Just been swimming!!

I have just been swimming for the first time since pre-K, not long after I started this blog in March 2008. I really have come along way since then. Although I am still lacking in confidence in the water and still need floats, the session highlighted a few things:

• Cardiovascular fitness is still very poor and overall endurance. I fatigued after 6 laps of 10 metres. I kept on doing laps of six throughout the hour I was there, and by the end of the hour probably managed 8-10 laps with one rather than two floats!
• My left-sided weakness was exposed in the water with the right side being more dominant and wanting to pull me over to the right. I got around this by stopping kicking with the right leg from time to time.
• Weakness in the upper body - I did some work with foam weights pushing into the water, starting from my arms out to the side at 90 degrees. 
• I tried some one sided float work, but freaked out when trying with the left arm working
• I did some walking in the water and feel my trunk is now working really well
• Overall my abs and trunk are working well in swimming, and the only thing stopping me swimming unaided is me!
• I did some floating and a little bit of going underwater and it is just a matter of confidence
• I had fun.....
• I came out feeling taller, stronger, fitter, that I had worked hard and... I had fun!!

So will I go again? I rather think I will - I have found out they do private lessons for adults which might be much better for me than going in a group session - less place for me to mess about and shy away from getting going. I think I will look into this (cost-permitting).

Prior to this I did a ballet barre at home - a self-taught one with no gaps. I was tired by the time I had done only a bit of centre work. This all highlights that it is now my lack of endurance and cardiovascular fitness that still needs work. Bring on the swimming - I think it will help with the ballet. I did do some ballet in the water as well - it is so good for that and doing jumping and much less stressful to my body than on land.

I will positive, energised and relaxed!

Physio Update and more calf work

I had physio yesterday and had arrived in quite an anxious state which I partially attribute to minor Autonomic Nervous System disruption (POTS), but also an element of fear because the calf work is so very difficult for me to cope with. In fact K and I spent about 1/3 of my hour session talking which was important because some of the fear relates to events from my past, as well as related to touch. We have both agreed that it is important to keep on going forwards (which is what I want) and we can work through the back legacy of issues, which is what we have had to do all along, and why I have been so complicated to work with. K and I have built up a very good rapport and much trust has been gained which is why she has been more successful in her work with me than anyone else. I have learned a lot about this in my own clinical work and how crucial trust is and being positive and encouraging with patients.

K was able to do a lot of anterior tibia/fibula work on my left leg and also release peroneals and flexor halux longus which was very tight. K agreed with me about doing very minimal or no jumping at the moment in ballet whilst I am in this period of transition. She commended me for my sensibility and rationality in recognising instinctively that jumping should perhaps be avoided. However, when it came to the crunch last night at ballet, and a different teacher, I did jump - but took it very easy, actually using less effort, so perhaps less tension, and so no harm done. I was a little more anxious of doing jetes, but again, just used less effort. K had released something where she said I would have been fixing in my foot and ankle (pseudo support) so perhaps I felt more liberated. I think I use too much tension anyway which is maybe why my calfs and achillies and soleus feel locked up. Demi-pointe work was OK - although there was one nasty moment - but my alignment looked much better on the left, and I need to keep my weight forwards and keep working on the new range of movement that K has given me.

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I slept very well last night, going to bed at 10.10pm and not needing the bathroom until 7am. I then went back to sleep again and got up at around 9am. K's work has really improved my quality of life in terms of sleep and bladder control. I am looking forward to my digestive system improving after necessary hospital treatment, as I am in a lot of pain today, also adductors and lumbar spine sore. I am much calmer again today.

My new book: A Guide to Living with Hypermobility Syndrome is out now!

http://www.singingdragon.com/blog/2011/07/interview-isobel-knight-a-guide-to-living-with-hypermobility-syndrome/

POTS/Adrenal Symptoms

I had a very bad night last night with feeling very anxious and was suffering with adrenal symptoms. This might also tie in some unpleasant revelations through some exploratory writing, but I don't think entirely.

Today I feel "out of my body" and I am experiencing both chest pain and then changes to heart rate level and nasty pressure in my head. It is all on the left side of my body. My TMJ hurts, I have a left-sided headache, and my hands are very different temperatures with my left hand being siginficantly colder than the right. My left leg feels unpleasant and quite wired throughout. Dorsiflexion is difficult. I feel shivery and cold. There is a deep fascial pull from SCM and throughout my left side.

These symptoms are related to the Hypermobility Syndrome, but are very difficult to cope with.

The cat has just jumped onto my lap. I am glad of his support!

