我遇到Barb当我成为团队的一部分协同卫生协会是一个基于按摩组健康和健身的从业者提供一个全面的基于团队的方法治疗疼痛。在我第一次会议与Barb她告诉我她会定期锻炼但只因为她认为她应该。“一开始,我没有动力,不相信它会非常,“Barb说。“我不喜欢锻炼,不是寻找一个啦啦队长。”Barb, who is obese, has pain in her legs which has made walking difficult. In the beginning, everything we did was from a seated position as she couldn't stand for very long and her postural muscles were weak. Lifting her leg or raising her arms overhead was an effort. She tired easily and didn't have the confidence to believe she could perform the movements I was asking her to do. I began by showing her how to pay attention to the muscles she was using. We started by strengthening her back which was over stretched due to her constant forward bend. As soon as she felt the tension she was able to create by focusing on the isometric contraction she realized she could be in control of her movements. Along with this work I added core exercises. As she began to learn how to engage her abdominals lifting her leg became easier. "It was hard in the beginning to find the power to move my limbs," Barb remembers, "but as time passed I found I had more energy and the movements became easier to do." After learning how to engage her postural muscles, Barb began to stand up straighter, however her gait was still more frontal plane then saggital plane. We worked on strengthening her ankles both for stability and mobility and she began walking without lateral movement. At first Barb trained with body resistance alone and then we added weight using both resistance tubing and dumbbells. As she became stronger I added balance exercises. It was difficult for her to balance on one leg as she transferred her weight to take a step but with practice she became more confident and was able to move quicker. We also worked on pivoting which was a new concept since she had previously turned her body by taking small steps in the direction that she wished to go. "I began feeling more like my old self and realized I felt more secure in my body movement," Barb said. Two specific incidents proved to Barb how far she had come. The first was her realization that she could walk from the elevator, as she put it," down the longest hall in the world" and not have to stop halfway or use her cane. The second was that she was able to regain her balance when she slipped on the pavement. She was convinced that before our working together she would have fallen. Besides strength and balance work, a very important aspect of our training is stretching. Barb feels that stretching has made a huge impact in her life and that without it she would hurt more. "Barbara has been an excellent trainer for me. Although she is in shape and thin, she gets me!" Barb says. "I see her twice a week and I do the stretching exercises at home. Barbara has given me exercises that I can do successfully and I am motivated to do them. Do I like exercising? NO! But I have developed motivation since I have seen the difference it makes in my body and my attitude. It's not chocolate, but moving my body has become part of my life." Barb works hard for her own self satisfaction but enjoys that people are noticing she is moving differently. I would like to add that although she was adamant about only training periodically she has never missed a session.