Last summer I spent a lot of time dealing with sciatica, which had me limping and having trouble with climbing stairs. Thanks to many months of physical therapy, I got better. My gait became steady and strong, and I could climb stairs without pain or favoring one side. Yay!
A lamb leaping for joy– my inner lamb is doing the same. By Jonathan Mabey for Unsplash.
Maintaining my hard-won stability and strength takes effort, and I’ve done my hip exercises regularly. But I noticed that if I read in bed before sleeping, I would be creaky or have some hip pain– not enough to wake me up, but noticeable.
Reenter yoga before bed. I used to do some rotation of gentle yoga exercises before bed most nights, but for no particular reason stopped.In the past few weeks, I restarted, and noticed happy changes:
no joint pain in bed during the night or in the morning
easier walking around in the morning
a little more stability and flexibility in general
What I do varies– sometimes it’s mini sun salutations with warrior poses and twists and forward folds, other times I’m on my mat in the living room doing twists and hamstring stretches with my yoga strap. I sometimes do tree pose as well, although I’m less balanced in the evening. So far I haven’t fallen over, which I’m taking as a win.
I’m not sure it matters exactly what yoga poses I do. But I’m thinking it does matter that I do it. So I’m doing it. Having restarted my posts for the 226 workouts in 2026 is helping motivate me to do it (almost) every night. Yay again!
Yeah, yay to that. By Fausto Garcia for Unsplash.
Readers, are you doing or re-doing something that’s making you feel good or better? I’d love to hear from you.
I love me some physical therapy. it has helped me come back from orthopedic surgery, injury, accident, wear and tear and repetitive motion-induced pains.
One of the things I love the most about PT (physio in Canada) is how much I learn about my body through interacting with my physical therapist, adjusting and changing exercises over time. We always talk about what’s become easier, what is still difficult, how different body parts and functions are changing over time, and how that affects my health and fitness goals and practices.
Last year, I spent 5 months in PT for sciatica that had gotten to the point where climbing stairs was painful, hip pain woke me up at night, and even walking right after driving hurt. Yes, I know, driving is the one of the worst things for our musculoskeletal systems. Whatcha gonna do…
By the end of that rehab period, I felt so much stronger and happier and functional and knowledgeable about my vulnerabilities, needs and resources. Yay! Thanks Julian and Louis!
Here’s the thing: PT/physio seems like exactly the kind of healthcare that needs to be in person, with two bodies present: patient and physical therapist. Recovery trajectories aren’t linear. They involve dips and surges, all of which require on-the-spot adjustments to exercise regimens.
So you wouldn’t think that anyone would even consider outsourcing PT/physio to something like AN APP.
But guess what? They have. Yes, I’m aware of the We’ve-got-an-app-for-that approach to healthcare, but I just got a most unwelcome update when my state employee healthcare overseers, MassGIC, started hawking a new app (this one is called Hinge Health), with the promise of ease, flexibility and no copays. They also included this on their website:
From their webpage: transforming how MSK pain is treated. and delivered. I don’t think that’s what they meant to say. But hey, I’m a fussy humanities professor…
To be sure, not all apps for all uses for all healthcare are ill-concieved. In a 2024 qualitative study of use of exercise apps for people managing osteoarthritis at home, both patients and therapists report convenience of the app over paper copies of exercises, increased accountability through digital reminders and ease of recording at-home exercise sessions. However, patients also reported problems with the quality of the apps, technical problems and security concerns about their personal data. Therapists reported concerns over compensation for interacting with patients over apps (that is, they frequently weren’t reimbursed for time spent with them) and overall a preference for paper exercises over app use.
For this company, I did a little sleuthing, and found that 37% of reviewers on TrustPilot, an independent reviewer site, gave it one star (i.e. bad bad bad). They cited aggressive marketing practices and also billing the patients when the service was explicitly covered by their insurance. Recall that having no copays was the primary appeal for patients. Sigh.
Technology continues to transform the way healthcare is delivered. I know this. And there are lots of advantages: increased access for those in less-resourced areas, ease and flexibility of access to information, tracking and accountability, and sometimes even cost.
One one size does not fit all. Some of us want and need in-person interactions with qualified health professionals for our care.
Also, when technology is poorly handled, those qualified professionals are either forced to do less or uncompensated work (e.g. emails, app chats, etc) or entirely supplanted by unqualified workers who must rely on canned materials to try to answer the complex questions of patients.
Which gets us to a bigger problem: trust.
I want healthcare that I can trust. And in order to trust it, I need to trust the healthcare providers. And in order to trust them, I personally need to see them in person, at least most of the time. Which sometimes can include telehealth, and sometimes may include email or patient portal messaging, and sometimes maybe even an app. But I need to know that my healthcare providers will provide me the access I need. Arguing with my phone is not how I want to spend my recovery.
