The joys of mobility progress
After a year and nearly 8 months since patella fracture, I am now experiencing the joyous resumption of vigorous activity, following numerous set backs, many delays, further injuries and a test of patience that nearly made me insane with frustration. Without the tools and principles of the Alexander Technique, my insanity may well have been confirmed!
My recovery has also relied upon the necessary assistance of experts in other disciplines that are compatible with Alexander thinking, most notably intelligent whole-person Physical Therapy, Osteopathy, and the comprehensive strengthening of Gyrotonic exercise. As an Alexander teacher, I have been able to bring a skill of intention and attention to the use of my self in the process of recovery. However, the experience of patella fracture and the requirements for full recovery in function have needed expert guidance far beyond my own skills.
Currently, I am thrilled to be able to run up hills every morning with some degree of ease. Running on level ground or running down even a slight grade is more impact than my injured knee can handle. There is no point in going beyond my current condition of self! Since running up hills is a bit easier every day, my hope is that my use of self and balance of strength will allow running on any grade with ease before too very long. My intention and hope is to be able to run on the pre-dawn beach in Kauai in December, with the stars reflected in the sand under my feet and the ocean licking my heels in a rhythm that spells utter delight.
Gyrotonic exercise explorations have also expanded in possibility. Many movements that previously challenged my injured knee can now be accomplished, as long as I continue to attend to my entire elastic self in response to movement stimulus. In other words, allowing the dynamic pause between stimulus and response so that the activity can do itself. Another way that I express this to my students is “going from undoing to doing without doing too much”.
I love my morning hill runs. I know all the locations where I can hear and observe various birds, and how the air shifts so that the scent of Puget Sound informs me. End gaining, as in pushing myself to run, is fruitless, and only results in pain and inflammation. Every morning hill run is unique and requires a willingness for new experience, for allowing the current condition of self to indicate appropriate vigor. If I hurry myself, I use myself poorly and suffer later. If I allow internal time and quiet the hurry-urgency, my use improves and I can accelerate with ease. There is a large difference between hurrying and moving quickly with good use.
And this all speaks, of course, to the long journey of recovery, of which I know far more than I ever wanted to know, and during which I learned more than I had previously believed possible. I am grateful for the learning, deeply appreciative of the very refined help I received, and ultimately hopeful that my challenging experience will somehow benefit others.
Urban mobility: great improvement
Mobility limitations and pain have receded, and desired activity proceeds!
I flew to NYC for the first time since hardware removal surgery. Although the cabin pressure and lengthy hours of sitting still inflame my knee, the discomfort is minimal compared to the excruciating pain I experienced when the hardware was still in place. This was a pleasant and very welcome difference. I could walk off the plane and proceed to public transport with ease, rather than hobble off the plane and limp to the subway. Grace in transport of my self was renewed.
While in NYC, I was very thrilled to average, according to my trusty pedometer, about 10 miles per day of walking, with some days of 15 miles! This was accomplished with ease and speed and tremendous joy. I also walked up and down numerous subway, hotel, and museum stairs with ease.
All of this improved mobility meant I could enjoy the city with great happiness and huge gratitude for my renewed mobility. I enjoyed time with friends, delighted in seeing art and parks and favorite trees, and experienced the city I deeply love without having to attend to knee pain. This is a quite different experience from even 6 months ago!
While in NYC, lessons with John Nicholls further improved my elastic connection to the ground, and overall expansion of self. I have been studying with John for over 20 years now, and find his lessons continuously inspiring. My condition of self always benefits from his work, and my respiratory response deepens and widens. Breathing and use of self become one and the same condition, which is a very joyous experience.
What a gift this improved mobility presents! I returned home able to run up hills in my morning explorations in an even more vigorous manner. Soon, I hope, I will be able to run on the flat (more impact) with ease and joy!
Hurray!
The minimalist run
Recovery from patella fracture sidelined me in numerous ways that have been amply described over the past year and a half. Being able to accomplish simple daily activities without pain or restriction has required continuous dedication, lots of help from other professionals, and patience beyond my personal limits. The fact that I can now walk with ease, pursue Gyrotonic exercise full tilt, and live with minimal pain brings me much joy, relief and gratitude. And, as I have expressed frequently in this blog, my hope and intention is to resume the joy of running again. Moving with exhilaration and rhythm calms my mind and eases emotional noise. Running in the morning air and light was my means of balancing my entire self previous to injury, and I have missed that joyous experience deeply.
During the past few weeks, I have been walking carefully down not so steep hills and walking quickly up very steep hills to strengthen an entire balance of tone with good use and elastic wholeness. Today, I actually accelerated into a run up two short hills!!!!!
