Exercises modified for disability, and who can help me find them
December 17, 2018 11:02 AM   Subscribe

I have a number of physical limitations that make all forms of exercise that I've tried pretty unpleasant. What kind of professional can work with me one-on-one to find alternatives or make modifications that will improve my health and fitness rather than leaving me worse off? If insurance might cover them, better yet, but I might be able to pay out of pocket for something great. Or if you have suggestions based on my snowflakes, I'd love to hear them!

I do not have clear diagnoses, but I certainly have arthritis and asthma, probably have fibromyalgia, and have unexplained joint/ tendon things that mean overuse (in me, this translates to just a tiny bit of use) will often mess them up for weeks or months. Doctors have not been helpful, and physical therapists have given me exercises designed to specifically improve whatever problem I'm there for, but nothing more holistic. (And unfortunately even very gentle PT exercises have exacerbated rather than improved things.) I'd like to work with someone who might be able to help me not be sedentary.

If you're interested in more exact limitations:

Bone spurs in my toes make walking painful. (I ignore this and still walk a good amount; this is my only form of exercise right now.)

My shoulder is messed up with symptoms identical to a rotator cuff tear, but more recently an MRI showed that I do not have a tear. I can't do much with that shoulder in any case; weight training even with light weights and swimming are out because of that.

My hands are arthritic enough that holding something like a racquetball paddle is out.

I used to bike commute every day but my hands can't work hand brakes any more and my wrists take a couple weeks to recover after even short (2 mile) rides. (The wrist issue is true even though my handlebars have always been well above the seat, and I've tried a number of different handlebar configurations.)

Any kind of repetitive motion tends to lead to serious joint pain for at least several weeks.

I have pretty serious exercise induced asthma, despite taking a daily steroid inhaler. This is true even if I use albuterol before exercise.

Essentially all I can think of are water aerobics, which would be expensive and difficult to attend in my area and I think I'd hate it, and going slowly on an elliptical machine, which might work but I know I'd hate it.

I am a 43-year-old woman, if relevant.
posted by metasarah to Health & Fitness (25 answers total) 2 users marked this as a favorite
 
This is nonspecific and a real swimmer should weigh in, but there are a lot of strokes and some might be shoulder-friendly. Laps with a kick board? Breaststroke instead of crawl? Sidestroke?
posted by LizardBreath at 11:10 AM on December 17, 2018


Are you allowed to do water walking in the lap lanes near you? It seems like that could be gentle enough given what you listed
posted by brilliantine at 11:21 AM on December 17, 2018 [3 favorites]


Best answer: I know physical therapists haven't worked before, but I'd be trying one that specialises in rehabilitation (and so are used to treating people with long term issues) and go in with a specific brief of needing regular exercise that works with your body. My brother is one of these and his whole reason for existing is to help people who find it difficult to exercise to not be sedentary.
posted by cholly at 11:44 AM on December 17, 2018 [3 favorites]


My YWCA has a water aerobics program and it's not expensive to join the Y; they do a lot of swimming programs for different goals. It certainly seems like swimming is the only thing that will accommodate your disabilities. Why you think you'd hate it?
posted by MovableBookLady at 11:46 AM on December 17, 2018 [3 favorites]


I swim for fitness, and I'm getting over some shoulder stuff, and I've been doing laps with a kickboard. No gripping required -- I can do it by resting my hands on the kickboard. This does require a lot of hip motion, though.
posted by Sauce Trough at 11:47 AM on December 17, 2018


Best answer: This is firmly in the wheelhouse of an OT, Occupational Therapist. They have sub-specialties.
posted by DarlingBri at 12:06 PM on December 17, 2018 [3 favorites]


If you can cycle but just not brake, have you considered a stationary bike? Or spin class if you prefer group exercise. Most exercise is going to involve repetitive motions though.

