Physical Therapy: Put in the Work, Trust the Process…

Preface: I just have to give a shout out to my friends at Benchmark Physical Therapy in Fort Oglethorpe, GA. I owe them a LOT, and I appreciate them always encouraging me to be the best me that I can be!

The image shows a typical red and white "Hello, my name is" type of name-tag. In the white space where the name goes, the word "Spoonie" is written in black letters.

The Pep Talk…

Spoonies are people who have chronic pain/illness, and the term “Spoonie” refers to Spoon Theory – this article from the Cleveland Clinic explains it well. With regards to physical therapy, many Spoonies have to do therapy/rehab at some point in time, it’s almost inevitable. Whether it’s to help us with pain, balance issues, mobility, stamina, or some other area in which we struggle – committing to a regular physical therapy routine can be vital to our overall health.

It’s not at all easy for a Spoonie to commit to physical therapy. I get it. I will also admit there have been many days (especially in the beginning) when I did not have the spoons to get out of bed, let alone to get up, get dressed, and go to my PT session. THOSE are the days when I’ve had muster everything within my personal arsenal of motivational “stuff” to do it. I may have little pep talks with myself and recite mantras like; “I am lucky to be able to go to physical therapy”, “I always feel so much better after PT”, “I am seeing major progress and I need to keep this momentum going”, and “If I want to ever walk again and be more independent, I HAVE to do this”… and so on. It usually works. Most days, I DO feel much better after my session. I am continuing to get stronger every day, and this keeps me going.

Granted, there have also been a handful of days here and there when I definitely could not have done a PT session – and that’s okay, too. A little grace goes a long way! (Stubbornly, I do have to work hard to give myself grace, but I usually get there in the end). That’s just how the spoonie life rolls. On those days when it might not be in my best interest for me to go to physical therapy, I have to make that judgement call for myself. I know in those instances my therapists would rather me stay safe at home than to be there and possibly get hurt because of how weak or dizzy I am. As Spoonies, we do have to pick our battles. Equally important, though, is that we also have to know when to challenge ourselves. We NEED that challenge, and, whenever possible, to embrace it and just get stuck in!

My physical therapists understand that I still have a lot of fatigue. They give me plenty of opportunities to take short breaks here and there as needed, always keeping me in the driver’s seat on that one. Due to pseudotumor cerebri (on top of the autoimmune diseases), there are days when I may be dizzy or experiencing a migraine… and they are also sympathetic to that. My physical therapists are highly trained professionals who are quite good at their jobs. In my sessions, the motivation and expertise they provide for me are paramount to enabling my success. I am truly grateful for their dedication to me. Lucking up on this physical therapy team was like opening a particularly stubborn oyster and discovering a grungy old pearl inside (myself). The pearl hasn’t seen the light of day in years but these physical therapists are working hard to rediscover the beauty residing deep within it. I feel as though they can help me to shine as I was always meant to as they teach me how to walk again (both literally and figuratively)!

Reality Check…

Do I still have pain? Darn right I do! At the end of the day, I still have six autoimmune diseases, and I will absolutely have pain – that’s unavoidable. I also have some suspected muscle atrophy from having been mostly bed bound for four and a half years, as well as some spinal stenosis, so my stamina isn’t what it could be. On the upside, the Wahls Protocol has helped to lower my inflammation as well as my pain levels. It has also reduced my autoimmune flares in both duration and frequency. Additionally, because I have lost 45+ pounds, I have come off the two meds I was on for blood pressure, and I have been able to discontinue the opioids for pain relief (opting now for CBD oil instead). I have far more going for me now than I did even six months ago. And guess what? Every week, physical therapy is advancing those improvements for me even more. In other words, I feel as though I can work through any residual pain in order to do these physical therapy sessions because of the gains I am experiencing.

Do the Work!

One of the most crucial tenets of physical therapy is this: You get out of it what you put into it. In this regard, you must not only work closely with your therapists at all of your sessions but also DO THE WORK AT HOME. Yes, you absolutely must do your homework! Like being in school, if you don’t keep up with your studies, you’ll fail the midterm. Motivating yourself to do physical therapy at home isn’t easy, but doing so will make your sessions go more smoothly. It will also enable your therapist to regularly introduce new therapies as you progress, which will facilitate further improvements to your strength and stability. Attending PT sessions and *not* doing the supplemental work in your own time is akin to just “phoning it in”. What’s the point? It’s a waste of your time AND your therapist’s. (Not to mention that it’s a waste of money – either your own or that of your insurance company).

