Papercut and colored pencil art by Sheryl Aronson X 5

Monday, December 6, 2010

Adaptation 101

I am an occupational therapist (OT). I am trained to look for ways that an activity can be adapted for differing abilities.  That really comes in handy when my body parts are complaining or my fatigue level is high. I have had alot of practice over the past year, trying to figure out how to take care of business with tennis elbow in my right arm flaring up at the least bit of exertion.
I have been going to a physical therapist for my arm, and have been having her give me exercises for my knee pain as well.  Several of the exercises she gave me to do I have had to adapt.  One of them is a stretch for the quadriceps muscles, he muscles in the front of the thighs.  The traditional way of doing the stretch is to stand next to something you can hold on to, lift one foot behind you, and grab onto your ankle with the hand on the same side of your body.  Point your knee down toward the ground, with your foot behind your butt, sole of the foot toward the ceiling.   You can increase the stretch by pushing your hip forward, and/or your foot back away from your butt.  (If you can't grab your ankle, you can grab your pant leg.)  I can't do this exercise the 'normal' way with my right leg, because it puts strain on my right arm.
I came up with two adaptations. The first one, I can do in my recliner chair.  I sit with my weight mostly on one hip, and bring the other foot up next to/behind me.  I then twist so that the foot is behind me, my knee is pointed away from my head, and push my hip forward and foot backward to get a good stretch.  As you might expect, I feel a bit like a pretzel doing this, and my other body parts ask me what it is I am trying to do.
The second adaptation is more creative, and also safer and more comfortable.  I discovered that our washer and dryer are just the right height to put my foot up on to do this stretch.  I simply turn my back to the washer, lift my foot up behind me, and balance the top of my foot on top of the washer, sole of my foot to the ceiling (my hand helps keep it in position, without undue strain on my right arm).  I do make sure I am wearing cushy shoes to do this, so the top of my foot doesn't hurt.
Occupational therapists are trained to adapt things, but you don't have to be an OT to do it.  I know that most, if not all, of my readers have chronic illness or chronic pain issues, that is what drew you to my blog in the first place.  Business as usual is not usual for us.  There are often things that we can't do, or can't do the 'normal' way because of the pain, fatigue, or whatever other symptoms might have cropped up that day.  Knowing how to make adaptations takes creativity and practice, but can be readily learned.
The formula for making an adaptation is as follows:
1.  Know what it is you are trying to accomplish.  In the case of an exercise like the one above, what muscle are you trying to stretch, and in what direction.
2.  What is keeping you from doing it the usual way?  In this case, it was my arm pain, so I needed to find a way to position my leg to do this stretch, without using my arm to do it.
3.  What are some options for accomplishing your goal, bypassing the problem area?  I outlined two options for doing this exercise above, each of which is feasible, one of which is better than the other.
4.  Decide which option seems the best, and try it.   If it doesn't work, try another option.
Not everything is adaptable for every situation, but you may be surprised and pleased with how many things you can do, just by adapting some of the factors to fit your needs.

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