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pahavit
Date: 7-24-2009 8:54 PM
Subject: Physical Therapy: The Struggle Continues
Security: Public
Tags:disability/medical, fibromyalgia, me/cfs, physical therapy, stanford pain management center
Physical Therapy: The Struggle Continues

Yesterday I did the most physical therapy exercises at home I've ever done, about half of the recommended amount. I woke up exhausted, stiff and achy. I can't imagine how awful I'd feel if I did the whole lot of them instead of just half. The cooler than usual weather lately also has made me stiff and achy. So I went into physical therapy today with two strikes against me.

The physical therapist was understanding. That always surprises me when I get one who's willing to let me work within my limitations instead of ignoring them and trying to push me into their inappropriate agenda for me.

I started out on the treadmill to get warmed up. They've never asked me to warm up here before. And I've never been on a treadmill before, either; very peculiar to walk and go nowhere. It would have been dead boring if they didn't have a tv to look at while monotonously walking.

Then we reviewed my exercises. The physical therapist mobilized my spine while I did my shoulderblade exercises against the wall. My upper back is still very tight and stiff. I'm beginning to suspect some of this is mild arthritis, because I already have arthritis in my neck which causes quite a bit of stiffness there already. The mobilization didn't hurt and helped loosen my shoulders, but the tightness and clenching in my upper back was still a problem.

Then she had me try standing with my back to the wall and my hands up, arms out flat against the wall. My shoulders were so tight I could not get my arms back against the wall, nor could I raise them the tiniest bit, not even a millimeter. I struggled and struggled with all my might to raise my arms, but my shoulder hurt and my arm muscles hurt and my arms simply would not budge at all. It was so frustrating I thought I was going to start crying for a second. It was also embarrassing not to be able to do something as simple as raising my arms up leaning back against a wall. I don't like being embarrassed in public and having my weakness on display for all to see. I don't like struggling to do a simple movement and failing utterly, especially in a room full of strangers. (Yes, I know they're not an audience watching me the whole time, but that still doesn't make much of a difference to how I feel.) The bottom line is I don't much like having to be in my body a lot of the time because it can be intolerable, and my best efforts to date to improve things have failed.

Fortunately my physical therapist, although perplexed, saw that that wasn't going to work for me, so we tried the same thing lying down on a mat. Gravity helped me get my arms down on the ground, and I had some modest success doing the exercise this way. So doing it that way is now part of my repertoire. It still hurt my right shoulder, though, and in spite of gravity I still couldn't get my right arm all the way down onto the mat.

We also added a doorway stretch, to stretch out my upper chest and mobilize my upper back. This is a variation of the corner stretch I'd been doing. It hurts to do this one -- my shoulder (rotator cuff), my upper back, my lower back. My muscles are so tight they cannot let go easily. The slightest stretch makes them tense up even more and cause pain. I am not convinced that doing these stretches as prescribed will get the muscles stretched out and keep them stretched out. I am convinced that the disease process itself of ME/CFS and/or fibromyalgia causes muscle contraction, and putting all this energy into stretching will yield the same long-term results as rearranging the deck chairs on the Titanic would have gotten. I'm beginning to think I'd rather use that energy for doing something else in my life. I think it might be a waste using it for this.

To end the session today, the physical therapist did some more manual mobilization of my spine, then I had 15 minutes of hot packs to soothe and relax my back. I used part of the hot pack time to practice the deep breathing relaxation exercises I learned about in the pain management class a couple of months ago. In spite of the hustle and bustle of physical therapists working on their patients all around me, I nearly fell asleep. (Of course, I also almost fell asleep in spite of the infernal racket during one of my rtfMRI scans too.) The warmth on my back was so soothing and comforting, and being allowed to be still and not expected to be doing something for a few minutes was pure heaven.


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