One of my therapists told me the other day that I was a “star student”. It made me sound a bit like the “teacher’s pet” (which I can assure you, I never was as a child) but in this instance, it also made me feel good. Mind you, I don’t do physical therapy for the praise or kudos – I never have. From the very start, I committed to this process to try and help myself to be more independent and to feel better. I wanted to be less of a burden to others – and to take care of myself. That’s all. Pretty simple, really. But… I won’t lie – hearing now and again that people see and appreciate the hard work you are putting in is truly a satisfying feeling. It’s also great motivation to KEEP GOING!

Need MORE Motivation? Read THIS!

Last week, I went in to one of my regular physical therapy sessions and I saw that they had a new poster on the wall. They do have a few other motivational posters scattered about the facility, but I noticed this one straight away because it had no imagery and was… well, wordy. It was right up my alley! I’m a big fan of ALL the words (there’s a reason I majored in English). I had a hard time reading it there, as it was lengthy and I needed to start my session. I tried to take a photo of it to read later, but it turned out a bit fuzzy. I was, however, able to do a search online based on the first sentence, and I found a more readable version. The person who penned this is a physical therapist themselves – which makes total sense. The author is Nick Hannah, and you can find them on Instagram. I will copy and paste the text below, as well as put it in the ALT for the image. This is POWERFUL stuff – and every word of it is SO TRUE!

For those of my Spooniekind who are in physical therapy, whether you are just starting out, or well into your routine, PLEASE take these words to heart! Trust in the process. Trust in your therapists. Trust in your medical professionals – OR find new ones that you CAN trust. Trust in yourself. Most of all… Trust in LIFE. You’ve got this! I promise, it’s worth it. Physical Therapy can be a GAME CHANGER for those of us with chronic illness AND pain.

The image shows a giant poster with a lot of words. The poster has a white background with black letters. It is about physical therapy and it says: “The plain truth about rehab if you dare to read it: It’s really hard! (For you, your therapist and everyone who cares abut you.) Hurt does not always mean harm. You will need to make actual changes. These changes may involve modifying your activities and/or taking steps to improve your general health. Your beliefs will be challenged. This process can be uncomfortable but you will learn a lot. You will make mistakes. It’s totally normal, but learn form them. Your health provider is not perfect. We’re human. Your progress will not be linear. There will be ups and downs in the process. Failures will happen. You will get frustrated. You will have doubts. Trust the process, yourself and your therapist. There is no magical quick fix. Passive approaches to rehab are not the solution. Gimmicky products are not the solution. Be wary of anyone who promises instant results or cure-alls for everything and everyone. You need to be empowered to control your own journey. Structural changes on scans often won’t totally explain your pain. (Nor do you need to change them to change pain). Multi-disciplinary care approaches will almost always trump singular care approaches. Pain may not be the first thing to change. Rehab isn’t just about improving pain- it’s about improving quality of life and well-being. Your pain is always multifactorial. No, you’re not making anything up. Nobody has all the answers, but find professionals with more scientifically backed ones. It’s all about the small victories: treasure them. You’ll need to ask a lot of questions. You’ll need to write stuff down. You’ll need to set goals and prioritise what’s really important to you. You probably won’t improve all on your own. There’s never any guarantees, but there is always hope. Remember, change is always possible. In the end, it’ll be worth it.”

“The plain truth about rehab if you dare to read it: It’s really hard! (For you, your therapist and everyone who cares abut you.) Hurt does not always mean harm. You will need to make actual changes. These changes may involve modifying your activities and/or taking steps to improve your general health. Your beliefs will be challenged. This process can be uncomfortable but you will learn a lot. You will make mistakes. It’s totally normal, but learn form them. Your health provider is not perfect. We’re human. Your progress will not be linear. There will be ups and downs in the process. Failures will happen. You will get frustrated. You will have doubts. Trust the process, yourself and your therapist. There is no magical quick fix. Passive approaches to rehab are not the solution. Gimmicky products are not the solution. Be wary of anyone who promises instant results or cure-alls for everything and everyone. You need to be empowered to control your own journey. Structural changes on scans often won’t totally explain your pain. (Nor do you need to change them to change pain). Multi-disciplinary care approaches will almost always trump singular care approaches. Pain may not be the first thing to change. Rehab isn’t just about improving pain- it’s about improving quality of life and well-being. Your pain is always multifactorial. No, you’re not making anything up. Nobody has all the answers, but find professionals with more scientifically backed ones. It’s all about the small victories: treasure them. You’ll need to ask a lot of questions. You’ll need to write stuff down. You’ll need to set goals and prioritise what’s really important to you. You probably won’t improve all on your own. There’s never any guarantees, but there is always hope. Remember, change is always possible. In the end, it’ll be worth it.”

Nick Hannah