Tag Archives: physical therapy

The Good Hurt After The Bad

Last summer, when I was having abdominal issues that are now thought to be related to a hernia from torn surgical scar tissue, I figured rigorous abdominal exercise was off the table for a long time. I was right. Activities such as pilates, carrying heavy items, running, and even walking too far were painful and exhausting.

In the fall and winter, I started taking my dogs for long walks out of necessity when we’d moved and had no enclosed yard. I had a little weariness in my joints and muscles toward the end, but I was also taking them for hour-long walks in 23F/-5C temperatures several times a week and not eating enough.

At the beginning of this year, I bought a house that had an enclosed pen, and ever since then, I’ve taken the dogs on zero planned walks (does chasing down a dog in the rain at 11 on a Sunday night really count as a walk? I can’t find that activity anywhere on MapMyRun) and took myself on one long walk before the weather started going all wonky. Seriously, snow during the first week of April? As a Kentuckian, I have only seen such things before while playing Oregon Trail.

A cartoon parody of an Oregon Trail screenshot.

Congratulations, weather. I have died of ridiculousness.

I took several months off from physical activity of any kind at the beginning of this calendar year when I was working 65-plus hour weeks. My  job has slowed down quite a bit, but I haven’t ramped up my activity. One-and-a-half pilates workouts in a week’s time do not a ramping make. But if I can make it several sessions a week, I’ll count that as a re-engagement in physical activity.

A chirpy host was leading a pilates workout I stumbled across on one of my long mornings last week, and I figured I might as well make the most of this easily accessible workout, since I’m paying out the wazoo for satellite service anyway and had nowhere to be for an hour and a half. I’m old hat at this stuff, so it should have been easy. But I sometimes forget that when you haven’t worked out in a while, your body’s not as flexible or as strong as it once was.

Roll-ups were once so easy; surprise crunches, now saturated with disappointment and with an odor of failure, were all I could manage. I regretted the side kick series toward the end of the first leg’s workout.

And let’s not bring up the modifications I had to do. With wrists that require braces and special keyboards, a knee that has worn a brace during most workouts over the last 8 years, ankles I bought hiking boots to support, and a shoulder that sent me to physical therapy, there were some exercises I just could not do. Thread the Needle was off the table. Anything related to planks and push-ups had to be done with bent knees and a small towel supporting my weak left knee. Sometimes, it feels useless to even pretend to try those exercises, for the net good they would do my body. In fact, several years ago, I made .mp3 files out of my favorite pilates routine so I could listen to them on my phone and exercise anywhere, and while making the files, I specifically edited out any exercises that were beyond my physical limitations.

Everything that I could physically do, I did, or at least tried. I remembered to bring in my weightlifting gloves for my next session to make working out a little easier on my wrists. And I have the little towel on standby, ready to cushion my long-suffering knee when I have to put any weight on it.

As I was driving home from work the day of my second workout, I felt a little abdominal pain. But it was a good pain. It was the sting of aching muscles complaining that they haven’t been used in a while. It felt very different from the sharp stab and lingering nausea that indicate something is physically wrong, and that you should probably skip eating for the next month. I was happy to be able to hurt that way again.

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Wake Up Your Legs, Woman

I’ve been moved into my new house for two months, and until yesterday, I had never walked farther than almost to the outlet of my cul-de-sac. It’s winter! I’ve been hard at work! Yesterday, I was tired of doing nothing, and even though I was on the threshold of sick, I went for my first serious walk since the move.

I had been used to hour-long walks with 60 pounds of dog dragging me up and down hills. I figured walking by myself for as long as I could take it would be a snap. And for the first part, it was. Beautiful day, gorgeous countryside, picturesque cows and horses – and best of all, the dead opossum had been cleared off the road. The land sloped ever downhill toward the creek, and I kept going.

About halfway into my trek, I thought to myself, “Walking back up this hill is going to be a bad time.”

Descent into a creek valley.
Once I reached a gentle grassy hill that reached the lip of the water, I sat on a rock for a few minutes and watched the stream. I took some pictures. Then, it was time to head back up the hill. My pedometer app on my phone told me I’d walked 1.36 miles. As I squinted at my phone in the sun and looked back at the road winding up the hill, I felt encouraged at how rested I felt. “I feel great for not having done any exercise or walking for two months. This should be ok.”

Two minutes later.

