problem solving physical therapy

Hello, reader! How are you? Do you have pain and / or reduced functionality of your body? Lately I’m problem solving physical therapy.

I have a very hard time inhabiting and moving my body in an intentional way, especially around people I don’t know well. Right now I’m on my third physical therapist, and all have been hell in different ways.

Have you had physical therapy? How was it for you? I hear some people are ok with it, and physical therapy actually helps them. I’m glad for them. I don’t think longterm chronic pain is what most physical therapists are set up for. They seem geared toward athletic people who have a sports injury, or anyone who had an accident or surgery.

first

My first physical therapy place was in Las Vegas and felt sort of like a sporty factory. I had an initial intake. Then they set me up on these machines, which were kind of fun. I pedaled bike pedals with my arms for a certain amount of minutes, one way then another. I pulled on elastic bands. There was a pulley machine. I came back and did these exercises a few times, at set intervals.

All made little to no difference with the pain or functionality of my shoulders. Then when my insurance didn’t want to pay anymore, I was done.

I’d been nervous about pandemic germs the whole time, and it all seemed futile. But my first PT was the least damaging.

second

Second physical therapy place, I felt very uncomfortable, even though Ming came with me every time. I sort of got kicked out of that place for canceling too much.

There I learned that trauma-informed physical therapy might really help some people. Touch, physical pain, and movement are a big deal for people who’ve endured violence including sexual violence.

You can read about my experience at that place and thoughts about trauma-informed PT here.

myofascial release

Then this new place I started going to, the physical therapist specializes in myofascial release. She evaluated me then told me a little about her methods, showing me her website. Then we tried a long-held stretch, with her pushing on a spot on my abdomen, and it was kind of terrible, being made to stay still.

I was in an unfamiliar place with the feel of an abandoned gym. The radio was playing oldies, and people were talking in an office nearby with an open door.

The PT had me lying on a table in an awkward position with a rolled up towel beneath my spine on my upper back, and asked me to hold that for a couple minutes. “Tell yourself in your mind that you’re safe. It’s ok to relax,” she said.

“Lovely Day” started playing on the radio. I have really strong associations with that song.

“You’re safe–it’s ok to relax,” I told myself in my mind.

I almost started laughing and crying. Wow– feel safe to relax? With someone I just met, in an unfamiliar place with strange exercise equipment and confusing light, while listening to Bill Withers sing about love?

safe

A news item I didn’t mention to the PT was that I haven’t felt safe with a human being other than Ming in a very long time. It would have been great if she had asked, “Do you ever feel safe?” before asking me to. She was being presumptuous.

We had not built a container of any kind. She’d mentioned she was moving to Bend with her two dogs and two horses. She looked like a sort of regular white lady. Not that she was mean or anything. Just I had zero basis to relax with this person who was pushing on my abdomen really hard, in a place I associate with ovary pain.

I did try to relax. Being told to stay still while my body is being acted upon in confusing, unwanted, possibly painful ways is definitely a trauma activator. You know I have trouble at the dentist, to understate.

What do you think happened next?

Things I thought about telling her:

I haven’t felt safe around another person since 1977, the year this song was released.
You have mistaken me for a happy, well-adjusted person.
Do you have a moment to learn about autism?
Relaxing is not my skillset! My ACE score is 9. What’s yours?

Things I could have done:

said no
screamed a lot
got up and left
asked her to get her hand off my abdomen
told her “stimming is my birthright– no one is allowed to tell me to stay still anymore”
blacked out
turned over the table

I knew if I started talking, I would cry, and I didn’t feel safe enough to cry there. So I actually did what many trauma survivors probably do– I went non-verbal and endured it.

panic attack

It was hard to recover from that appointment. She asked me a question on my way out, and I forced myself to answer it. I think she was checking to make sure I could talk, but I’m not sure. Somehow I got through the rest of that day.

Then the next week, a few hours before my next physical therapy appointment, I had a panic attack. Sorry about that, Ming.

I had not panicked that hard in a long time. No way in hell could I walk to the car, ride in a car, arrive there, be an appropriate therapy person, then be a human being afterward. About an hour into the panic attack, Ming called to cancel for me. True, I was sick.

I don’t think I’m cut out for this. What do you think, reader? How would you proceed? Probably you don’t know the extent of my trauma, social differences, or sensory differences. But maybe you could imagine.

Here’s a brainstormed list of some things I could try, if I want to attempt PT again, generated by me and Ming.

morning appointment, nothing scheduled beforehand
after-treat planned, nothing else scheduled afterward
aftercare the next day
explain to the PT that I don’t generally feel safe outside of my home
ask them to go slow and explain what we’re doing
ask them to let me know when we’re halfway done, almost done, etc
get a private PT
get instructions through a third source
do it on my own from youtube videos
find a PT through the local permaculture guild or other friend of a friend
Ming could take PT CEUs
or we both could
ask for something more informal
ask for incredible gentleness or to be treated like I’m four years old
sedate myself beforehand
see an EDS doctor instead
or a PT that specializes in hypermobile joints

thank you

Thank you, reader, for understanding that different people need different things. What’s very easy for some can be so difficult it’s almost impossible for Laura-Marie.

I’m not trying to be difficult. However, I am difficult, which is valid. I didn’t choose to have needs many people are surprised by. We all deserve help with our pain, not just people who have standard social, sensory, emotional, and physical needs.