Lifetime Physiotherapy

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At my dentist’s office, I was sitting in an exam chair before my appointment. Nearby, I heard her talking to another patient, who sounded male and youngish. I vaguely made out the conversation. “So, when can I use my front teeth,” he asked, “to bite into something like an apple?”

“Never!” my dentist said, adamant, but with a smile in her voice. “You should always cut up that apple. For life.”

I’ll always remember her unequivocal response. It reminds me of physiotherapy after an injury. I once assumed that PT exercises are temporary—to be done for several weeks or months, until healed. Now I know better. I believe that physiotherapy must be done “for life.”

Note: In Canada, the term “physiotherapy” is typically used for “physical therapy,” while in the US the latter is more common.

Lessons from My Shoulder

About 15 years ago, I had rotator-cuff surgery on my right shoulder—for torn supraspinatus and infraspinatus tendons. Never before had I undergone general anesthesia or been incapacitated in my dominant arm. But the surgery was successful and, in two weeks, I started physiotherapy. At first, the therapist passively manipulated my shoulder, but soon I was doing exercises using a pulley and then TheraBands and dumbbells.

In six months I resumed yoga classes. By then I’d stopped going to physiotherapy. Although my right shoulder would never be 100% normal, I had full functional mobility and strength. I not only could reach for that top shelf, but I could also do Sirsasana and other inversions, Chaturanga Dandasana “push-ups,” Gomukhasana with clasped hands; I could lift weights at the gym.

A decade later, my right shoulder began bothering me again. It hurt during some yoga poses and whenever I held my arm at particular angles (e.g., while toothbrushing). I lost strength and couldn’t throw a ball far enough for Stella, Giant Schnauzer / Lab, recently adopted and at her athletic peak. Like a wide receiver, she’d dash off the instant I raised my arm—and then outrun my pathetic throw! Anyway, I’d somehow reinjured my rotator cuff, although less severely. No need for surgery, just physiotherapy exercises. After my shoulder recovered, I didn’t stop.

An injury probably causes permanent effects. That sounds dire, but physiotherapy can maintain almost-normal function and prevent relapse. Note that I’m not talking about little bumps and bruises, but acute injury or chronic pain.

My PT Routines

In addition to yoga, walking, and gym workouts that I do by choice, I do two PT routines weekly. They take time, but not too much. I consider them an insurance policy against future injury and pain.

  • Shoulder Twice weekly, I do shoulder exercises, once with TheraBands, once with dumbbells. During my original injury, I did PT daily; after my flare-up, several times weekly. Nowadys twice weekly is enough.
  • Foot/ankle Twice weekly, I do a mini sequence including sole strengtheners, ankle circles, Achilles tendon stretches, and my 10-minute Vrksasana. I targeted this area after I rolled my ankle while walking Stella soon after she arrived. It was minor—no swelling—but I wanted to prevent a repeat.

Does Lifetime PT Apply to You?

Lifetime physiotherapy. Does that sound off-putting to you? Do you have “better” things to do with your time?

Maybe it all depends on how much physical health matters to you. For me, being in shape has always been high priority. When I started teaching yoga, it became even more important. In Iyengar yoga, the teaching method might not look physically demanding at first glance. It’s not “follow the leader” with the teacher performing the entire sequence in sync with students.

But Iyengar yoga teachers are constantly moving and using their bodies—adjusting people of all sizes, navigating the room countless times observing students, demonstrating poses “cold.” Once, on a freezing winter morning, I was doing a Prasarita Padottanasana demo with dynamic side lunges—and lunged too deeply. My muscles weren’t warmed up and, oops, I moved too far, too fast. Another time, I was walking with arm raised, Urdhva Hastasana, and abruptly turned my head to view a row of students. Ouch! Don’t move your head carelessly, colleagues.

Sometimes I repeat a pose numerous times in a given week. Too many times for my body. This happened with Paschima Namaskarasana. Doing the pose repeatedly felt fine but, after several days of teaching, I felt a twinge in my left shoulder (the uninjured one).

