MOVE for Pain: An RA Story

Movement – yeah, right!  Not when it hurts, dude. Racing my older brother on the street and he thought he was way ahead of me. Without looking, he cut me off trying to win by taking a short cut. My front tire hit his back tire and I flipped over both bikes sliding across the pavement. Skinned hands and knees, my body burned and ached. My left knee was painful and looked out of place. I cried and laid by the ditch. A teen aged girl from the community pool was walking with friends and picked me in her arms. She carried me home with a trail of kids following, last of which was my brother.

The X-rays showed torn ligaments and tendons under my knee cap, an injury requiring a bent cast and rest. I started fourth grade on crutches, left leg frozen in a quarter tucked position, and pain. When the cast was removed weeks later, my physical therapy was climbing trees and riding my powder blue steel-framed white banana seat bike again. I guess physical therapy wasn’t prominent in the 1970’s.

A year and a half ago, I spent the summer in and out of bed after suffering bout after bout of Rheumatoid Arthritis flare-ups. There were days when climbing the stairs was more than my body wanted to accomplish. After months of struggle and inactivity – because it hurt – it being every joint, every muscle, even my chest and neck, the pain made my injury at nine years old seem like nothing.

When my husband, Greg, suggested we think about getting some cleaning help around the house, I balked. How could he suggest I needed help? Was my physical condition so far gone we had to pay someone to care for our home? I had a choice: Accept how things as they were, be resolved to the fact that the pain was winning and my inactivity, aka rest, was my fate – OR – Do something to get better. I chose the latter. At the direction and support of my Rheumatologist, physical therapy was my response. I had to learn to move again.

The pain changed how I walked, as if I still carried a crooked cast on my leg once more. I had little strength in my hands and dropped things – not simple objects, either. More like full bowls of oatmeal and freshly made jumbo cups of coffee. Ugh – and the stairs – just walking up the stairs left me in hurting and breathless. I was becoming an invalid and invalid at 49. Hence, physical therapy twice a week for six weeks.

The young doctor, fresh out of the University of Pittsburgh, worked with me to evaluate my strength, flexibility and abilities. He promised to tailor-make a regimen to get me as close to normal as possible.

“What are your goals?” he asked to help in the evaluation.
“To vacuum my house and climb the stair without difficulty,” was my wish. Telling of my decline.
“We will get you there, Mrs. Williams,” he affirmed.

Funny thing about physical therapy – it reminded me of my recovery at nine. I climbed and rode, along with other strength training exercises. I climbed the stairs and practiced going up and down using proper form – like climbing the huge pine tree behind our Cape Cod in 1977. And I rode the stationary bike. Gratefully, the seat was much wider than the banana seat of my old Schwinn, but the motion of peddling reminded my of the freedom in a good bike ride.

“Movement is key,” the young doctor advised as I sat on the exam table in the third week of therapy. He explained, “Your muscles reduce inflammation by flushing out waste allowing the body to carry the toxins away. Drinking water, stretching, all good things for muscles. Joints, however, are different. The way to remove inflammation, besides medication, is to MOVE. Movement causes the joints to expel inflammation, and pain reduction will follow.”

We talked through the physical techniques and the emotional and mental aspects of pain management to come up with two good do-it-yourself at home therapy plans – one for those days when I had a flare up and another plan for when I did not. Each focused on stretching, strength training, and movement. Done routinely and consistently, my body would respond with better mobility, reduced pain, increased balance – a pretty normal life. And it has.

Despite what my body wants to do, what it’s trained to do, which is “pain recovery equals rest”, my brain learned to override what the body signals were saying and do the right thing. Move for pain, move for pain, move for pain – when it comes to inflammation in the joints – M O V E is the prescription. The counter intuitive action helps me have a better quality and more active life. I am grateful for that knowledge and carry it with me as I move through each day. The pain still comes – but I know what to do.

RESOURCES:
Best Exercises for Rheumatoid Arthritis – Arthritis Foundation

Rehabilitation Management for Rheumatoid Arthritis Patients – Johns Hopkins Arthritis Medicine

BOOKS:
For any fitness level and situations for strength training – comprehensive step-by-step exercise manual by  Carol Corning Creager, PT:

Therapeutic Exercise Using Resistive Bands (Therapeutic exercises) by Caroline Corning Creager, 1999

Therapeutic Exercises Using Foam Rollers by Caroline Corning Creager, 1996 

READY TO FIND A PHYSICAL THERAPIST?
American Physical Therapy Association (APTA)  Find a PT allows you to search a national database of physical therapist members of the American Physical Therapy Association (APTA) for the exclusive purpose of seeking physical therapist service.

Or contact your insurance provider to find a physical therapist in your area and covered in your network.

DISCLAIMER: Hey, don’t take my word for it! Go seek the advise of your physician before making any medical decisions.