I remember one time, I was visiting at my sister’s house. We were only about two to three hours apart at that time. I started driving home, and all of a sudden, my shoulders were stuck. I couldn’t even handle the steering wheel. I pulled over, stopped, and called my sister. She and her husband had to come get me. I literally could not drive.
Such is the life of a person with chronic pain — at least in the beginning.
By this point, I’d had it a few years. But this incident served as a key lesson for anybody with chronic pain syndrome. At my sister’s, I had stretched myself too far. Now I know when I’ve done too much, but at that time I had no idea. My sister and brother-in-law took me back to their house, where I had to stay another day in bed.
This lesson is also one of the most important things for aquatics professionals to remember when working with clients who have chronic pain syndrome. It’s all about how you manage the pain — and you can’t push yourself.
Tough lessons
When I was 38 years old, I had a full hysterectomy. Everything seemed to be going very well, but when I went back to work, I started experiencing a stinging, burning and searing pain at night.
When you’re a workaholic and you own your own business, you sometimes ignore things. But that didn’t last. At night it would get so severe that I would cry and say, “I know something’s wrong, but I don’t know whom to go to.”
My doctors couldn’t diagnose it, so they would give me a pat on the head. It took five years, but one event finally put me in the hospital, and my physician said, “I think we hit it. We know what we’re dealing with.” That’s when I first learned the word fibromyalgia. This was in the early 1990s, when that condition wasn’t recognized by the medical community.
Once I had my diagnosis, it was clear that exercise is a key factor, but you have to know how to use it. A lot of times we’re told by doctors, “You just have to exercise.” But they don’t provide specifics. We also hear, “No pain, no gain.” But when you have chronic pain, that doesn’t work. You have to start at the very beginning and accept that you can’t do what you used to. In fact, you may not be able to do certain things that older people can. I was in my late 30s, and I had people in their 70s and 80s doing more than what I could. That’s not easy, especially considering that many people with fibromyalgia are Type A personalities.
Eventually, I came to find out that I am in control, that if I do something that creates pain, it’s on me. So there are days when you say, “I can do this today, but not that.” You have to prioritize things.
Fortunately, I learned how to use water to calm my brain, and then that went through the rest of my body. Once I learned how to do that, and realize I should not push through the resistance and expect to achieve the same level of muscle training and high-power aerobics, I started to see my days improve. You have to use the water in a very soft, gentle way and focus on diaphragmatic breathing.
I had already established a career in aquatics. In 1972, my husband Mick and I had built an aquatics center. I love to help people and solve problems. I wasn’t going to let this get me down, so I used the exercise plan that I created for myself to help many of our members who didn’t even know that others had the same thing.
I found that I felt better when I was in the water, so I knew other people could benefit from that. Usually, you can see the pain in your clients’ eyes. But once we got them in the water, it just dripped off of them. They figured out that they can move in the water, and the benefits will last a certain number of days. Then they can get back in the water again. So water became their medicine.
Gradual progress
When you’re in chronic pain on a scale from one to eight, it can go up and down and up and down. So you start guarding your body. When you’re guarded, your muscles contract and you are not very flexible, so you walk like a robot. That adds to the problem.
So this group needs to understand that their aquatic therapy takes place in a slow progression, and that they should not compare themselves to others. I’d tell them, “You need to only focus on how you feel, not your neighbors.”
I developed a progression that began with very gentle water walking, then moved into the aerobic piece. We have to work on increasing range of motion and muscle strength, but we can’t do it all at once.
These clients usually begin with one-on-one sessions. I know that I was very private about what I was going through, and many others don’t really want to share that with too many others. So being the professional, you have to pull that information out so you can give them what they need. Some clients will prefer the camaraderie of being in a group with similar conditions, if you can offer that. But group classes usually come later.
When working with this special population, aquatics professionals should learn as much as they can about chronic pain and its effects. I’m part of a group, called Wavemakers, which provides mentorship and training to help instructors and coaches understand different diagnoses and how to progress with them.
You also should find out all you can about the client, to become familiar with their limitations and which boundaries not to cross. We talk about what’s going on in their life, and we get into the positives – what are their goals?
We also explain the properties of water, so they learn how it can either flare you up or calm you down, and how they can expect to progress.
Probably the most important thing, when working with this population, is to have empathy. Chronic pain sufferers have a gut feeling for who understands them and who doesn’t. We want somebody who’s going to understand us and not push us over the limit, but who also has enough knowledge to help us progress and see benefits.
We don’t necessarily want sympathy, but we do want understanding.
