You have to be ok with being alone. I used to have a problem with this – weird for an introvert to say that. I had a problem when people weren’t around – people I knew, friends and family. Not a bunch of strangers at a party or a bar, I guess that’s the difference between intro and extroverts. Anyway, I used to need people, I hated living alone, I needed a roommate. I hated being alone – hence my tendency to jump from one relationship to the next. I spent a long time looking outside of myself for something to make me happy. Now, I only look inside myself to make me happy. And if someone/something externally comes along that cheers me up – that’s a bonus. I still need people – don’t get me wrong. There are certain people who I couldn’t live without. But other people making me happy is no longer a necessity. Now I have a much, much healthier relationship with myself and my need for other people. I amuse myself a lot, I can laugh at myself for hours. 🙂 Everyone needs to learn this lesson. I had to learn how to do this at the same time as I was recovering from a recent massive stroke. Talk about awesome!!!!!!! I don’t recommend doing that. I don’t recommend doing a lot of things the way I’ve done them. But I have good stories to tell! I’ll never have a boring date again, provided I ever go on another date.
I’ve been writing this blog for over a year…it’s about time I did this post. I had a stroke in the cerebellum. The cerebellum is the “little brain.” It’s the baseball sized thing located at the back of and under the big brain. Actually, the size of it varies a lot. This kind of stroke is…..well kinda different. This is called a posterior stroke, in the back of the brain. While anterior strokes I think are more common, posterior strokes – if severe enough – are more lethal and can have worse consequences like Locked-In Syndrome. So I guess I’m “lucky.” Most strokes will cause some kind of movement issue. Now, I have movement issues but they have to do with coordinating and controlling my movements rather than my ability to do certain movements. The cerebellum fine tunes movements, the initiation of movements is controlled elsewhere in the brain. So I can do any movement at all, it just takes a while and a lot of it looks bad – it’s uncoordinated and shaky. And my balance is off. It used to be way, way off but now it’s just off. My fine motor control is pure crap. Well no it’s not, it used to be pure crap but now it’s better, now it’s just crap. A lot of strokes will cause difficulty with word finding and speaking. I have speech issues but again they involve the coordination of the muscles that produce my speech rather than an inability to speak or find a word. Some strokes affect personality and emotions – mine did not. Some strokes will cause sensation issues such as pain, numbness, or tingling – mine did not. But this can happen with cerebellar strokes and I have met some people who had posterior strokes who have sensation issues. I was at a stroke support group recently and I commented that most people who have had a stroke seem to be right side affected and a woman said “and that means that the left side of our brain was injured.” In most cases, yes, but not in my case. Generally, the body is controlled by the opposite side of the brain, but not the cerebellum. The stuff that the cerebellum controls is on the same side of the body.
No matter where in the brain you had a stroke, it’s all brain damage. There really is no difference between me and my friend who had a stroke in her left frontal lobe – we both have brain damage. We may have different effects from our strokes and her and I have to work on different things but it’s all brain damage.
There is oodles and oodles and oodles of research about how meditation affects the brain. Oodles. Go onto pubmed.com and type ‘meditation’ and over 3500 articles come up. When you have a brain injury, you better meditate. You can work out a ton, and I can give you all kinds of exercises and suggestions as a physical therapist, but if you’re not meditating and doing breath work you’re not going to get the results that you want. You need to work on the brain directly for anything to truly change.
Please go here for a better, affordable alternative to learning Transcendental Meditation.
Peter G. Levine, please read this!!!! Thanks for the mirror therapy suggestion. I think that stuff is like some kind of magic. Not really, but it obviously works really well. In just 2 months of doing this, I have WAY more control over my right hand. Before Peter suggested it, I thought I was too high level for it, that it couldn’t help me. Nope, I was wrong! I wish I knew about mirror therapy when I was practicing. If I ever practice again, this will be a standard therapy. No matter how smart you think you are, the brain can be tricked.