When I had a bad shoulder, I found using the float wasn't great but lying on my back and just doing legs worked, you don't get very far very fast but you might enjoy the "weightlessness" of water and a bit of exercise.
posted by missmagenta at 12:17 PM on December 17, 2018 [1 favorite]


A sports medicine physician can evaluate you and refer you to a physical therapist or an occupational therapist who can teach you adaptations. This is exactly what PTs/OTs do. They are all covered by most insurance. Please don't take advice from random people on the Internet who have never seen your body, evaluated your condition, or watched how you exercise.
posted by matildaben at 12:26 PM on December 17, 2018 [2 favorites]


I would meet with a physical therapist to get a plan. There may be exercise machines that would be good for you.

I had 'frozen shoulder' @ 20 years ago from a fall. MRI did not show a tear. Physical therapy did not provide relief; surgery did.

I have many similar symptoms; it looks a lot like rheumatoid arthritis, but I don't have the RA blood factor. I try to eat foods that fight inflammation, reduce sugar, and increase minerals - magnesium has helped - nuts and dried fruits. B12 via red meat at least once a week has helped. And I gave up dairy, which seems to have helped. Can't ride a bike because it hurts my arthritic feet too much, but still swim in summer, am in a dance group, and walk. I also stack and haul wood for the wood stove; weight-bearing exercise is useful. Music really helps me tolerate activity that I might not otherwise do.
posted by theora55 at 12:30 PM on December 17, 2018


Response by poster: Thanks all! Do you have suggestions for finding a PT/OT who focuses on this? (I've been to three different PTs, and they haven't.)

MoveableBookLady, I don't think I'd like it because I generally don't enjoy being in the water, pool chemicals badly irritate my eyes and skin, and my chest feels painfully tight if I'm in the water for more than 15 minutes or so. (And unfortunately a Y membership is over $1000 per year in my area, and water aerobics are only offered at times that I normally work.)
posted by metasarah at 12:44 PM on December 17, 2018


One term that might be helpful in your search is "adaptive" (or "adapted") fitness.
posted by mandolin conspiracy at 12:51 PM on December 17, 2018


I work with a physical trainer who is expert in helping people with chronic injuries work out safely. Would recommend unreservedly - look for that in your area. Mine has a master's degree in exercise science - you want someone with way more than a 6 week certificate in training.
posted by leslies at 1:13 PM on December 17, 2018


I know this is going to sound crazy, but have you considered ice skating? It involves pretty much zero upper body, and the gliding motion is very smooth and non-percussive. If you have a modicum of balance you may never fall. I started at age 50, very out of shape, very overweight, with a bad lower back. I've only fallen a handful of times in 1.5 years. I can see vast improvement in my cardio stamina and I've never hurt my back or my joints. I took an adult beginner class to learn the basics.
posted by BlahLaLa at 1:13 PM on December 17, 2018


Best answer: If you are looking for an exercise program, look for a kinesiologist - they are the ones that have a degree in exercise science and are trained for full-body fitness. Some programs are called "active rehabilitation" and may be covered by insurance.

Pilates is another good alternative. Clinical pilates (1:1 lessons designed for rehabilitation) may be covered by your insurance as a type of physiotherapy. I think this might be a great alternative for you.

Personal training with a trainer that specializes in aquatics will also work. 1:1 training will include things like water walking or running, different motions in deep water, etc. None of the bouncy music or other classmates that make aquatic fitness sometimes problematic. These instructors are harder to find than the professionals listed above.

Chair yoga and adaptive yoga might also work for you. Although regular yoga is troublesome for shoulders and wrists, you should be able to learn a modified program and practice it with some individualized instruction.
posted by crazycanuck at 1:15 PM on December 17, 2018 [2 favorites]


I had an amazing private yoga teacher who was great at adapting yoga to my needs. I started doing an hour of yoga every morning and felt wonderful. Unfortunately, he moved across the country, and I've never found another one who was good at it. But if you want to try looking, google "therapeutic yoga."
posted by FencingGal at 1:15 PM on December 17, 2018


Have you ever tried a recumbent bike? You can always find fantastic deals on them on craigslist, it seems. Check out actual moving bikes and also stationary ones.
posted by the webmistress at 1:25 PM on December 17, 2018


Since they're non-profit, the YMCA usually accommodates low-income issues. They've adjusted my membership price to a rate I myself specified as doable, so it might be worthwhile to ask your local branch for help if you do decide to do something water-based!

