Squeezing that butt, and other truths of physical therapy

The lithe, handsome young soccer player’s voice had taken on a subtle but distinct note of desperation.

Over the last hour, as he jogged and zigged and zagged around the room and occasionally wandered over to our tables, dripping sweat, to squirt water into his mouth from a plastic bottle, it transpired that he was a superbly fit undergrad who was four months out from one of the same surgeries I’d just had: repair of a torn labrum (cartilage in the hip joint).

“I’ll roll it at home,” he pleaded with the physical therapist when she got him back on the table.

“Get on your left side,” she heartlessly replied, and used a small cylindrical device to steamroller a portion of his right thigh.

The soccer player draped a small white towel over his face and howled.

The torture chamber.
The torture chamber.

Everything I’m terrible at

In the last few months, I’ve decided PT stands for “pure torture” as well as “physical therapy.”

Physical therapy is like the encapsulation of everything I, a writer, am worst at in the world: exercise and numbers. Was it four sets of fifteen reps at two seconds each? Or four sets of ten reps per leg? Three sets of six reps, up and down? Or was it just a single set of fifteen reps of five seconds each? One, two, three, four, five, ONE. One, two, three, four, five, TWO. One, two, three, four, five, THREE.

Using the muscles properly while I remember to breathe feels as complicated as learning to dance, especially when you’re like me, with the kinesthetic prowess of a broken hunk of concrete.

I’m done some version of it almost every day since May. That, frankly, is a big reason I haven’t been writing too many essays. (If you’re not caught up, you can read about surviving the surgeries here and here.) Being a person who spent the last several years ignoring her body as much as she could because it was always in horrible pain, I had no idea how much focus this new physical regimen was going to take.

Getting the body you want

At the same time that my body got its literal physical revamp, with muscles cut and re-attached all over the place, bone shaved down, scar tissue scraped away, and flapping hip cartilage tacked back into place, I had to come to terms with a new attitude toward exercise —ironically, just as many people who see me for the first time since the surgeries have exclaimed over my weight loss. (The Pain and Stress Diet; it’s great.)

For most of my life, exercise was essentially a tool I berated myself for not using well enough to look better than I thought I ought to look. Exercise was about slimming and sculpting. How many weeks it might take to get my stomach flat and my arms toned.

No more. Exercise is about teaching my damn muscles how to work at all. How to walk without a limp, without spasms, without a buckling hip and knee, without trembling quadriceps and screeching flexors. And this is a tangible and liberating thing.

What lies beneath? (One of five incisions from May.)
What lies beneath? (One of five incisions from earlier this year.)

Skip the PT, go for the book deal

That’s why I was extremely annoyed by the closing essay in Sara Barron’s 2014 book, The Harm in Asking: My Clumsy Encounters with the Human Race. It’s called “Daddy’s Girl Should Wear a Diaper (A Tale in Twenty-Five Parts).”

Barron’s been in Vanity Fair and on NPR. I brought her into my post-op bed for a reason, but she let me down sorely with the saga of her shattered ankle. She does nail the experience of pain that is so bad you want to die, right here, right now, and the humiliations of post-op care. But what comes later, after the surgeries and the healing scars?

PT, that’s what. My own doctors warned me that I could need up to six months of intensive PT to regain my strength after my own surgeries.

Unfortunately, while she can tell a funny story, Barron seems to suffer from that syndrome of many essayists, wherein she apparently believes that writing herself as a foolish, unglamorous, lazy character is necessary to winning the reader over (before gushing in the Acknowledgments about her fabulous agent, editor, friends, family, and perfect husband).

In short, Barron claims she can’t get behind any real effort on her PT, dodging questions about it to her orthopedist because she worries that his work ethic is greater than her own.

“Even if I could channel that sort of dedication, why would I want to put it toward my ankle? I’d have one less thing to complain about if I did. One less thing to make me feel special and unique,” she writes. “Shouldering responsibility for my own recovery would rob me of hours in the day I preferred to devote to self-pity.”

She calls PT “torturous” and “excruciating,” and yes, she’s right.

“Too much hurt too much. And that — by my estimation — is how you know it’s time to walk away,” she adds.

Please.

She turns the claim that she doesn’t do her PT unless other people are around to witness her efforts into a weird sort of boast that I suppose is meant to be self-aware and quirky.

The conclusion of her essay about the busted ankle is that “the byproduct of this ongoing neglect has been an ankle like a baby: feeble and incompetent.” She hurts and she limps, but prefers this to doing the work to get better. The last lines of her book are devoted to the fact that she likes to wallow, but that is a different thing than being “left to wallow. That I do not care for. I like to know I’m being overheard.”

A real leg

Ok, I get it — a story about getting all smashed up and then working hard every day to regain your health isn’t exactly comedic gold. But can we please get real about this?

My first post-op physical therapists didn’t understand how to help me exercise without setting off a chain reaction of agony in my broken-down body, or even how to make my muscles relax so that they could work. So I found somebody else.

PT became lying flat on my back with my knees in the air, squeezing my glutes and quads in a rubber-smelling gym (which to my great chagrin houses an adjacent Crossfit facility), discussing the latest New York Times reporting on the human microbiome with man named Richard who is hoisting small dumb-bells.