I know, phone, it’s not you, it’s them… Thanks Konstantin S from Unsplash.
Being a person who is good at getting things done is part of my identity.
And yet lately, I’ve been struggling. Not with everything. In the world of fitness, I’m struggling with one very specific, very small thing: doing my daily mobility routine. The routine includes exercises to improve my hiatal hernia, hip mobility movements, and some stretching to maintain the range of motion I worked so hard to get after knee replacement surgery.
I’ve got three different 10-minute routines–one done lying on my yoga mat or in bed, one to be done with a chair, either seated or standing holding the chair for support, and a flow version for when I’m feeling extra good.
My plan is always to do them in the morning. In theory, I’ve got time between when I take mediation and when I can eat breakfast. There’s supposed to be a full hour there! And yet…sometimes between Wordle, and drafting my #ThreeGoodThings and “Hey, Google please play the CBC news” and similarly “Hey, Googling” the weather in Guelph today and showering and putting on coffee and thinking about breakfast and lunch…well, you get the idea.
I’ve written about my 5 to 9 routine here before and admitted that really for me, given my work schedule, it’s more like 5-7 am and I listed some options for what I might do in that time. The options were write, walk Cheddar, ride my bike, or my physio/mobility routine. And yet I’ve mostly managed to do none of those things in the 5 to 7 am time slot! It’s all Wordle, scrolling and going back to sleep. To be fair, that’s also when I share our blog posts to social media, which WordPress won’t do automatically anymore.
I said “mostly” because the week gets a great kick off with all my Monday morning energy going into the Herd’s Morning Morning Coffee Crew ride. And Tuesdays and Thursdays we’re at the gym at 7. The mobility routine has to happen first, before these things. And it’s just 10 minutes.
I could do it while the coffee drips! Actually, that’s not a bad idea. I might try it.
Do you have a small thing you struggle to do? What techniques have worked for you to just get it done? I’m listening….
My lower back is often tighter than I realize. My massage therapist kindly reminds me to keep walking, lifting and stretching. It usually keeps things decent.
My last physiotherapy appointment I asked Emily if we could assess my right hip. It was very painful after swimming last week.
Emily asked me a bunch of questions then set about assessing my hip and back. I stood on one leg, then the other. I did side bends. She then had my lay on my back and put my leg in various positions asking me to press or pull.
“Ok. Now I want you on your stomach and just go into a baby cobra as relaxed as possible.”
The pain went away. Yet another moment of “what I go in for is not the issue”. Translated pain is the name of my game.
So I’m on a tummy time routine with hourly baby cobra. It’s definitely working.
No more hip pain but WOW is my lower back screaming day and night.
It’s frustrating as I continue to chase one petty injury after another.
Looking back there have been many things to irritate my lower back.
My fall in December , walking in snowy conditions, less strength and cycling and, oh yes, shoveling a shit tonne of snow the past month.
It’s the injury of desk jockeys, those of us with extremely sedentary jobs.
“But Natalie!” you exclaim, “you are a very active person!”
Not farmer active. Not contractor active. I’m active around an 8 hour day of sitting. So I’m using the standing option as much as possible. I change up where I’m meeting. I use stretch brakes. Walking commutes.
While I am frustrated at always being in physiotherapy for something I’m grateful I can access expert care.
It’s tempting, laying here writing to just stop doing everything. But I know it will only make the pain and my quality of life much worse. So. Baby cobra and being kind to my back it is.
My latest physiotherapy move is designed to help my shoulder stay seated in place.
Emily demonstrated the move, arm out sideways and bent at the elbow up. Gripping a tension band rotate the hand down, parallel to the ground and back up.
“Oh it’s like the waving cat statues!”
A white cat waves at you
“Yes!” Emily grinned “A Lucky Cat!”
It’s a classic silly little move that hones in on a weakness. I could only do 4 reps and completed the remainder without tension.
I’m grateful for more days pain free. I’m glad I’m seeing progress. It’s very slow but definitely happening.
Strength has returned to my left hand. The nerve pain has retreated to my shoulder. I have a buffet of simple exercises I use to keep the healing on track.
If I’m very lucky I’ll be able to have a full range of motion in 2026.
I’ve been in physical therapy for a recurrence of sciatica since late July. I’d had pain and weakness in my right hip since May, causing me problems climbing stairs and pain that would wake me up at night. Blech!
Once I finally acknowledged that yes, I needed some help, and got started with a supervised twice-a-week plan, plus at-home exercises, I felt relieved. Relieved that I had a structured plan for dealing with the pain and getting stronger, and also relieved that I could leave this plan up to the professionals (thanks, Julian and Louis!), who would guide me through a process of healing and rebuilding my muscles and getting needed functionality back. Ahhh…
Starting with stretching exercises and some easy strength-building (e.g. bridge, clamshells), I moved on to a full array of hip machine exercises, leg presses, balance activities, farmer’s carry, and stair climbing with dumbells on one side. It’s been gratifying to see and feel my strength increase and pain decrease. Yay!