My new book: A Guide to Living with Hypermobility Syndrome is out now!

My new book: A Guide to Living with Hypermobility Syndrome is now available!

Calf Work - Historical Moment

Thursday 14th July was a highly significant physiotherapy session. Not only was it my 3 and a quarter years of being in physio session, but it was the first time that I had truly allowed K to palpate and do work on my calf muscles. It was a very tough session from both my point of view, and I should imagine; K's.

There was a lot of fear involved in this from my point of view. I was terrified that the muscles would go into a major cramp:

My calves are still palpably very tender to the extent I have great difficulty in palpating them myself, let alone allowing K (or others) to do this. I am very frightened that they will “cramp up”, cause me unbearable pain and I will scream in response. I am terrified of losing control of myself, of crying. I wonder if this is just because the area is literally loaded with painful episodes, and like releasing other memories of trauma, I am very fearful of what might happen. I am sure that K is perfectly able to cope with any repercussions, which in actuality might be less severe than what I consciously fear. Maybe not. I am writing this and trying hard not to cry. My body is spasming in obvious recoil. I just don’t understand why this is so obviously difficult for me. I think my largest anxiety is of a loss of control of myself – either emotionally or through the pain or hitting tender points and then a hugely vocal response to pain. Being in control is something very important to me. There is a link here with that and the fact that the cramp is so “out of my control” when it strikes. I cannot think of any other obvious traumas to my calves (as if the above is not enough) but the area needs to be tackled and released. (From 'What is it about my calves?' Knight, 2011)

 K started off by doing some work on my lumbar spine with me lying prone on the couch. I sort of coped with that, but had my legs crossed in order to protect my calves (or that was my theory). When K did start to palpate my calves I was lying diagonally on the couch rather than in a straight line with my head buried in my arms. I sounded like a child, and could barely communicate with K. I had to ask her to stop for a brief time and then decided to ask her if she could work with me seated so that I could see. She kindly agreed to do this, but said that she had to do the work just the same (necessary evil). When I could see it was a little better for me because I felt I had more control of the situation, but there were a lot of "ouch" moments and K having to say "sorry" because she knew that this was all difficult for me. I did cope with it and K certainly managed to work on the distal third of superior tibia/fibula, as well as accessing the musculotendonous junction. All work was done on the left calf today, but that is the one with all this referred neurology going on and strange symptoms and sensitized pain. K said we must try and desensitize the area. At one point my heart rate accelerated briefly, which K said was not normal, but then the whole situation is not normal. Physios would not take over three years to access a particular body area. From that point of view I am totally abnormal.

K also worked on my hamstrings and gave me back some of my lost ROM. She concurred that a loss of 5 degrees of my ROM has widespread implications, and I agree. We discussed again how difficult it has been to ever follow a normal treatment plan when working with me because things change on a week-to-week basis. We also discussed how much movement I need to feel normal myself and not stiff - although compared to a 'normal' person - my desire for movement is grossly abnormal. I want so much more!!

K got me to do some work in dorsiflexion which I found very difficult because of a fascial pull which was making extension of the left leg very difficult. However, this is a new exercise, in addition to some exercise to improve the alignment of my head which is protruding too far forwards in relationship to my body.

It was a highly significant session and I survived it despite immense fear and anxiety. K survived not getting kicked by me and there were no tears after all! K is very brave - in her work with me. I am an extremely challenging patient!

True Parallel and Calf Preparation - from ITB Goes on Holiday!

"When I first got on my bike today, but my bum was sore, but my left knee really hurt, and that caused me a little anxiety – but I realised that I am really experiencing training pain – which explains also why my lower back is sore. After my 90 minute cycling stint I realised I was tracking my knee really nicely and on walking to the Cafe Du Commerce, realised that my left leg was in total parallel." (Day 2 from ITB Goes on Holiday" Knight, 2011)

 "It occurred to me that K is going to have to get into my calves and achillies now, as the insertions of hamstrings, which feed into calf, are also tight. I decided that now was the time (then and there, at 4am) for me to start to properly acquaint myself with my calves and start to learn to love them, a bit like I had to do with the skin in the same area, when I did CAT in 2006, and started applying cream to my legs to cope with palpating my skin. I felt that if I didn’t do some preparation work myself, it is going to be harder for me to allow K to access the area, and have some suggestions for her as to ways forward. I need to be seated during the treatment and to be able to show her what I can manage myself first to give her  some sort of starting point. Given that we have worked together for so long, and that there is so much trust between us now, I believe this will be possible, but I need to get over this." (Day 7 from "ITB Goes on Holiday" Knight, 2011)