The dangers of physiotherapy and being unassertive

When you see a physiotherapist nobody tells you that it can be dangerous, that you can be injured either by what the physiotherapist does to you or by the exercises or advice that you are given. I saw a physiotherapist regarding a knee problem a couple of months ago. To test the strength of my quad muscles, he asked me to lie on a plinth (similar to a massage table) in a semi-reclining position where the back of the plinth is raised at a 45° angle. He then asked me to lift each leg in turn as many times as I was able to. I was aware from the start that my semi-reclining posture was not right, but I did not feel confident enough to challenge him. I find that these incidents happen so quickly that you do not always react in the best way. In hindsight I could have asked him to simply adjust the angle of the back part of the plinth so that my back was properly supported. Anyway, the following day my back hurt and this continued for a few days thankfully it eased off eventually. It seems obvious that raising your legs in the semireclining position would put a lot of strain on the lower back.

Unfortunately this incident of being injured through physiotherapy is not a one-off in my case. I tore my medial meniscus in my left knee after following the wobble board exercises that a physiotherapist had given me. On another occasion a physiotherapist tried to strengthen my knees by getting me to lift heavy weights in the gym. This caused pains in my feet. If you are taking a medication there is normally a leaflets in the medication box that lists a whole range of possible side-effects that you can get from taking the medication. However there is no similar system with physiotherapists and the exercises they prescribe.

On another occasion recently I was helping a friend, John, clear out a garage. He passed me a box that felt quite heavy. I thought that because I was in a good posture it was okay for me to carry the heavy box. Over the following days I felt discomfort all around my waist. Rather than simply rest this time I decided to use some ice and whether it was the rest all the ice after a couple of days the pain receded again. I think that the mistake that I made was that I thought that because I was in a good posture it was okay to carry the box. However because I haven’t been lifting much recently it was clearly too much for me. As with the physiotherapist it was also a problem with not being assertive enough. In the case of the box if I had refused to carry it it wouldn’t really have been a problem. John could have simply emptied some items from it and I would have been able to have carried it then I think. He might have been reluctant to have done this because he was wanting to get the job done so it is difficult in the moment to resist the pressure of somebody being persuasive through their body language and tone of voice.

Anhedonia, Isolation and Physiotherapy

I don’t know if you have heard of ‘anhedonia’. It is where you don’t feel pleasure doing something that it normally pleasurable. It’s something that I experience quite a lot, and I don’t know exactly why. I think it is probably because of anxiety and depression. But it does make socialising a little bit more difficult because it means that you are not smiling as much.

Socialising is very important for people experiencing anxiety and depression because of the humour that it can give rise to. I’ve had a couple of instances recently where I’ve experienced a sense of release through spontaneous laughter. Everybody needs to have a feeling of release from their frustrations. This is why many people turn to drink and drugs and of course end up creating a whole new layer of problems. Maybe my craving for chocolate is a response to anhedonia. Yesterday I succumbed to eating some chocolate, which I know is a migraine and reflux trigger for me. I managed to partially restrain myself by only eating about half of the bar, and then I realised that the only way to avoid eating the rest of it was by throwing the remnants in the bin.

I noticed that though the desire to eat chocolate was initially very strong, it passed. I wonder if this is true for all desires and whether it applies to anxiety. Us anxious souls, can we just learn to let the feeling pass, even though like the urge to eat chocolate it can seem overwhelming?

Another habit that I am trying to break is putting grass in my ear. I know this sounds weird but the sensation gives me a real sense of release. However, the downside is that it’s probably harmful to your ears. Last month I had an ear infection which may have been a result of this unusual habit.  I’ve managed to avoid the grass trick, though every few days, particularly if I am experiencing hyperventilation, I have succumbed to temptation.

Going back to the social contact theme, I’ve been spending more time by myself in the last few days and I’ve noticed that I’ve been getting more depressed. Yesterday, I went out and met up with a friend and had a few casual words with people and felt surprisingly better. A lot better than on Sunday when I just talked to people on the phone. Even though it was Skype it didn’t seem to have the same beneficial effect as face to face contact. I guess some people would put this down to oxytocin. The problem I find with socialising is that it takes up so much time that you don’t get anything else done, once you’ve done your chores.  I guess the trick is to have a balance and to learn to endure the feeling of isolation from time to time.

The reason I’ve been spending more time by myself is because I’ve resting my ankle, so I had to cancel going on a walk at the weekend. I think that an exercise that the physio gave me was too much for my ankle. The exercise involves resting your head on a balance ball, creating a bridge with your torso and legs and then lifting a leg off the ground.  It was the lifting my leg off the ground that seemed to be too much. I think the lesson is not to do any exercise that feels like it is a strain and to make your mind up about which physiotherapy exercises you are prescribed are safe for you to do. It is difficult to get the balance right between exercising enough so that your body is being challenged without causing strain. The right exercises involve stress without strain.

Going back to the topic of social isolation, what is the best way to deal with this. We live in a society where more and more people are feeling isolated due to demographic changes around people moving away from family because of work reasons, relationship breakups and a society where we are increasingly doing things by ourselves. We go to work in our separate cars, spend less time walking where we are more likely to meet people, watch films by ourselves at home. In fact an increasing number of people live by themselves. Any kind of illness or disability can add to feelings of isolation for a whole range of reasons.  Mental health issues make it harder for people to interact with others. Mobility issues can make it more difficult for people to participate in walks or sporting activities or use buses. My current thoughts about this are;

1) Do not feel bad about yourself if you are feeling isolated. As you can see from the list of reasons that I give above, there are many things within modern western society that cause isolation, and most of them are nothing to do with what you are like as a person

2) Organise your life so that you do things around people. For example, rather than work on your computer at home take your laptop to a cafe or work in the local library. Rather than have your own car, participate in a car share scheme. Buy food from a local co-operative that buys in bulk.

3) Try to have some regular activities each week that involve doing things with other people, these could include a religious or humanist or secular meeting, undertaking voluntary work, joining a choir.

(Sorry, I know that I’ve started doing what a lot of people do on these blogs, i.e. just churn out a load of tips, but I think I’m sticking to my original goal which is to focus on general ideas of how to approach things, rather than throw loads of ‘tips’ at people).

I saw the podiatrist yesterday.  She also, as it turns out, has problems with her knees. My problems relate to my feet and not resting properly after injury. She made me think though that maybe part of dealing with these physical limitations is to take an attitude of acceptance in some ways and to focus on what you can do. I do find this hard because I think that most of my injuries have been avoidable, but maybe many people could say this. I think that when we move from seeing ourselves as victims and feel more grateful for what we do have then our general mood improves as well.