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Dear Friends,

“Sometimes the bad things that happen in our lives put us directly on the path to the best things that will ever happen to us.”
 
I often wish the above quote could be in the minds of the patients that walk, ride or are pushed in a wheelchair into our clinic. So many of our patients have been thrust into, a challenging health journey, often with little knowledge of what would lie before them. Many surgery patients think their pain will go away immediately after they have surgery. They have little idea about how long their new pain and limitations from that surgery will last. This is an extremely tenuous situation which can bring up inner fears they might have never imagined!
 
It is not unusual to hear patients say, after a total knee replacement, shoulder surgery or spine surgery, “I had no idea the pain and restrictions would be so severe. I think my pain and restrictions are worse than before”. It is during these times that I am hopeful that we can help our patients move into a better mental state of mind with the thought above. Most patients were in a great deal of pain going into their surgeries. Unfortunately, they may not have realized how much pain and effort it was going to take to get back to a better condition after their surgery. Surgery can help, but, most of the time, it requires a great deal of challenging work in physical therapy as well as effort, discipline and some pain to fully recover.
 
I recently ran into two patients from a number of years ago. We talked about their health, and one of them brought up being one of my original patients down in the basement office on Monroe Street. We talked about the fun we had during those times how I had only one person working for me, and it was a small and cozy place. Neither of these patients discussed the difficulty of their rehabilitation. Does time heal all wounds? Do we have the ability to forget our past pain and challenges as the years pass us by? Based on many of my patients over the last 40 years, I believe we do.
 
Unfortunately, this doesn’t help while we are going through the painful experience. Patient after patient, even if they had a similar surgery many years before, forget how difficult their first surgery was when they are making their decision about a subsequent surgery. How can we forget how painful an experience was, when at the time we thought we would never be able to overcome the terrible pain we had experienced? While we are in it, we sometimes develop anxiety to a point that we are having nightmares about physical therapy or about excruciating pain and we are wondering if we will ever be better and/or sleep again?
 
This is a challenging question that many patients share with us. Addressing this psychological and emotional issue is paramount in helping each patient as we accompany them through an extremely painful experience. I can experience anxiety just driving to an unfamiliar town to stay for a few days in an unfamiliar hotel. This is nothing compared to having surgery! What our patients go through is as challenging as any of us can imagine! We can only try to be as empathetic as possible and try to help them achieve their particular goals.
 
Working with each patient often puts us in a very challenging situation. Even though our patients are dreading the pain, we must focus on their overall goal of getting stronger and more independent every day, and help them achieve this goal. This sometimes requires us to push each patient to, what might seem to be, their maximum ability to handle pain. It is during these times that we, as physical therapists, need to pull from our experience, as well as compassion and bring each patient to that place which later becomes the best place they had hoped for, following their surgery or injury.
 
Victor Frankl, a holocaust survivor once said, “We who lived in concentration camps can remember the men who walked through the huts, comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of human freedoms — to choose one’s attitude in any given set of circumstances, to go one’s own way.” Although neither our patients nor our staff are experiencing the tragic horrors that Victor Frankl describes, I think his quote holds great wisdom and hope for anyone facing their own challenges in life. If we can all step back from the tragedy of his experiences, I believe he is speaking to everyone. In any given set of circumstances, each one of us has the power to choose our attitude and response, no matter what the challenge. I hope and pray our patients can see their way through their painful recovery journeys with less anxiety and that we can guide them and bring them comfort along the way.
 
Thanks for allowing us to be your family physical therapists. We are truly honored to walk with you through these challenging times in your lives.

Enjoy the journey of being stronger every day,
Fran McDonald, PT,DPT,OCS
10 Exercises To Do In the Pool

Aquatic exercise refers to exercises performed in water using various water depths. It is a physical activity that offers many benefits. Buoyancy, which is a water property, also benefits the person exercising by supporting a portion of their body weight.

Being immersed in water can allow a person to perform exercises that may be difficult to do on land. The buoyancy of water can make it easier to move and improve your flexibility. Water also provides resistance to movements, which helps to strengthen muscles. In addition, by supporting much of a person’s body weight, buoyancy reduces the load placed on joints. This can allow a person to exercise sooner after an injury or surgery than would be safe or possible on land.

Strengthening and flexibility exercises are important for managing and recovering from many conditions. Regular physical activity can benefit your physical, mental, and social health. It also can help you prevent or improve many chronic conditions, such as heart disease, diabetes, obesity, depression, and weakness associated with cancer treatment.

Pool exercises can improve your:
  • Agility (ability to move quickly and easily).
  • Balance.
  • Cardiovascular fitness.
  • Flexibility.
  • Strength and endurance.
  • Walking.

Many conditions can benefit from and improve with pool exercise. These include, but are not limited to:

Pool exercises also are helpful for children with developmental disorders such as cerebral palsy, spinal muscular atrophy, and autism. Also, older adults can reduce their risk of falls when exercising in a pool compared with exercising on land.