I was at OT today and saw something really upsetting. A guy was pushing an old woman in a wheelchair and came upon a little curb. Not a full curb, just a little one. So the guy didn’t re-adjust the wheelchair or try to lift it, he probably didn’t think that he needed to. The wheelchair tipped forward when it hit the curb and the woman almost fell out. I haven’t written anything about using wheelchairs because I’ve been EXTREMELY lucky and didn’t need one after a couple of months. I really don’t know how long I used one, I can’t remember. So I haven’t thought about wheelchairs in quite a long time. Well I thought about wheelchairs today.
If you’re pushing someone around in a wheelchair, there are certain principles that you should know. When I was in PT school, we spent a few weeks on just using wheelchairs. We learned how to do wheelies and were tested on that. We learned how to use a wheelchair on stairs – yes, stairs – going both up and down. We got so good at popping wheelies in our wheelchairs that I remember during that unit walking into the lab and people would be studying in a wheelchair in a wheelie position. The purpose in learning that was to learn where it’s easiest to maneuver a wheelchair. I did a post on the center of gravity. This is the balance point of the body. You have to know this stuff in order to know how to best position your body in the wheelchair and when moving to different positions and stuff. Well, on the actual wheelchair there are moment arms, kinda sorta similar to the center of gravity. On things that rotate around other things, you have moments. An empty wheelchair’s moment arm is like…..right at the front of the back wheels on the ground. There is equal force causing it to rotate back and rotate forward….so it stays still. So when you do a wheelie in a wheelchair the moment moves backwards on the wheels and it’s easier to push. So what the guy today should have done is lean the wheelchair back so that the moment arm moved back and it would’ve been very easy to push the w/c up the curb. Here, this explains moments.
Well Dean, going down steps is an eccentric contraction. I know you know what that is so I won’t describe it, for anyone that doesn’t know – click the link. You said your knee pops out of alignment, I’m assuming that means your kneecap. This movement is made better by strengthening the quads and hip abductors eccentrically. Here are all the eccentric exercises that I can think of for the quads. Step downs, lateral step downs, squats, single leg squats, anterior lunges, side lunges, posterior lunges, wall slides. That’s a pretty freakin’ cool website. knee extension eccentric, TKEs, walking backwards on a treadmill – do that very slowly – actually don’t do that. And hip abductors!
Ok Elizabeth, I’m gonna tackle the shoe issue. Admittedly, I’m not positive what causes this to happen to us. I’ll tell you what I’ve had luck with and what I THINK is going on. First, really thorough knowledge of the gait cycle(walking cycle). So, I’m gonna describe this about the right leg. I’ll start with the foot on the ground, this is called stance phase. So while your right leg is on the ground, your left leg is in the air swinging the left foot forward. Stance phase starts when the heel of the right foot strikes the ground. Then your weight shifts forward from the back of the foot to the front of the foot. Your right foot then lifts up a little by the calves, called propulsion, you have toe-off and you go into swing phase. In this phase your right leg swings forward and you prepare for heel strike again, another stance phase, and repeat. Now, I used to have like no control over my right leg, I do now. So knowing about the gait cycle helped me to minimize the problem because I would be very forceful (as forceful as I could be) about my heel strike. Also, when entering swing phase, my right leg used to come up really high. I’m not sure why. I used to lift my right leg really high when I walked and as you said “walk right out of my shoe.” To combat this, I would attempt not to let my right leg lift as I entered swing phase. Soooo, that’s not really about strengthening muscles – well yes it is – as much as gaining control over a group of muscles. Gaining control is a part of strengthening. The group of muscles that caused my problem was the hip flexors. It probably seems weird that muscles at your hip would cause this issue, but they certainly did for me. This is a very basic exercise but very effective. Then do these to strengthen the entire hip. The hip 4-way. I like this. I love this exercise, I’m not sure why. I hope this stuff helps.