Yoga teaching can be hazardous to my health! Just kidding. The point is that I prioritize physiotherapy because it’s necessary to keep me healthy—as a yoga teacher and in general.

Practical Tips

  • Initial Injury The more serious your initial injury, the more attention you must give physiotherapy. For minor issues, temporary exercises might be sufficient. For major damage, long-term maintenance is probably needed.
  • Frequency How often you do PT can vary over time. At first, you should do your exercises daily or several times weekly. Once you recover, adjust based on your overall activity schedule. If you do lots of sports or physical activities, do PT once or twice weekly. If you’re sedentary, doing your exercises several times weekly can keep you active.
  • Set a schedule Decide which days of the week you’ll do your exercises. Mark your calendar. Write it down. Otherwise you’ll forget or end up doing something else. I employ the  “don’t break the chain” method with my favorite to-do list / habit tracker app, Streaks.

Whether you have an injury or a dental condition, the upshot is similar: Your body, your life, has changed forever. You can’t turn back time and avoid what happened. Reality is living with that change.

Images: Supermarket apples, Save On Foods, Vancouver, March 2024, Luci Yamamoto.

9 responses to “Lifetime Physiotherapy”

  1. Colleen Filler Avatar
    Colleen Filler

    Excellent advice. Just the way it is. Thank you.

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    1. Luci Yamamoto Avatar

      You’re welcome, Colleen. Yes, pretending that your body hasn’t changed (in whatever way) only exacerbates the situation. Hope to see you in May!

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  2. Keith Avatar
    Keith

    Hi Luci: While I’ve never had PT, I suppose my always-evolving home yoga practice is my pre-emptive PT. When practicing or teaching yoga, or practicing Lomi Lomi or Thai massage, I am always asking myself about previous injuries, noticing common problems, and taking mental notes to improve my own yoga workouts—for example, to prevent myself from getting ‘frozen shoulder’ or sciatica. And even when I’m not officially practicing, I find myself reaching behind and grasping opposite elbows, or sitting in double pigeon, probably to the annoyance of those around me. Hahaha. It’s like taking care of our teeth. Quality, quantity, and frequency of care really makes a difference as we get older and arguably more susceptible to injuries. Or cavities.

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    1. Luci Yamamoto Avatar

      Good point, Keith, that our actual practices/activities can also be our PT. For my right shoulder, PT was phase one and yoga was phase two. Yoga developed my ROM and strength beyond what’s needed for everyday function. As for doing yoga “moves” in non-yoga settings, LOL.

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  3. belledeforest Avatar
    belledeforest

    For injuries sustained in a car accident about 55 years ago I have benefited tremendously from various health practitioners, with years of pauses in between. I also started to practice Iyengar yoga 40 years ago and I am so grateful for how it keeps me aware and flexible. The effects of the accident tightened the membranes around my heart and lungs, however, although the symptoms didn’t show up for many years, partially due to less intercellular fluids as I aged. For these symptoms, I’ve received visceral manipulation and I am also grateful to have discovered this modality.

    Belle Parkinson

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    1. Luci Yamamoto Avatar

      Belle, many thanks for highlighting the synergistic effects of various modalities. Although I teach yoga and appreciate its valuable therapeutic qualities, I don’t believe that it’s a cure-all. You also make a good point that effects from physical trauma are sometimes delayed. Thanks again!

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  4. Cynthia Avatar
    Cynthia

    I wish it wasn’t true but it is, as I have found out. (I hope that my recent experience with a recurring knee injury is the last time I “discover” this important lesson.) Thank you for this reminder which has made me put the PT in my calendar.

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  5. […] get me wrong. I’m a big fan of long holds. For example, twice weekly I hold Vrksasana for 10 minutes per leg. Occasionally I hold Downward Dog for five or more minutes. […]

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  6. […] work.” But did they actually do the homework? Also, as discussed in my post “Lifetime Physiotherapy,” you probably should continue PT exercises […]

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