Taichi is probably something you could do as well. Lots of slow, controlled movements but nothing too repetitive.
posted by thebots at 1:51 PM on December 17, 2018 [2 favorites]


Any chance mega doses of glucosamine and chondritin might help the joints? It helped my early osteoarthritis.
posted by pseudostrabismus at 2:14 PM on December 17, 2018


Sounds like you need both a better doctor (maybe rheumatologist?) and a better PT-any issues that crop up arising from PT treatment should be treated by that PT along with adapting the underlying exercise that caused it, like, the very next session. It sounds like you've only had experience with either very junior or very specialized physical therapists; lots (most?) of physical therapists see people for an injury who also have chronic health issues/long term injuries to work around.

This may be too expensive or not a thing in your area but have you tried a salt pool? I would imagine that the chlorine is exacerbating your asthma, especially if it irritates your skin/eyes. Also curious if you've tried a low-inflammation diet, or cutting out things that are known to be inflammatory (alcohol, dairy, wheat in some people, etc). This is something that a doctor should be helping you with too though.
posted by love2potato at 2:45 PM on December 17, 2018


Best answer: I've learned recently that there are different types of PTs. There are your usual ones who are trying to make you "better" after an accident or injury, and there are "neuro-PTs", who work with people with more chronic-type of disability. You might search out some neuro PTs and see if they are open to working with you. I'm don't think your disabilities are neurological, but this type of PT may still have the right training for working with you.
posted by hydra77 at 2:46 PM on December 17, 2018 [1 favorite]


I would look for "chair yoga" classes in your community or on YouTube.
posted by loveandhappiness at 2:46 PM on December 17, 2018 [1 favorite]


I know an archery coach who often works with kids with disabilities, because she's a big fan of archery and wants to share her love of it with other people. She isn't someone you'd find by any kind of Google search; I stumbled on her at a time when I needed her. If there's a sport you find interesting, you could contact a local club and see if there's anyone who would like to work with you.
posted by The corpse in the library at 4:37 PM on December 17, 2018


Tai chi can be adapted as well.
posted by oceano at 4:47 PM on December 17, 2018


For your question in finding a therapist that does this sort of thing, I think it will depend on where you are. I'm not sure where you are, but in Australia I'd call a rehab centre/hospital, and find out where they contract their therapists from. The other things to look for would be a practice that advertises that they do orthotic/prosthetic work and/or hydrotherapy - would indicate that they don't just do regular sports treatment. Holistic practices will usually also talk about education on their websites. Then call them and be very clear on what you're looking for and if they can't confidently tell you that's what they do then call the next ones on the list.
posted by cholly at 5:54 PM on December 17, 2018


I came in to echo crazycanuck. Pilates is designed for people with injuries (Joseph Pilates developed his exercise system in part for soldiers injured in WWI, many of whom were bed-bound). Many of the exercise are done lying down, so you're not bearing weight on your feet. I'd start with private sessions, so you can give your instructor a lot of feedback about what doesn't feel good, what seems hard, what you want to work on, etc. The exercises are very very adjustable, so if you speak up, your instructor can make several modifications to help you feel better. Also, it's meant to address the body holistically, so even when you're, say, doing foot exercises, you're also paying attention to how your core is supporting that work.

There are some combination PTs/Pilates teachers out there, so that would be your best bet for potentially getting some insurance reimbursement. But if you can't find one of those, I'd suggest looking around for a teacher who specializes in rehabilitation. My teacher (in NYC) is a former dancer who has had much of his own physical therapy and seems to work with a lot of older folks, and this background (I'm 36, ha) has really helped me as I've suffered a few chronic injuries over the years.

Good luck! You can do this.
posted by CiaoMela at 6:50 AM on December 18, 2018 [1 favorite]


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