An Unexpected Journey

"Health is the condition of wisdom, and the sign is cheerfulness — an open and noble temper." – Ralph Waldo Emerson

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Physical Therapy: A (Long) Description

pulleyI’ve mentioned physical therapy in previous posts, but I realized while going through my session today that I never actually described just what I was doing in physical therapy.  To recap, after some unspecified injury, I developed Adhesive capsulitis (aka “Frozen Shoulder”).  It’s a condition where your range of motion becomes limited and there is pain when you attempt certain movements.  Certain daily activities as mundane as reaching for something on a shelf or putting on your shirt can suddenly become difficult or even painful.

At first, my routine only consisted of a couple exercises and then my physical therapist would stretch out my arm and shoulder beyond what I could do on my own.  However, over time I’ve been given more and more exercises.  My routine now takes me about forty minutes and that’s before I see the physical therapist!  Here’s that part of the routine:

Hand Bike
This piece of cardio equipment has two grips that you hold and rotate around, just like the pedals on a bicycle.  I use this for five minutes to “warm up” the joint.

Arm Pendulums
Bent over, using one arm to support yourself on a bench, you rotate your arm clockwise and counter-clockwise.  What’s important is to keep your shoulder blade back, you don’t just let the entire section of your back/shoulder/arm hang down.  You move your whole body to move the arm in the circular motion, twenty five times in each direction.  This is done five times in between the other exercises.

Finger Walks
This can be done with or without equipment.  At my PT center we have the equipment for this.  Imagine using your pointer and middle fingers to “walk” up slowly on a wall until you’re stretching the joint.  At the PT center they have a wooden piece on the wall with little “steps” to go up the wall.  At home or in the gym, I just use any old wall.  You go up, hold for five to ten seconds then “walk” your fingers back down for a total of ten times.

Cable Pull (Arms)
With the arm at a right angle (upper arm straight, forearm out to the side) you pull the cable (or exercise band) in across your body and then out, fifteen times for each.  Two sets total.

Back Row
This too can be done with a cable or exercise band.  This is your standard back row, with an emphasis on getting the shoulder blades together.  There is only one set of these, but thirty reps total.

Dumbbel Lateral Lift
I’m currently on 8lbs, but started with 5lbs.  This sounds mundane, but it’s a challenge for an injured shoulder.  Each rep involves lifting the arms, holding it for five seconds and then coming back down.  This is done ten times for two sets.  There is a secondary lift where you invert your forearms and lift the weights wide in a “V” shape in front of you slightly (not all the way up).  That too is done ten times for two sets.

Pull Up Assist Machine Hang
Generally when you go to a pull up machine with weight assist, the idea is to well, do pull ups.  In my case however I put the weight at the bottom so it will support my full weight.  I then hold on to the two grips that are parallel to each other and lower myself slowly.  Then I push my chest forward, the idea is forcing my shoulder/arm to stretch using gravity to pull the joint.

Using a pulley with two grips, I pull down using my right arm which pulls the left arm up.  This stretch is done for ten seconds for a total of ten reps.  It is often one of the more painful parts of my exercises along with the pull up assist hang.  You’ll see a picture in this article of the one I wound up buying to use at home.

Bar Exercises
Imagine a metal bar about three feet long with a handle set at a right angle on one side and a grip on the other end.  Using this with a weight tied on, I swing it over head slowly to give my arm another stretch.  This is also used to stretch my arm out laterally and at a right angle, all with the purpose of getting my range of motion back.  This too is quite painful.

Behind Back Stretches
This is exactly what it sounds like.  Imagine you’re using your thumb to scratch your back so you reach back and your arm is at a rough right angle.  That’s what I have to do, except the frozen shoulder keeps it form happening naturally so I use my other arm to force it up.  This is painful but worthwhile.  When I started I could barely get to my belt line.  Now I’m getting towards the top of my lower back.

After all that, my physical therapist then performs stretches on me, taking the arm farther than I can get it on my own.  This usually means laterally, overhead and at an angle.  She really knows how to lean into it and make the joint hurt!  There have been times I’ve coughed in pain or my body temperature shot up and I started sweating because it hurt so much, but it’s absolutely necessary.

This routine repeats itself twice a week, though I want to aim for three soon.  it has been frustrating, but at the sam etime I know it’s working.  My range of motion is better and I’ve had much less pain in the shoulder during sleep and work than I had say three weeks ago.  Let’s just say I really look forward to the ice pack afterwards!


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Just do it

I start this blog entry feeling like I’m walking into a room that hasn’t been dusted in a while.  As I wander around clearing cobwebs out of my head, I stand here a bit weaker, a bit defeated and definitely more tired than the past summer when I was moving like a freight train towards getting healthier and stronger.

