August 17, 2006
Today’s outing was first to Wal-Mart, where we ran into Janet Rogers (how’s that for a neat coincidence!), then to the rehab place, where we sat around waiting for the therapist for a half hour. We were worried this might be typical, since we’d waited a half hour last time too (certainly not the way Shepherd was run), but it turned out another therapist at the place hadn’t been able to make it that day, so Gary’s therapist was double-booked. I wish someone had explained that to us ahead of time, so we could either have come later or at least known what the delay was (I did ask at the front desk if Gary was down in the appointment book and if they were aware he was there) but I guess I should be complaining to them, not you. But then, I am a big talker unless it is to the person the complaint is aimed at ;-)
The therapist had Gary start out with grip and wrist strengthening exercises. For the first exercise, he squeezed a Digi-flex, which as you might guess, flexed each finger. This he did for two sets of thirty. Then he did a series of wrist curls, starting with reverse curls. These he did one hand at a time, in order to keep his balance. He noted that his right hand was stronger than his left. I asked him if that meant he’d “like” a heavier weight for it. He smiled and said he knew I was going to say that, but agreed to a heavier weight (three pounds instead of two). After he did one set of thirty, the therapist had him do the second set emphasizing the eccentric contraction – in other words, he lifted the weight to a count of two but lowered it to a count of four; if you’ve never tried that before, you will discover that definitely makes the exercise harder! He did a set of fifteen that way (neither he nor the therapist seemed capable of keeping track of the number of reps the entire session, so I did it for them – see, I knew I was good for something ;-)). The next type of curl imitated a hammering motion: keeping the forearm stationary, raise and lower the wrist with the palm facing in (officially, “ulnar and radial deviation”) – two sets of fifteen. The last type of wrist curls were what I think of as “regular” curls, palms facing up. Two sets of fifteen, emphasizing the negative.
Next she had him do some exercises for his upper arm and shoulder muscles. She reminded him that now that he was so dependent on his arms for his locomotion, he was at risk for repetitive motion injuries in his shoulders, so he needed to keep those muscles, as well as his chest and upper back muscles strong. On a cable machine, she had him do tricep extensions, where, facing the machine, he pulled down and back. She stabilized his shoulder for him by gripping it in the front and the back (she was being extra careful because of the shoulder problems he already has). He did thirty of those on each arm. He finished the strengthening part of the workout by turning his back to the machine, taking the handle on the cable, and punching forward – these she said would strengthen his pecs (and I think she said his anterior deltoid, too). He did two sets of twenty on those.
She mentioned that any bench press type of exercise would have a similar effect, saying he could do them while lying on his bed holding some weights. I asked how often she thought he should do these exercises (he’s only being doing the theraband and terrible three exercises since being home, and I want to make sure he doesn’t lose the strength he built at Shepherd, though on the other hand I know he doesn’t want to start back in with heavy exercises like pushups and dips until his shoulders feel better). She told him he could aim for two-to-three times a week, depending on how he was feeling.
She had him finish up by doing some isometric exercises which she said were for his stability. She had him hold a stick (like a shortened broom handle) out in front of him, then she gripped it too and told him not to let her move it (but telling him ahead of time what direction she was going to attempt to move it in). First she tried to pull it to his right for a few seconds, then his left, then up and down, then backward and forward, then she tried to twist it out of his grasp (so, like wrist curls), then she tried to move one-half of the stick upward and the other side downward. She then did the exercises with me (which pleased me and gave me more hope she won’t eventually throw me out of the rehab gym ;-)) in order for me to see what Gary was feeling during it, though I know it wasn’t entirely the same because I was recruiting ab muscles to stop her movements. She thought he might have some ab muscles helping him too, but he said he didn’t. She didn’t seem quite convinced and had him bend forward and then sit upright in his chair a couple of times. Gary did so and assured her those movements were governed by his head movements, not the use of his abdominal muscles; she felt his abdominal wall as he did them and then was convinced. She said he made it look easy, and I told her it certainly hadn’t looked that way at the beginning.
She said the two of us could do these stability exercises with Gary sitting on the edge of the bed and holding a broom handle, but she had immediate second thoughts and said we’d try it first in the gym (one of those “don’t try this at home” admonitions ;-)), just to make sure Gary would be stable enough (so that I’m not calling math volunteers to help me get Gary off the floor after I pull him onto it ;-)).
After the session, Gary remarked that so far he really likes this therapist, and it seems to me too she’s going to be a good one, which is so gratifying to us both – we weren’t sure what we’d find here after being with the therapists at Shepherd who work only with those with SCIs.
All for today.
