Rehab is NOT Linear

Sep 12, 2022

For this blog, I wanted to talk about when you are rehabbing an injury or some type of issue, your progress is never linear. I think when we have something going on, we're in the type of immediate gratification kind of society, where we want to see immediate results, we want to see improvement right away, and we don't want to have to put the work in behind it.

I get people in the office a lot who have had a certain issue for literally years, sometimes decades, and they want to know how many visits it's going to take for them to feel better, or they want to feel better after one visit or something like that. And if you think about the patterns and groundwork that you've laid down over your entire life to cause whatever issue is ailing you, I think it's pretty unrealistic to think that you're going to make long-term change in one visit or by not doing any of the extra work that we give out for you to make those consistent patterns.


Consistency: The Magic Maker For Creating New, Better Patterns To See Changes

I've said it before, consistency is really the magic maker when it comes to creating new, better patterns and seeing a real change. And usually, I give patients exercises after their visits. I'll e-mail them and send them a link to our videos, and I'll say, just generally, how many repetitions or how many times a day should they do these exercises.


A Different Approach Of Giving Exercises To Patients

I just had a patient on Friday, and she is just like me. She is very busy, has a young child, has a busy career and the daunting task of putting one more thing on your plate, I know, it sucks. It seems like you have not even a spare minute in the day.

So instead of just writing the exercises out and making it as a list, I told her to do A, B, and C in the day. When you’re looking at it in an e-mail you will see I wrote it this way, “This is what I want you to do before you get out of bed. And it might only take 30 seconds to do your little bit of breath work. That's where I want you to do it at,” ““When you brush your teeth, like how many times a day do you brush your teeth? We're going to do kitchen sink breathing for 10 breaths when you get to the kitchen sink, or the bathroom sink,” “Okay, do you get in and out of your car a lot in the day? We're going to have you do this thing, and when you're in the car, I want you to be mindful of not tucking your tailbone under and unclenching your glutes.””

It's more so setting up patterns like that - that are consistent and spaced out through the day that change your habits to the core, rather than doing exercises in a little block, isolated in a little sphere, that then doesn't translate into your everyday. Changing those patterns in the everyday life is what's going to make those changes for you, not just isolating it, and maybe you get to it that day, maybe you don't.

So, spreading it out and saying things like, “When you're at your desk for long periods of time, every hour set a timer on your phone, and I want you to do rugs exercise or stuff like that.” So, it’s building it into their day, so they don't feel like they have to designate a time when they're kid is not awake, or when everything is done for the day, and you're so exhausted. It’s spacing it out so that it's super manageable, little bits that you sprinkle into the day. It’s more about mindfulness rather than let's do three sets of 10 reps of each, A, B, and C. Because I feel like that can be a lot more manageable, especially for someone who already has a maxed out plate.


Being In A Relaxed State Will Help Your Healing

This is important because I've talked with colleagues and friends who are in this body mechanics chiropractic healing type arena. They shared with me that if you can't get out of that stressed and fight or flight mode, you're not going to be able to heal well and heal efficiently because it's very difficult to heal when we're in fight or flight mode.

I did blog on giving birth and how it's very hard to give birth when you're in fight or flight mode and relax and let the whole process happen. The same is true with healing, and we're just conditioned with the busyness of our lives, the amount that we put on ourselves, whether it be work-wise or family-wise, constantly running, constantly using screens, constantly not hydrating and not eating well. It’s the snowball effect of can we get to that de-stressed space where we can give ourselves the grace to heal.

So not only is there the, “Have you done your generic exercises?” it's also “Have you been able to de-stress enough to be able to heal to your fullest stability?”


Breathwork In Relation To Be In A Relaxed State

Okay, let's say we're working on your headaches, but we can't seem to get under control the immense amount of stress you're under and you're still gritting your teeth and it's causing you to have a paradoxical breathing pattern. You're breathing with the front of the neck, it's locking down. You can't just rub away stressed-out muscles. You have to work on that stress response that is causing you to clench your shoulders up to your ears.

