yogameditating

I used to imagine that as I grew older I would find more time to do my daily practices. My current practice may be yoga, quiet sitting, reading a text that lends me insight, or pursuing another creative endeavor to slow down and reflect. Yet, as I age and accumulate responsibilities, I find that it is extremely difficult to continue to engage in the mindful practices that I know I need. Whereas I assumed the choice for mindfulness would become easier over time, I have experienced the opposite. The choice becomes more and more intentional every time I make the conscious and active decision not to do another activity, in order to focus on active growth and intentional change.

Over the years, at any given time, the physical practice I found most meaningful has depended on which part of my body was loudest in its request for immediate attention. I have met a variety of physical challenges, none of which (I assume) I am alone in experiencing. Sometimes the backs of my legs might feel extremely tight for several days, or my back might be stiff and sore when I am bending, or maybe my shoulder is bothering me with reaching. I tell myself that I will practice some strengthening activities to protect against injury when I get some extra time. Inevitably, this extra time never arrives. But it occurs to me more strongly each day, I will be extremely unlikely to “find” any extra time. I must actively create the opportunity to mindfully explore my movement patterns and ensure that I am able to move with ease. I want to be able to enjoy movement for as long as I can!

And that brings me to this challenge that I see every day in myself and with my patients: how do we make the time to practice our exercises? Instead of providing a step-by-step list of how to do it, I am going to offer a few thoughts that may help to inspire us when we are faced with not wanting to do our intended daily practice.

First of all, I will try to answer the question, “If physical therapists have several tools in their kit, why do they so often use exercises to treat their patients?” The exercises we prescribe are designed for the patient in order to strengthen a muscle; to stretch a muscle or tissue; or to improve neuromuscular coordination (that is, proper sequencing for muscle action to occur appropriately). Therapeutic exercise is one of the tools most consistently used because it gets the patient involved in their own rehabilitation process on a regular basis. We see patients perhaps one to two times a week for a half hour, but the body is continuing along in all its activities 24 hours a day. The exercises are a way to guide the body on the correct path: a little nudge here, a little nudge there, each time we practice. Remember the maxim, “Give a man a fish and he eats for a day. Teach him to fish and he eats for a lifetime.” We want your body to return to all activities with ease of movement.

We have to guide the body to do something, but then we have to listen with our sense perceptions about how we respond to this new activity. And as a matter of fact, your physical therapist will often ask you how the exercises went. This is a good time to share any insights you may have gained during your exploration.

Secondly, think of your exercises as an exploration. Do you remember what it is like to do something for the first time? Whether that is to taste a new food, travel to a new place, or go to an event you may not have considered previously, when you do something for the first time, you are actively receiving information without interference from your previous experience. All of the exercises will have the same nature of give and take. We have to guide the body to do something, but then we have to listen with our sense perceptions about how we respond to this new activity. And as a matter of fact, your physical therapist will often ask you how the exercises went. This is a good time to share any insights you may have gained during your exploration.

And finally, allow the practice to be mindful. Pay attention while you do your exercises. As a matter of fact, some studies have shown that simply performing rehabilitative exercises in one’s mind can assist in the healing process. Conversely, performing the exercises while distracted may not make for as effective treatment. If we are trying to do something else while practicing the exercise, then we will probably have to do it many more times or for an extended period, and will most likely still not have the desired effect. Performing the exercise with quality in mind may actually reduce the amount of time you need to spend doing it in the long run. This practice of concentrating on one thing at a time may perhaps also help you to develop your ability to focus on other aspects of your life as they are presented. A few minutes of mindful exercise is more than none!

So, when you feel overwhelmed by the thought of your exercises as just another thing on your to-do list, return to the basics. You are getting involved with your own rehabilitative journey. You may learn something about yourself. You strengthen the effect each time you intentionally practice. Sometimes I have to tell myself how satisfied I will be when I know I completed my exercises. Sometimes I tell myself how good I will feel physically. Sometimes I tell myself I will sleep better. But no matter what the reason, I never regret having made the choice to practice.

~ Courtney Germano PT, DPT

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