One of my worries with the move to San Diego was figuring out all the movement/rehab options. I loved doing pilates with Stephanie. How would the replacement look? Would I be able to afford it? Luckily, one of the first people I met in San Diego was Doreen, a physical therapist and pilates instructor who is interested in working with SCI patients. She had met with Stephanie at different Pilates conferences and was learning how to work with a client who has a cervical-level injury. Shortly after my move Stephanie actually flew down and did a workshop with Doreen focusing on developing a program both for her other client and for me. I felt really fortunate for such a smooth transition and I enjoyed working with Doreen but for the first couple of session I struggles with the schedule. As a physical therapist, Doreen follows a regular, insurance and field-perscribed practice of (relatively) short sessions. The 45-min session was one of the reasons I gave up on my cheap (co-pay only) Stanford PT option. That time frame is enough to warm me up, to begin to move. It always felt very cruel to wrap things up after 45 minutes. Somehow, Doreen then found me a time slot of two hours. And stretched our regular, insurance-covered session to that length. I am so grateful for her generosity. But now I’m burning through my 14 PT sessions per year, as covered by insurance. I may pay out of pocket after that, as I weigh my options. Working with Doreen has reminded me about the strengths of a sharp-eyes and experienced physical therapist. She has been expertly poking at my poor right shoulder, showing me lines of weakness and pain that travel from my neck to my lower back. We’ve been stretching that whole mess and doing simple exercises that somehow still border on the impossible. Hopefully with her help (and a lacrosse ball) I can stay on top of that old climbing injury.

With Doreen I’ve also been working on strengthening my glutes, hip flexors, and right quad. (We always start with punishing ab work, though — as per the punishing classical pilates training.) The atmosphere is more collaborative — we work together to figure out the boxes and props required. And often I start by showing her an exercise I’ve done before and then she modifies and extends and we end up somewhere different. I guess I’m writing all this to say that I’m grateful and satisfied here. And though this doesn’t quite look like the Absolute Center — and I do miss that community — I am glad that this is where I ended up.

My other rehab home has been Adapt — an exercise-based rehab place similar to Project Walk and a dozen others. Though I was suspicious of the predatory nature of such places (they tend to over-promise to attract vulnerable, recently-injured individuals and under-deliver while both risking the safety of the staff and the clients… but, that rant is for another time.) My hesitations were dissipated once I learned a few key details and had my first session. First, the place is entirely trainer-run and owned and operated. It isn’t making huge profits for one “owner” at the top. And they have a strong commitment to building community and providing many different kinds of opportunities. For example, they have an ‘open gym’ policy so, if you’re a member, you can come in at any time and use the equipment. They have free cross-fit and yoga classes. They also partner with many organizations to bring events like a surf day at the beach, adaptive riding (coming soon!) and biking. So, they seem singularly focused on improving the lives of their clients, which I value a great deal. And given everything I’ve seen in the organizations that work with the disabled community, this is not something to take for granted. I may have some inner rage about the horrible customer service I’ve experienced, but I’m going to stay on track.

Adapt also provided me with financial aid. Through their fundraising activities they are able to subsidize my sessions and I only pay a fraction of the cost. To give you more detail, if I were to spend two hours at Adapt a week, the full price would be $850/month. This is way out of my post-doc budget range. I’m grateful no-one is asking me to spend that much on my physical therapy. But many people chose to do this and find it worthwhile.
After a spinal cord injury the range of exercises that you can do on your own is staggeringly small. Of course with higher injuries that list is pretty much non-existent. But, at the same time, exercise feels really good. To move relieves most people with SCI of spasms, nerve pain, and just the general discomfort, stiffness, and aches associated with being trapped in one position for long periods of time. It’s not only about investing in recovery and walking again. Often it’s about sleep and pain management and depression. So, we pay what we can.

At Adapt my trainer and I work a lot on stretching and reversing the stiffness that creeps into the front of my body from being in a seated position all day. And then I do exercises that focus on challenging my balance in a variety of kneeling and standing postures. At Adapt I also tried walking on a treadmill for the first time since my injury. I did it in a harness that took off a percentage of my body weight and kept me safe. And without bracing for my right knee. Instead, the trainer positioned himself in front of me and helped lock of my right knee with his hand. I have to say I was highly skeptical that it was going to feel good. I hated treadmills before my accident and viewed the possibility of trying one with my braces on with genuine fear (and genuine curiosity) after. But why would I want to be strung up like a rat in a full body harness over a conveyer belt when all I needed to walk was my braces and walker/crutches? Well, I may be a skeptical person but I am also one deeply committed to trying new things. And not writing them off until I try them. So, up I went.

It felt like running. I quickly learned how to move my legs efficiently in the new system. My trainer needed to give my right leg just a small push and then I was able to keep is locked straight for the rest of the gait cycle. I was surprised by how little help my right leg needed; how strong it felt without the heavy stance-control brace. And how quickly I was walking. My pace was a mile an hour, which is about twice as fast as I walk on my own with the braces. It felt like a sprint! My heart was going and I started to sweat and I was grinning. What a valuable experience. How freeing it felt to move my legs without worrying about tripping or falling or losing balance. I found the added challenge of coordinating quick movement to be all-encompassing, mentally. And something valuable.

So, overall, I’m really happy with what training at Adapt has given me.
And I’ve noticed changes and progress, already. After two months of rehab twice a week I feel much stronger. I’ve noticed increased stability when I do many of the old exercises. But more importantly, I feel it when I walk in my braces. As frustrating and difficult as my new brace has been, I’m finally starting to feel progress. And that’s an addictive feeling.