Ten things

Years ago when I was a young grad out of physical therapy school I had the opportunity to care for a young veterinarian who worked in the Air Force and who was an avid runner. She had run pretty much every day of her life and was sent to me when she had an injury while doing calisthenics during training on the base. She was a talented, capable woman and she was determined to get better and run again as quick as possible. Of course, this was exactly the kind of patient I loved to take care of, one who was motivated and sure of their goals. So in my mind I thought no problem. As I began caring for her it became evident fairly early on that this would be no easy task. Her knee had taken years of hard training and in her profession she lifted and carried animals all the time, so her knee had little or no time to ever really recover. As a result she was not progressing according to the scheduled plan and of course, she became discouraged. What I thought would be an easy progression turned difficult.

In physical therapy school at Loma Linda University I had been taught the mind body connection, but at the time I had no idea how powerful this connection really was when it comes to physical injuries. It quickly became apparent to me that the mind is so powerful that often the psychological and social load from a trauma is just as devastating as the loss of a person's physical ability. This particular patient suddenly lost the ability to physically run everyday and train as she had always done. But her mind also lost a unique coping skill that she had used all these years to deal with some hard issues in her life. So not only was her knee injured, but her entire life was turned upside down.

Often when we are healing from physical injuries it all just takes time. The first two weeks after an injury are the most important. What we do in those first weeks determines our long-term outcomes and yet most of the time our patients haven't even seen the doctor by then. My patient was no different. She had not been referred to physical therapy for months and she had all kinds of residual issues such as swelling and weakness. She was not happy as you can imagine and she was very impatient with such slow progress. Very quickly I realized that she had been so focused on all the negative issues associated with her injury that she had little or no ability left to focus on any positive possibilities. And as a result it was highly probable that she would never run again any long distances and most likely not every day.

What to do? She needed some new coping skills. Because she had always used running as her outlet, she began to spiral as people often do when some type of trauma or loss of their physical well-being has occurred. The more pain and discomfort her knee had the more her mind focused on all the negative aspects of her life. This is a common problem that we often see in physical therapy and I was young and new in my profession and unsure how this mind body connection actually worked. I had read a lot about gratitude and the power of positive thinking and I had been raised with a strong spiritual connection. So I tried to encourage her as much as I could while she was in physical therapy, but her constant negativity was hurting her chances for any healing to occur whether physical or mentally oriented. I thought about her often and was unsure how to help her. She had gone to counseling and was in Bible study but her physical loss was destroying her. One day while taking care of her I shared with her something I had been thinking about. I asked her to write down every day the 10 things she was thankful for every night before she went to bed. That way when she woke up in the night (she was often plagued by nightmares) that she would be reminded of her blessings and not focus on her loss.

At first she said she had nothing to be thankful for. She couldn't think of one thing she was thankful for and she didn't want to try the experiment on positive thinking to promote healing. I didn't buy it and I knew she was a different person inside however her physical loss had pushed all her limits and she had lost her spirit. So I pressed and finally she started. At first there was maybe only two or three on the list. And then four or five. And then seven or eight and then finally she had 10 things every night. She began to focus her energy on the positive things in her life instead of her loss. They were little things at first, because it was all she could think of. Maybe things like her little dog Kayla or her short commute to work. But it was amazing to her this idea 10 things, and it actually began to transform her life. And slowly, ever so slowly her knee began to heal.

She called me a few months ago out of the blue and reminded me that she now had been doing her 10 things for over 25 years. She says she has stacks of journals in her library and she can't believe she still does it every night before bed. She said her knee isn't perfect but she has been on the path to healing all the avenues of her life, not just her physical one, since she hurt her knee so long ago. She reminded me that the mind body connection is a powerful tool and that it can heal even a knee that no one thinks you can fix.

Sheree DiBiase, PT, and her staff can be reached at Lake City Physical Therapy (208) 667-1988. She was an Adjunct Professor at Loma Linda University, School of Physical Therapy for over seven years and taught Kinesiology and gait training. She believes in the 10 things to help heal your body and your mind. Go ahead and give it a try, write down your ten things and change your life just like my Air Force friend did over 25 years ago.