Dr. AGB Goes to Back Rehab

Not back to rehab

Archive for the tag “therapist”

Day 7: Parts of the Program

My schedule today:

  • Feldenkrais
  • Nutritional Support Group
  • Relaxation Group
  • Physical Therapy, Individual
  • Outing Planning Group
  • Mindfulness Group
  • Conditioning

Today I want to talk about what some of the groups that are part of the program consist of.

The Feldenkrais Method® is a an approach to human movement, learning and change originally developed by physicist Moshe Feldenkrais. It is based on principles of physics, neurology and physiology. Feldenkrais seeks to improve posture, flexibility, coordination, athletic and artistic ability and to help those with restricted movement, chronic pain and tension (including back pain and other common ailments), as well as neurological, developmental and psychological problems. Feldenkrais therapy allows for for new patterns of thinking, moving and feeling to emerge by ferreting out outmoded and dysfunctional patters of physical and psychological behavior and helping to eliminate them.
(Adapted from the The Feldenkrais Institute of NY.)

Feldenkrais. Years ago a therapist recommended that I attend Feldenkrais and I felt overwhelmed by what was on my plate at the time so I resisted going. I was dealing with the early stages of chronic pain including physical and occupational therapy as a young mother, a working woman and a wife—what an order, and not necessarily in that order. Things rise to the surface to be handled when there is too much to get done in any one day, even for the most organized of people. So, every week when I would sit down on his couch for our session, which included hypnotherapy, looking for peace and serenity, he would ruin it with yet another recommendation that I attend Feldenkrais! I was juggling all that I could without drowning I would remind him, so I did not think I could go. I finally had to stop seeing him so that I could stop the pressure. While he was well-meaning, he was not a very good therapist who could never hear me. (Years later I ran into him on the street and he was just as clueless!)

But, I digress. This time when I saw Feldenkrais in the schedule, I was interested, not at all resistant, and curious. What could this process do for me? I was just as baffled after the first session—these series of moves in a prescribed sequence developed by a physicist to retrain the body after injury. The Feldenkrais instructor asked how I liked it and I had no real answer, so I told him, “I’ll let you know after the third session—it takes that long to tell, you know, like eating Sushi.”

So, today was my third trial of Feldenkrais and I got a pelvic release. It was amazing. I was in the middle of the session, scanning my body after a move to see what points were resting on the floor and there it was—no tension in my back, a nice lumbar lordosis supported by points around it and a neutral pelvis. I curled it front and back (like a scorpion—the old Jane Fonda term) and it moved effortlessly. So, what do I think of Feldenkrais? I love it but not enough to make a part of my routines, at least for now.

Foods that fight inflammation:

  • Blueberries
  • Cayenne Pepper
  • Celery
  • Celery Seeds
  • Cherries
  • Dark Green Veggies
  • Fish
  • Flax seeds and Flax Oil
  • Ginger
  • Raspberries
  • Blackberries
  • Strawberries
  • Turmeric
  • Walnuts

(List adapted from here.)

Nutritional Support Group. Nutritional Support Group is a session led by a therapist (the lawyer in the group queried, “Why isn’t it a nutritionist?” which is a good point but I think they only take it so seriously and she takes it seriously so it’s probably easier than hiring the professional in the field). It is part lecture, discussion, and handouts. The support, which often comes with group therapy in the form of peer- and professional-support, is sharing ideas and reactions to the topics. How does one incorporate a certain spice in one’s cooking at home? Although, based on how this group works I think the “support” modifies “nutritional” and not “group.” The subject today was foods that fight inflammation.

Relaxation Group. In this session we go as a group to a large room, settle ourselves on thick, luxurious, comfortable mats (if we are unable to get on the ground we sit in chairs with our rolled towels for back support, foot rests so that our knees are at 90 degree angles, etc.) and do what we can of the exercise. The instructor talks us through the relaxation exercise; I put emphasis on the word “exercise” because relaxation is an active process. We are not on the mats to sleep, though from time to time we snore, whimper, and breathe adorably through slightly parted lips as we drift in and out of consciousness. When we drift off, the instructor or a neighbor, gently touches us and we resume our practice.

