accessibility · aging · disability · injury · motivation

An apology: A thing Sam thinks she needs to stop saying…

My life has changed a lot since we started the blog and the fitness challenge. There are things I say when we’re promoting the book that now strike me as wrong or at least not as simple as that, or maybe even naive.

Things feel a lot more complicated since osteoarthritis and advanced cartilage degradation made me a candidate for knee replacement.

It’s hard to get a more nuanced message across when you’ve just got four minutes on television so I’ve been sticking with the simple story but the truth is I know it’s not so simple. I’m not staking out a position here or defending a claim other than than claim that things are messier than I thought. I do know the blog can handle more complexities than the media buzz around the book can take. So you blog readers get the messier story.

Maybe after the book promotion I have to stop saying “if you don’t love it, don’t do it.” There are a lot of things in life that I do but I don’t love. These days a lot of exercise feels to me to fall into that category. Knee physio can be tedious and sometimes painful. And I do it most days. There’s no way to love it. You watch Netflix to distract. You give yourself rewards for finishing. I need to do it but there’s little joy in it.

Instead, I take pride in my grit and determination, in my resolve.

See When exercise isn’t fun.

Why am I doing it? Not love of the thing itself that’s for sure. Partly to be sure it’s instrumentally justified in terms of continuing to do things I love. Canoe camping, hiking, biking. I want to keep these things in my life.

But it’s also instrumentally justified in terms of basic movements, like walking to campus, between meetings, getting in and out of chairs.

To suggest that we approach all exercise from this “loving it” perspective comes from an incredible place of privilege. I had that privilege. I don’t anymore and I’m sorry if I sounded insufferable, naive, and smug.

I saw it again today, by the way, in an online body positive fitness community of which I’m part. Someone offered the advice to another community member to do whatever brings joy to your heart. And the thing is I too reject the imperative that we all have to do joyless exercise to tame or unruly, overweight bodies to keep them in line. I also know though that life is complicated.

Just as Tracy rejects body positivity as just one more demand, I’m coming to feel that way about “if you don’t love it, don’t do it.” No one loves knee physio. It’s okay not to like it and to do it anyway.

It’s okay to be angry and sad and roll your eyes at people who say they just don’t feel like running this morning. You don’t get to yell at them that at least they can run and tell them to just go do it because you can never run again. Just say it in your head. That’s what I do.

It’s okay to think, “I’m tough and I’ve got this” instead of I’m doing this because I love it . Because that’s what’s true: I’m tough and I’ve got this.

Maybe that’s true for you too. I’m sorry for saying you have to love exercise. You don’t. Right now, a lot of the time, I don’t. And that’s okay too.

accessibility · disability · fitness · illness · injury

consider pain: why the social model of disability fails (reblogged)

We don’t reblog a lot around here but sometimes something just strikes me as so right and so important I want to share it. As I’ve been thinking about injury, disability, living with pain, and trying to come to terms with my left knee, I’ve been thinking about the social model of disability. Here’s Andrea Zanin on what the social model of disability leaves out.

I’m hoping to get Andrea to guest blog here about her return to yoga and biking and other things after years ago coping with pain and very serious health issues for many, many years.

But we can start with this. Thanks Andrea.

Sex Geek

pain punctuationToday I am spurred to rant about the social model of disability and why it’s inadequate.

The social model says, essentially, that disability, rather than being a characteristic of an individual, is created by society. On its surface, this is super useful. For instance: if a building has stairs, and a person cannot go up them because they use a wheelchair, then the disability is caused by the lack of a ramp, and by the lack of universally accessible design more broadly. Problems are also caused by ableist attitudes, both interpersonally and within larger power structures.

So far, I totally agree. When the built environment is designed on the assumption of a normative set of physical or mental abilities, then all who fall outside that set have trouble navigating it. Which includes almost all of us, eventually, as we age. It’s good for pretty much everyone if we shift the…

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accessibility · disability · inclusiveness · injury · traveling · walking

Bremen, so many steps, happy tears, and academic travel

It’s summer. I’m in Europe. It’s part of the rhythm and flow of academic life. What’s new? This visit I’m here in my Dean’s role rather than as researcher/writer/philosopher. We have an exchange program with the University of Bremen, involving faculty, grad students, and undergraduates. I’m here with the former Dean to meet the people and learn all about Bremen and the Bremen Guelph connection.

It’s also the 10th anniversary of their Institute for Quebec Canadian Studies.

Just as academic life has a pattern and rhythm so too does the blog. It’s time for the annual post about how much more I’m walking in Europe. Here’s my day on Tuesday.

