A 75-year-old with advanced osteoarthritis and chronic pain (Which includes osteophytes, spondylosis, ankylosis, stenosis, some nerve root impingement, a slight scoliosis and dysfunctional sacroiliac joints.) who was labelled ‘severely disabled’ and told her spine was crumbling – is now lifting 8kg kettlebells and has a ‘life plan’ to take her well into her nineties thanks in part, to support from Connect Health.
Geraldine Vinall, from Milton Keynes, has dealt with neck and back pain throughout her adult life, following polio and a horse-riding accident as a child, and a car crash at age 21, which injured her neck.
Diagnosed with advanced and severe osteoarthritis in her cervical spine in her early 30’s, Geraldine struggled with increasing pain, stiffness and immobility, despite regular dog walking and visits to a chiropractor. She attributes the first Covid lockdown to her realisation that she still had a life ahead of her that she wanted to enjoy to the full.
“The women on both sides of my family live well into their nineties, and I wanted to be able to plan for the next 15-20 years,” she explains.
Yet dealing with the pain…. I don’t like to say depressed, but I was getting disheartened. The pain was becoming more acute, which discouraged me from using the gym, and regular trips to osteopath or chiropractor aren’t affordable on a pension income alone.
Five months of self-isolation at her former home in East Hertfordshire, allowed her the chance to re-evaluate her life. Before lockdown, at age 74, she’d still been working as an Aviation Security Officer. Prior to that, she’d had a varied career as a secretary, a prison officer and a call handler and despatcher in a police control room, and raised two children.
During lockdown I was alone – I walked my dog and I spoke to villagers, but I had no ‘bubble,’ as my children weren’t close by. Despite sometimes feeling miserable because of the pain, I decided to view the situation positively. I saw it as a bit of a retreat, and it was then that I realised that the time was now.
Aside from the pain, it was the first time in my life I felt free. Responsible only for myself, lockdown took me off the treadmill of having to work, of having to report to somebody, of having an alarm clock. I decided that ‘free’ was my new favourite four-letter word beginning with ‘f’!
Geraldine made the decision to leave work and move back to Milton Keynes, where her children live, to build a ‘little retirement den.’
On her return, she immediately sought help to manage her pain, and was referred by her GP to community healthcare services provider, Connect Health. She had a phone consultation with one of Connect’s MSK (musculoskeletal) clinicians, Charlotte Hopper.
During that first chat, Geraldine had so much to say – she’s a very bubbly, motivated lady, but she felt she’d been ignored by medical professionals in the past. She’d been told her spine is crumbling, she’d been passed from one person to the next and never offered any real solutions. She needed reassurance about how to manage her pain, and to understand what is going on with her conditions.
The pair began initial one-to-one gym sessions, before Geraldine joined small group classes with other patients, led by Charlotte.
A gym member for many years, Geraldine had lost confidence and belief that it was the right way for her. Diminishing outcomes had led to lowered expectations, and motivation was becoming harder to sustain. She and Charlotte laughed about ‘needing WD40 for the joints.’ Charlotte explained that ‘loaded weights and strength training – encourage synovial fluid – Nature’s WD40 – into stiff and painful joints to optimise flexibility and reduce pain.’ This was a new approach to using a gym for physio and rehab. Geraldine said she imagined physio would be ‘a bit of massage and maybe some ultrasound’… neither of which had worked in the past ‘but Charlotte’s idea made sense, and hope started to return.’
In the first one-to-one, it took me 20 minutes to get her on the cross-trainer, I think she was weighing me up. But once she got going, she made amazing progress. Then we moved onto small group classes, which I think was the fix for her. She’s quite competitive, so she would be watching the other patients – most were younger than her – and want to be better.
At first, she’d barely do a squat, but soon she was lifting 4kg weights, and then she’d pick up an 8kg kettlebell and start squatting. She flew through the circuits we set for the group.
The pair kept in touch outside of the classes via app updates, where Geraldine would keep Charlotte posted on her progress while doing the exercises on her own.
Geraldine discharged herself from the group, as she felt there were others who needed the place more than she did. She is keeping up her workouts at home and in the gym – where she’s also planning to start virtual spin classes.
It was sad when Geraldine left the group – she was the person who talked to everyone else, made them laugh and motivated them. We had a great phone call where she thanked me and said, ‘you’ve changed my outlook, I’m feeling so much better.’ But I learned from her too – she’s an amazing lady.
Charlotte is my guiding light; she’s my technical advisor. I’m still under the guidance and support of Connect Health, and that’s keeping me confident in the gym and stopping me from wimping out or being afraid I might damage something.
I don’t say ‘I am disabled’ and I don’t say ‘I am arthritic.’ I have arthritis. I have a disability in my spine. There is a difference. I am not defined by pain – it can be a challenge. But you don’t have difficulties, you have challenges, and challenges are there to inspire and motivate, and hopefully rise above.
I’ve gradually switched the focus over the years from [looking after] everyone else to looking after me. I’m finally, truly, independent, although I’m still evolving. I want to be like Dame Judi Dench, she is my icon. I look at her and think ‘well, she’s doing it’ – and I know she’s got ten times the money I’ve got, but it isn’t about money.
Age is an attitude, that’s what I tell people. And I tell them if their attitude stinks, if they’re saying why they can’t do things. I look at how I can do things instead.
I regularly meet with another lady I met in the group – we curse our dodgy old joints together; we go for walks and we look at what we can do.
Charlotte’s advice for getting active, and using exercise to manage pain
- Anyone living with chronic pain should seek individual, professional advice before undergoing exercise – once you’ve got the green light, you can go for it.
- Don’t dismiss it before you’ve tried it – it’s completely understandable that gyms can seem daunting, and that people can feel shy or embarrassed about exercising in front of others. I always say to patients, ‘try one class. If you honestly think it’s the worst thing ever, you don’t have to do it again.’ I don’t think I’ve ever had anyone not come back to me.
- Think of muscles as being like a car. If you don’t use your car for a long time, it won’t always work properly when you get back behind the wheel. If you don’t use your muscles, they get lazy, they don’t work as well, your mood drops. During Covid, when we couldn’t make long journeys, people would take their cars for a spin around the block every week to keep things ticking over. We need to do the same with our muscles – just get up for 20 minutes, walk round the block and your muscles will keep going.
- Make exercise part of your daily routine so it becomes second nature. I tell patients that while they’re waiting for the kettle to boil, they’ve got two minutes to do some hip exercises. While they’re brushing their teeth, they can do calf raises. Every time they get up to go to the kitchen or toilet, they can try three ‘sit-to-stands.’ It’s exercise without really having to think about it.
- Discomfort from exercise is normal, but it should settle within 24 hours – during a flare-up, you can reduce exercise levels. And remember that pain management and recovery isn’t linear – there will be good days and bad days, but in my experience, exercise can definitely help reduce the number of bad days.