I started physical therapy last week for the first time ever. It’s probably long overdue; I’ve had some lower back stiffness and pain on and off for nearly a year now. My first appointment with a kind woman named Rebecca resulted in a little worksheet with drawings of a person lying on their back — single knee to chest stretch, double knee to chest stretch, isometric abdominal exercise for core stability.
Today, I went back for the second time. For 45 minutes, I enjoyed the novelty of focusing on a single thing: My lower back. I could practically hear my body thanking me for listening. I made some mental notes during our session. Now it’s later, and I’m sitting here in the yellow chair that is probably not great for my back, the sun streaming in through south-facing windows warm on my hands over the keyboard.
Here’s what I learned today during physical therapy, that I’m pretty sure I can apply to writing and life.
1. Be honest.
Rebecca: How’d it go this week?
Me: Well [looking down]… I didn’t really do my homework.
R: Thanks for telling me.
Me: Reminds me of writing, or anything, I guess. It’s easy to make excuses, when really, I just didn’t do the exercises.
R: Well, let’s get started and see how today goes.
That was it. She asked, I told her. And now? We added a few things, and it’s up to me to decide how important this is to me and what will help me commit. Lying about what I did or didn’t do is certainly not going to alleviate my pain.
2. Pay attention and slow down.
Rebecca: You might want to hold each of these stretches for about 30 seconds.
Me: Wow, that makes me realize how fast I’m usually going.
The sensations and movements, like the learning itself, are so subtle sometimes you could miss them altogether if you rush through. Awareness of what’s happening requires slowing down — something that comes as a revelation all over again.
I’m reminded of a conversation I had on Sunday; at one point, I asked a question and then launched into a story, only pausing when the person I’d asked pointed out that I had said I wanted to hear her thoughts. I wasn’t paying attention. This doesn’t have to mean I was too much, it just means “push pause.” Undoing shame around this is a practice itself.
3. A little is more than nothing.
Me: I always tell the people in my writing groups that some words are more than no words.
Rebecca: Right. It’s like that here, too. Some movement is more than no movement.
Will I do ALL of the exercises today and tomorrow, before my next appointment on Thursday? I don’t know yet. But I will do some. And that will more than before, which was none. Enough said. More words is more than no words. Five seconds is more than no seconds. Seriously, it is that simple.
4. Most things don’t happen suddenly.
As we were talking about various yoga poses this morning, I flashed on classes I took as long as 15 years ago, when I would avoid certain back bends or find myself seeking relief in child’s pose. Why? My lower back ached. I also remembered feeling that same ache after a long day of walking in NYC or Boston — as a teenager.
In other words, it suddenly became clear to me that no single injury, incident, or accident had landed me in Rebecca’s PT office.
My natural (hyper-extended) posture + two pregnancies + running + not much core strength + time = pain that had finally become chronic enough not to ignore.
How bad does something have to get before it warrants your time and attention?
5. It’s nice to have help.
Oh, it felt so good to lie on the table, even on top of that paper covering that gets all creased and makes that papery sound. To let her bend my leg, her hands on my knee and heel respectively, yielding completely to the movement she initiated. It felt good to be learning useful things.
It felt good to be doing something about something that hasn’t been working — and to have some guidance about how to do this safely and effectively in ways I could take home.
It felt good to have help.
6. You can’t know in advance.
My hope, of course, is that working with a physical therapist and learning what I can do on my own will pay off with pain relief and greater strength. It’s likely that I’ll get out of it what I put into it.
This reminds me of something Krishna Das said at the Kirtan we went to last weekend:
“We want to know what chanting will do — to us, for us — before we chant. And there’s no way to know. You can only begin and, in his words “keep singing.”
It is so simple as to be obvious that this applies to not just chanting, but… everything. No matter how many people before you have walked a given path, there is no precedent, ever, for your own lived experience. The deeper you go, the more your own body and mind and heart and choice and voice may surprise you.
And the fact remains: There’s no way to know in advance how it will go or what it will “do” for me, no matter what “it” is.
I don’t always have the most disciplined track record. When did I stop stretching? I asked Rebecca at one point (as if she’d be able to tell me). But what I didn’t do doesn’t matter. And while there’s no predicting how this will go, I’ve signed up to give it a shot and see what happens. My job is to keep singing, er, stretching.
7. no one else can do it for you.
Unless you live in some kind of cool sci-fi world where people have actual body-doubles, there’s no surrogate for you. I am the only one who can take the time today — five or ten minutes at a pop, say — to take care of my body. Nobody else is going to do it, nor could they even if they offered.
Whether it’s on the yoga mat or the blank page, there’s no substitute for the ordinary yet radical act of showing up.
8. change happens. so does inertia.
If I go to physical therapy and do my homework, I may see changes in my body. My hope — my expectation — is that these will be positive changes. Improvement. I’ve defined this as less pain, more mobility, and greater strength and endurance.
If I don’t go to physical therapy, or I go but don’t do jack shit at home, I may also see changes in my body. My guess is that things will at worst, worsen, and at best, continue to go the way they’ve been going — a little something we call inertia.
In this case — where there is actual pain — I am essentially inviting more pain but doing nothing. The changes that will happen may be negative; they will hurt, they will limit me in some ways, and I will have to adjust other things in my life around that.
Inertia is not an inherently good or bad thing, but it is a thing. And it is, to some degree, a choice.
9. don’t wait.
If you’re hurting — whether it’s your body, your heart, or your mind that hurts — don’t ignore yourself. I say this knowing full well how easy it is to put stuff off, to say we don’t have time. In fact, I said that to Mani last week — on my way to PT, no less! I believe our exact dialogue went like this:
Me: I don’t have time for PT.
Her: You don’t have time for not PT.
(Wise, that one, isn’t she?)
If you don’t know where to start, start right where you are. Write something down. Make a list of symptoms, whether they’re physical or emotional, specific or vague. Tell a friend, cast a line, or make the call.
10. trust yourself.
Always. Both with doctors and teachers, I’ve had experiences when I pushed aside my own experience and deferred to the “expert.” Every time I’ve done this, it caught up with me. I “paid” for not listening to my body or not taking my own instincts seriously. Just because someone has professional training does not mean they know more about you than you do.
At the end of the day, only we can know what it feels like in there. (May we encounter practitioners who value and respect this dance.)
11. the world needs us whole.
We can do so much more from each other when we’re tending to our own pain rather than lobbing it at each other or hobbling around hurting and unable to deal.
These insights may not be life-changing or new. But more and more, I find that it’s revisiting the small things that makes for big changes in my life — all of it, the loving, the working, the writing, the having a body thing. One knee lift and one word, at a time.