My classes are all on the second floor of one of the campus buildings, with extra stairs to get into the building. I’ve really not enjoyed waiting for the super-slow elevator to take me to my floor, but it was necessary. Until the past couple of weeks. I’m now taking all the stairs, and my strength has increased so I don’t need to rely on the stair railing to offset weakness in my hip. Yesss!
I knew it was coming, so I wasn’t surprised when I got a call from the PT practice to say I didn’t need twice-a-week sessions anymore. I’ll go once a week for the next few weeks to transition to discharge. This means they think I’m recovered enough to maintain my newly-regained strength and flexibility on my own. Uh, yay?
I mean, here’s the thing: I know I should be feeling like this:
This lamb is feeling it. Thanks, Jonathan Mabey from Unsplash.
And I am. It means I’m pretty recovered and functional. I’ll have 4 more hours back for my week. I won’t be paying $40 in co-pays each week. I’ll be climbing stairs to beat the band!
But I also I feel a little like this:
This woman is also not completely sure about the plan. Thanks Simon Abel for Unsplash.
What am I worried about? I’m worried about the challenge of keeping up my fitness maintenance without the help of the PT bros, who I’ve come to like and respect and depend on. Now I have to depend on, well, me. Hence the worried face.
The good news is that my gym has all the machines I need and is a mile from my house. I also know what to do, and in fact like the experience of the weight work and strength training. And, I can bring a friend to my gym for free on the weekends, so I can enlist help in getting there.
And yet.
I’m almost at that transition point– not yet finished with PT, not yet into a regular gym routine. So that’s my next challenge: get to the the one-mile-away-from-my-house gym to do those exercises without the guidance of physical therapists, but instead with the company of other exercisers, including friends.
Maintaining strength, flexibility and functional fitness is really important to me. And it doesn’t always come easy. It’ll take some adjustment, just like twice-a-week PT and at-home exercises did. I’ll report back in a month to let you know how things are going.
Dear readers, what have your experiences of transition from PT/physio to maintenance exercise been like? I’d love to hear what’s worked for you.
October is an extra-busy travel and research month for me. I’m giving four talks and flying to two conferences, one in Hamilton ON and one in Portland OR. I also have to decide what to pack for Portland, as the peaceful and creative citizens of that lovely city have broken out the Halloween costumes early in response to incursions by masked ICE teams and National Guard troops. The main choices seem to be frog or chicken suit:
A guy in a chicken suit looking up at Kristi Noem, who is surrounded by National Guard troops with nothing to do.Civilians in work casual and froggy attire gather peacefully outside a Portland, OR ICE facility.
As you can see, there’s a lot on my plate this month. However, in the brief lull beforehand, I found myself last Friday with room for some self-care. Herewith, my trifecta of attention to reducing stress and increasing yummy feelings of well-being.
Stop one: physical therapy.
I’ve been in PT since August for sciatica, and am recovering, albeit slowly. The last thing to get better is my ability to climb stairs without pain or weakness in my right hip. It’s improving, but not there yet. So, the PT bros at my great physical therapy practice have me working with weights, from farmer’s carry to asymmetrical weights for stepping up and down stairs and such like. Also, I’m doing one-legged leg presses (which are harder than I expected, but good for me) in addition to regular leg presses. And of course core and stability stuff. All good and good for me. I felt thoroughly worked out by the end of the 60-minute session.
Stop two: acupuncture.
I have been getting acupuncture for musculo-skeletal pain for many years now, and I really like it. There’s ample evidence for its effectiveness– look here, for example, for a review of studies. I also find that I’m super-duper relaxed after a session, due to addition of ear points (see here for an interesting case report), dreamy music and a heat lamp on my knees. My only wish is that someone would show up at the end of a session to escort me to the back of their station wagon and drive me home… However, I did manage to get in my car and get back to my place with no problems. Once home, I did some reading and then fell asleep for a 30-minute luscious nap.
Stop three: restorative yin yoga.
After waking up refreshed from movement and chill stillness, I did some light housework (dishes, laundry, and a little cooking) before heading out to my local yoga studio, Artemis in Watertown, MA, for evening restorative yin yoga. Norah had saved a spot for me up front, and I gathered up an armload of blankets, a long round navy-blue bolster, and blocks, depositing them in my little space. There was slow, chill music playing, and I settled in for 75 minutes of stretching and relaxing. Here are some yin poses, including several we did Friday night:
Our yin teacher, Liz G (there are multiple Lizzes teaching at Artemis) apologized for not having a yin bus parked outside to take us all home afterwards. We agreed that this would be a welcome addition, but we happily toddled off to our respective homes after class.