Preparing for the Pool
Before starting a pool exercise program, check with your physical therapist or primary care provider to ensure the exercises are right for you. Then, follow these tips for the best possible experience:
  • Water shoes will help provide traction on the pool floor and protect your toes from being scratched.
  • In general, exercise in water that is waist or chest high. If you have a specific condition, ask a physical therapist for the best water level for your condition.
  • Choose a water temperature that is best for your condition. Exercising in cooler water may allow a person to exercise more without fatiguing. Exercising in warmer water may be good for reducing pain.
  • Use a Styrofoam noodle or floatation belt/vest to keep you afloat in deeper water.
  • Slower movements in the water will provide less resistance than faster movements.
  • Use webbed water gloves, Styrofoam weights, inflated balls, or kickboards to increase resistance.
  • Never push your body through pain during any exercise.
  • Although you will not notice it, you still sweat with pool exercises; it is important to drink plenty of water.

10 Excellent Exercises for the Pool
  1. Water walking or jogging (forward, backward, and sideways). Start by walking forward in chest- or waist-high water. Walk 10-20 steps forward and then the same distance backward. Increase speed to make it more difficult. Also, increase the intensity of your effort by jogging gently in place. Switch between jogging for 30 seconds and walking in place for 30 seconds for five minutes. You can hold a kickboard vertically in the water while walking to increase resistance. Sideways walking: As a progression, try walking sideways by crossing your right foot in front of your left, bringing your left foot back to start, then cross your right foot behind your left foot. Continue with this pattern for 20 steps in one direction, then 20 steps in the other.
  2. Forward and side lunges. Stand near a pool wall for support, if needed, and take a big lunge step in a forward direction. Do not let the knee in front of you advance past your toes. Return to the starting position and repeat with the other leg. For a side lunge, face the pool wall and take a giant step to the side. Keep your toes facing forward. Repeat on the other side. Try three sets of 10 lunge steps. For variation, do your lunges forward or sideways across the pool instead of staying in place.
  3. One leg stand/balance. Stand on one leg while raising the other knee to hip level. Place a pool noodle under the raised leg so it forms a “U” with your foot in the center of the U. Hold as long as you can up to 30 seconds, then switch legs. Try one to two sets of five on each leg. If you have trouble with balance, try this exercise while holding onto the side of the pool or without using a noodle.
  4. Sidestepping. Face the pool wall. While keeping an upright posture, take sideways steps with your body and toes facing the wall. Take 10-20 steps in one direction and then return. Repeat twice in each direction.
  5. Hip kickers. Stand with the pool wall to one side of your body for support. Move one leg forward with your knee straight, like you are kicking. Return to start. Then move the same leg to the side and return to the start position. Then move that same leg behind you. Lastly, move your leg in a circle (as if drawing a circle on the pool floor). Repeat three sets of 10, then switch the kicking leg.
  6. Pool planks. Hold the noodle parallel to the pool floor with both hands (shoulder-width apart). Keep your toes on the pool floor as you straighten your elbows and lean forward to submerge the noodle in front of you, so you end up in a plank position. Your body should be straight and diagonal to the pool floor. Hold from 15 to 60 seconds (as long as comfortable). Repeat three to five times.
  7. Deepwater bicycle. In deeper water, loop one or two noodles around the back of your body and rest your arms on top of the noodle for support. Move your legs as if you are riding a bicycle. Continue for three to five minutes.
  8. Arm raises. Stand in water deep enough to submerge your shoulders. Using arm paddles or webbed gloves for added resistance, hold your arms at your sides and bend your elbows to 90 degrees. Keeping your elbows bent and your shoulders down, raise your arms outward toward the water surface, then bring them back to your sides. Repeat for three sets of 10. You can perform arm raises while standing on one leg to challenge your balance during exercise.
  9. Pushups. While standing in the water at arm’s length from the pool edge, place your hands shoulder-width apart on the pool edge. Keeping your feet on the pool floor and your body straight, lower your chest toward the pool edge. Then press your weight through your hands to raise your body back up to the starting position. Repeat for three sets of 10.
  10. For more challenge: While standing close to the poolside, place arms shoulder-width apart on the pool edge. Press your weight through your hands to raise your body up and halfway out of the water (keep your elbows slightly bent). Hold for three seconds, then slowly lower your body back into the pool.
  11. Standing knee lift. Stand with your back against the pool wall and both feet on the floor. Lift one knee like you are marching in place. While your knee is even with your hip, straighten your knee so your leg is parallel to the pool floor. Continue to bend and straighten your knee 10 times, then repeat on the other leg. Complete three sets of 10 on each leg. For more challenge: Try this exercise without standing against the pool wall.


** from choosept.com
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One of the many things that makes MPT strong is the depth of experience of our team. Pam Powell is celebrating 30 years with us!

McDonald Physical Therapy
(574) 233-5754