That’s why one of the reasons why I try to do breathwork with every single patient, because I feel like we're fundamentally stressed. I've never met anyone in the office who can honestly say that they have no stress in their life – whether it be family, social, money, any of those topics – we just all have some level of stress on our plate and we have to be able to manage that enough so that it's not affecting our body – it doesn't just have to be headaches.

We tend to hold our stress in our pelvic floors, tucking the tailbone under, clenching the glutes, and that is going to really, really hinder how we can rehab that area. I've seen it so many times, where I'll be working with someone with those kinds of issues, and it's so difficult to make real headway when we're just under a mountain of stress. A lot of times, you can't just have someone change jobs or fix the stress in their life. Even if you fix the stress or make big changes, that's great, but stress accumulates in your body, and if you don't address that accumulated stress, you're not going to be able to chip away at that mountain that you've got there.

So, how do you release stress? It can be through all those probably seeming to people, woohoo kind of things – human contact, laughter, the breathwork, REM sleep, meditation - that meditative state that helps us to release stress and so by sleeping really well and getting that great rest helps to release a little bit of stress and that's kind of the body's built-in way to release stress, but it's definitely not enough to chip away at a built up backlog of stress.

So that's why sometimes I will ask my patients, how many hugs do you get a day? Or how often do you laugh? Like full heartedly laugh? Because those are ways of releasing stress. And I have little kids, so I get hugged to death, but I have lots of patients out there who don't have a lot of human contact just because of maybe the nature of their work or they live alone or those kind of things.

To reiterate, taking a good look at your stress level plays a huge role in how we repair our bodies and have that shift towards healing ourselves.


Rehab: What It Really Looks Like

So if you're working on your headaches and you're making progress and then you have some kind of stressful event or something, know that there are many different things that can cause dips and flare-ups. It doesn't even have to be what seem like a physical event that causes the issue.

I think we don't give enough credit to how much that affects us physically, but I think we're starting to get it. We're starting to get on track that we really need to take a well-rounded approach to how we target these things that are affecting us and we're getting there, but I encourage people not to get discouraged with what they think is not a quick enough recovery.

I have someone working on pelvic floor leakage and incontinence and making progress, but not able to run again. And they've been working on it for a month and a half and have seen progress, but they were on vacation for a week and out of town again for a couple days, so they were not doing their exercises for that time. So they have probably really only been doing their exercises for a month and then the stress of some stuff sprinkled in there recently, and they were like, “Oh, this is probably as good as it's going to get. And I probably just am not going to be able to return to running.” If you've been having an issue like this for years and years, and you've seen progress with only a month of work, that is not the end of your journey, you can do so much more from there. A one month of work compared to a decade, more than a decade, of this issue slowly creeping up into your daily habits, that's nothing! That's a drop in the bucket and you really need to stick with it, make it part of your everyday habit and then slowly work it.

And when you have those stressful periods creeping back in and we know the pelvic floor is heavily, heavily influenced by stress and all sorts of different elements, we'll know our triggers and we'll know, “Okay, so stress is a trigger. I really need to double down on my breathing, down regulate my nervous system, try to stretch out the pelvic floor, because we know it's probably getting tightened.” So part of it is then seeing what our triggers are and knowing what to do, that we have to double down and do the work and push forward. So it's really important to realize that decades of an issue brewing and becoming something that has affected your life is going to need more time than just a month of effort.

It’s like thinking of it as training for a marathon or training for a figure competition or something. You're not going to work on your physique for a figure competition for a month. You would not be ready in time. You're not going to train for a marathon from scratch in a month. It takes time, just like anything else. And it takes patterning and it takes working on that stress response.

And again, with those flare-ups, we're identifying the flare-ups. We're seeing what we can do to mitigate them and working through that. And that's why I say that the progress is not linear. We're not just slowly chugging up towards that point. We are going to have those ups and downs, peaks and valleys, and that's normal. And you would see that if you were training for a certain event anyways, as well, so one month is a small piece to trying to fix a problem. That's decades old in the making.



So don't get discouraged. You have got this and it is a lifestyle change like with the giving people stuff to do throughout their day. That's important to remember too, because if we just go back to our old habits, then those problems are probably going to come back. So lifestyle change is better than just fixing it and going right back to what we were doing.

Have a good one!

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