The wrong side of a hill.
I took off my light jacket and made my way around the curve, winded but enjoying the exertion, through the steepest part of the ascent. I think it’s been long enough that I felt the burn, but I was more than capable of accomplishing the walk without having to stop and catch my breath.

The land began to level off a bit after a half mile or so, and I went back to taking photos and inhaling deeply the cool air (this became more shallow breathing when the wind was coming off a well-used horse pasture).

Hay.
Today, my calves are a little sore. Tomorrow, I’ll likely feel that soreness even more. But I had a great time. And if I wasn’t sick today, I’d make plans to walk the same route tomorrow to give my underused calf muscles a chance to stretch out and help me do what I most love to do: enjoy the physicality of being alive.

Later this week, I’m setting up my physical therapy gym in the spare room of my house to get back to work on my shoulder. I stretch every day, but it needs more work. Spring seems like the best time to get back to the business of repairing myself, getting serious about my eating habits, and enjoying some time outdoors.

Return to Physical Therapy

My world changed again, and I’m staring down the possibility of more at-home physical therapy to fix the things I have done to myself in the last month.

In December, I went house-shopping, found something I really liked, and put a down payment on it, a la Beyoncé. With lightning speed despite the winter holidays, my lenders came through for me with a mortgage and gave me this new house to fill with all my stuff from my last house. Living with family again was memorable and special, but it wasn’t fair to the animals to keep them cooped up all the time in our room, and we wanted to get a head start on our lives again.

We took a long weekend to paint the interior walls of the house, which sounds like a fun project until you’re halfway done with the first coat in the living room and realize every single room has to have multiple coats and all the edges trimmed in. My boyfriend and I both have our shoulder issues that made days of meticulous brushstrokes a torture and a task instead of a fun project. But we powered through it. He went back to his manual labor job, and I went back to my desk job.

The next weekend, we moved. We moved practically all by ourselves over the course of three days: packing, carrying boxes down a flight of stairs (I only fell down the stairs with a box in hand once, to my credit), taking the front door off the hinges to move the fridge into the house, somehow moving impossibly heavy wooden furniture from the garage to the moving van to the new house’s outbuilding. I don’t know how we moved a heavy CRT television as often as we did, as awful and heavy as it was, and as tired as our bodies and minds were. I don’t know that I’ve ever been more tired.

To my chagrin, my bad shoulder began to ache while we were painting. One or two nights after our move, I tried to sit up in our bed and wound up tweaking a muscle in that bad shoulder, sending a long, mean message to my brain to stop doing whatever I was doing, because that hurt. I’ve felt an occasional tingle in my upper back near the shoulder every so often, and I know that’s not a good sign.

I’ve been quite busy at the office, but I know I have to take care of myself, and the tingling, while not worse, is not better. So I’ve been bringing physical therapy stretches back into my life in order to ensure that my muscles are being worked the way they ought to be worked.

I’ve done the exercises enough to not need to look at my diagrams to tell what to do, and I usually have the patience to do all the exercises at night  before bed. I sometimes do the wall-cleaning maneuver until my shoulder is warm and I’m sapped of strength.

Another boon, in a way, though perhaps also a detriment, is that I don’t have to walk the dogs several times a day anymore. I can take them to an enclosure in the back yard and let them run around to their heart’s content, which is, by my watch, about 4 minutes before the girl dog starts baying bloody murder at the latched gate to be brought back into the house.

The upside to no more dog walks is much less stress on my shoulders from trying to control them as we walk. The downside is that I haven’t been walking or getting much exercise for a month, and my  muscle tone has suffered.

My approach is two-pronged: more physical therapy, and a visit to a lingerie store where I can ensure that I’m wearing the proper sized bra. The pain tends to occur at or just above the band of my bras, and with my weight fluctuations over the last year (I’ve been holding steady for several months), I’m not sure if the tingling and occasional pain could be helped with better support.

I’ll discuss the disaster that is my diet sometime later this week. Right now, it’s time to get ready for bed by leaning against the wall for a while.

Staggered Sign-Ups and Long-Term Physical Training

I’ve got a handful of pet causes for which I like to do 5k walks (my body isn’t up for a run yet at all). Now that the weather is calming down after another blazing summer, reminders have been going out for my favorite events, each peppering a different weekend from now until the end of November.

