It is and it isn’t about the Bike.
It’s about reclaiming identity and having goals that seem impossible. .
“It’s been 3 and half years since I’ve been able to ride my bike” my patient told me on our first visit several months ago. . I heard something in her voice, the voice of her inner athlete despite the fact that she struggled to sit for more than 10 minutes on any seat with additional support from the portable cushion (that she took everywhere.)
. We dug deep into “Pain Education”. It was effective in part because we had the time to foster a real understanding. . As she improved in multiple areas including movement, strength and understanding of pain her symptoms decreased. I encouraged her to get back to the gym despite her fear. . I accompanied her on that first trip back. Witnessing how happy the gym environment made her even though she wasn’t doing as much as she used to was emotional. It was almost like she was a different person because she was where she belonged. . We set up a program for her and she continued to get stronger and more resilient which helped her manage her flare-ups. . Then one day I told her I thought it was time for her to get back on her bike. I’m pretty sure she thought I was crazy at the suggestion...at first.
. It started with a few laps around a park that despite her hesitation didn’t cause any pain. A few weeks ago she came in and recounted her story of doing her very favorite ride the past few weekends. Big hills and all. She told me this story with tears but they were happy tears this time. . I asked her to send me a picture of her bike. This picture symbolizes many things for me but mostly…..
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Patients with persistent pain are brave. . Patients with persistent pain CAN improve and return to doing what they love to do.
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They should have goals that might seem lofty and bold. We ALL should
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And.... Graded exposure wears many hats. Find the one that fits best you or your patient.