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2009-11-10 - 9:18 p.m.

..the first day of physio...

I stayed home from the office today so that I could go to my physical therapy appointment at 11am.

I went in for the appointment and was seen immediately. My therapist assessed the problem muscles within five minutes of my walking and bending and balancing (the left quadratus lumborum - or "QL" - and the right supporting "iliac crests"). She also quickly assessed that there is no neurological damage which is a good good thing, and reason to be hopeful for some rapid improvement.

She also had some interesting points to make about core strength - which in my case pretty much evaporated after childbirth. This has felt very bizarre for me because I've always had naturally very strong core muscles. So to feel as though I cannot control my core has been very uncomfortable. I stood on the street last week and simply tried to pull everything into a reasonable alignment, and I had this disconcerting sense that I couldn't do it.

So it was rather enlightening today when the therapist explained that part of what happens is that the neural connection between one's transverse abdominal muscles and the brain are essentially shut down when one is way way way pregnant. Because these muscles just need to be stretched way beyond normal. Then, after childbirth, these muscles basically need to be re-engaged and worked regularly.

It was like having a light bulb come on over my head. I remembered the exact same feeling - the disconnect between brain message and muscle - occurring after my knee surgery. After one week of not contracting the muscle on the top of my knee, I could no longer do it, and had to retrain the neural connection. This is exactly how my transverse muscles feel - as if I'm ordering them to contract or flex, but they won't.

This is all probably way too much information for anyone else out there, but I found the whole thing kind of fascinating. I'm super impressed with certified massage and physical therapists - they REALLY know how muscles, tendons, nerves and other tissues connect up with our skeletons. I ask a ton of questions, because I just love listening to their overviews of how the body works.

I learned another interesting tidbit, too - about my heel that went numb for about a year after childbirth. I had always associated that strangeness with the epidural. But the therapist clarified this one, too. Epidural needles enter the lumbar 3, the portion of the heel that I described is actually more closely connected to the sacrum. During childbirth, the sacrum is stretched, rotated, and even jarred, so the numbness in my heel was undoubted a result of this connection, NOT the epidural. Huh. Well reasoned. I was impressed.

So the therapist massaged a bit and then sent me away with a series of stretches and exercises. I'm already on my way to a morning and evening ritual of completely them. I'm sore today, but I have great hopes for improvement - at least a stronger sense that I'm taking some control back. Yay me!

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