I don’t want to overextend myself through commitment to things I’m not sure I can see through, I don’t want to hassle friends and family for donations, and I don’t always have the cash on hand to register right when I think of it, so I’ve had to set up email reminders in Google Calendar to remind myself of when to register for events. But I’m excited to participate in them, not only for the altruism and community-fostering aspect, but also for the accomplishment of performing a physical feat.

This fall, I have plans to participate in:

  • The Undy 5000 colon cancer event
  • A non-Komen-affiliated breast cancer event
  • St. Jude Children’s Hospital Give Thanks. Walk.

As I have said, my plans to participate in running (not walking) events of any kind are contingent upon my preparing my body to be able to run without further injury. My running will only happen after I’ve worked to ensure that my core is strong, my shoulder is rehabbed well enough to allow me to wear a sports bra without pain, my feet are regularly stretched properly to prevent plantar fasciitis pain, and my knee is well-supported and protected by muscles and my continued weight loss.

To those ends:

  • I’m resuming my 3x/week 45-minute shoulder physical therapy routine at home.
  • I’m adding small parts of my pilates exercises to my routine, evaluating how much further to go based on the presence of pain the next day.
  • I’m getting back on the total paleo-ish eating plan again, since I put on several pounds from emotionally-driven and laziness-driven cheat meals.

I am sorely in need of physical activity again, besides taking the stairs at the office. After my first physical therapy workout in months, my arms have been sore from all that lifting and manipulating three-pound and five-pound weights and stretch bands. I would be more embarrassed about my weakness, but at least I intend to do something about it, and I have the tools, knowledge, and motivation I need to do it.

It may be next spring before I can run in an event, but I want to use the cooler weather months wisely, as my training period, and make myself ready to face whatever challenges I present to myself when I feel I’m ready.

Take The Stairs

My abdomen is mending, so I’m going to start taking the stairs again. You should, too!

I work on the second floor of a building equipped with elevators. The elevators are right off the lobby, so it’s so easy to walk in, say hello to the security guard, and glide into an elevator. You have to walk halfway through the building to get to either set of stairs. Out of sight, out of mind. Even though the elevators are prone to malfunction, and my coworkers and I are pretty sure they’re going to eat us one day, force of habit over many years led me to take them all the time, whether my knee hurt or not.

A cartoon of a woman standing before an evil, toothed elevator

The elevators are frequently taken out of service for maintenance. I wonder why that is? Could it be… could it be all the bones?

Back when I was 40 pounds heavier, walking up stairs sucked, because my knee was under more pressure and more prone to hurting. I’m so glad that my doctor’s food lifestyle change has worked out for me as well as it has, because I kind of missed stairs, which sounds weird, I KNOW. My grandma’s house, where I grew up, had stairs that went straight up, then wound back in a semicircle, and when I was a kid, I’d take them two at a time once my legs were long enough, playing counting games and trying not to touch the floor 13 times on my way up. What can I say, we didn’t always have a Nintendo.

I started taking the stairs for a challenge on the Slimkicker app a couple of months ago. Good for points, and good for my body, and once I got into the habit, it was so easy. I only walked up a flight of stairs a couple of times a day, but since I do such little cardio otherwise, I got a lot of benefit from it. Plus, the back exit of the building leads to a decorative tree area where I can walk out into a bit of nature to defrost from the frozen tundra that is my office during the warm months.

Photo of glass double exit doors for an office building

Exit near the stairs – portal to a few minutes of lunch respite, or to the end of my work day.

Since I stopped taking the stairs, I’ve not replaced it with any other form of exercise, and I have begun snoring again. I can’t help but think the two are related.

When your knee is borked, do you want to take the stairs? Understandably, no. When your abdomen is healing from surgery or from torn scar tissue, do you want to take the stairs? No, no, no. Ack. Related question: do you want to just never move again and never test your body’s healing process, just opting out of using body parts as they break down, and get less and less fit? Um… no? I guess not?

I remember doing my favorite pilates workout for the first time several months after my 2010 gallbladder surgery. I don’t know if my discomfort was more physical, stretching muscles that had healed but hadn’t really been worked very hard, or mental, thinking about what could go wrong, imagining worst-case scenarios, as I’m apt to do. I got through it, though, with the thought that hell, I did a fundraiser walk two months after going under the knife, why am I afraid of twisting around on a mat on the floor?

