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Priority #1: You

Depending on what you do you may notice that the same topics always come up when meeting strangers. For bankers it's interest rates and cost of homes, for brokers it's the markets and current state of the economy, for fitness professionals it's current sporting events and injuries they are dealing with and for physical therapists it is always injuries, aches and pains. I have yet to meet someone this month that didn't say "Oh you're a PT, I need a ton of work there."

Why is everyone hurt?

Simple, what we do with our bodies is not well adapted for what our body's were designed to do. Newton's First Law: a body in motion, stays in motion. A body at rest, stays at rest. This most certainly applies to humans and the demands of our day.

When our body begins adapting to remain in a rested state (by sitting still at school/work, by getting injured and not ramping activity back up appropriately, or by adopting behaviors that support others health/wellness over our own) we start to change our strategies for moving. Some muscles will get "tight" while others will down regulate tone to allow for ease of movement into the positions we demand of ourselves. Just like the frog that sits in cool pot of water while a fire is lit underneath, we don't feel the issue developing. Instead, we wait for the boiling point to occur and then we are injured.

A real life example that seems to be increasingly common is how we manage our upright posture. As a child you are told to "sit still," and "sit up straight." If we sit in a chair with a back rest we are effectively able to relax our posterior gluteus and hamstring muscles (these muscles hold us upright in standing) as well as our abdominals (which is replaced by the back rest not letting us fall over backward). We use our back extensors (the muscles lining the back of your spine) to keep our back erect and do our absolute best to maintain this position for as long as possible. This would be no big deal if we spent as much time countering this posture with an appropriate standing posture. However, 14 years of sitting at a desk in school pretty much guarantees the postural preference for us Americans is a seated one. We then buy a standing desk at 38 and think, this should fix the pain in my back! If you take a stone out of the ocean the waves may stop rolling it over, but the edges don't get rough again. Your body adapts to the demands you place on it, and often it will take time if change is going to occur.

Does that mean you should wait it out? Your back hurts now but you've changed your habits and eventually it will get better, right? Maybe, but there is an easier way.

You can accelerate the adaptation process by training. If you trade your desk job for a warehouse job your arms will get bigger, you will get stronger, but if you hit the gym they will grow a lot faster.

That's where physical therapy comes into play. We can identify all the various strategies your body has adapted and begin rolling back the clock on the stress and strain your inappropriate movement patterns have encouraged. By cleaning up inappropriate movement patterns the body decreases tension, stress and potential for injury. All while encouraging improved strength and functionality.

When living a life it's not uncommon to notice limitations and discomfort with certain movements. I am personally one to believe that if it doesn't stop you from doing what you want to do, it's not a need to fix issue. If it does stop you, it is a need to fix issue. When it doesn't stop you, but changes the quality of your activity; the decision to fix or not becomes grayer. As a survival technique we can easily become accustomed to small limitations and discomforts without developing anxiety or severe pain around the issue. This is a wonderful thing. However, you don't have to be gravely injured to seek out a professional and have your issues addressed. The decision to get an issue resolved or not all comes down to how you prioritize your life.

If you are having an injury or limitation that is impacting you but is not high on the list of priorities in your life, you are likely being relied upon by others. As an empathetic social creature you tend to put the needs of those close to us above your own needs. You have the emotional capacity to support those around you, so they look to you for strength and guidance. You feel selfish or insecure when you think about taking time for yourself and you hate the idea of spending your resources on an activity that is just for you. The truth of the matter is, the time you spend on yourself is for those around you. You are the only one who can decide how your time is best spent and it is not the job of those around you to tell you, "you should probably get that hip issue checked out." If it's not life threatening, they likely won't say a word. They don't know how it impacts you because you ignore it yourself. That doesn't mean it doesn't effect you. And that doesn't mean it doesn't effect them.

The most common short term patient I see is someone who is not that hurt, but has a clear injury that is in the process of healing and benefits from guidance surrounding inhibiting inappropriate movement patterns so an injured structure can get true rest/recovery. The most common long-term patient I see is someone who is not that hurt, but has a nagging long term injury that they have never had time for. The reality is, this long-term patient and the newly injured patient have the same 24 hours, similar schedules, similar family structure and transportation struggles. The short-term patient acts now for themselves while the long-term patient acts now for others. The long-term patient, while making daily decisions that support others does not realize that the quality of life they are becoming accustomed to is impacting others. They don't realize that their minor injuries alter their mood, behavior, and overall presence. When a change is apparent, it is most often passed off as stress from the known daily activities. However, our ability to deal with stress (physical, mental, emotional) is like a cup. The stressors themselves are like water. As we pour in a job, family responsibility, financial obligation, homework, and injury, the cup begins to overflow. Getting rid of a job or your family isn't exactly reasonable. I recommend going after the lowest hanging fruit, injury. It hangs low because it is reparable.

I tell this story from experience. Not just as a PT but as a patient. I was a long-term patient. I remember coming out of PT school a total train-wreck. My hips didn't move, my back had the consistency of poorly pressed plywood, my feet couldn't handle a mile and my abs were pathetic for a 20-something year old male. I knew something had to change but what was I to do when I worked 30 hours a week while attending graduate school and had several group projects, presentations and study groups to work with. My time spent at the gym was used to exhaust my cardio system for the endorphins and pump the bench because, you know, #gymlife.

I never had a clear turning point, although I do remember working with a mentor who asked me after our second session how the home exercises went and I truthfully said "I didn't do them." He responded with a brief explanation about adaptation principles that I understood but didn't care about and then he moved into his own personal experience of going home at night and making dinner for his children while finishing up his documentation and then going to bed feeling dissatisfied with himself because he didn't exercise the way he preached or prioritize his body's needs. It took a while for this to settle on me but after about another year of not being able to squat to parallel without overt pain, I finally shifted my mindset.

I had a little help from my peers, I joined Crossfit at an amazing gym in Vermont, Mountain Trail Crossfit. The community was great and I had two friends join with me. Competition to not look so pathetic while attempting overhead squats also boosted by desire to work on myself. But there was one more motivator. I was not a good person when I was always hurt. I would find myself complaining about little things, limping around like an abandoned labrador, being short with people, etc. All because my physical self did not match the mental picture I had of myself. I had trained my body to be stiff, tight, immobile and unhappy but I wanted to be a physical specimen. My mental state was a reflection of this chaotic dichotomy. I will add that I achieved this miserable physical state while playing anywhere from 3-8 sports for just about my entire life. I wasn't lazy. I lacked variability in training and only exercised to compete.

Once I hit graduate school I continued to "exercise" but I always worried. I worried about time, money, my grades, my classmates. I was unselfish, prioritizing anything and everything that would please others over myself. I wanted to make money to not rely on my parents, so I worked. I wanted to do well in school to impress my teachers and make my parents proud, so I studied. I wanted to help my classmates and improve our class community, so I participated in study groups. I didn't even realize that I hated my job, half read and half daydreamed, interrupted others and got frustrated because I was not right with myself. I did not have any external motivation for addressing my issues and therefore did not pursue physical health. Crossfit, a mentor, and a community helped me change that. I consider myself very lucky to help others achieve this same understanding of prioritization in my everyday practice.

When it comes to Priority #1 it has to be you. If you don't prioritize your well-being, how can you appropriately perform for those that rely on you? Do not make the mistake of putting yourself second and allowing your life's performance to falter.


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