Today’s outing was first to Wal-Mart, where we ran into Janet Rogers (how’s that for a neat coincidence!), then to the rehab place, where we sat around waiting for the therapist for a half hour. We were worried this might be typical, since we’d waited a half hour last time too (certainly not the way Shepherd was run), but it turned out another therapist at the place hadn’t been able to make it that day, so Gary’s therapist was double-booked. I wish someone had explained that to us ahead of time, so we could either have come later or at least known what the delay was (I did ask at the front desk if Gary was down in the appointment book and if they were aware he was there) but I guess I should be complaining to them, not you. But then, I am a big talker unless it is to the person the complaint is aimed at ;-)
The therapist had Gary start out with grip and wrist strengthening exercises. For the first exercise, he squeezed a Digi-flex, which as you might guess, flexed each finger. This he did for two sets of thirty. Then he did a series of wrist curls, starting with reverse curls. These he did one hand at a time, in order to keep his balance. He noted that his right hand was stronger than his left. I asked him if that meant he’d “like” a heavier weight for it. He smiled and said he knew I was going to say that, but agreed to a heavier weight (three pounds instead of two). After he did one set of thirty, the therapist had him do the second set emphasizing the eccentric contraction – in other words, he lifted the weight to a count of two but lowered it to a count of four; if you’ve never tried that before, you will discover that definitely makes the exercise harder! He did a set of fifteen that way (neither he nor the therapist seemed capable of keeping track of the number of reps the entire session, so I did it for them – see, I knew I was good for something ;-)). The next type of curl imitated a hammering motion: keeping the forearm stationary, raise and lower the wrist with the palm facing in (officially, “ulnar and radial deviation”) – two sets of fifteen. The last type of wrist curls were what I think of as “regular” curls, palms facing up. Two sets of fifteen, emphasizing the negative.
Next she had him do some exercises for his upper arm and shoulder muscles. She reminded him that now that he was so dependent on his arms for his locomotion, he was at risk for repetitive motion injuries in his shoulders, so he needed to keep those muscles, as well as his chest and upper back muscles strong. On a cable machine, she had him do tricep extensions, where, facing the machine, he pulled down and back. She stabilized his shoulder for him by gripping it in the front and the back (she was being extra careful because of the shoulder problems he already has). He did thirty of those on each arm. He finished the strengthening part of the workout by turning his back to the machine, taking the handle on the cable, and punching forward – these she said would strengthen his pecs (and I think she said his anterior deltoid, too). He did two sets of twenty on those.
She mentioned that any bench press type of exercise would have a similar effect, saying he could do them while lying on his bed holding some weights. I asked how often she thought he should do these exercises (he’s only being doing the theraband and terrible three exercises since being home, and I want to make sure he doesn’t lose the strength he built at Shepherd, though on the other hand I know he doesn’t want to start back in with heavy exercises like pushups and dips until his shoulders feel better). She told him he could aim for two-to-three times a week, depending on how he was feeling.
She had him finish up by doing some isometric exercises which she said were for his stability. She had him hold a stick (like a shortened broom handle) out in front of him, then she gripped it too and told him not to let her move it (but telling him ahead of time what direction she was going to attempt to move it in). First she tried to pull it to his right for a few seconds, then his left, then up and down, then backward and forward, then she tried to twist it out of his grasp (so, like wrist curls), then she tried to move one-half of the stick upward and the other side downward. She then did the exercises with me (which pleased me and gave me more hope she won’t eventually throw me out of the rehab gym ;-)) in order for me to see what Gary was feeling during it, though I know it wasn’t entirely the same because I was recruiting ab muscles to stop her movements. She thought he might have some ab muscles helping him too, but he said he didn’t. She didn’t seem quite convinced and had him bend forward and then sit upright in his chair a couple of times. Gary did so and assured her those movements were governed by his head movements, not the use of his abdominal muscles; she felt his abdominal wall as he did them and then was convinced. She said he made it look easy, and I told her it certainly hadn’t looked that way at the beginning.
She said the two of us could do these stability exercises with Gary sitting on the edge of the bed and holding a broom handle, but she had immediate second thoughts and said we’d try it first in the gym (one of those “don’t try this at home” admonitions ;-)), just to make sure Gary would be stable enough (so that I’m not calling math volunteers to help me get Gary off the floor after I pull him onto it ;-)).
After the session, Gary remarked that so far he really likes this therapist, and it seems to me too she’s going to be a good one, which is so gratifying to us both – we weren’t sure what we’d find here after being with the therapists at Shepherd who work only with those with SCIs.
All for today.
posted by Peg Daniels at 7:29 PM
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