injuries


I’ve been working seriously on changing my posture for the last six months. I’ve been seeing a chiropractor, a massage therapist, and a physical therapist. On normal days I do about two hours of stretching and strengthening exercises–postural reprogramming stuff that they have assigned. On super busy days I do about an hour’s worth.

I’m strengthening the muscles that hold my shoulders and head back and up. I’m lengthening the muscles that pull them down and forward. I’m decreasing the exaggerated curvature in my thoracic spine (called kyphosis), especially focusing on the top few thoracic vertebrae. I’m increasing the twisting range of motion in my thoracic spine and ribs. I’m learning to relax muscles in my legs and butt, back and shoulder blades. I’m learning how to sit differently, stand differently, sleep differently, and especially walk differently. I have an alarm set to remind me about posture every 20 minutes that I’m awake.

The thing is, I’m almost 40 and I don’t have kids yet. I need my body to stay fit for at least another 20 years, and preferably more like 50 more. But nearly three years ago I started having some serious pain in my body–after 37 years of being as athletic as I pleased, I was suddenly limited in how much I could run, lift, swim, and sometimes even walk. One year I could go to a Lindy Hop event and dance all day and all night, and the next I had maybe two hours, maybe 15 minutes in me. Unacceptable.

And it turns out it’s because of my posture. Joints, muscles, and their connections do not work properly if not in the optimal relative position to each other. The habitual position of my joints had put enough strain on my body that I started having intense pain.

My chiropractor once told me, “You are the most compliant patient I’ve ever had.” My PT and massage therapist have said similar things. That is exactly what I’m aiming at–the most compliant patient. I do not just show up. I do not intend to waste my money or my life getting care and then not following through with the recommendations of my providers. If you tell me not to ride my bike for 3 months, I start walking or taking the bus. If you show me how to walk differently, I will walk differently. If you tell me to do 45 reps of some new, super-awkward exercise every day for the foreseeable future, I will do it. I am your perfect patient. I do it because I’m hoping you know what will help. I want to make you look brilliant. And I do it because if, after a couple of months, what you do and have me do has not helped noticeably, I will find someone else to work with, because I have tried you and your ideas out to the letter.

Advertisements

I am in a long, slow recovery from a sacroiliac joint sprain. I’ve just started being able to do more exercise than mild physiotherapy exercises, after almost nine months. I have to be careful, but I can do it. I am in the worst shape of my life, and generally I dislike it. The one nice thing, though, is how little I have to work to reach an aerobic heart rate.

In my normal shape, for example, bicycling is not a good choice for an aerobic workout. I have to push uncomfortably hard just to get to my minimum, low-level aerobic heart rate. [Which is somewhere around 108 beats per minute–60% of an estimated maximum of 180, since I can’t yet push hard enough to discover what my actual max is.] Now I can hop on my bike and hit an aerobic zone within a minute of riding gently. Pretty nice!

I’ve often wished I had a biofeedback device that could tell me whether something I was doing was good, bad, or neutral for my body. I have found pain and other sensations ambiguous directors. What are they asking for? This has been especially important in the last few years, dealing with injuries and slower healing. I recently asked my physiotherapist, Shannon, for her general recommendations for reading pain related to an activity. This is what she said:

1) Joint pain is never okay. If you experience joint pain during or after activity something is wrong; consider getting help to figure out what.

2) You should have no muscle pain during an activity (if you do, it means you are doing way too much).

3) Muscle pain after an activity means you are close to the right intensity – try lowering intensity and/or duration for a while and see how you respond.

4) Mild to moderate muscle pain in the next couple days is fine as long as it doesn’t escalate.

5) Each time you add an activity, do it at a constant level for 1-2 weeks before increasing duration or intensity

Today a chiropractor told me, based on my x-rays, that my left pelvic bone had gotten stuck. He held his hands out as if he were going to catch a basketball and said, “Imagine my hands are your pelvic bones and we’re looking at them from behind. Your pelvis did this [bending his left wrist back] and got stuck there.” He adjusted my pelvis, which seemed like a very mild adjustment for the problem he described, and gave me this list of “do’s and don’ts” for the next few weeks. Following them will mean walking a lot more and sitting a lot less–probably a good thing even if my pelvis wasn’t twisted.

1. Do not sit for extended periods of time. Alternate your positions–standing, sitting, walking, lying down. When driving long distances plan to stop every half hour or so for a brief walk.

2. Walking is the best exercise for you at this time. Temporarily discontinue all other sports activity and exercise programs. Ask us about a particular activity if you are not sure.

3. Avoid movements that use your abdominal muscles and the muscles of your lower back. Avoid awkward twisting, bending, and lifting movements. Get next to, under, or behind any object or load that you need to lift. Use your leg muscles as much as possible and spare the muscles of your lower back. Avoid “sit-up” type movements.

4. Avoid movements that spread one leg far apart from the other–all straddling positions.

5. Do not cross your legs or ankles.

6. If any discomfort occurs in the sacroiliac area ice can be applied 15 minutes out of every hour.

7. The proper procedure for lying down and getting up is most important. To lie down, first sit and then slowly lower your body bringing up both of your legs, being careful to keep them together. Then, turn your body on your back using your arm and leg muscles. When arising, turn your body on its side, drop your feet to the floor while pushing up with your arms and legs, not using your stomach or back muscles.

8. When moving objects from one place to another, make sure that both your feet are pointing in the same direction as your upper body. Do not keep one foot planted while twisting your body and moving the other foot the direction your are twisting.