Showing posts with label physical therapists. Show all posts

Maybe it was around the time I started jumping, skipping, and running in my walker that my physical therapist decided to switch to crutches. Mind you it wasn't the kind of crutches that dig a deeper pit beneath your arms but the kind you slip your wrists through, and then grip. I'd had my red walker since I was in Kindergarten till the fifth grade, and very rarely did the arm rests need adjusting (maybe once every 3-4 years?). My red walker was like my own mini-fort of safety, confidence, and independence. There were four prongs, the front two were wheels and the rear prongs had rubber stoppers. There was a front piece to it that served to connect everything together, and in my mind also served to stop me from falling over or from otherwise getting hurt. I used to turn around and sit on that front piece (even though it wasn't really a seat, and even though my P.T. said it wasn't safe). I could put my entire weight on that walker! I was able to lift it just enough off the ground to be able to turn corners, or even do a full 360 turn-around. Suffice to say I felt safe in that walker, it was with that piece of equipment that I learned to take my first independent steps in.
So when all of the safety, comfort, and security was stripped away from me I got nervous. Immediately the first thing I noticed while wobbling in my crutches was: there is nothing in front of me. My face could see the immediate floor in front of me. I then noticed how much of my weight I had distributed throughout my forearms with the walker. In crutches all of my weight seemed to be leaning on to two metal extensions, resting on rubber stoppers that were never completely flat on the ground - but instead always at an odd tilt, this made me nervous. What if it slipped? All I could see in my head was the replay of me face planting onto the pavement, crutches flying with arms and legs pointed in every which direction - kind of like a cartoon dog slipping about on ice skates.What if I forgot which I was supposed to move first - my leg or my arm? With the walker everything seemed so basic, so intuitive, it seemed like I had to relearn and reteach my body how to walk again. Had I really taken steps towards my independence? Or was I now just re-inventing the wheel?

"Okay, so which do you want to use today?" My middle school physical therapist had both my red walker and my new silver crutches in front of me. Without hesitation I pointed at my red walker.
"Well let's do some walking with your crutches first okay? And then we can play soccer in your walker, does that sound good?" 
"Fiiiine-uhhh" I grumbled.
Slowly and with a lot of patience from my physical therapist my body became used to the crutches. I found that I was able to stand with a lot more ease, move quicker, and suddenly my movement seemed to flow a lot more naturally. I was no longer pushing and jerking myself forward. Everything seemed so intuitive after a few weeks: I knew just how much to put my crutch forward without over-extending myself, I could match where my foot stepped to with where my crutch was, I understood the cross-rotating pattern of left-right-left-right-crutch-foot-crutch-foot. The weight on the palm of my hands where I gripped loosened over time, I was no longer as nervous, I was no longer scared of my new boundary-less independence.

It became clear to me that I became comfortable in my crutches when I used them on my own, at home. I knew that I preferred my crutches when I chose them over my walker when my physical therapist asked. And most of all my crutches soon became a natural part of my school day when I felt comfortable enough to walk with them around my friends at school. I was no longer limiting my use of the crutches when everyone else was in study hall and the pathways were safe for me to exercise in. I'd use them to go to lunch, I used them during P.E. class, and sometimes during the day when I was tired of sitting in my wheelchair.

The decision to switch from a walker to crutches reminded me of how resilient my body is despite its genetic fragility. It still shocks me how adaptable we are and how with practice even the most challenging and daunting experiences can become second nature to all of us.

The one thing I dread most about being discharged from the hospital after an operation or after I get my cast off is the physical therapy that follows. If you are a Physical Therapist I'm sorry, but all the PTs before you ruined it for me. As I am laying on the plush blue mat, they are always kneeling besides me with the condescending smile frozen on their faces:

"Can you bend your knee aaallll the way up to your chest for me?" She says as she tries to collapse my freshly de-casted leg towards me as if it were an accordion. Then it always gets to a certain point where my finger tips are digging into the mat, my face contorts into a wince, and I am trying to wriggle free from her grasp. My body is confused because it isn't sure how to interpret the strange sensation in my leg: is that sharp pain that I am trying to resist really just a muscle that hasn't been used in 5 months? Or is what I'm feeling a fracture on the verge of happening? Because whenever a P.T. is flexing, bending, or stretching me I always assume that she will snap something in half. I start to sweat, my stomach tightens into a knot, and I am literally waiting for that snap and then the burning sensation.
No dammit, I can't bend my knee all the way up to my chest for you! In fact I don't want to do anything for you! But of course I am old enough to know better than to snap at her, have had too many experiences to know that she won't break anything; and yet there I am, my body always resisting what she is trying to get it to do. Instinct? A deep mistrust I have of anyone touching me? Maybe it's because it always feels like she is forcing my joints to break through the rust? And doesn't that just sound painful?
Part of it is also because my body has memorized and internalized a lot of painful incidents. So as the PT is handling the latest traumatized limb or area of my body, I imagine that it is freaking out as she drags it kicking and screaming to re-visit the motions of the injury - except this time to do it correctly, safely, and in a way that won't put me back in fiber glass for another 3 months.

Several weeks later it'll be completely different:
"Wow! Look at that! See? I knew you could do it all along! You've re-gained complete range of motion in your leg again!" They are always right in the end, in my experience anyway.

Every physical therapy session I have attended is always a test to see what my body is capable of. It's probably because of the nature of the OI that this in of itself sounds so terrifying. Because usually when I have inadvertently learned what my body is capable of, it results in an injury, some painful fracture. So as I'm laying on the blue mat for 45 min at a time, I am usually trying desperately to be as mentally positive as possible - anything to make the flexing and stretching easier on me.


On Physical Therapy:

• I have yet to meet anyone who looks forward to attending physical therapy sessions. It isn't supposed to be fun! Having more realistic expectations of what PT is meant to accomplish can make the struggle less challenging
• As I have gotten older (both in part from the lectures my PT/ortho gave me, and from personal experience) I have learned that the rehab time following an injury is just as important as getting a cast on in the healing process
• Regularly including PT in the fracture management process helps young kids understand that rehab and PT are not separate to fracture care. Just because your leg is no longer in three pieces, or just because you have the cast off and everything feels fine - doesn't mean that we are in the clear
• PT sessions are not just limited to regaining range of motion or strength. There have been many instances when my body has gotten stronger than I expected it to, when I came out of PT more physically independent than I thought was possible. 
• And you know what they say, no pain no gain!