I Love........Physical Therapy

I love PHYSICAL THERAPY. I "graduated" today from a month of physical therapy on my knees. My right knee is a bit of a mess internally.....there is evidence of an old injury (of which the clumsy me has no recollection of injuring, but they say could have even gone back to childhood), bone spurs, and most importantly the start of arthritis (which is here to stay....it is not going away). Lisa, the physical therapist that developed my care plan, has also said that neither of my knees is "tracking straight" and there is fluid built-up behind them. Oh, and I could play one of Cinderella's stepsisters right now, because they are downright crunchy! You can tell it fascinates me a bit. OK, a lot. Still I have been incredibly healthy most of my life and the idea that this area of my body is "turning on me" alternately annoys me and reminds me how fortunate I am.

I've had pain in my knees since spring. I tried to "push through" it, as many suggested to me, but that just didn't feel to me like the best way to care for my body. I'm a believer that we can ruin our bodies with excess just as we can with neglect and I have come to a point where I try to listen to mine, and learn the difference between building it up and tearing it down.

My wonderful nurse practitioner Judy offered me a couple of suggestions when I was discussing it with her during my annual physical. My choices as I saw them were I could start visits with an orthopedist (which makes me think of shots and surgery), I could go straight to physical therapy, or I could continue doing nothing. The physical therapy seemed to make the most sense to me.

Since I had benched myself into not working out at all due to the pain (awesome excuse....and it is so easy to just give it all up!), I had already seen my whole body impacted. Yes, there was the weight gain that is a horror to any woman, but to see my muscles soften and sag was the most heartbreaking. And probably the most motivating to get out of the rut, because I believe that one of the major responsibilities God has given me is to be a good caretaker to this shell I reside in.

I've already written about my feeling of hopelessness I felt when I was told I couldn't run again at my first physical therapy appointment. Well, it wasn't necessarily forbidden. I was told I could do it if the idea of knee surgery in my near future was acceptable. As caretaker of my body, that seems like lighting a fire to a room to clean my house. So no, not the best option! I knew I had to change my mind about the direction in which my body needed to head.

Since I was using physical therapy to strengthen rather than cure, I think my experience was better than most. Well, easier anyway. It seemed simple. I had to do things like step up and down a stair. Sounds really easy, doesn't it? Then why did my body weirdly wobble at times as I attempted to keep my balance? Why couldn't my brain keep the right pattern in it and get the proper rhythm going? At times it seemed like all these mini-failures were going on, but eventually it would click. And yes, I would feel pride that I was getting it right. I could do this.

I listened intently for anything that would give me information about my body. They confirmed the lack of strength in my legs (shocking because my legs have always been pretty strong), and that my balance is terrible. They explained the areas of my legs we needed to build up to take over some of the weight bearing that my knees just can't handle. As experts their eyes could see things mine couldn't. They could see a slight tremor and know what that particular muscle was experiencing and how to make it stronger.

The physical therapists constantly asked me my pain level. I have a difficult time answering that question. I still don't think I do it well. I am sure it is because I over-analyze the question in my quest to come up with the "right" answer. Maybe there isn't a right answer. Maybe it is just a matter of the relationship between all of your answers. My four may be someone else's eight...but what matters is when that four goes to a three or a five. I felt like it was maybe a three or four when we started out. They weren't making me do much that caused pain to my knee, but it did hurt when I did certain things. Through most of PT, though, I didn't feel pain. My level was zero. They said that was good. But I learned to articulate another level of things. I learned to be able to express while at times there was not pain, there was discomfort. That still was significant. I learned that sometimes that discomfort was a good thing, as I was building things up, but sometimes it meant that I was headed in the wrong direction and I needed to back off or try something new. I had to think about it to try to figure out the difference. As someone with focus problems ("Squirrel!!"), I had to make sure I kept myself aware of how what I was doing impacted my body. I learned to try to mentally articulate what was doing on. A bit different than my typical "I hate this, I hate this, I hate this" I normally focus on when working out.

You do physical therapy in a room with others doing physical therapy. I saw many recovering from knee surgery. They faced much more pain than me...a reminder of what I was possibly avoiding in trying to make a pre-emptive strike. I'd hear other patients report pain levels of eight and ten. How fortunate that even at my worst, when the pain got too painful to run, that I don't believe I would have been at that level of pain.

Physical therapy reminded me the little things matter.

• A slight twist of my foot may make a calf stretch a bit deeper.
• Not going down so much on a squat would give me the stretch my body needed without making my knees hurt afterward.
• A few extra reps of a lighter weight may build up my strength faster and safer than doing fewer reps of a much heavier weight. Doing a lot of reps of a simple move may take the muscle from comfortable to throbbing.
• To get stronger, you need a bit of resistance.
• You can wear yourself out doing an exercise wrong, but not get any stronger. 

The most important thing that physical therapy reminded me is that where I am today is OK. Yes, had I done certain things differently (such as continuing exercise that didn't stress my knee when I started having issues) I would be in better shape today. But what is gained in letting my mind stall in that place? I still have a distance to travel to be where I need to be, but I have more tools in my arsenal. For example, I don't have to give up my treadmill. I can use it differently. Who knew that walking on it backwards, slowly, could strengthen the muscles I need to strengthen most? When I master that, I can add some sidestepping, that will strengthen other muscles and help me work on my balance. There is no need to be bored.

When I took yoga classes years ago, I saw that everything yoga requires, I lack. Balance, attention span, flexibility. The instructor taught that the first thing that was necessary to practice yoga was that you looked within and didn't compare yourself to anyone else and that you learned to know your body and listen to its natural wisdom. Physical therapy reminded me of these concepts.

Our bodies are great gifts, and regardless of their current shape we must treat them well. Good can go to bad, bad can go to worse. But also, worse can go to best. The plan for care is as individual and unique as we each are, but it needs to be a plan where we succeed. You need to compel yourself to  advance and change course as needed. And you need to celebrate the small victories, because they win us the war.

I'm glad to be a graduate of physical therapy. I love what it did for me. I will now enroll in grad school.