The injured knee was confused, and the uneven strength of my legs was distractingly obvious. One leg is responsive and elastic, and the other is slow and heavy in response. New brain maps have to be developed and coaxed. My gait can only be described as uneven, clunky and unintegrated. All of my Alexander thinking can’t override the results of 18 months of very asymmetrical use.
Knowing all too well the downside of pushing beyond a current condition of self, I am proceeding with care and awareness. I am resisting (with difficulty) a plan to increase running, attending to the means-whereby, delighting in progress, and accepting whatever pace my morning hill walk reveals.
Delights: Absence of pain, renewed mobility
A year and a half after injury, I am at last experiencing steady progress and reliable strength. Pain in my foot and/or knee arises now and then like an old outdated message, but not enough to seriously limit mobility. I am walking with ease and speed an average of 4 miles daily, with frequent days of twice that mileage. I limp far less, sleep with only minimal pain, and rejoice constantly in increased activity. My injured leg is still less muscular and responsive than my non-injured (and over-strong) leg, but balance in bipedal strength continues to improve.
Old pre-injury habits of use have become more apparent as the fog and distraction of pain and partial function clears. Having learned from my numerous set backs, I am ever attentive to using myself well as the possibility of more vigorous activity becomes a welcome reality. I approach all increased activity with a happy curiosity as to how to light up my entire self with an intention of ease and balance. I want to dynamically refuse any narrowing or shortening, so as not to imperil my new-found freedom with end-gaining beyond my current condition of self, and yet appropriately challenge myself to increase balanced strength. It is a finely tuned line to walk, but clearly not impossible.
No, I am not yet running, but I am deeply enjoying morning walks up steep hills (and the necessarily careful walks down hills). My Gyrotonic sessions have expanded, deepened and refined in explorations of grounding to spring into action with ease and whole self awareness.
This arduous recovery has required time, attention, tremendous assistance from other experts, and a constant application of Alexander principles. It is nearly impossible for me to imagine recovering from a serious injury without Alexander principles as a deep source of informative intention, or without the guidance of complimentary disciplines. We are elastically integrated systems, us human animals. A change anywhere in ourselves means change in our entire selves, for good or for ill. Whether we are injured or non-injured, our only choice is in our response.
As always, I am grateful to professionals who have assisted me and continue to support my progress. I am also deeply thankful for my dedicated students, who have witnessed, experienced and been compassionately patient with my long and difficult recovery. My intention has been, and continues to be, that communication about applying Alexander principles to injury recovery will assist others, for the best outcome of all concerned.
Impatience, inhibition and vigorous exploration
It has been one year, 5 months and 20 days since I was last able to enjoy running through the morning air, and all the associated delights of moving with ease, speed, rhythm and timelessness that running means for me. Recovery from injury has proceeded with many bumps, set backs, discoveries, moments of welcome progress, and incremental victories. (Being able to walk down stairs with ease stands out, for instance.) The possibility of using myself well even with considerable physical limitations and rather constant pain has yielded an ever deepening confidence in Alexander principles.
Patience has never been a major aspect of my being. I am constitutionally restless, over-quick in thinking and in temperament, reactive in nature. My chosen mode is “go!”, but this lengthy recovery has forced me to a nearly intolerable “slow”. My tolerance for a reduced pace in being has challenged me at the very deepest levels of self.
The foot pain has thankfully retreated to a murmuring discomfort rather than a crashing interruption. The deep impatience and overwhelming urgency to run tempts end-gaining beyond my current condition of self. Having learned the risks of pushing beyond limitations, and yet desperate for the delights of vigorous motion, I have chosen the means-whereby of activity in which I can use myself intelligently.
So, I dress in the early morning as though I am going for a run. Then, I don’t literally run, but walk my run route (formerly called my “faux run”) with the added detail of walking with vigor up hills. It is challenging, fun, and an almost run experience. I can observe my use in energetic movement, hear birds, see trees and flowers, smell the morning marine air, disperse my excess emotional energy, allow thinking to quiet to a dull roar.
Walter Carrington’s wise advice that one always has time to attend to use of the self takes on a larger meaning with a long term recovery from injury. I struggle with allowing time, but acceptance, and an intention for dynamic non-interference (inhibition) are the only tools that are effective for me.
One of these mornings, I will spontaneously accelerate into a run. Time will blur and slow, distance will minimize, and an exhilarated sense of being will renew itself like the wind.
Every change shifts the entire Self
As I often tell my students, a change anywhere in the self changes the entire elastic Self. There is no isolation in structural change, as the entire self is continuously and elastically connected. This notion is evidenced by the foot pain I have experienced in the last month.
