I initially began therapy on my left shoulder because of severe pain. There was a standing order to stretch my arm and shoulder each morning, but my deltoid began hurting so badly that I soon had them to pause working with me until I could have an x-ray done. The x-ray came back negative, but I was still in therapy. Although there was no damage to the region, it still required professional attention to resolve the issue.
During my first treatment session, the therapist stretched my arm and probed the shoulder area for any muscle problems. She told me that a stiff pectoralis minor was what actually was causing me pain every time I extended my arm to the side. In order to avoid further aggravating the joint, I would need to isolate and strengthen my rotator cuff – the tiny network of muscles and connective tissue surrounding the shoulder joint. What I had been doing was working the auxiliary muscles. This was largely why my range of motion had remained fundamentally unchanged.
She showed me a basic exercise for this. Lying on my side, I was to take two small face towels; roll them tightly; and tuck them in my arm pit. Then I was to tuck my elbow to my rib cage and swivel my fist back and forth. I asked the therapist whether I could perform this exercise at the gym using very light weight. She advised against it. She told me that working against gravity was providing enough resistance at this time. I really wanted to do more, but I realized she knew what she was talking about. All the muscles on my left side had been compromised due to my stroke. I would have to engage in basic rebuilding for over a year before I could hope to do any serious training.
I was to do this rotator cuff exercise every day. I found it frustrating to roll the towels and keep them in place, so the following week she gave me a therapeutic band to try out. I was to wrap one end around my left wrist and hold the other in my right hand. I could barely move my left arm through this moment, so she had me lie on my back and try it. That was much easier.
She told me that trying to move my wrist instead of my hand would stimulate less tone in my arm and would be a much more productive way of building strength. Doing three sets of ten would be more than enough exercise every day. I left the clinic excited for a third week in a row. The exercises prescribed for me were very light, but I was being directed by a medical professional. I no longer felt like I was doing everything on my own. It’s always easier to stay encouraged when you have someone to push you.
The shoulder irritation was just a minor setback. I had planned for 2019 to be a year of radically increased physical activity and rehabilitation. Hurting my shoulder was a mere byproduct of enthusiastically trying to lift more weights with my left arm. But while I now had to take it easy with my shoulder for a while, I didn’t slow down on the challenges to the rest of the left side of my body. I was still going to make 2019 a year of unprecedented muscle recovery.
My leg was the easiest thing to target. While weak, my upper leg had been working since two months after my stroke. I felt comfortable pushing it as hard and as frequently as was convenient. When I was at the gym, I performed squats, leg curls, leg press, and leg extensions. When I was going about my day, I was constantly walking. To increase the speed of recovery, I began going shopping more frequently and going to places like museums that required more walking. I had avoided going to these places before because I didn’t want to exert myself. Now I just wanted to push my endurance to its limits.
The leg curls and leg press were exercises that were designed to make me focus on bending and straightening my knee. I couldn’t lift as much weight with these exercises, but that wasn’t the point. I wanted to get as much practice swinging my knee as possible. That way, my walking stride wouldn’t be stiff. I also began trying to walk the weight room floor more often. I would start by carrying weights to and from the various workout stations. When I was empty handed, I would marvel at how easy it was for my leg to move more naturally. I looked forward to rebuilding a lot of grace and stability.
While I was trying to rest my left shoulder, I still wanted to increase strength in my arm. Although I now knew that I was probably adding to the tone in my biceps, I wanted my triceps and wrist to become accustomed to work again. The simplest way for me to achieve this was to start carrying weights in my left hand whenever I was in the gym. If I wasn’t doing a targeted movement, perhaps the level of tone buildup wouldn’t be quite as bad, but the muscles would get a little stronger. It wouldn’t culminate in my being able to fully straighten my arm, but I gradually began to feel my triceps firing even while I was just sitting in a chair.
The most obvious unintended gain from my arm workouts occurred to me one day while I was sitting at dinner. I felt like resting my chin on my hand. This had been impossible since my stroke. My shoulder had been so tight that I would have to tug on it to get it to rotate. I could barely move my arm voluntarily, so I would have to guide it to my head. Once it was in place, I would need to crank my wrist back with my right hand. The whole thing was uncomfortable and difficult to maintain.
Now as I sat there, I thought to myself, It’s been a while since you tried binging your fist to your chin. I bet you could do that. I expected it to be difficult, but I tried it anyway. I slid my elbow onto the table, then slowly rotated my arm until it was upright. As I brought my chin to rest atop my knuckles, I couldn’t believe how effortless the whole process had been.
The next big challenge I was looking forward to was going to the gym with my new shoes. They had arrived the week before, but I hadn’t dared to work out in them until my ILS worker was with me. Since I wouldn’t be wearing a brace, my ankle wouldn’t be nearly as stable. I preferred having someone there to prevent me from falling.
The first exercise I tried was walking on the treadmill. I had expected my left foot to drag, so I fired up the treadmill anticipating that it would be a little difficult. However I was surprised at how easy walking was. The shoe was a half-size smaller, and I wasn’t wearing a brace, so my left shoe felt surprisingly light. My foot came up high, only dragging a few times. To combat this, I would squeeze my inner thigh and glutes, helping me to easily lift and advance my foot. All I would have to do to maintain a normal stride was concentrate on my thigh and glutes each time I stepped. It would take a great amount of concentration, but the key was to keep doing it every time I walked in the shoes until walking became normal again.
The next exercise on my agenda was quadriceps extensions. These had felt like an easy thing to do, because my thigh was probably the strongest muscle group on my left side. From my earliest workouts, I was always able to generate some movement. The hardest part had been that due to the constraints of the brace, I couldn’t point my toe. Although it is a thigh exercise, having the ability to point one’s toe means that one is getting the right amount of ankle flexion to complete the movement. Since the point of working out without a brace is to regain strength and mobility in the ankle, it felt good to feel control in my foot again.
The third exercise I tried was seated leg press. The key thing affecting my performance with this exercise had also been my brace. It hugged my leg so closely that I couldn’t feel adequate movement in my ankle or calf. Without the brace, I could feel these areas of my leg working. I would set the machine to a severely acute angle, so the brace would normally rub against my leg before my leg was fully extended. With no brace to constrict it, I felt the warm sensation of exertion surging through my calf. It felt wonderful to be working again.
The last exercise I would try for the day would be squats. In many ways, this would be the most vital part of my rehabilitation. Since it was the only standing exercise, the ankle stabilization provided by the brace had been vital. The brace also didn’t allow my toes to curl involuntarily, forcing my foot to sit flat. I aligned my body for the exercise. This was the moment of truth.
I squatted down and shot back up. I didn’t like the way the first rep felt, so I repositioned my left foot. Without a brace constricting the movement, it was remarkably easy to shuffle my foot along the floor. Now I began exercising in earnest. I could feel my individual toes grip! When I was done, I stepped away from the bar. It did feel like there was slightly too much room around my ankle and heel. However, I knew this was merely because I had grown used to the sensation of wearing a brace.
Even though I considered this a light day in the gym, my body was pouring with sweat. I wiped my face and neck with paper towels three times. I walked slowly toward the front door, careful not to fall. This workout was a promising first step. The road I was about to walk down in 2019 would require a lot of discipline, but it was full of promise.