How to garden smarter when you have chronic pain

Plus: How to get the most out of a doctor's appointment [View this email online]( [NPR Health]( May 14, 2023 by Andrea Muraskin Want to plant but afraid of the ‘ouch’? We asked a physical therapist for advice on how to get hands-on in the garden, even if you’re pain-prone. Plus, public health experts help us figure out [how to act now that the COVID public health emergency is over;]( a task force recommends [mammograms starting at age 40]( and a primer on [how to get the most out of your next doctor’s appointment](. --------------------------------------------------------------- Growing without groaning: a brief guide to gardening when you have chronic pain [Digging with her right arm close to her torso, Rebecca Stephenson supports her weight with her knees and right arm.] Digging with her right arm close to her torso, Rebecca Stephenson supports her weight with her knees and right arm. Andrea Muraskin for NPR When I look at the economic news: the housing crunch, the rising cost of everyday items, the possibility that AI will render my professional skills obsolete – I often come back to the same thought: I should start growing my own vegetables. But there’s a problem. [Like about 20% of adults in the U.S.]( I live with chronic pain. Mine is in my pelvis and legs, and it can make repetitive bending or crouching very uncomfortable. Fortunately for me, this spring I’ve been seeing Rebecca Stephenson, a clinical specialist in physical therapy at Newton-Wellesley Hospital in Massachusetts. She has a passion for planting, and a lot of ideas about how to modify gardening activities to prevent pain. In her own garden she grows sedum, coleus, peonies, herbs and shade plants. Stephenson says the activity of gardening can benefit people with chronic pain. “You're exercising, besides breathing outside in nature and getting good lung expansion. You're also using your arms and legs in a coordinated way, and there is a way to garden so that you don't hurt yourself and end up in pain afterwards.” Here are some of her tips for getting your hands in the dirt, without the hurt. Pace yourself Like any physical activity, Stephenson says, gardening is something you build endurance for, step by step. “It’s happened to me where I've, in my enthusiasm, gone out for four or five hours, and it's gonna cost me for two weeks”, Stephenson says. But her professional training helps her stay grounded. “I think from my physical therapy, I come at it from underneath. Instead of going over your limit, I try to come under,” she says. “What I really recommend is to take your garden project and see how you could split it up into smaller pieces and be very reasonable about the amount of time that you're physically able to do it. So it might be a half an hour, it might be 15 minutes, it might be an hour, and then take a break, change your body position, do some stretches,” she says. Take a seat, and get up gracefully Stephenson suggests using a stadium chair, [the kind that rests on the ground and provides back support]( to work in a seated position. Position your legs in a V shape, with knees straight or slightly bent, and work on the patch directly in front of you. You can also tuck one leg in with your foot resting against the inside of the opposite thigh. When it’s time to get up, roll to one side and get on all fours, and stand up from there. [Kneeling on a pad, Stephenson supports herself with her left hand while she uses her right hand to clear debris. Her left arm is perpendicular to the ground, and she's extending her right arm beneath her body] Kneeling on a pad, Stephenson supports herself with her left hand while she uses her right hand to clear debris. Andrea Muraskin for NPR Try ‘the quadruped’ For a bit more range of movement, kneel with both knees on a foam pad. Then, placing both hands on the ground, come forward into a table top position, with your back straight and your arms and legs perpendicular to the ground. You can then work with your dominant hand while supporting your weight with your non-dominant hand on the ground. Take a knee Kneel with one knee on a pad and the foot of the opposite leg on the ground, (as if you’re proposing marriage or protesting the National Anthem at a football game). Use your extended leg to brace your elbow as your work. This is a good position for using a small shovel or trowel, and you can work with both hands on the tool. Embrace ‘functional bracing’ “Sometimes people wear a back brace just for gardening, and that gives them a little bit more of a reminder to be using their abdominal muscles and less strained,” Stephenson says. It's not like your grandmother where you're wearing a girdle all day. You're just wearing it for an hour.” Consider raised beds Instead of getting down on the ground, you can bring the earth up to you with a raised bed that reaches hip level. The bed should be about twice as wide as your arm length, Stephenson says. You engage your abdominal muscles