show that exercising can help alleviate some of the anxiety, tiredness, pain and body changes that frequently accompany cancer treatment. In many ways it made writing the book very easy as I could find loads of really helpful, robust knowledge to call upon.

 

I’m really pleased to say that my book is being published in November. I still haven’t caught up with the bookkeeping!