February 18 2009: fractured left patella in a fall
February 19 2009: emergency surgery for repair of patella. Two titanium pins and a figure 8 wire installed for repair. Sent home with a full leg splint immobilizing leg into full extension
March 4 2009: Splint removed and full leg Bledsoe brace applied with full leg extension.
March 5 2009: Returned to teaching private lessons and to directing training course with leg brace/full extension.
April 1 2009: 30 degrees flexion allowed in Beldsoe brace
April 15 2009: 60 degrees flexion allowed in Beldsoe brace; began Physical Therapy
April 30 2009: Bledsoe brace removed
June 3 2009: gave presentation to Group Health Optimal Healing Group on the Alexander Technique.
May 8 2009; resumed Gyrotonic system exercise with expert care and supervision
July 18 2009: was able to travel to NYC for much needed Alexander lessons with John Nicholls
August 12 2009: released from care by surgeon
Since release from care by my surgeon, recovery has been a incrementally slow, non-linear, and often deeply discouraging process. If not for my Alexander skills and tremendous support from friends, family, and care professionals, I would have given up all hope. Physical Therapy continues, and will most likely continue for many months.
Alexander skills gave me the means to accommodate living with a leg in full or nearly full extension for a many weeks, and to move, despite crushing pain, without hurting myself further. A determination to both learn from this experience, and to deepen my teaching skills in the midst of a very challenging recovery, has increased my confidence in Alexander principles as a means of surviving injury, pain and all the dismay and potential depression that recovery involves. Being able to think with my entire self, to use the tools of intention and attention, has been key in this long process. The Alexander Technique does not in any way promise cure or even solution to injury, but does provide the skills to respond to current conditions with conscious choice. Although I may not be recovering with the speed that I would prefer, I know that I can make moment by moment decisions for the best use of myself, given that pain, limited mobility and ongoing frustration describe my current state of being. As previously stated, I have learned, reluctantly and with great resistance, that the pause, not the push, is essential to progress.
Putting a pause on exploring more than ordinary activities (see previous post) has had an overall good result. I can sense new support in my injured leg from my intention to allow new connections neurally and muscularly, as well as from simple PT exercises. Today, I could squat for the first time since injury in February! I also danced like a crazy person to music at home. The squat came quite naturally while refilling my cat Carmella’s food bowl. The dance was for sheer joy.
Walking with speed also came easily today. After 9 months of hobbling and limping and having my attention drawn ever downward to my all too painfully present knee, this was delight beyond belief! Limping may return, I know, but experiencing ease provides evidence of the value of inhibiting end-gaining, allowing quiet and a slower pace. Slow is not my favorite speed, of course. Habits of self are being addressed on myriad levels.
Now, I have to be sure not to end-gain beyond my current condition, to attend to the means-whereby, and to not challenge myself out of undue optimism. I have learned from my setbacks, and will, with cautious hope, progress from here onwards in a circular (not linear) fashion to the full recovery I so entirely seek.
A long recovery, and the patience required to resume desired activities, tempts end-gaining at many levels. What was previously “normal” in terms of simple daily pursuits becomes accessible at a frustratingly slow pace. Exertion at more challenging levels begins to seem a distant dream.
I so desperately want to resume my very active life that I often push ahead of my strength in an end-gaining pursuit of the many joys of vigorous exercise. This urgency has resulted in a cost of returning pain and immobility. It is a fine line to both respect current conditions of self and also strengthen for progress.
This morning, I had the joyous experience of walking to work with no knee pain whatsoever! None! I could even think of other subjects than my knee! According to my habit of self, I wanted to plunge into more vigorous movement by attending a Gyrokinesis class, despite the evidence of the past few weeks of pain and difficulty. Hey, I felt better now, why not go further?
Inhibition (quieting, refusing to narrow or shorten, requesting widening and lengthening) won, for a change. I may be crazy but I am not always stupid. I restrained my impulse to experience further vigor in a Gyrokinesis class, decided to enjoy the simplicity of pain-free walking, just taught my regular schedule of lessons, and relinquished challenge as a need for today.