Your body heals and rebuilds itself if you feed it properly and if everything is working correctly on a chemical level. The hardest aspect of restarting a workout routine after you’ve had a surgery or an injury is mental, and there are two sides of the same coin: overdoing it too quickly because you think you can do more than your body is capable of handling, and you wind up reinjuring yourself, or you are so afraid of experiencing that pain again, of aggravating the soreness of a sore spot, that you avoid exerting it at all. There’s a middle ground to be found through both listening to your body and having the courage to try, no matter what you’ve been through.

With that in mind, I think it’s a bit too soon to get out my mat and throw on my favorite pilates DVD. My healing abdomen needs another few weeks, occasional twinges of pain reminding me that I’m still knitting back together. In the meantime, I have vowed to take the stairs – slowly and carefully – as often as possible, unless my body tells me to take the elevator and ice down my abdomen.

So: being more cardiovascularly active, potentially improving my snoring, strengthening my leg muscles for walking or running endeavors, and using those abdominal muscles – benefits of the free mini-workout my office makes available every morning, if I’d just make myself get back into that habit. Better than trusting my body to the man-eating elevators.

Is My Knee Up For C25K?

My doctor took a look at my knee last summer during my first-ever visit in order to evaluate my knee pain. I tried to shove aside the embarrassment of having missed a spot when shaving my legs earlier that day and listen well to what he said so I’d know how to proceed with my fitness goals… and whether I really had arthritis, as I self-diagnosed myself as having in my early twenties, since one of my siblings with similar knee problems had arthritis already.

After extending it and palpating the sides, he said, “Feels like you may have a torn meniscus.” That’s not arthritis. That’s not so bad, right? He said he could do more tests to find out what was going on, if I cared. I could do physical therapy for it (not a high priority at the time, since I was still suffering frozen shoulder and was totally focused on that). It was possible they could do some surgery to repair or rig up something, but once you start in on the knee, he went on, it’s pretty much surgeries for the rest of your life. “Well, you don’t do a lot of running, do you?” Wait, how could you tell, me being obese and having knee pain?

All photos of me being active over the last few years depict me in a Velcro knee brace that minimizes the pain during the activity, and I elevate/ ice my knee down after anything strenuous just in case. That joint has been behaving rather well for all dog walkings and the several 5k events I’ve done since I began losing weight. There’s been less stress on it and therefore fewer instances of pain. I’ve even been taking the stairs up to my office as much as possible, partly to save electricity, partly to add just a little bit more exercise to my life, and partly to benefit my leg muscles.

A woman in athletic clothing and a knee brace

From Komen 2010: “Braaaaace. Brace? Braaaaaaace!”

When I did the local 5K in May with my dog, we ran in short bursts, and it was a lot of fun for both of us. And it didn’t hurt me that much; I elevated and iced my knee right after the race, and I was fine the next day save muscle soreness, which is a whole different, wonderful beast than joint soreness. It would be fantastic to take both my dogs out to run more often… once the Texas summer is over (so, in October? Sigh).

I tried the well-known Couch to 5K program back in 2006, but I was a little bit more out of shape and was about 40 pounds heavier than I am now, and I didn’t own a knee brace or an ice pack. I lasted about two weeks before it just became too painful. It didn’t help that, at the time, I lived on the third floor of an apartment building with no elevator, so when my knee hurt, I had to tough it out and walk back up those stairs. Exerting oneself to build strength and test strength is one thing; stressing a body part that needs to heal is another. As a previously injured person, I wasn’t doing myself any favors by trying too much, too soon.

An MS Paint drawing in the style of a video game looking at a tower of stairs.

BUSTED KNEE TOWERS: THE VIDEOGAME didn’t sell very well, for some reason, despite its graphics being slightly better than Ski-Free and Donkey Kong.

I wonder now if I’m ready to start running. I would love to test it out, though I’d rather start in a field on dirt and grass. And maybe I should get my strength up in other ways, too – start out with a month of pilates to work on my core and get everything used to moving again. And I should continue with my at-home physical therapy for my weak shoulder. I have missed a few workouts due to being ill the last several days, but I feel better when I get it done.

I go back to my doctor in a month or two. I will start preparing myself to run by continuing shoulder therapy, doing pilates at least twice a week, and researching exercises I should be doing to strengthen the muscles supporting my knee. Then, I’ll discuss it with my doctor. I hope to have lost even more weight by the time I see him, blowing right past the goal weight he set for me back in February. I’m sure that will help my chances of being able to run more comfortably and with less chance of seriously hurting myself if I start running.

