16 May Rehab is like…swimming upstream?

The rehabilitation process is different for everyone: some need a tune-up, some a new set of tires, and some a complete overhaul. But when people ask me to describe the rehabilitation process in a nutshell, I keep coming back to the analogy of swimming upstream: making progress is difficult, the selection of challenges can be counter-intuitive, once it gets easy your therapist simply raises the bar, and there is frequently a difference between what your body wants to do and what it should do. Don’t worry, the analogy ends before you lay eggs and molt in the shallows near the stream you were hatched in.

One example that comes to mind is muscle flexibility. Left to our own devices, we typically stretch areas that are relatively loose and more comfortable. at the expense of muscles that are tight, limited, and adversely affecting our ability to move freely and without pain. At best, I find that patients are performing a standard set of stretching exercises previously prescribed by a professional, so even if the target is wrong, the form might be correct. At worse, folks have been performing the same incorrect exercises since Junior High Gym class.

Another classic example is strength training. We are traditionally trained to strengthen large muscles: thighs, chest, biceps, but too frequently at the expense of smaller stabilizing muscles. A typical example is a runner or walker with strong thighs and calves who struggles to perform a small single leg squat without the knee turning or falling inward, or the hip drooping due to weakness of the small muscles that stabilize the hip. Continued training of larger muscles at the expense of stabilizing or opposing muscles create imbalances that lead to overuse and injury.

So why is swimming upstream important? In rehab we identify the neglected areas of tightness or weakness, and focus efforts on the difficult ‘upstream’ areas that you were either avoiding or unaware of. As you begin to embrace the effort needed to push upstream into areas of restriction and poor muscle performance, you will begin to experience the most valuable part of the rehab process: the pride of well placed efforts in improving function and decreasing pain. And when you are able to run, or walk, or swim, or cycle again, or resume participation in your favorite yoga, Pilates, or Piyo class, you will have learned that swimming upstream is not just for Salmon, but is the essence of the rehab process that reaps rewards often hidden from conventional wisdom.

So, if you have been floating downstream this summer, unsure of how to regain your form, let one of our 15 physical therapists in one of our four convenient locations get you hooked on rehab. At best, you get tossed back into the deep water and happily find your way home; at worst, you lay some eggs and get a free T-shirt. What do you have to lose?

To your successful struggle,
Brian