As PT's, we tend to have phrases that become our default -- "universal truths", if you will, that we find ourselves saying over and over again regardless of the condition because we believe them to hold common value no matter what. As I have learned more about the world of social physics and how humans really learn and change behaviors and beliefs, I have learned these collective phrases are often referred to as "the narrative". I have also learned just how powerful the consistency of these narratives that we are surrounded by really is. In fact, in times of doubt, question, and uncertainty, we will almost always default back to what the dominant narrative says, regardless of what we think, know, or otherwise believe. If this sounds like a bunch of theoretical mumbo-jumbo, let's walk through my own competing narratives the past few weeks to see how it plays out, and how important controlling the narrative can be in our own lives for recovery and beyond.
If you read my last post, you could probably sense the "competing narrative" that tried to sneak in during the few days following my injury. That ugly narrative was soaked in doubt, worry, and fear. Catastrophizing every little symptom, twinge, "funny feeling", or limitation into signs that things were worse than I thought and obstacles destined to set me back further and further.
With this narrative leaking in, the stress boiling underneath the surface started to show up in my objective measures of recovery (check out the red box in the image to the right...creeping stress scores as measured by a recovery metric called HRV tracked through our CISRS platform the few days following my injury). Whether we realize it or not, the narratives at play in our internal (self-talk) and external (people around us) environment have a POWERFUL impact on our actual internal physiology (as seen above), so much they can actually drive our bodies further away from an optimal recovery state if we allow them. BUT, the cool thing is, when we get these narratives under control, we can leverage them to drive us closer to a state of optimal recovery. So what happened the day just to the right of my peak stress score following injury (on edge of red box)? I talked to an OT colleague Abby McDowell from the gym about my injury and she reassured me I WAS going to get better, to trust the process, to focus on my recovery one step at a time...effectively building up the "good" narrative I know and love that had gotten muted. What about the day indicated by the blue arrow (BIG drop in stress score)? I went to see my buddy Zach Long to get my shoulder evaluated, and he told me my shoulder was strong, it was stable, it was going to get better. He made me do things I was afraid of, and showed me it was fine. The days in between? I had an awesome coach encouraging me daily to keep grinding and keep my head up, as well as a ton of other people in my ear encouraging me, pushing the narrative. And slowly but surely, I could hear that ugly competing narrative getting quieter and quieter and being replaced with the narratives I KNOW to be true. I started to trust the process. I started respectfully poking the edges of pain, treating it for what it IS -- the brain's best-guess as to what will optimize survival (of a tissue or system), which is sometimes right, and sometimes wrong -- instead of treating it for what it ISN'T -- an absolute indicator of tissue status. After all, the brain has ALOT of information impacting this best guess, and sometimes, it's just wrong, and the only way to show it that is to challenge those edges little by little. There are still many instances each day that I hear the ugly narrative rear its little head (cue when I try to put a coffee cup on the top shelf 🤦♀️) , but with every day MY narrative gets stronger and stronger, making it easier and easier to drown out the noise and position my physiology to optimize recovery.
Some people call this mindset, the power of positive thinking, positive expectation, or a million other things. And they are all right. And they work -- as we can see, they LITERALLY change the physiology of our body and it's recovery process (trust me, I'm a nerd and I am tracking this stuff, including how my shoulder pain is more tied to my sleep quality than it is to what I did with it the day before 😳). Whatever label you put on the concept, controlling the narrative is POWERFUL. It has the impact to not only change the trajectory of your recovery, but also the trajectory of your life and the lives of the people around you. So take note of YOUR narrative. What are the phrases you consistently hear, from yourself and the people you spend time with? Are they positive for your recovery/health/personal growth? No? Then you MUST change them. Can't figure out how? Find other people with competing narratives to offer, and use their narratives to help quiet the ugly ones following you around. There is no shame in seeking help shifting your narrative. Even with all the time I have spent studying this stuff, It has taken TONS of input from my colleagues, Pro-Activity partners, family, friends, coaches at the gym, and so on to keep the narrative in check. It's not easy, and it's not exactly a clean swap (ugly narratives are STICKY), but I promise your body will thank you for every step you take in the right direction.
PROGRESS LOG
Day 9 (12/14)
Exercise: 4 way isometrics 3 x :30s, AROM scaption to tolerance
Workout: 2 mile run (first real running, kept the sling on for safety but felt pretty good!), followed by 30 - 20 - 10 Goblet squats, rearfoot elevated split squats, DB push press R arm only
Day 10 (12/15)
Complete rest day
Day 11 (12/16)
Visit with Zach, started me on a new 4 phase exercise program and helped me figure out what things I can do vs. what I should scale for my workouts
Phase 1: Foam roll flexion to lift off / arm bars (love these >>, feels so good to hold some load in that arm!) / Turkish get ups / prone external rotations
Lots of movements added back in to my workout possibilities (YAY😍) ie deadlifts, elevated pushups, strict burpees, planks, loaded carries, ring rows, rowing, front squats to tolerance, etc.
Day 12 (12/17)
Phase 1 rehab exercises
Workout: 20 min EMOM - 1) 40s goblet squats 2) 20s cal assault bike 3) 1 round Durante core 4) 40s cal row
Day 13 (12/18)
Phase 1 rehab exercises
Workout: 10 x 3 tempo pause back squats with wrist straps mimicking safety bar / 3 minute max reps 10 tuck jumps, 20 mountain climbers
Day 14 (12/19)
Phase 1 rehab exercises
Workout: Modified 12 Days of Christmas >>
Day 15 (12/20)
Complete rest day
Day 16 (12/21)
Phase 1 rehab exercises
Workout: 4 x 8 front squats @85# (nudging edges of shoulder pain), smith machines split squats 4 x 12 ea, single leg leg press 4 x fatigue, 1 mile as fast as possible.
Day 17 (12/22)
Phase 1 rehab exercises minus KB work
Workout: 3 mile run, Durante core
Day 18 (12/23)
Phase 1 rehab exercises
Workout: 4 rounds (different cardio each round) 500 m row/400m run/60 second assault bike/60 second assault bike, 20 goblet squats, 10 partial range pushups, 10 ring rows
Day 19 (12/24)
Workout: 4 x 8 ea rearfoot elevated split squats on smith machine, smith machine back squat R arm support only; 3 rounds for time 20 front foot elevated goblet lunges (35# KB), 20 sumo DL's 50# KB, 20 jumping squats; hill sprint repeats as finisher.
Day 20 & 21 (12/25 - 12/26)
Complete rest days/travel