Starting Small is Still Starting

Reflections on Rehabilitation

Feel good before you start deciding what to decide.  Otherwise, your decisions will not be good decisions.

Richard Bandler

I have been really lazy recently. There is a gym two doors from our office and not far from home, and yet I have not been making the effort to go and train. Of course, I can make excuses, but it's not excusable. I know better. Somehow, the "pain" associated with going to the gym must have become greater than the perceived pleasure and reward that comes from going. The problem is that without exercise, we decline physically and mentally. It's simply inevitable, but of course, the effects of exercise (or lack of it) are not immediate. We have to look forward to a goal and take the daily steps to get the reward from exercise. This is something we need to do for all our lives.

We have many clients who have experienced a catastrophic injury and are now striving to recover whatever function they can. Recovering from a catastrophic injury means starting a journey that no one (ever) willingly signed up for. Each step forward to recovery, no matter how insignificant it may seem to others, represents progress. Rehabilitation often demands immense determination and patience, as even the simplest functional tasks must be relearned. Acknowledging these small victories along the way is crucial, as they lay the foundation for long-term recovery. Inevitably, for many, complete recovery is not likely, but some will discover that taking the journey is just as important as achieving the goal. We need the goal though to get us to take action.

The path to recovery is rarely linear, with setbacks serving as reminders of the importance of resilience and adaptability. Staying focused on the end goal while celebrating incremental achievements empowers individuals to reclaim their independence and rebuild their lives piece by piece.

Have you heard the expression, "How do you eat an elephant?". The answer is "One small bite at a time". We sometimes get distracted by the size of task, and our ability to achieve progress seems daunting. The effort we can make seems futile against the size of the task.

One tiny act, though, is infinitely more than zero. The hardest part isn't the physical therapy—it's overcoming the idea that your first steps toward recovery need to be impressive.

They don't. They just need to happen.

You dont need to walk on water to make progress. Take little steps to make progress

A five-minute session of gentle stretching won't restore full mobility. One attempt at standing won't get you walking again. One day of exercise won't heal your body. But small movements, repeated relentlessly, compound into remarkable progress.

If you're waiting for the perfect moment when the pain subsides completely or when you feel completely ready, stop. Your body will never feel perfectly prepared. Start healing anyway. One finger flexion is infinitely more than a static hand. One assisted step is infinitely more than staying in bed. Not long from now, you won't remember how small your first movement was. You'll just be grateful you began.

Many people hesitate because they're frustrated by how far they've fallen from their previous capabilities. But the truth is, your body doesn't care where you used to be. As your physical therapist will tell you, each person's recovery journey is uniquely theirs. You probably wouldn't feel so self-conscious about your progress if you could know how focused other patients are on their own rehabilitation.

The only thing that matters is that you engage with your recovery today - that you, as the Stoic Epictetus wrote, "Don't seek to have events happen as you wish, but wish them to happen as they do happen, and all will be well with you" (Enchiridion, Chapter 8).

Basically we need to quit making excuses. The next movement after the first will be easier. Then the one after that. Eventually, you won't remember what it's like not to be making progress. A year from now, you'll be standing on the foundation of healing you built—while so many others are still waiting for their injuries to magically resolve on their own.

In my past career, I remember seeing our amputee patients sitting outside the hospital limb fitting centre in their wheelchairs with one limb missing and still smoking. Presumably, the immediate pleasure of the cigarette outweighed the less immediate damage to their peripheral circulation.

I suppose, humans can be categorised into two types: those driven to avoid pain and those motivated to seek pleasure. I think most people weigh the immediate consequences of their actions more than the long term consequences. We sometimes need at least a reminder of pain to get us moving. What are you putting off. Let's take some action today.