Some instructors take us on a trip or journey, others coax us to scan and relax body parts. Either way, our pain scores go down and our satisfaction is always up afterwards.
Physical Therapy Individual. During an individual session—we have at least one daily—we meet with the representative of the discipline assigned to us. So for PT, I run downstairs to the PT space to meet with my girl “A”. Most of the PTs in this program are young women with perfect posture. But they all have a story and understand our issues, having had to correct a posture problem or rehabilitate an injury in their own lives. “A” is a runner, and has had her share of injury so she “gets me.” Not that the others don’t; I actually have worked individually with two different therapists because I wanted a consultation with one that specializes in mechanical processes. (A benefit of this program is the collaborative nature of the work with all disciplines weighing in and contributing to the solution.) “A” and I also met in the elevator on my first day and she was friendly and engaging and has brought that ever since. I tease her that the other PTs are jealous because she has in me the best patient ever. I am serious about that: we attack our work with vigor and I am getting better. In an individual session, I warm up on a treadmill or bike for 6-10 minutes, stretch, do nerve glides, and get put through my exercises. If I need to be advanced I get new exercises that are drawn out with specifications to how many and how often. If I am having a bad day, “A” slows it down, steps down my exercises so they are not as difficult or address the new problem, and sometimes just lets me breathe. I entered the program with high expectations about Physical Therapy as I have had a lot of care over the years. My expectations had to be reset as this program will not do anything for you that you cannot do for yourself at home. So, no massage, fascia release, ultrasound, etc. Just plain old work with bands, assists, and core balls!

Outing Planning Group. This is a group managed by the Occupational Therapists. They offer a variety of services from individual sessions, assessments, computer mechanics, grooming (shampoo my hair standing against the wall of the shower for support and keep my elbows straight out in front of me hinging there to get from the top of my head to the nape of my neck, keeping my scapulae from winging out which puts stress on my rhomboids), and other functional applications of mechanics to support my core and not re-injure. PACING is a big deal to OTs. Today, we are meeting as a group today to discuss where we want to go on an outing that occurs in the last week of the program. We all have goals that relate to being functional and self-sufficient so the outing is a way to put us through the paces of the anatomy of an outing, planning for success, and execution of a plan. We have tons of interesting things to do in location of the program so we first decide how much money we are willing to spend then decide on a site to visit. There is a large mall nearby and a tourist overlook so we decide to go there, check out the sights, then do some shopping. It will involve walking to the site (walking outside on concrete is different from the treadmill), pacing, standing, and shopping. We are given worksheets to assess what problems we might encounter and plan how we will approach the trip from our own set of abilities. Every member of the group has a different source of pain and tolerance level so we set to work on our own solutions. We’re all excited.

Mindfulness Group. Mindfulness Group is run by the psychologist who provides me with individual sessions. I am always excited to see her on the schedule. When I see her individually I call her “Master” or “Buddha” because she is well practiced in the art and science of mindfulness. We do the group in the conference room with our binders, notes, and sit-assists (cushions, rolls, foot stools, etc.). From time-to-time someone has to stand to relieve a pain, shift a pressure point, or as a matter of pacing. We are used to it as we all have different tolerance levels for sitting and standing. Today’s lecture is about how the brain is trained or prone to a negativity bias—it is out looking for problems. It is a survival skill. We do a small exercise where we asked to attend to the clock. The clock got louder as we paid more attention to it. Zen master says, “Be careful what you attend to.” She also advises us to allow, step back, and watch. “Don’t be a slave to automatic thoughts.”

Conditioning. We finish the day in the gym, conditioning. I spend at least 20 minutes on the treadmill at 60% my target heart rate. It’s easier every day. I do some stretches and rest on the Styrofoam roll- stretching out my chest to undo the tightness I developed sitting at the table for mindfulness and in the outing planning group.

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