As I have said countless times, at a certain point, physical rehabilitation is no longer exhaustion and sheer physical pain. Once I had regained a lot of muscle function and gotten back to where summoning the energy to lift weights was easy again, just going in and trying not to be bored became my new challenge. It was a given that once I was on the bus and headed to the gym, I would be able to get through my workout. But I was worried that the workouts themselves were becoming stale. Staying mentally engaged would be vital if I hoped to keep progressing.
My arm was the body part that required the most work. The most instinctive thing to do would have been shoulder exercises. However, the physical therapist had informed me that these kinds of exercises might be great for regaining brute strength, but they could be hampering my muscle control, because they didn’t allow me to isolate fine muscle movements. Working my arm along a single plane would mean that the elbow would stop flaring out every time I attempted to lift my arm.
Once the physical therapist explained this to me, it became a lot easier to stay focused. I could now design workout plans that were more streamlined, because I was limited in the number of upper body movements I should perform. Knowing that compound movement was contributing to the problem also meant that I could alter the way I lifted for even better results. I concentrated on tucking my elbow in towards my rib cage each time I used my arm. This helped me to build strength and increase my range of motion. Before long, I was performing things like lat rows with very little impairment.
Leg exercises were coming along even more smoothly. Working out exclusively without my leg brace was giving me a lot more confidence when walking around in the gym. It also meant that I could flex and extend my more foot during leg exercises. This led immediately to better form. I was able to keep my foot engaged with the floor or the weight whenever I lifted. My lifts were no longer short or jerky; I was exercising the way these exercises were designed. I noticed strength gains immediately. When I had to step into position to use a machine or onto a bus, I began always leading with my left foot. Gains would be used to spur more gains.
Learning to walk without the cane or brace was the ultimate goal. To make this feel less alien, I always tried to warm up by walking on the treadmill. Although this was good for relearning the mechanics of walking, it was still aided walking. In order to work on balance, I needed to practice walking with nothing to hold me up. I had begun carrying weights around the weight room a few months earlier. That gradually became easier. Now I had to start doing it without the aid of a brace.
At first I worried that my ankle would buckle or that my foot would drag. But I took tiny, measured steps. I bent down to pick up the 25-lb plate, then I swiveled to carry it over to the machine. Now I was even more methodical in the steps I took. Now I had to figure out how to get the weight safely onto the machine. I sidled up next to it so the weight was still close to my center of gravity. It took me a few heaves to get it up high enough. But I was finally able to swing the plate into position. After a couple weeks of carrying and loading my own weights, I was even more comfortable walking without adaptive equipment.
As always, the goal of all the exercise I was putting my body through was to ultimately be more functional. The place I had always gone last year to gauge my progress was the Target main store in downtown Minneapolis. It was the closest location to me when I was on 2nd Avenue, and this hadn’t changed now that I was on 3rd Avenue. It was only about a ten-minute trip from either building, so it was the most convenient shopping trip I could book.
Security had been my primary concern the first couple of months I went to Target. At the time, I felt less stable and in control of my body. I worried about tripping and falling while crossing the street. After entering the store, I would head straight for the men’s room, afraid that I might not make it back in time once I started shopping. Upon leaving the restroom, I would find a riding cart and start shopping. I always gave myself far more time than I needed, because I also feared not being back at the front of the store in time and thus being left by my return driver.
I would text my shopping list to myself so it was impossible to lose, then I would place my phone in the basket of the cart, because I didn’t trust myself not to drop my phone. Usually I still had about an hour between the time I was finished shopping and the time my bus came. Since I still worried about incontinence, I would take my cart down the family restroom, where I knew I could transfer my bags from the cart to the restroom floor. When this was occupied, I would ask a store associate to watch my bags. Once I was done, I would ride my cart to the front of the store, and wait by the security desk until my ride arrived.
My trips to Target had been exciting challenges. I was always excited to go, and every couple of weeks I reached a new milestone. It was during these trips that I had become comfortable handling money in public; I had regained the balance to stand and take things from the store shelves; I began walking instead of riding while shopping. I would not have traded these trips for anything, but I always worried about falling, losing money, forgetting merchandise, or wetting myself until I was safely home again.
Presently I booked a ride to Target. I needed to buy razors, bleach cleanser, and energy drinks. These were for shaving, cleaning up messes, and heavy weightlifting days – all things I could handle for myself. I wasn’t worried about how long it would take me to get to the restroom, or juggling my wallet and merchandise. I had the leg strength to walk confidently across the street, and up and down the aisles. Shopping was no longer an endurance sport for me.
My leg was getting so much work every day that I felt like it wouldn’t be too difficult to achieve my goal of not needing a cane by the end of the year. But working on the shoulder was more difficult. I was doing a lot at the gym, but I was worried that when I was away from the gym or physical therapy, it would just constrict again, negating a lot of the progress I had made. One thing I did to counter this was to try to elevate my left arm while sitting.
I had begun this practice in 2019, while in transitional care. I would sit on a couch in front of a television and raise my arm as high as I could, hoping to rest it across the back of the couch, using my right arm to guide it into place. Because my shoulder was so tight, my arm would not stay in place, so I would have to push it over and behind the couch. I could sit like this for a few minutes, feeling the joint stretch passively. But it would begin to hurt after a short time, and I would have to pull it back down altogether. What I later learned in physical therapy was that as you stretch a muscle group, tone often kicks in in the corresponding muscles, causing the body part gradually snap back into constriction.
During my physical therapy sessions, the therapist would perform the stretches in slow movements, supporting the weight of my arm with hers. Since the movement wasn’t so sudden, my arm wouldn’t just snap back into place. Over time, this would alleviate a lot of the pain and constriction. Then one day, I decided to wait for my ride on the bench in front of the building. As I lifted my am, I noticed that it didn’t require assistance. It cleared the back of the bench by several inches. I rested it for about ten minutes. Before long, it became obvious that I could have left it there indefinitely without feeling the slightest amount of pain. Slowing down was speeding up my recovery.
I was feeling a lot more confidence in the recovery process. Every morning I was gaining energy, and I was also regaining more control of my body. One morning I awoke to find that Mary had thrown up in the living room. In the past, I had panicked when this happened, because all I could imagine was losing balance and falling face first as I attempted to clean it up. But I wasn’t nervous this time. I knew my mind and my body were up to the task.
I sprayed bleach cleanser on Mary’s mess and placed paper towels over it. I put Mary’s leash on her and we went outside for half an hour, just so she could throw up or use the restroom until everything was out of her system. When we returned, the paper towels had soaked up everything. So I was able to use it to scoop up the dried vomit and throw it in the waste basket. Then I sprayed down more cleanser so I could disinfect the floor.
Knowing I could get down on one knee and clean for myself felt so empowering. It allowed me patience and foresight to work out a plan of action. Developments like this are how falls and personal security concerns lessen with physical rehabilitation. You become comfortable with what your limitations are, but you constantly push past those limitations in carefully controlled environments. As you gain more control, your reflexes increase. Time “slows down” and the world doesn’t seem so chaotic. Soon you’re no longer thinking about every movement because your body is working instinctively again.