Optional stop four: the Great British Bake-Off
Once I got home, I remembered that there was a new episode of Bake-Off, so I woozily watched the contestants labor over pastries. However, I felt no stress at all, either on their behalf or mine. Not too long after, I shuffled to bed, sleeping like a log, perhaps dreaming of elaborate confections.
Unsplash calls this pastry, although it’s possibly a hybrid? It’s exquisite, in any case. Thanks VF for the photo.
So readers, what are your favorite chill modalities when you have some time to shift into the slow lane? I’d love to hear any suggestions.
In architecture, form is supposed to follow function– the style of an object or structure should reflect its purpose (says the NY Times, paraphrasing Louis Sullivan). But I’m being reminded (again) in physical therapy (for sciatica) that form in fact precedes it.
I guess we all know this– from tennis strokes to proper stance for weight lifting, getting the form right is key both to success in performance and reduction of injury risk. The “aha” moment of getting the form just right and feeling the movement as fluid or effortless or smooth or faster– it’s one of the great personal pleasures of physical activity.
One of my physical therapists (I alternate between Louis and Julian, both of whom I really like and respect) started me doing some piriformis and hip flexor stretches before doing work on the hip machine (extension, flexion, abduction). There was a noticeable reduction in the difficulty and improvement in the feel of the exercises, especially the abduction ones (moving my leg outward using the weight machine).
I mentioned this to Louis while I was using the machine. He said that this was very good information for us, that the exercises helped improve the structural form of my hips, glutes, etc, so that my muscles worked more efficiently. He said other things which I can’t quite recall, but the point was that the stretches helped my body getting in the right form for weight-bearing effort. And I think it’s helping. Yay!
I’ve still got a ways to go before I’m back to climbing stairs without pain or weakness. But this week felt like it gave me more tools for working my body and reminding it how to do its job for me. Yay again!
I’m not planning on buying one of these, but it’s my good friend these days.
I’ve been in physical therapy for six weeks for sciatica, which has been centered on my right hip and glute. I had the same problem in my left hip and glute two years ago, and got physical therapy for it, which helped enormously.
But it came back, this time on the other side. Which brings me to the first lesson from this round of PT:
Lesson one: our physical vulnerabilities don’t ever go away; they’re always there and in need of attention and care.
I knew this, of course, as do we all. But when we devote concentrated attention to some problem, we tend to hope and believe that it’ll be fixed, once and for all. Well, in the case of our musculoskeletal bodies, this just isn’t true.
Lesson two: slow and steady actually works.
Once I got into physical therapy and made a little progress– less pain and more function– I was ready to throw myself into more intense activity. But they counseled me to let pain guide me; if doing something hurt a lot, stop doing it. Sounds simple, but this bears repeating.
Lesson three: more activity brings more discomfort, but it’s okay.
When I was on vacation in Canada, swimming and dog walking and just generally being more active, I had some level of pain every day, for much of the day. Because I’d been prepped for this, I didn’t freak out. I did what I wanted and could do, took Tylenol when needed, and enjoyed the fact that I was able to be more active and out there than the previous month. Yay.
Lesson four: sitting in cars and planes is evil for the body (or at least my body).
Yes, I knew this, but driving from Boston to Ontario and back again (with some detours along the way) showed me once again how my body is vulnerable. And don’t get me started on air travel; that’s what precipitated this flare-up. This doesn’t mean I can no longer drive. But it does mean that 1) I should stop more often and get out and stretch and walk around; 2) I should know that after a very long drive, my body will need attention through stretching, rest, and movement; and 3) If I ignore and push through this, I do so at my peril.
Lesson five: bodies are wonderful things. They take a licking and keep on ticking. And they respond to focused attention and care. This means that I have renewed appreciation and love for my physical self. This time around, both the physical therapists and I are working on a maintenance plan that I can and will follow. I really love what my body can do, and I want to keep doing it for a long time to come.
Two physiotherapists from Kitchener-Waterloo from a 2019 blog post on the Ontario Physiotherapy Association web page. They are showing off their blue T-shirts, which say #PhysioHelpsLives
May is National Physiotherapy Month, and FIFI bloggers are big fans. Almost all of us have written about injuries and how physiotherapy has helped.
Sam is probably the most prolific: she worked with physiotherapists both before and after having two separate knee replacements. They helped her remain mobile, then prepare for each surgery, and then recover to the point that she is back to regular cycling and long walks with Cheddar.
Cheddar the dog, from one of Sam’s blog posts in 2024. he is a blue-eyed golden lab, I think.
If you are struggling with balance issues, arthritis, stiffness, or injury, and are able to see a physiotherapist, you might want to get things checked out and get support to keep you moving. May is when we celebrate physiotherapists, but any time is a good time to check in on your bone and muscle health and strength.