Ok, the inversion/eversion problem. Inversion is when your foot turns in, eversion is when your foot turns out. Ever hear of someone “rolling their ankle?”. That means that they sprained the ankle(stretched the ligaments too much) by over-inverting it during walking. Actually, the complete motion is called supination of the foot. Supination of the foot is the combination of inversion and plantarflexion (plantarflexion = pointing the toes downward). So if you roll your ankle, generally you over-supinate your foot. Pronation of the foot is the opposite of this. It’s a combination of eversion and dorsiflexion (pointing the toes upward and lifting the foot). To help rolling in of the ankle, you want to get your pronation muscles as strong as possible. The muscles on the outer side of the lower leg that control eversion are called the peroneal muscles. And you want to strengthen the dorsiflexion muscles too, I wrote about this. You want to strengthen everything in the ankle, but really focus on the pronator muscles. Do this, and this, and this, and these. By the way, when your foot is naturally overpronated, that’s what they call flat feet.
I’m gonna start with the neck because treating neck and back pain used to be my specialty. Soooo, Robin and Shelly – forget all the neck stretches you’ve been given. They aren’t doing anything to help and are possibly making it worse. Robin you know medical mumbo jumbo so I’ll say this to you: exhaust the sagittal plane before you go lateral. Imagine a string held at the crown of your head that goes all way down to your feet. All movements in the sagittal plane are “front to back” movements. Bringing your chin to your chest or looking up at the sky – those are movements in the sagittal plane. As soon as you tilt your head a bit to the right or left of the string, that’s a lateral movement in the frontal plane. You’ve probably been given a stretch where you were told to tilt your head to one side to stretch out the upper traps – that’s in the frontal plane. So, disclaimer first – I have not evaluated you and seen the range of motion of your neck so….I don’t know, just thought I’d say that. But these exercises will probably help, they won’t hurt you. I understand the fear of not wanting to do exercises with your neck – I understand that well. Try this………………
As with everything, POSTURE!!!! Get yourself in good posture before you do this. Always have good posture, always. Every second of the day. Then start doing some neck retractions. Do them frequently throughout the day, every couple of hours. There are a lot of progressions to this exercise, which I would be glad to share with you, but this is frequently what I would give a patient for neck pain on the first day of seeing them.
Hi readers!….just curious if there are any requests that you’d like me to write about from an orthopedic standpoint like any group of muscles I haven’t touched on or any pain anywhere? Just thought I’d ask, I could give a PT’s take on it.
A brain injury is a lifelong battle. It’s not something that you just “get over” or recover from within a few months – or years – or ever. If you’re lucky enough to have a brain injury you are forever changed. FOREVER. I had a massive brain injury. Some moron in my life that didn’t understand why I was still sick a year later said to a friend of mine “is she trying hard enough?” Someone also said to me once “you should be happy, you were almost dead a year ago.” I cannot begin to explain the stupidity of these comments. Stupid is not even the word for them. The people who made these comments are no longer in my life (thank God) so I feel ok about calling those comments stupid. 🙂 That’s what they are. They are extremely, extremely, extremely insensitive and stupid. Anyone that would think even for a second that I’m not trying is out of their mind. But, nobody knows anything about stroke, especially strokes in young people. Don’t think that your doctors know anything about strokes – they don’t. The lack of knowledge about strokes is NO excuse for being so insensitive though. Learn how to act and what to say.
I’m kinda just venting but I want this written down so that I never forget this experience. So, being in the hospital for a month was the absolute most horrible, terrible, awful experience that I think I could have possibly had. Lucky me! Maybe I wouldn’t have absolutely hated it so entirely much if I was able bodied and could speak. But I wasn’t/couldn’t. I had to be taken to the bathroom, I had to be washed and fed. I got a migraine every other day that would make me puke. Oh and I was bald. Oh and I had a severe intention tremor so my whole body shook terribly anytime I moved at all. And on top of all of that, I couldn’t speak so I couldn’t articulate what I was feeling and on the inside, I was cognitively OK. I didn’t have any feelings of taking a break and getting to rest a bit, no I didn’t have those feelings AT ALL! It was AWFUL! I remember thinking back in the old days, that needing to be in the hospital for a few days would be relaxing and a nice break. OH MY GOD NO. ONLY a stroke survivor will get this, NO ONE else can come close to understanding this experience. If you ever have the good fortune of being hospitalized, I hope that your experience isn’t as immensely horrific as mine was.