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Sunday, July 17, 2011

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!

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