The result for today (tomorrow or next week may be different) is that walking continued to be relatively easy. I bussed, rather than walked, the two miles to the Gyrotonic studio, and enjoyed a thoughtful, attentive time of gentle exercise supported by the weights and pulleys that the Gyrotonic system so intelligently provides. A few weeks ago, I tried to do it all (walking over 3 miles, a Gyrokinesis class and a Gyrotonic session) with excessive optimism.
I am learning that waiting is not going backward, but rather is respecting how I am now. Resuming previously enjoyed vigorous activities will only happen as I learn to wait. In the Alexander Technique, we allow a pause for the old habits to quiet and new neural connections to be made. Progress occurs with the pause, not the push.
9 months is an excruciatingly long time for a typically active person to be far less than fully mobile. The emotional, psychological and physical challenges of injury and long term recovery require a level of patience that is nearly beyond tolerance. A sense of personal identity, of safety and well-being, of confidence in life are all put to a test. End-gaining (pushing to an outcome) defeats and impedes recovery. Only the means-whereby (attending to the use of the Self) has any hope of success.
My own patience with rehabilitation and recovery frequently wears thin. My formerly easy mobility and joyous exploration of many activities seems a distant memory, a dream that I can’t fully recall. Now, I am just happy to be able to walk with a minimum of ease.
Daily gratitude is an essential component of my well-being. The dance of self pity, of focussing on limitation and pain tempts me with devilish attraction, but only diminishes my overall elastic response. If I pull down to the disturbing sensations of my knee, pain worsens. Although I don’t in any way ignore these sensations, which are often quite severe, if I instead bring a wider awareness of myself in the world to mind, pain is only a part of my picture, and pain is less overwhelming.
In that light, I make a daily list of gratitudes to keep my picture bigger than my own sensations. The friends, students and professionals who assist me in recovery by their belief that I will indeed resume being my formerly active self are a continuing source of inspiration. This has been a long road for them in supporting me, and I am deeply grateful.
So, my thanks to: my students, who teach me constantly; my friends, especially those who continue to provide humor and cheer without unwanted advice; my extraordinary PT, Heidi, who guides me with deep compassion and skill; Lindsey, my Gyrotonic instructor who helps me strengthen and explore movement in a very attuned and means-whereby fashion; the folks at Lighthouse Coffee who daily note both my progress and my setbacks with interest and empathy; Carmella the cat who insists upon daily play as a necessity; various valued canine friends, Oliver, Ella, Ruffles, Georgie, who express enthusiastic acceptance; Marty for his tolerance, patience and love; F.M. Alexander for providing a way of being, a skill in activity, that is expansive in possibility, and endless in process.
It is now seeming like a given that if I experience exhilarating progress, I will also endure setback. Thus, for no explainable reason this week, no massage, no excessive activity of any sort, my knee swelled to a point of immobility, pain increased to a very high level, and simple activities became hugely challenging once again. After 9 months of recovery, my tolerance and patience for pain, immobility and dependence on others has thinned to a shred. Returning to needing a cane to walk and assistance to dress is nearly unendurable after some months of nearly normal mobility and independence.
I have to remind myself, with this renewal of pain and immobility, that this current condition is temporary. I can teach well and easily without pain because I attend to a bigger picture of self, use my entire elastic system, and focus far less on sensation when I am teaching. I don’t in any way suppress or diminish pain as information, but instead take that information as part of a wider field of input. I use myself as well as possible so that pain is not an issue.
Given my current level of frustration, anger and depression with this setback, you would think that I could bring the use of myself while teaching to daily non-teaching activities, like walking to work (currently using a cane, again). But I am a flawed and frustrated human, and I just can’t, don’t want to, and I rebel and protest instead, like a child who wants to run but can’t yet manage the coordination.
This setback provides an insight into the experience of people far more injured than I who have to endure even longer recovery patterns than mine. If I have run out of patience with all my Alexander tools and excellent professional resources, if I am battling depression and hopelessness, how do people without these tools even begin to cope?
Thus, I humbly continue with my refusal to shorten or narrow, with my request to widen and lengthen, and with a deep hope for reprieve from pain and immobility.