Month: July 2018

I recently read an article by Carla Kimbrough-Robinson called “Change Happens: Deal With It.” Ms. Kimbrough-Robinson writes about how change is inevitable.  She asks her readers to take a personal inventory, prepare for changes, and to seize opportunities. [1]

I recently celebrated a Birthday.  Birthdays are my time for reflection and taking stock.  In my mind, I do not feel any different and yet change has happened all around me.  In the last year alone, I have had close family move out of State.  I changed jobs.  Change of any kind is scary, unsettling, uncertain, and messy.  It takes time to find a new equilibrium.

A person reading this might think after living with Spastic Cerebral Palsy (CP) for over 40 years, I would be prepared for and used to change.  The stiffness and spasticity I experience from CP changes daily.   Spasticity is a condition where certain muscles, leg muscles in my case, are continuously contracted.  This contraction causes stiffness or tightness in the muscles and interferes with movement.

There are days when my legs refuse to bend because of the stiffness and other days when my legs are very loose and pliable.  Regardless of how stiff or spastic I am, I have had to learn to adapt and acclimate to changes in my mobility and environment.

My typical way of adapting is to push through any task or challenge.  The Nike slogan “Just Do It” could be my mantra.  Yet, sometimes that mantra has failed me.   Pushing through can be harder due to an injury.  In November of 2015, I broke bones in my right ankle.

When I broke the ankle bones, it was like I ran into a brick wall and life came to a screeching halt.  I discovered I could not “Just Do It”.  I was forced to stop.  I could not accelerate the healing process even though I searched for ways to get back on my feet faster.  I have written about this injury in other articles. I found that I just wanted to get back to my life as I knew it and what I was used to.  I wanted to return to my usual routines, complete mobility, and independence.

A line in Ms. Kimbrough-Robinson’s article is one that I wish I had written. “We get comfortable with routines or a certain lifestyle and get nervous when change knocks on our doors.” [2]  When change knocked on my door, I became very fearful and uncertain when rehabilitation and mobility strategies that worked before did not work in the same way.  I had to find a new way.

I had to be educated about how my recovery would be slower and longer than expected.  Professionals often have to remind me to slow down and to quiet my “Just Do It” mentality.  My mobility and function have changed.

I now look for and go to the flat curb cut to get onto sidewalks or into buildings versus trying to maneuver steps and curbs that remain too high. My approach to improve my mobility has become more incremental.  My walking program is currently focused on improving strength, flexibility, and re-developing movement patterns.

The mantra of “Just Do It” has been modified slightly to say “One step at a time”.

[1] Kimbrough-Robinson, C. (2008, March 1). Change Happens: Deal with It. The Quill, 96(2), 35.

[2] Kimbrough-Robinson, C. (2008, March 1). Change Happens: Deal with It. The Quill, 96(2), 35.

My efforts to walk without devices frequently remind me of trying to unscramble a scrambled egg. An egg cannot be unscrambled because once heat is applied it changes the composition of the egg. Similarly, I am trying to defy existing patterns and mechanics I have used for over 30 years to move and learn new ones.

I have dubbed the general labors of my walking program as “training” because of the frequent repetition, coaching, and drills required in my efforts. After years of working with a series of fitness professionals, I started to think about what elements have remained constant in my training.

In my training, there is a lot of repetition— demonstration and reiteration of visual and verbal cues from the professional I am working with along with correction of posture and limb position to try to impress a pattern in my brain that is foreign to me.

Process

When you scramble an egg, first, you are supposed to crack and thin the egg with milk. Then you are supposed to whisk the mixture until everything is combined. Finally, you cook the egg over a particular level of heat.

When you walk, the process is supposed to look something like this. A person is supposed to stand “tall” with a straight back. A person is also supposed to bend their arms approximately 90 degrees at the elbow I learned; and swing with the opposite leg. When this sequence is performed “correctly”, it is supposed to balance the body.

When a person walks, their heel is supposed to hit the ground first and then there is supposed to be a type of “push off” from the toes. There are other nuances about having steps of equal length… When my efforts to perform these walking steps do not come together as intended there is a re-introduction to the steps and sequences and the process begins again.

Repetition

During one training session, like many sessions before, I stood in the middle of the fitness center training room with two thick, long, black ropes laid out by my feet. The ropes are there to act as guides, and I walk in between them. I walk back and forth between the ropes approximately ten to twelve times.

The fitness professional working with me regularly intervenes and maneuvers my ski poles, (my replacement for crutches), straight ahead, closer to my ribs and sides, or in some other pattern. They support the adjustment of my foot position. I hear the verbal cues, “Use your legs, not the poles,” and based upon the adjustment, I repeat the sequence. During my completion of the sequences, the fitness professional might have me perform the walking drill outside on cobblestone, concrete, or inside on a carpeted or a wood floor surface. Regardless of what the surface is, the sequence is the same.

The Result

Once heat is applied to an egg, there is no going back. Once an egg is cooked, the flavor, texture, and consistency of the egg are different. When I work with a fitness professional, we are striving for the creation of new movement patterns. Unlike scrambling an egg, I am trying to break and unscramble old patterns to establish new ones. Once the process starts, there is no going backward and I have been forever changed by the effort.

This article was originally published in the “Endless CapABILITIES Blog”, and National Center on Health, Physical Activity and Disability, sponsored by The National Center on Health, Physical Activity and Disability (www.nchpad.org). NCHPAD is part of the UAB/Lakeshore Research Collaborative and supported by Grant/Cooperative Agreement Number U59DD000906 from the Centers for Disease Control and Prevention (CDC).