More clarity was revealed when I saw my Osteopathic doctor this week. Dr. Bensky determined that the forcible (and necessary) immobilization of my leg during hardware removal surgery had diminished the elastic response of that leg, so that the foot had few choices but to become painfully inflamed. The forcible fixing of my leg also instigated back spasms, as my entire self had to accommodate unnatural stabilization.
From an Alexander point of view, this makes great sense, as F.M. Alexander saw the entire self as integrated, and all responses interwoven and inseparable.
After Dr. Bensky’s work on me, my back became temporarily far more painful, then much better. I had the opportunity to visit with Walker the horse, a very handsome and sweet-natured animal. He was patient with my painful condition, and also a bit alarmed by my sudden needs to accommodate pain. Horses don’t miss any detail in human coordination!
My foot has improved significantly. I can walk now with only minor pain, and have hopes that even this discomfort will quiet with good use and expert intervention.
Hope returns for continued recovery to full and pain free mobility. It has been a very long journey, and possible in progress with assistance from skilled and like-minded professionals of several disciplines. The big lesson continues: attend to the entire self so that specific results occur from improvement of the whole condition of self, and the manner of use supporting the improvement of whole self condition.
The continuing subject of pain
Pain has been my informative companion, my constant feedback, and a rather primary sensation since I fractured my patella in February 2009. I have learned more than I really wanted to know about how much pain changes and challenges attention, and how daily life must be shifted to accommodate pain. There was a glorious month between hardware removal surgery and the onset of foot pain when I could move easily and comfortably. I am grateful for the reprieve, but also mourn that dream of pain-free living.
Applying Alexander principles of a wider attention and an intention for overall elastic response has made my pain-informed life tolerable. When I am teaching lessons or workshops, and thus very much attending to a larger view, without in any way repressing pain signals, pain takes a background seat.
There is also the pain, which is much more difficult for me, of not being able to move as I would prefer. How to apply Alexander principles to this emotional discomfort is still hit and miss for me. In the notion of whole self elastic coordination and choice in response, I can refuse to narrow or shorten, and quiet myself in reaction to emotional dismay. The strong intention to remain lengthened and widened, on the ground and springing up, increases respiratory freedom and quiets my mind chatter. I can see the larger view of recovery, in moments, and rejoice. Then, I struggle again and despair. When will I be able to run or even walk with ease again? The battle continues, with no known outcome that is yet clear.
The whole self in recovery from injury
The Alexander Technique is, to put it most simply, an education in the use of the self. The Alexander Technique does not diagnose or treat any specific symptom. We are teachers, not therapists, and have no medical education. Our job is to assist people in improving both manner of use, and thus, indirectly condition of use, by offering the complex skill of dynamic non-interference, and a choice in response to stimulus.
As an Alexander Teacher who has experienced a dramatic injury and an ensuing long term recovery, I can view the benefits of Alexander skills from a very personal viewpoint. My education as a teacher gives me a valuable perspective of the whole elastic response, whether ideal or disrupted by injury, as key in recovery from injury. The Alexander Technique could not in any way heal my knee directly, nor address compensatory muscle patterns in a direct manner. The Alexander Technique is always indirect in solutions. Improving the harmonious balance in response, and the manner of response with the entire self, has the potential to improve the condition of self. Even with my diminished and very challenged condition of self post injury, I was able to return to teaching in a short amount (two weeks!) of time. We can make the best of even very difficult coordination challenges with a wide attention to entire use, rather than specific attention to fixing of parts. Indeed, specific fixing of parts limits overall response, and thus overall recovery.
My recent experience of severe foot pain illustrated these principles. Although I could have attended primarily to the painful foot, I knew that the location of discomfort and the cause of discomfort are rarely the same. After I calmed my panic and distress, I realized that my foot was simply the weakest part of a system that had become unbalanced. Since I was born with an inwardly rotated leg, my pelvic support and leg-back coordination has always been compromised. After years of studying and teaching the Alexander Technique, this imbalance had improved to quite functional levels. The patella fracture, and the ensuing leg brace, had renewed my original imbalance to a marked degree. There are limits in what I can ask of my neuro-muscular system, even with best possible use. My foot expressed imbalance to a painful degree. Other assistance to re-establish a level of structural integrity was needed. Thus, I have sought intelligent Physical Therapy, osteopathy, and the integrated exercise approach of Gyrotonic.
The Alexander Technique cannot solve every physical difficulty, nor is it intended to do so. Compatible disciplines that assist in shifting structural interference, combined with Alexander skills, yield results that are comprehensive.