Then came the shoulder injury.  I won’t go into detail (I did that in previous posts, and if you know me personally you’ve gotten the updates).  Needless to say, it’s derailed me quite thoroughly the last few months.  I’ve lost muscle tone, I’ve gained weight and I thought I had been totally fed up with this enough to act a while ago, only to go crashing even deeper into an abyss of non-action.

I think we all have a personal threshold and when we know we’ve hit it, it doesn’t require force (be it physical or emotional) to move beyond it – and that’s where I find myself.  My mistake was looking at everything like a big struggle, or some mountain to climb (pick your metaphor).  Sometimes, you just have to stop thinking so dang hard about things and just DO something.

Starting today, I’ve begun my workout routine again (modifying as necessary).  I’ve also begun recording my food log again, critical steps in any weight loss program.  No grand epiphanies, no big miracles – just simple steps to start things over again.

Hang in there dear readers, more updates to come!

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Rising to a challenge, one painful step at a time

When I set out to write this blog, its purpose was to inspire and inform.  I hoped my story would help others move forward on a path of self improvement.

The balance you strike sometimes to improve yourself is a precarious one, and the unexpected can completely knock you for a loop.  Such is the case with my life at the moment (hence the lack of regular updates recently).   After a couple of orthopedic appointments and a few weeks of therapy, my diagnosis for my left shoulder has gone from an impingement to a “frozen shoulder”.  For those unfamiliar, PubMed describes “frozen shoulder” as: “The joint capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint.”

And this describes what I am experiencing to a tee.  My arm’s movements are limited.  Putting on a shirt or even my backpack requires me to be careful lest I wrench the joint too far and cause significant pain.  I’ve been going to physical therapy three times a week (recently interrupted by the Christmas break).  In total, physical therapy is a solid hour each time.  It begins with exercises to warm up my shoulder, then stretches followed by stretch band and weight exercises.  This is followed by an extremely painful five to ten minute session getting the arm stretched by my physical therapist.  She’s really great and works with me as best she can, but the pain gets almost blinding at times.  Most recently I literally had my eyes clenched shut trying to work through the pain.  Needless to say, by the time I leave PT, I’m drained both physically and mentally.

It has been a difficult couple months.  My workout routine has been severely curtailed, and because of that I’ve gone back to restarting the South Beach Diet, the diet that I began many years ago when I first started to lose weight.  I had forgotten however that the first two weeks are a pretty intense detox period, and I literally spent a week suffering from withdrawal symptoms due to having almost no sugar.  Shakes, headache, queasiness – all check.  Spending a whole week like that didn’t help my emotional state when going through PT.

Now, I sit here with eight more weeks of physical therapy and a new year.  It’s cliche, but I am going to use the new year as a launching point for restarting my workout routine and going through my physical therapy in earnest.  While part of me is still angry/frustrated/depressed, a part of me is also determined to move forward and get myself back to where I should be.  It’s a daily struggle, but not one I feel I have a choice in.  Sometimes that’s just how life works and you have to roll with it.  It’s times like this that I remind myself that life presents challenges, often unexpected ones and how you rise up to the challenge is what determines your worth.  I intend to live up to this challenge, but it won’t be easy.

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A Super Storm, the Turkey and a Shoulder

Over the course of the past few weeks, I have consistently found this thought running through my head on a daily basis “I need to update the blog.” and then something else would occupy my time, a reminder that I have been spending the last few weeks reassembling crucial pieces of my life.

Several weeks ago, a “Super Storm” known as Sandy hit my area.  This wasn’t just some rain and wind, this was going to be severe winds with the potential of causing incredible amounts of damage.  I had to prepare to deal with no power, lack of supplies and stock up on more canned goods than I’ve owned at one time in years.  The storm came and knocked out everything from mass transit to power to supply chains for stores.  All my paranoid preparation had paid off, but as you can imagine, getting to the gym and eating fresh foods was not in the cards during the week the storm struck and my city dug its way out of what it left behind.

Almost in parallel, what had been an annoying pain in my left shoulder finally took a turn for the worse, becoming extreme pain and limiting my mobility to an unacceptable level.  After visiting an Orthopedist, it was determined that I have an impingement in the left shoulder.  Between the diagnosis, the pain and my lack of mobility, I decided to begin physical therapy and this will be the first full week.  One of the key points made in therapy was that I cannot exert that arm and shoulder too much.  My therapy is focused on strengthening and stretching exercises (with some electronic stimulation, heat and ice being applied).