15,000 steps is a lot of steps given that it included a full working day.

On the one hand, I love living even temporarily in a less car reliant culture. I love being part of a community in which exercise is part of everyday life. But I also worry about access and inclusion and where this leaves people who aren’t so mobile.

I raised the worry in this blog post about walking lots while at a conference in Berne Switzerland four years ago. I blogged about it again from Sweden two years ago (see here) also Scotland and Innsbruck, Austria also two years ago.

It’s a thing I note and wonder about and enjoy all the while worrying about disability. That said, European friends tell my worries about disability are unfounded. What’s your experience? Do you use a wheelchair? Have you traveled around European cities? How did you find it, recognizing that Europe isn’t one place?

The worry, well founded or not, got personal this year traveling to Germany with my injured knee. I noted that the agenda for my campus visit to the University of Bremen included a two hour walking tour of campus. I was frightened I’d have to decline. It’s a big change in self perception and identity.

And the big day of walking was fine. Thank you knee brace. I got all teary wth relief.

(The emotional moment was likely also due to the movers who’d been signed up to do our move phoning me to say they couldn’t do it after all. It’s the busiest weekend of the year for movers, they say, and my agreement made back in April didn’t count for anything. Sigh. Luckily the company who came in second for the bid was willing to take it on.)

But I have wondered how I would have coped had my knee not been in good shape. I’m going to have to learn to advocate for my mobility needs. Lots to learn. I also had an experience in the airport with airport security as my knee brace sets off alarms. I told them it would hurt to take it off and send it through security and they didn’t insist.

The one thing that did hurt was my feet. I haven’t been walking so much in sandals and the weather was warm.I ended up with blisters. The next day I swapped for running shoes and ended up looking very much like a North American tourist. The German women faculty members would have appreciated my Fluevogs. They wear great shoes but I’m not sure how they manage to combine the funky footwear with walking so much.

What do you wear when walking lots, when you’re in urban environments (not hiking) and want to look both stylish and comfortable?

aging · disability · health · injury · monthly check in

Sam’s monthly check-in: What’s up, what’s down, the May version

May! Finally warm weather. The best thing about May is riding my bike. It was 50 km the first week and 60 km the next . Weekdays I’ve been exploring my new home, Guelph, after work and running errands on bike. That’s what’s up. It feels great.

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Not so much “up” is my left knee. It doesn’t feel great.

I met with the knee surgeon again. Total knee replacement still looks far away. At least I hope so. See 9 Things No One Ever tells You About Getting a Knee Replacement for details. We’re still seeing how things go with the goo injections and the brace.

I’m wearing the brace for walking. I’m doing physio still. And I’m riding my bike. That’s all good.

The surgeon and his team are busy telling me that all the activity I’ve done isn’t responsible for my knee osteoarthritis. They do also tell me never to even say the word “running” again. Fine. See Sam struggles not to run, ever!

But they do say I’d be in less pain if I lost weight. More seriously they say that losing weight would help me put off total knee replacement. That’s big.

Now they used to also say that knee patients should lose weight first, before the surgery. See Researchers Find Weight Loss Not Necessary for Joint Surgery

But if you think you must lose those extra pounds before a knee or hip replacement, think again, as researchers with UMass Medical School found long-term relief from joint replacement surgery was almost the same in obese and non-obese patients.

“The conventional wisdom is that the lower your body weight, the lower your body mass index, the better you will do in joint replacements, and there has been an increasing push to say that if you are obese you should not have joint replacement – either knee or hip replacement,” Dr. David C. Ayers, chairman of orthopedics and chairman and professor of orthopedics and physical rehabilitation at UMass Medical School, said Thursday.
Dr. Ayers is the co-author of a study reporting the findings published last month in the Journal of Bone and Joint Surgery.

“What this study shows is that people who are overweight and are obese get the same type of pain relief and improved function that non-obese patients do,” he said.

Surprise! Fat people are people. Fat bodies are bodies. And knee pain hurts a lot no matter what your size.

The old wisdom sounds just like, “You’re fat so must pay the price! Suffer! No knee replacement for you!” Doctors can be jerks.

But in my case we’re not talking about weight loss before surgery. The issue is weight loss to put off the necessity of joint replacement. Total knee replacement is worth avoiding. Right now knee replacements last 20 years max. So if all goes well, I might need a second one. It’s big painful surgery with a very lengthy recovery time. I don’t want to do it twice.

