Wednesday, September 25, 2013

Feeling Stronger Everyday - Rehab: The House of Pain/Gain

Update:  Great news!  My Doctor says that I am exceeding expectations, and has lifted all restrictions (to “as tolerated”) and has given me the go ahead to ditch my crutches.  I am back to using my cane.  Hopefully in another month or so I can ditch the cane as well.  I have been given a whole new set of rehab exercises to strengthen the lateral movement and muscles of my left leg.  They are extremely difficult but I am moving around much better.  This week I am going back to traveling on the bus on my own for the first time in months.  I now have a semblance of normalcy returning to my life.  Yes!


Rehab: The House of Pain/Gain

If you've ever gone through major limb or internal surgery, or are planning on going through a surgery, there is one thing that will always remain a constant:

Rehab sucks!

Now I'm not saying this to discourage you from having surgery.  We all must do what is best for our bodies, and for our lives.  However, there is a truth here.  Every time the human body is cut open, it becomes weakened.  Even after the external scars heal, there are situations happening inside the body that still need to be dealt with. Your body will be contending with inflammation, pain and discomfort, infection prevention, overall weakness, muscle atrophy.  While inflammation, pain and discomfort, and infection can be combated by ice and medication, and overall weakness eases over time, there is only one way to fight against muscle atrophy.  Exercise!

I have gone through Physical Rehabilitation (Rehab) enough times during my life to wince every time a hospital Escort pushes my wheelchair to the room that is boldly marked: Physical Therapy.  I have always referred to PT as “The House of Pain,” because I knew that inside this room, well meaning and overly cheery men and women were going to strap me into strange machines that manipulated my body, or make me do funny looking exercises that would make the previously operated body part HURT...A LOT!   I knew that they were just itching to watch me sweat, strain, and cry out as I repeatedly moved the affected body part the way they wanted me to, over and over again.  I earnestly hoped within the fabric of my very being that I was able to do what they asked, and in the proper form enough times, so I wouldn't have to do, “just one more.”  Drenched in sweat, and throbbing in pain at the end of each session, I dreaded hearing the Tech say, “Great job!  Now let’s get you scheduled for your next appointment!”  Each day I screamed inside my head, “Oh, HELL NO!!”  But out loud I would say, “ok.”

Y’know what though?  After the sessions, I found that I was moving better and better with less pain each time.  Funny how that works.

I've also seen the results of those who refused to deal with Rehab on any level.  It’s painful to watch people who are limping around for years after surgery chained to a walker, crutch or cane. Or observing the troubles of those who can't move or lift their arm, or bend over to tie their own shoes, or who are generally and fundamentally “not right.”

I get it.  Pain hurts, and the body does its best to avoid it at all costs or at least as much as possible. The paradox is, in the case of rehab exercises, the pain is there, not to tell you, “Oh my God I’m gonna die if you make me do this again,” but to tell you that this body part has a problem and needs your help to solve it.
Oh, the pain!  The Pain of it all!

 Let’s face it: after surgery, you body part is spazzed out.  There are ligaments and muscles that have shrunken and need to be stretched, or have been cut and need to be worked back into proper shape, or strengthened so that they can hold the load of the body again.  It is tough to do, but it is a necessary evil.  And as much as it hurts to work them, it is so much better to go through short term pain, than the alternative: long term disability.

 I am currently doing side leg lift exercises (among others) for my new hip replacement, and brother, it is very difficult to do them correctly (which makes the hip hurt), when my brains screams PAIN, and my body’s immediate reaction is to “cheat” and move to do the exercise improperly (less pain).  It’s amazing how my mind can justify this by trying to convince me that, “at least you did them.  That’s something, right?”  Wrong.  In this case, if it’s not hurting, it's not helping.  Doing the exercises in the proper form is extremely important as well; otherwise for the most part you are wasting your time.  This is a case where the more sweat equity (or pain equity) you invest, the more you get back.  Believe me, you will be surprised by your results, and how quickly you are able to achieve them.

Keep in mind I am not a doctor, nor do I purport to be one.  However in the spirit of offering the benefit of my own experiences, here are some tips that have helped me, and may help you with your own rehab:

1)      If you are planning to schedule surgery, or have just scheduled, contact your healthcare professional and find out what pre-surgery exercises you can do to strengthen your body before hand.  It is far better to approach surgery with a stronger body.  This will help make your rehab far more productive and speed up your results. 

Post Surgery
2)      Get a sheet with a diagram of the exercises that your healthcare professional wants you to perform, including the number of repetitions and duration of each one.  Set this where you can see it so that you can perform the exercises correctly.  Don't strain yourself by trying to remember how your exercises are supposed to be done.  You’re probably on pain medication anyway which will affect your memory.

3)      Take your pain medication 15 minutes before doing your exercises.  This will take the edge off the pain you will feel later.  Trust me, this helps!

4)      Music!  Play your favorite up-tempo tunes as a background for exercising.  You can use it as distraction to help as you are counting out each exercise rep.  Not a music person?  You can also use TV as a background.  Turn on the big game, or a favorite program and use that as a distraction.  Don't forget to keep count if you do.

5)      Find a motivation!  Do whatever you can do to motivate yourself through your exercises.  Place a photo of yourself when you were well in front of you to look at while you are exercising.  Or think about how good life will be as you gain more strength or mobility.  Personally, I have watched the Gatorade "One More" commercial before doing my exercises, to give my competitive juices an added push.  

6)      Keep a journal and/or make note of your progress and achievements every few days.  Can you do something now that you couldn't do last week?  Did you reach that shelf, or walk without that walker?  Note it, honor it, and celebrate it.

7)      Do your best!  Even if at first you cannot do all the exercises the first time, eventually you will.  Don't give up.  Keep pressing.  Yes it’s hard, but you can do it.

8)      Do not skip a session!  Do not allow yourself any excuses.  The mind can and will play tricks on you and come up with a myriad of reasons why you cannot rehab today.  If you skip out of rehab today, believe me it will be doubly harder to do those exercises tomorrow.  The harder they become, the easier it is to say “forget it.”  You do not want to do this to yourself.  Bite the bullet and do your rehab exercises everyday.  Whether you are traveling to a rehab facility, or doing exercises at home, try to do them around the same time each day as well.  This way you can plan the “myriad of other things” around your rehab schedule.

9)      Push, but not too hard.  If you are doing well and want to increase the number of reps you do for each exercise, that’s fine.  But be reasonable.  Increase your reps incrementally and build yourself up to do more.  Remember: One more!  Don't worry about being a workout wonder.  You are only competing against yourself.

10)  Be positive.  Your amount of success will depend on your commitment.  This task is not insurmountable though.  Picture the healthy new you, and fix it in your mind. You are undertaking a tough job, but YOU CAN do this.

Remember, rehab is supposed to be a pain, but if you focus and fight through it with the right mindset, it will be a gain.  Now say it with me…

“One More!”



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