If running is completely taken off the table, I’ll have to suck it up and content myself with walking, which I already love, and weightlifting, when my shoulder is ready. I’ve got a backup plan based on my current reality, but I am shooting for a goal that’s seemed out of reach for most of my adult life.

Restarting At Zero

A while back, I strained my shoulder while lifting weights. I lifted too much too quickly, and I didn’t give my long-term injury enough time to heal, or enough build-up to what I was trying to do.

I’m not in serious trouble with the law offices of Left Shoulder and Buttkick; I can still lift my arm above my head just fine, I can still wear my bras, and it doesn’t hurt when I shrug. But I can feel soreness again, an all-too-familiar pain, when I have carried something that was too heavy.

So it’s time to start building up my strength again and stretching those ligaments and muscles. This is my “Super excited to be shackled to this routine again” face. But like I said, this isn’t me trying to talk my arm into moving normally again; now, I’m just building up strength and stamina. And it’s been far too long since I stuck to an exercise routine.

Last fall, while I was doing at-home physical therapy workouts 2-3 times a week, I was also pretty good about throwing in walks, pilates, and other kinds of workouts on the other days, giving myself one or two rest days a week. This routine gave me stamina and strength, but it wasn’t really budging the scale, mostly because my diet was still crappy.

There’s nothing more boring, though, when you’re not aching for physical relief, than holding a stretch for several seconds. I had 7 exercises of stretches to do, each 5 sets of 15-20 second holds, and as I lay on the floor this evening with my elbow perpendicular to my body, pushing my forearm arm down parallel to my body, and holding that gentle push for 20 seconds, I thought, “Oh, my god. I am never going to get through these.” There aren’t that many? Yeah, I know! But doing them twice per day? You mean, I have to exert myself? The horror.

Doing the wall push-ups isn’t so bad, as there’s a lot of coordination involved in keeping me upright enough, pushing off, breathing out when I push, all that crap. There isn’t time for my mind to wander, and my sets are counted with completed push-ups, not arbitrary seconds that I can shave or bloat based on how quickly I count. Not so when I’m sitting in a chair trying to read my screen as I pull my head slightly forward, wondering how long I can take sitting there before my pose is over and I can finally scroll down the screen.

Cartoon of a woman struggling to get through timed physical therapy stretches.

Resolute stretching: “I am going to get through this, damn it. Why do we never vacuum this stupid rug! The dog is licking my knee!!! …Oh, hey, set’s over.”

I’m a quiet, patient person, and I can contentedly sit in silence letting my mind wander if there’s the leisure to do so. I’m the only person I know who can go on long road trips with nothing but occasional radio to keep her company; letting my brain chew on threads of thoughts and digest others without the interruption of distraction is something I rather enjoy. When I have uninterrupted periods of idleness, I can adapt much more easily to doing nothing than if my concentration lasts only 20 seconds before I have to move. These exercises I’m doing are small oases that I don’t have time to appreciate, little meditations on the value of taking recovery slow, but I occupy my space, get into my position, and count down the seconds, anticipating the change and wanting to be done already.

I should be more grateful that I have the tools to repair myself, that my body is adaptable enough, and that I’ve had medical advice to get me back to where I want to be, and all I have to do is exert myself just a little, no matter how boring.

It’s going to be worth an hour’s worth of staring at the carpet to not have to worry that the longer I ignore the twinge in my arm from sleeping on the affected shoulder, the more likely it is that my injury is going to slowly creep back into my life and make it incrementally harder to move that joint and more painful to do everyday activities. I have to take it slow. I have to make myself take it slow, and make myself take the slow route of careful, measured steps toward increased strength. There’s no fix besides effort, so like it or not, I have to suck it up and get it done.

I’ll probably give this recovery, if I can sustain the necessary energy to continue with my stretches and some exercises, till the end of the summer, then go to my doctor and get a recommendation as to whether I can start lifting weights again. I might even consult my old physical therapist to seek his advice.

My life has been drastically improved by seeking help for my injuries and sticking with a recovery program of physical therapy and rest. I will honor the time, money, and energy I’ve spent so far on making myself better by continuing to take care of this body as best as I can.