See here. Point 1: “For many, weight loss is a basic but crucial way to help avoid knee surgery. Shedding just 15 pounds can cut knee pain in half. And should you need arthritis knee surgery later, you’ll decrease your risk of complications and reduce strain on your knees, which will make your rehabilitation go more smoothly.”

So, what to do?

I’m reading a lot about knee pain and weight. No surprise there!

But I’m also researching weight loss for medical reasons. Maybe like me you thought that weight loss is hard but once you’re told you need to lose weight for medical reasons, you just do it.

I’m here to tell you the sad news that it’s not so simple. Your body doesn’t care what your motivation is. It’s not like it ignores the diets for beauty’s sake and pays attention to the diets for urgent health reasons.

I think when I was younger I even thought it would be good to have a medical reason to lose weight because then you’d be serious about it and just do it. I could be a feminist and be skinny because I was dieting for health reasons. Bah.

Now I have very good reasons, I’m being serious about it, and I’m still struggling.

Tracy and I were chatting today about whether it ever makes sense to talk about weight and weight loss on the blog. It’s not something we talk about much. It’s a blog about fitness not weight and shape and we’re very keen to distinguish these things. In this case though weight loss isn’t a goal that I want to result from my fitness efforts. Weight loss may be necessary to keep me active.

We’re all about staying fit and strong in midlife and beyond. That’s the overarching message of our book. But given my knee and the state it’s in, staying active may mean losing weight. I’m trying. I won’t post much about my successes and failures. I know that’s too much for those of you with histories of disordered eating. Even though I’m one of the larger bloggers here, that’s not me. I like food and my relationship with it. But I also feel the need to be honest on the blog about what’s up with me fitness wise.

Have you had or contemplated having knee replacement? Have you struggled with medical reasons to lose weight? Tell me your story

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Also, hello May, I’m tentatively making plans. There are plans afoot for bike/boat holidays, for canoe/camping trips, for long bike rides. I love the summer and I’m going to enjoy it.

accessibility · disability · fitness

Fun, Live, and Move: Fitness is for Everyone!

A few posts ago I mentioned that one of the exciting things about my new job is meeting my wonderful new colleagues in the College of Arts at Guelph and finding out what they’re up to, where they’ve come from, and what they’re passionate about. See here. But because it’s me, I’m exploring a bit more broadly than that. I’m meeting a new physiotherapist. Hi Jeanette! And a new personal trainer too. Hi Meg!

Meg’s got a lot of cool things going on in her life. And she’s an amazing personal trainer. She works for the university fitness centre part-time but is also pretty busy parenting. When we’re at the gym, we’re doing lots of fun leg things that don’t hurt my knee. Thanks Meg!

She’s also got a special interest in working with clients with disabilities. One of her projects–currently on pause–but I am blogging about it because it’s so cool is called “Foov.” It’s an app for the iPad that makes moving fun. You can read about it more on their Facebook page. While the project is still under development you can download the free app from the iTunes store.

Here’s a description: “The special needs community has been taken with the iPad for learning and intellectual development. Sylvie and Meg, co-founders of Foov Fitness, combined their expertise in e-learning design and fitness to create Foov’s first life-script based workout for the intellectually disabled. When interacting with “FOOV at the Ballpark” participants don’t just passively watch the iPad, tap and swipe at it, they experience and learn the life-script of going to a baseball game at Wrigley Field, and move with the device through a complete workout program. Meet the founders, Sylvie and Meg, and their partners in this venture: Brian from NogginLabs and Harriet from the Center for Enriched Living in Riverwood.”

Go watch the video!

body image · disability · fat · fitness · health

Reflections on the exercise pill by a reluctant desk potato (Guest post)

The exercise pill is in the news again. We’ve talked about before (here and here), as has Fit and Feminist (here). The pill made the headlines again this week because of new experimental results that the drug allowed mice to run on a treadmill for 270 minutes before exhaustion set in (compared with 160 minutes for untreated mice).

Here’s a quick explanation of the experimental drug from The Guardian:

Scientists led by Ronald Evans at the Salk Institute in San Diego made the discovery after they set out to explore what endurance meant on the molecular level. “If we really understand the science, can we replace training with a drug?” he said.

They turned to a drug known as GW501516 which had previously been shown to improve stamina and burn fat faster. Through a series of tests with mice on treadmills, Evans found that the drug changed the activity of nearly 1000 genes. Many of the genes that became more active were involved in the breakdown and burning of fat. But other genes were suppressed, including some that convert sugar into energy.

The result is a pill that reproduces some of the effects of endurance training, with some other downstream effects, such as less weight gain and better control of blood sugar levels.