Specialized electric currents help get my quads working again.
Specialized electric currents help get my quads working again.

PT became Jim Brennan, one of my current therapists, critically watching me crutch away after an appointment and exclaiming to all in the general vicinity, including a couple of contractors putting up a new wall, “Squeeze those butt muscles when you walk! Yeah! That’s right. That’ll stabilize your pelvis.”

Damn right I want to stabilize my pelvis.

“Now that actually feels like a real leg,” Jim told me in July, as he got me on the table and deftly squeezed my right thigh.

It was better than anything I ever heard about looking skinny (because I had been in too much pain to eat properly).

Loosen up

I can’t lie. Jim’s starting point was so horrible my tears dripped onto the table. He found all the most painful points in my muscles and fascia, from my low back to the top of my calf, and pressed them until his fingers felt like firebrands digging into my limb.

It’s sometimes called “manual therapy,” not to be confused with massage therapy, which involves gentle hands, fine lotions, soft music, and a general internal dawning of the concept that life might be worth living after all if it can offer this.

But a funny thing happened after the manual therapy. My knotted, spasm-ridden tissues released. When I stood up again, I had an ease I hadn’t felt in years.

“You just needed somebody to loosen you up,” Jim likes to opine. “Somebody shoulda done this for you years ago.”

A big fat thank-you to every doctor who suggested antidepressants

But my biggest PT breakthrough so far wasn’t mastering a new exercise or finally leaving my crutches at home. It was lying flat on the table at Jim’s direction and picking my left leg straight up just fine, and then discovering I couldn’t pick up my right leg, the site of the hip operation, at all.

This was painful, humiliating, and depressing.

It was also a clear picture of the work I needed to do. And a sudden, blinding understanding of why I’ve been in so much pain for such a long time. If one leg was so weak and painful I couldn’t even pick it up, no wonder my muscles, particularly in my back, had been outraged and dysfunctional. How long had it been like that? Years. And doctors just kept offering me narcotics and antidepressants.

“It’s not rocket science,” Jim likes to say, exasperated, as he prods my fiery iliotibial band into submission.

“What would you want to people to know about physical therapy, if I wrote about it?” I asked.

“Make sure they put their hands on ya,” he said immediately. “Make sure they’re actually treatin’ the problem.”

I don't need this anymore.
I don’t need this brace anymore.

Fifteen reps, baby

The truth is, as Barron herself pinpoints with her strange brew of entitled self-indulgence through self-deprecation, PT is agonizing. But I can’t knock myself down for the sake of a funny story and then thank all my loved ones for playing along.

As well as I understand the creative life, I have my regimented side. No, it’s not a sexy, funny, dramatic story. It’s just building my strength back up one bridge, ab crunch, and leg-lift at a time. By the way, I can lift my right leg up now. That’s right. Three sets of five, five seconds each, with a one-pound weight on my ankle. You can send the balloons now.

And I’ve also had to understand just how much PT encompasses, when you choose to think of it that way. Sometimes, PT is lying down when your muscles are in revolt. Sometimes it’s being determined to take the subway to a meeting. It’s saying yes to a dance. It’s taking time every day to concentrate on activating my diaphragm properly when I breathe.

It pays off when I can jaunt right down the stairs by myself, get in and out of the car without help, fix my own meals, hold a toddler on my lap, sit through a play, drive, and take a walk. And after being in so much pain for such a long time, how could I choose limping and self-pity over a functional body, if it really is up to me?

A messed-up body is the worst, surgery’s a bitch, and PT might be the crowning agony of them all: it’s time-consuming and painful, with the added benefits of never giving instantaneous results and often being embarrassing to perform in front of others. It also never gets any easier, because as soon as I master one thing, Jim adds more weight or points me to a new machine.

I have to work late at night to make up the time l lose going to PT three days a week. But I’m also convinced that as necessary as the surgeries may have been, they would’ve been worthless without the PT to relax my muscles and teach them how to work again.

Have you been through a stint of PT? How did it affect you?

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5 Comments

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  1. That was MY TODDLER on your lap, right?!? We’re famous!!!

    Totally loved this post. Yes, have done PT, may do it every day for the rest of my life if I want to keep a stable core and avoid debilitating sciatica and blah blah blah. My own dear husband says I look like the poster child for the Ministry of Funny Walks when I’m doing my warmups. Whatever.

    OMG speaking of my husband just realized I have GOT to get him to read this. Nineteen or so years ago he had to relearn to walk too.

    Anyway, stupid antidepressant-prescribing doctors. I’m glad you have Jim. Glad I have Matt. Love you.

    • Well, certainly some people do need antidepressants and/or benefit from them…but they won’t cure a physical deficit or injury like the one I had. Of COURSE I feel bad, I’m in horrible pain! Let’s take a look at why I’m hurting, shall we? Or…no, nope, she’s depressed, she needs some pills.

      Without PT I would probably still be the poster child for Life Lived Mostly In Bed, but now I can do things (within reason) again.

  2. So glad the blog has returned. Keep it up, we are so proud of you.

  3. I am SO proud of you, your courage and the progress you’ve made. Doc.

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