For many people around the world, regular physiotherapy is an accepted part of life. This doesn’t just go for chronic illnesses or long-term disabilities either. Plenty of people get short-term physio for acute injuries or a little physio input as they get older and less mobile. Simply needing physiotherapy doesn’t mean you’ll find it easy to stick to even if the results are great. For many people the prospect of long-term physiotherapy is pretty daunting.
In order to manage the joint instability associated with my Ehlers Danlos I do physiotherapy daily. When I tell people this I’m often greeted with surprise. How do I find time to do all my exercises? What about on bad pain days? Doesn’t it make you tired?
In this blog post I’ll attempt to answer these questions and share my personal approach to physiotherapy.
I’ve done physio on and off since I was about 14 years old. Since my diagnosis of EDS age 19 I’ve done some form of physio pretty much every day. I’ve used a lot of trial and error to find a routine that works for me. Since starting my Occupational Therapy degree I’ve been refining my routine using basic principles of OT.
In order to make my physio plan seem less overwhelming I split my physio exercises into groups. I have 3 different exercises that work my hip and bum muscles, these form the ‘Bum’ group of exercises. I have 2 different exercises in the ‘Ankle’ group, 3 exercises in the ‘Shoulder’ group, 4 ‘Core’ exercises and 2 ‘Balance’ exercises. If I was to do all of these in one go it would be a disaster! Instead I try to get one from each group done every day. Over the course of a week I vary the exercise I choose from each group to make sure I’m doing all of them equally.
Now, instead of doing intensive physio twice a week I’m doing more gentle physio every day, much better in terms of pacing.
Now to take pacing a little further. I have 5 exercises to do each day, I can either allocate some ‘Physio time’ and get them all done in one go (followed by long rest) … or I can spread them throughout the day disguised as other activities…
Here’s where the Occupational Therapy magic comes in. Through out my OT training so far I’ve been encouraged to problem solve and to think outside the box. So lets say I need to do 20 calf raises and I also need to brush my teeth twice a day… Why can’t I do 10 calf raises by the sink each time I clean my teeth? This has not only killed two metaphorical birds with one metaphorical stone but it’s also helped me improve my calf raises. While doing them in front of the bathroom mirror I’ve been able to spot issues with my posture and correct them.
Later on in the day I’m watching TV. The advert break comes on, I can either check Facebook until my program returns or I can hop off the sofa and onto the floor, a quick set of core exercises passes the time quite nicely. Maybe in the next advert break I’ll sit on a gym ball for a minute or so. By the time I’m done watching an hours worth of TV I’ve finished all of my core exercises!
Evening routines are great for squeezing in some sneaky exercises, I get ready for bed in stages. I’ll clean my teeth again and finish the days calf raises or do some shoulder exercises while the bath fills up. When it’s time to get ready for bed I’ll pop on some hand cream while sat or stood on a wobble cushion. Maybe I’ll try to brush my hair while sat with perfect posture. Finally I’ll do some bum or leg exercises while I set my phone alarm for the following morning.
By doing things this way I’ve managed to finish my physio for the day without actually setting aside any dedicated physio time! Pacing my exercises this way also helps me avoid over-doing-it and wearing myself out. I can now spend the ‘Physio time’ on something more enjoyable!
I’m not suggesting that all exercises can be combined with other activities. Cooking a meal from scratch while bouncing on a gym ball is probably not a good idea. Neither is combining squats with embroidery. Please make sure you’re comfortable and confident with the exercise in question before adding in any distractions. More injuries might well lead to more physiotherapy!
After getting the hang of my integrated physio and making a lot of progress I’m now finding new and imaginative ways to turn every day tasks into physiotherapy type exercises.
When mum drives me to or from university every week I play ‘The Roundabout Game’ basically every time we go around a sharp corner or a roundabout I have to try to sit up using just my core muscles, not leaning on the seat back or the door. The first few times I tried I fell straight over but now (after 5 years of travelling to and from Uni) I’m getting rather good at it.
Another simple but very effective challenge is to sit with perfect posture every time you go to the loo. Sounds silly I know but if you add up the perfect-posture-peeing for a week you get a surprisingly long time sat upright!
Physiotherapy, for me, has become a series of habits. It’s almost second nature to do calf raises when I reach for my tooth-brush. I’m beginning to think about my body more and more, it’s becoming natural to do simple tasks with poise and precision as a way to help further my control over my wonky joints. That said, I do still have a long way to go and I still fall over a lot more than I’d like!
Hopefully while reading this you’ve started thinking creatively about how to merge physio into your own daily activities. If you have any clever ideas I’d love to hear them.
**Do please remember I’m not a physiotherapist so if you’re unsure if this is going to help you just speak to the person who prescribed your exercises before making any changes to your current routine.**
As always please feel free to get in touch!