TLDR: When the fear and/or anxiety that you are having starts to interfere with your life and your ability to participate with your day to day tasks, and/or the things that you enjoy doing, that is when there is a “problem”. It doesn’t mean that it will last forever, it just means it’s time to work on it! You can work through this fear and anxiety with the help from your physical therapist, friends, family, and even from your therapist (highly recommend that everyone has a therapist - it’s great).
To build off of this subject of fear and anxiety after an injury, pain or surgery, that we started talking about last week, I’m going to use myself and my experience from my recent hip surgery as an example.
Like we talked about last week, initially having some fear is good because it is a way of protecting ourselves from any further pain or injury during our initial healing stages. However, there comes a time when fear is no longer helpful in the recovery process and instead can slow us down and hinder our day to day lives. There is no one specific timeline for when your fear and anxiety should “go away” regarding your injury and situation - IT DEPENDS. It depends on what type of pain/injury you are dealing with, how long you have been dealing with it, how it happened in the first place, if you have any specific precautions/restrictions from your doctor (weight bearing, specific movements, etc.). Keep that in mind as we are talking about this subject. It depends and everybody is different.
The main thing to be aware of when it comes to the fear and anxiety in the healing process, is if it starts to slow you down. Is it keeping you from going to work? Is it keeping you from getting up and playing with your kids or nieces/nephews or grandkids? Is it keeping you from going out and having fun and doing the things that you want to do and that you enjoy? Are you afraid of bad weather because you are afraid you are going to fall and hurt yourself again? The list goes on and on - the biggest thing to be aware of is the INTERFERENCE of your life. Now, also keep in mind that we are talking about the fear and anxiety of the potential of pain or injury - not if you are still in pain or still have these precautions. This is AFTER the initial stages of healing when you are allowed to do the things you want to do and can’t quite get back to them because of the fear itself.
When I had my hip labral repair in November 2022, I was non-weight bearing and on crutches for 6 weeks. After that I had to wean myself off of the crutches as I started to learn to walk again. For background, I live in Connecticut and the winter months can be pretty rough with snow and crappy weather frequently. This winter was not awful, and while I was on crutches there was 1 maybe 2 snow storms and then a bunch of rain. I noticed that I was super anxious about going out on crutches when the weather was potentially slippery because I was afraid of hitting a slippery spot and the crutches sliding out from underneath me and either having to put my foot down and/or falling. That can be a typical fear for many people on crutches. I realized that I had that fear because of a time when I was younger and on crutches and that had happened when the crutches slipped out from under me in the hallway at school because of dust and I fell. I didn’t get hurt that time, but that memory sticks with you (thanks for that, brain!). So having that in the back of my mind and the fact that I did occasionally have to put my foot down quickly this time around because of slipping a little, I was really anxious. Luckily, no damage was done this time around either, but it definitely hurt when it happened and I was doing my best to avoid it. So whenever it was rainy or snowy or icy, I was making sure that I wasn’t going anywhere (which wasn’t hard to do because I couldn’t drive myself!)
Fast forward a few weeks when I was back to walking and getting back to work and my daily life. It was still winter at the time. And I was still very very anxious about having to go out in any kind of slippery weather, or potentially slippery weather. Initially I didn’t think much about it, I just thought about it as being cautious, because I was still recovering and didn’t want to mess up my healing process. After a little bit longer though, I realized that it was actually a problem. I unfortunately canceled plans sometimes, and I canceled a couple of clients for work and a stretch class that I was supposed to do one weekend as well, because I was having full blown panic about the fact that it could be slippery and that I might fall and hurt myself. This was a “problem” because it was interfering with my ability to get to work and go about my day. It was something that needed to be worked on.
The other issue I was having was that I was keeping myself from going for walks while I was at work, because I was afraid of being too tired to get back to my office. I work in an area that is overall pretty good for walking, and pre-surgery I would go for walks frequently on my breaks when the weather was nice. Once I was back to work post-surgery I had convinced myself that I couldn’t do that because “what if I couldn’t get myself back to the office because I’m tired?” Initially, because my leg was still super fatigued and weak, this was normal. Then eventually I realized it had become an irrational thought and an overpowering fear. This again was when I knew it was a problem, because it was interfering with what I enjoyed and wanted to do.
I eventually had to slow down and think about it from a PT point of view. First of all, there wasn’t a specific distance that I had to walk and I could stay close by to the building at all times so that if I did get tired, I could still get back before I was exhausted. Also, even if I was too far from the office to get back right away, there are benches and chairs and tables and stores and so many places that I could sit and take a break if I needed to! So little by little I started to work through that fear and start going for a little bit longer walks as I was able to each time. Sometimes, I still get nervous and if it’s one of those days, then I just go a little bit shorter and take my time and show myself again that I am able to do it.
In PT we are taught ways to help you and teach you and show you when your body is ready to do something and help you to recognize it too. I will never push somebody to do something that terrifies them, and I will at the same time help you work through what is scaring them so that we can build up to it. It is for sure a process and it will take time to work through it. Some people will deal with it longer than others, some people may not deal with it at all, and there’s no right or wrong way.
In my case, I realized that I was dealing with it significantly and even though I have now been working through it, there are still times that it pops up. Our brain’s job is to protect us from anything that can be harmful or painful, so part of the process will be continuing to teach your brain that you are no longer in a potentially harmful situation. So if you come across something that you haven’t done in a while because of your injury, chances are you are going to be a little bit anxious about it before you do it for the first time. AND THAT IS OKAY! THAT IS EXPECTED! I GUARANTEE you that when I am able to get back into running, I am going to be SO excited and yet at the same time, freaking out on the inside because I don’t want anything bad to happen. So I am working on that ahead of time, by not only getting my body strong enough in the correct ways, but also my mind so that I can continuously remind myself as needed that I have done the appropriate strengthening and I am in the appropriate phase of healing to be able to do something like running.
All of this is so much easier said than done. I wanted to use myself as an example, not only because it’s been happening in real time right now, but also to show that even as a physical therapist, I work through the same struggles when it comes to injuries, surgeries, and pain. You are not alone in this journey. And it is SO important to have a physical therapist as part of your support system to get you strong enough physically to get you back to the things you want to do, and mentally to show yourself that you are in fact strong enough physically to get you back to the things you want to do. (NOTE: While PTs can get you back to feeling less anxious, keep in mind that a talk therapist (psychologist, social worker, counselor, etc) can also play a huge role in finding out if there's anything that is keeping you from being able to work through this anxiety and fear!)
Also, note that I said "support system". It is so important to talk to at least a couple of friends or family members that you trust and know you can rely on and not feel "judged" about the fears you are dealing with. If they are aware of it and you can talk through things more and let them know that you are feeling anxious about certain things, it can be helpful in the process of healing through this part of the journey.
As I said, it is a process, and it is a variable process, AND it can be done! If you are living in fear of pain right now, just know that you don’t have to! I can help you through that and I would love to talk to you about what you are dealing with and what you would like to be doing!
If you don’t have a physical therapist to work with yet, this is your sign to get in touch with me today! Email me today at livewithoutlimitspt@gmail.com and give us a follow on Instagram.com!
Thanks for being here!
Dr. Katie
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