while leaning forward against the bed wall, which provides support for your pelvis while your upper body does the gardening. You can even prop one foot up on a stool for more support. Stephenson particularly recommends these raised beds for senior citizens. ”A senior could have one in their backyard, in their condo, on the back porch. That could have their lettuce, could have spinach, a lot of herbs that could change how they're cooking to make it a little bit more exciting,” she says. Short of building a raised bed, veggies can also be grown in planters that hook over a railing. Have you got tips for gardening with chronic pain? Send them to us at shots@npr.org, and you could be featured in a future edition of the newsletter. (For now, I’ve got a few herbs on pots on the back porch – it’s a start). Happy growing season! --------------------------------------------------------------- Newsletter continues after sponsor message --------------------------------------------------------------- [Coronavirus FAQ: 'Emergency' over! Do we unmask and grin? Or adjust our worries?]( [A poster in Kolkata, India, from peak pandemic days sends a message to mask up. Now that the official COVID-19 global emergency is no longer in effect, some folks are thrilled to stop masking — but others wonder if it's a good idea to keep up certain precautions.]( NurPhoto via Getty Images The CDC ended the national COVID-19 public health emergency on Thursday. Just the week before, in an ironic twist, [35 attendees at a CDC conference in an Atlanta hotel tested positive](. 323 Americans died from COVID in the first week of May, the lowest weekly death count since March 2020. The World Health Organization has also announced the end of the international COVID emergency, although thousands still die around the world each week. So what does the end of the ‘“emergency” mean? How do you understand COVID’s risk in comparison to other communicable diseases? And can [the negative effects of loneliness]( be worse than the case of COVID you might catch at a social gathering? NPR asked public health experts to [help us make sense of this new phase of the pandemic](. [Also: Pandemic hits 'stop button,' but for some life is forever changed]( [If you're 40, it's time to start mammograms, according to new guidelines]( [New recommendations from the USPSTF advise that women get biannual mammograms starting at age 40 to detect breast cancers.]( andresr/Getty Images Until now, women in their 40s have been encouraged to have a conversation with their health care provider about when to start mammograms based on their personal risks. But after reviewing the most recent data, scientists at the U.S. Preventive Services Task Force are urging all people assigned female at birth to get screened every other year, starting at age 40. "If all women followed our new recommendation, we could reduce mortality from breast cancer in the U.S. by about 20%, saving about 8,000 lives a year,” says Dr. Carol Mangione, co-author of the draft guidelines. [Learn why a younger set should get their boobs checked, and who’s at higher risk.]( [Plus: Colorectal cancer is rising among Gen X, Y & Z. Here are 5 ways to protect yourself]( [Do you freeze up in front of your doctor? Here's how to talk to your physician]( ljubaphoto/Getty Images Cardiologists, along with oncologists, are perhaps the type of specialists whose opinions patients are most likely to be taken as the word of God. But Dr. Jennifer Mieres, professor of cardiology at the Zucker School of Medicine at Hofstra/Northwell, says she wants patients to understand that doctors are not all-knowing. "I always say I didn't have ESP to figure out what was going on," says Mieres. Rather, she suggests you think of your physician as a “co-detective,” working with you to crack the case of figuring out what’s happening inside your body. And that relationship works better when you come prepared, and stick up for yourself if necessary. [Read Mieres’ tips, and watch Life Kit's video for a role play demonstration of how to advocate for yourself in the exam room]( [Also: Listen: When a doctor becomes the patient]( We hope you enjoyed these stories. Find more of [NPR's health journalism]( on Shots and follow us on Twitter at [@NPRHealth](. All the best, Andrea Muraskin and your Shots editors --------------------------------------------------------------- Listen to your local NPR station. Visit NPR.org to find your local station stream. [Listen Live]( [Facebook]( [Instagram]( [Twitter]( What do you think of today's email? We'd love to hear your thoughts, questions and feedback: [shots@npr.org](mailto:shots@npr.org?subject=Newsletter%20Feedback) Enjoying this newsletter? Forward to a friend! [They can sign up here.]( Looking for more great content? [Check out all of our newsletter offerings]( — including Goats & Soda, Daily News, Best of NPR and more! You received this message because you're subscribed to Health emails. 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