It wasn’t until I moved to the Midwest that I began associating February with winter. Growing up in the Deep South, I had seen it as a mild month right before Spring Break. In Wisconsin and Minnesota, it was a period of brutal temperatures where people had to find something to do besides hunker down and await warmer weather. When I was younger, I would pass the time with indoor sports and weightlifting. Sports were no longer an option. But now that my body was functioning better again, I threw myself back into exercise.
Now that my occupational therapy was in full swing, they were constantly adding new exercises for me to work on. The first one they had me try was for weight bearing on my affected arm. I had to place my forearms on a kitchen countertop. Once my upper body was positioned above my arms, the therapist had me move my feet backwards until only my toes were in contact with the floor. This would stop the force of my weight from routing through my thighs. Now she had me do ten modified pushups.
I’d assumed that this exercise would be simple, but it was unexpectedly difficult . I had been working out very hard. Indeed, that was the only reason why the therapist said that I looked strong enough to attempt the exercise. But the movements I’d been doing were designed to isolate individual muscle groups and to work them in specific planes. Therapy is about relearning to move the body functionally. The movements I practiced here were about reintegrating the various muscle groups so that they would allow me to move my body naturally again. The goal was to work at it until I no longer had to actively think about coordinating the different parts of my body again.
Next she had me sit up on the edge of an elevated therapy mat. Then she gave me a hoop with a bar fixed on the inside. I was to roll the hoop back-and-forth as far as I could in either direction. The idea was to try and regain the ability to rotate my wrist. After I had been going for a time, she instructed me to try initiating the movement from my elbow. This was counter intuitive, but I tucked my elbow and concentrated on spinning the hoop. As I did, it became easier. I realized that this was an exercise designed to prevent my elbow from flaring out to the side when I moved my arm along a certain plane.
The last thing she had me do was to lie on my back and, using my cane, push with my right arm to see how far I could stretch my left. My left arm was tight and mostly resisted. But overall, the session was a success. I had a series of new exercises I could work on at home and I would learn more in the coming weeks. As I walked away from the office, I was already calculating how I would integrate what I had just learned into my upper body workouts.
Occupational therapy was a lot more productive now that I was going through it while also doing outside exercise. I was so happy that I’d found the lateral shoulder raise machine at the gym. I was using it every other time I worked out. In just two weeks, I’d progressed from lifting 10 pounds to 50. When I looked in the mirror, my shoulders were level again. It became more difficult to put on my backpack because my left arm wasn’t pinned to my body, so my back was wider. I even found it easier to rest my body weight on my left arm because I no longer experienced shoulder pain.
The increased range of motion also made it easier to perform any exercise that required my arm to be elevated. This was particularly true for lat rows. In the past, I could only due this exercise with limited range on my left side. I would be able to pull the lever all the way to my body with my right arm, but my left arm would stop a few inches short. I could have used less weight, but too little weight wouldn’t do anything to work my right side. I could’ve gone with less weight on just my left side, but I didn’t want to exacerbate the issue of asymmetry. So I went with a compromise weight of 25 to 35 lbs.
Now I sat down and warmed up at 25 lbs. I went up every set by increments of 5. When I got to 45 lbs, it was still remarkably easy. The only reason why I didn’t continue to add more weight was because of time constraints. I had completed five working sets, and it was time to move on to a different station. But this exercise felt so easy that I will warm up on 35 lbs in the future. That will allow me to add a set, and as my splint stretches my wrist more, I will be able to work out with even more weight.
The wonderful thing about increased shoulder mobility was that it didn’t only make upper body exercises easier. It also worked when I wanted to use the Smith machine to do squats and lunges. In the past, I’d often had to start the exercise with my left shoulder being a little tight. This could cause me to twist my body to the left, which could result in loss of balance or spinal injury. With the shoulder working better, it was pliable enough for me to slide the arm into place and start lifting correctly right away. Because of improved balance, I was able to get lower on every rep. This helped me to recruit my calves and ankles. As I walked away from the machine, my steps required even less concentration than they had moments ago. Working my shoulder was going to help me to resolve a balance issue.
When I went back to occupational therapy on Wednesday, the therapist told me that my elbow splint had come in. When she presented it to me, I was surprised. Since the person who’d cast my arm had used the same gauze as the one who had done my leg spliednt, I was expecting the splint to also be a plastic shell. Instead, this one had a lot more metal. It reminded me of the type of armor that baseball players wear.
Looking at all the straps, buckles, and moving parts, I asked her whether this was the sort of equipment I would be able to work out in. She responded that it was for passive use only. After my arm was ready, she would give me something I could lift weights with. We tried putting the splint on my arm. It really pinched my forearm. Since the DME representative who made it was still there, the therapist asked him to widen it. When he brought it back, the splint fit comfortably.
I had brought my wrist splint along in case my therapist was ready to adjust the wrist. She told me that she wanted me to try wearing both splints together first. I was able to put the wrist splint on by myself, so she had me put that on first. Then she helped me put the larger splint on over it. The larger splint stretched from my wrist all the way up to my underarm. Although it wasn’t as bulky as I thought it would be, it would definitely be solid enough to hold my arm straight.
This splint was a little more complicated than the cloth one I was used to. She showed me where the adjustment hinge and locking mechanism were. She unlocked it, had me get my arm to a slightly more extended position, then locked it in place. The dial settings were 1 to 7, 7 being the point where my arm would be fully extended. If I’d been able to set the plan the program, I would’ve started with the splint set to 4. But she told me that we needed to start on 2. I would have to wear it for one hour on the first day, then wear it for an additional hour each day.
We played with it a few times so I could learn how to show staff members how to help me put it on. Taking the splint off was so simple that I could do that unaided. The most difficult thing was learning how to use the locking mechanism correctly. The final thing she helped me with was to put a sweatshirt on over the splint. The splint was so sleek that the sleeve went right over it. I took it back off right away. Although I could wear the splint outdoors, I didn’t care to because I would only be wearing it when I wasn’t using my left arm.
I went home and had the assisted living staff help me put on the splint for two hours. Although it was more than the recommended one hour, I was eager to get started. The next morning, I went to the gym and worked my biceps and triceps for an hour. That evening, I wore the splint for an hour beyond the recommended time period. I was going to continue being aggressive at restoring the strength in my arm.