Fast forward to this week.  Between Sandy, my injury and Thanksgiving I know I’ve put on a few pounds (the ol’ belt feels tighter) and I’ve felt rather lethargic.  Unfortunately entropy began to settle in last week based on a mixture of frustration with my injury and falling into old habits.

Starting this Monday, I decided to use a modified version of my workout routine.  Much less emphasis on the upper body but a focus on cardio.  This is a mixture of my normal Boot Camp style classes (where I have to modify exercises regularly), running and stairmaster work.  I’m still doing lower body weight work and my physical therapy allows me some upper body band work.

My therapy is going to be at least six weeks worth of hard work (I’m usually exhausted after each session) so it’s going to take some extra discipline to get me back on track.  Fingers crossed!


You’ve got to be in it to win it: The awesomeness of trying something new

Several years ago when I started working out, exercise was a very solitary affair.  Sure I chatted with friends at the gym and hung out, but ultimately I was there to work out and that generally meant about forty minutes on a cardio machine watching TV or listening to music as I worked up a sweat.  After that I would do weights, again, on my own and that would be that.

Many of my friends would go on and on about the classes they took and how I should try them.  Whether it was Spinning or Zumba, all my friends each had “their thing” they liked to do.  Me?  I never wanted to take classes.  And for several years I stuck to my guns with the exceptions being super small classes given at my company, but a corporate gym is quite a different animal than a public gym.

So why the reluctance?  Frankly what it comes down to is not wanting to look silly in front of others.  There’s a certain degree of social pressure being in a class put on me that I wasn’t ready to confront.  “What if I screw up?” “What if I make an ass out of myself?”  “Will people laugh at me?”  All these questions ran through my head as I contemplated the 101 reason I would never take a class.

Then something curious happened.  I’m not sure why exactly, but at the beginning of the summer I became positively fixated on the idea of trying out a class – but what to pick?  I wasn’t coordinated, so Zumba was out.  Sculpting wasn’t what I was looking for (I wanted cardio) so finally I decided to try out a class called “Pre-Season Sports Conditioning”, a class that emphasized cardio combined with fast reaction exercises.  It wasn’t just about moving and sweating, it was moving and sweating with purpose!

I entered the class and stayed in the back.  As the instructor took us through a warm up, I seriously felt like I was going to die.  Then a few minutes later when we began the “real” workout, I started off feeling like “I can’t do this!” and then pushed myself to do it.  Being in class and looking like a fool is one thing, quitting and walking out was purely unacceptable!

After the class, I felt like hell.  Every muscle in my body was yelling at me like “What in the heck was THAT?!” and seriously, for two days I could barely get through my daily commute walk of two miles, no less work out more.  But something else happened at the same time – I became addicted to the class.  Far from being the judgemental jocks I imagined, the class was full of friendly folks, young and old.  They guided me, made sure I did what I was supposed to do and even encouraged me!  The class went from being a scary experience to a fun one that I looked forward to every week.

Several months later, I’m now taking several classes of this style every week, and I’ve even incorporated such exercises into my solo workouts.  Working with a group has become fun, and I’m much less reluctant to walk into a class environment.  Challenging myself brought a new level of self awareness (and fitness) and it’s something I encourage everyone to do.  Find your own challenge and tackle it.  The results may surprise you!

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Forgiveness: The Key to Moving Forward

Frustrated“To err is human; to forgive, divine.” – Alexander Pope

I’ve seen the look many times.  A friend has been following a diet plan perfectly for weeks, maybe even months.  They’ve lost weight, they felt better and then one day or one night they “cheated” and now they sit in front of me grim faced, shoulders slumped and feeling like they just did something akin to kicking a puppy.  I’ve felt this too, and I always have a deep sympathy for people in this position.  In one moment, you feel like you’ve done something wrong, like you’re a loser and worse: you feel like giving up.

My first response to this?  “You have to forgive yourself, then move forward.”.  This isn’t just a platitude that I throw out to people.  It’s something I say to myself often.  When you have that dessert at dinner or an entire weekend of careless eating, one’s automatic instinct is to look back and think “I could have done that different, I shouldn’t have eaten this or that” but going in that direction quickly leads down a very dangerous path of self recrimination that gets you nowhere or worse, for an emotional eater it leads to more counter productive behavior (trust me, I’ve been there).

Whenever we stumble in life, it is important to remind ourselves that we are all only human.  You’re going to stray off any path eventually, but you are only one decision away from getting right back on it.  Even better?  Every day is an opportunity to do new things.  Every minute is a new chance to think of a new challenge to overcome.  Forgive yourself, embrace new challenges and remember, you are always stronger than you know!