I might not be walking at all, whether my injury had occurred or not, but for Alexander skills of intention and attention with the whole self. And that being said, finding professionals with Alexander compatible awareness of the entire self in response have been necessary for continuance of recovery. In the big picture, all are interwoven, integrated and necessary. Attention to the whole self is key, and indirect solutions work best.
She walks! Back in action again..
My foot seemed to turn a corner toward increased function and lowered pain levels a few days ago, thankfully. All improved further after my friend and Gyrokinesis/Gyrotonic instructor, Lindsey, came to my office yesterday. Lindsey guided me through a seated series of Gyrokinesis exercises, all emphasizing whole self awareness, connection to the ground, and thinking into activity.
After our Gyrokinesis exploration, Lindsey and I walked to my home together. Just a few days ago, I could barely walk a few blocks without severe pain. Yesterday, I walked the uphill mile home at a decent pace with relative ease.
Given the whole elastic system of tonal response that we each maintain through use, habit, activity, belief and structure, no specific area of discomfort can be isolated in cause or resolution, unless a specific trauma (patella fracture, for instance) has occurred, and even then an overall response of choice and tone is necessary for renewed function. I knew, both intuitively and as an Alexander teacher, that my foot pain was due to overall structural and elastic rebalancing after the knee hardware was removed. Since the motions of Gyrotonic and Gyrokinesis so improved the comfort of my foot, and without directly addressing my foot, and since my foot rarely hurts when I teach (when my use is at its hopeful best), it seems obvious that a larger solution of improved elastic response would benefit my foot. My incredibly gifted PT Heidi agreed with my assessment. She observed many shifts and fixing of pelvic and back support that would potentially impact foot response, and helped me to unravel a bit, with subtle and skilled manual guidance, and without directly forcing any shape or postural mode.
The result? I walked a mile to friends’ home in lovely Summery weather and back again with only minor pain. I remained more aware of the ground as support for my upward response but forced nothing (dynamic non-interference). I delighted in walking, which was more than enough.
Landscape of recovery: renewed hope
Hope, post injury, is typically renewed for me by increased ease in exploring activity, and by experiencing some measure of pain free living. Both increased activity and decreased pain have been achieved in increments since patella fracture. Progress has not been in any way linear, but instead a spiral of set backs, re-learning, long plateaus and welcome improvements. This is the landscape of injury recovery. It is a journey without a map for me. I can choose to use myself well, no matter what my condition of self happens to be, and at whatever point in the landscape I happen to be traveling, and I can select professionals of other disciplines to assist me en route. Otherwise, my control seems to be nil. Indeed, relinquishing control seems to be my major (and very difficult) lesson in this ongoing journey.
Yesterday, I had the delightful experience of a private Gyrotonic session with Magali Messac, Master Gryotonic Trainer. Magali also takes Alexander lessons with me, and is thus aware of Alexander thinking about undoing into activity. Magali, as a former dancer of much renown, has experienced injury and recovery. She knows from personal experience the urgency I express to become active and strong in my participation in life. She also knows that I end-gain to achieve, and can spot this tendency with great perception and accuracy.
Magali expertly guided me through a challenging and joyous 90 minutes of exercise that did not stress my poor foot. I emerged invigorated, renewed, energized and thrilled.
I decided to direct myself after this very happy experience to walk and move as though my foot was not an issue. I am not suggesting that I ignored or suppressed pain. Instead, I refused to expect pain, or to compensate from that potential expectation, and to begin to welcome a more upright and widened overall response. I chose to believe in my graceful possibility, and to be willing to stop and re-direct if pain indicated doing so.
Then, this morning, I attended a Gyrokinesis class given by Kelly Reynolds. Kelly is a wonderful teacher. She and I know one another not only from her terrific Gyrokinesis classes, but as student and teacher in the Alexander Technique. Kelly has taken many Alexander lessons with me, and also was a trainee on my teacher certification course, until her life’s needs compelled her to pursue other activities.
Kelly’s class was, as usual, energetic, rhythmic, and really fun. Since the hardware removal from my knee, I can do much more of the class without discomfort. I had to accommodate my foot to some degree, but was joyously able to challenge myself with care and attention.
For any or all of the above reasons, or for reasons that are mysterious to me, my foot hurt far less today. I was able, with a much slower pace than I would prefer, to go downtown for various errands. A limp still informs my walking, but pain is quieter and movement is easier.
So, there is hope on the horizon of this up and down landscape. I may encounter more rocky bits, but will allow hope to inform me as I proceed onward, my use as a constant choice, and my chosen professionals as guides.