I listened to a discussion of the new results on CBC’s The Current this morning. The conversation inevitably turned to a discussion of who might benefit from the drug – athletes, folks with limited mobility who aren’t able to do endurance exercises, couch potatoes. At that point, the interlocutors chuckled at the notion of someone who could exercise taking a drug instead. LOL. Just imagine being such a couch potato that you would take an exercise pill!

That got me thinking about the ways in which we moralize health and fitness. I’ll be honest. I’m pretty sedentary these days, owing to advancing arthritis, injuries, and an out-of-control work schedule. (Really, I’m more of a desk potato than a couch potato.) And I feel guilty about that, as if it’s some kind of moral failing not to work out.

As I listened to The Current, I found myself both thinking that it would be great if I could take a pill and thereby acquire some of the benefits of endurance training, and feeling guilty for wanting to take a “short cut.” What the heck? Exercising is fun, and can support good health. But surely it’s not a moral duty.

I mean, we’re not opposed to short cuts in other domains: we take them when we’re driving, and we adopt tons of conveniences to make our lives easier (pre-fab food, dishwashers, motorized lawn mowers…). So, it can’t be the very notion of taking a short cut that prompts my feeling of shame when I think about how great an exercise pill would be. If there is a moral tinge to the notion of an exercise pill, that element must come not from the short cut part but from the exercise part.

But what makes exercise a moral obligation? Plausibly, the moral valence that we seem to attach to exercise and fitness is an side-effect of fatphobia. (Sam talks about similar stuff here.) Regular readers of this blog are well aware of the ubiquity of fat-shaming. When folks are pressed on their fat-shaming (and sometimes even when they’re not), they associate being fat with being lazy and therefore not exercising. Of course, no one makes corresponding judgments about skinny people who don’t exercise. They’re not lazy; they’re just lucky. This is pretty similar to the way in which a fat person with a milkshake is mocked (a standard trope on social media, alas) but a skinny person with a milkshake is celebrated for not being obsessed with dieting.

I don’t know if the exercise pill will ever make it to market, whether it will be safe, and whether it will be affordable. But I’m going to declare here and now that if there is ever a legal, safe, affordable exercise pill, I’m not going to let internalized fatphobia and accompanying moral double standards cloud my judgment about whether the pill is right for me. And neither should you.

A light skinned woman wearing glasses. She is standing in front of a window, smiling slightly.

Shannon Dea is an Associate Professor of Philosophy and Women’s Studies at the University of Waterloo. Her research areas include (among other things) the metaphysics of sex and gender, and applied issues related to sex and gender. Before she became a desk potato, she was an avid runner. 

disability · fitness · injury

When exercise isn’t fun: Sometimes it’s boring and repetitive, painful, and not the least bit joyful

My new physiotherapist tells me that I’m tough. She also says I’m determined.

That’s the kind of praise I need these days.

Because contrary to our usual message, I’m not exercising these days because it’s fun or joyful or at all social. I’m doing a lot of boring, repetitive, sometimes painful exercises, mostly by myself, in order to regain basic knee function so I can do things like climb stairs and get out of chairs without grimacing. I’m also making time for it when I am super busy and when the exercising part doesn’t feel like a reward at the end of a long day. It’s more like punishment.

So when Tracy wrote yesterday that “our number one piece of advice for anyone is to find activities that you enjoy” I admit that I kind of flinched. Because my life isn’t like that right now. Right now I am doing a lot of physio. My knee hurts. I’m resolute and determined to get back on my bike even though I’ll never run or play soccer again. Aikido? Maybe. I’ve got hope for cycling. We’ll see. I’m in mourning a bit for my former self!

In my Facebook memories newsfeed a happy photo came through of the Run for Retina 9 years ago. It’s me and cousin Tara doing the 5 km. Look at our smiles! Look how happy we are!

tara

I’m not sure why I am telling you all this, except to find company and to reassure those of you, who like me, who are in pain, that you are also not alone.

I do exercises to support my knee function to my pain tolerance and then it’s all ice and ibuprofen after. I’ve missing the Fowler Kennedy game ready ice and compression thingie. I want one for home!

Yesterday, I was balancing and marching and doing squats on a bosu ball. See here for how that helps.

So contrary to our usual message of “if you don’t love it, don’t do it,” this is me saying, it’s not always fun or joyful or social and sometimes you need grit and determination and you do it anyway. That’s part of my character, a big part of who I am.

What was Tracy’s message last week, life on life’s terms? Something like that.