Core Strength

Foundation. Structure. Function.

As an osteopathic physician, I often counsel my patients that there are external supports that can be utilized when needed, but first line is to see what the body can do on its own. This can be in reference to a bite splint, orthotics, braces, wraps, tape, walking sticks and other implements. One I used often during my residency was a heel lift. For a short leg, a heel lift can be used, but only after mechanics, strength and flexibility are optimized. Patients can find an external support to be inconvenient or unreliable, serve as a crutch and, if not utilized appropriately, allow underlying imbalances to be untreated or ignored. Sometimes it is a reset – allowing the muscles of the body to adapt around a new neutral and can eventually be removed.

Sometimes it supports a temporary situation – for a pregnant patient where asymmetry results from the postural changes of gestation or in a patient with post-traumatic joint degeneration that is eventually treated with joint replacement surgery, the use of the lift is discontinued as the acute leg length discrepancy has resolved. Sometimes it is simply needed. We are not symmetric creatures and, though we have tremendous capacity for compensation, something, or more likely a combination/accumulation of many somethings, pushes the limits and a person simply cannot maintain balance without a bit of extra help.

From a young age, I found myself practicing independence and self-reliance. Making life decisions as they came with minimal counsel. From college and scholarships to medical school and deferment to residency location and modifications. To be clear, I was not alone, but prided myself on managing responsibility on my own.  I have felt strong and capable, confident especially in my physical capacity. Even through knee surgery, that did require assistance in driving and a forced respite from training, there was a finite element that made it seem manageable. Fast forward to June 14 and this all came crashing down when a perceived bought of severe indigestion, after a curious week of severe pain and wondering, turned out to be a significant tear of the deepest, most critical stabilizer of my abdominal muscles.

With the announcement that the only treatment was complete physical rest, I could not fathom the state of incapacitation and lack of independence rendered by this dictum. Given the severity of the pain and the desire to banish it as quickly as possible, I committed to the prescription and surrendered to the process. With grace and kindness, my family, friends and community offered the help I needed and, with the salvation of working through the additional support of an abdominal binder, I crested the 42ndday with much smaller muscle mass but much larger appreciation for the ability to accept help as freely as I might give it.

Best external supports ever!

Embarking cautiously on a rehabilitation program and gradually gaining strength, I began to feel whole again and it seemed I was in the category of “in need of temporary support,” now able to do for myself, shed the binder and resume life as I knew it. All was going swimmingly as I prepared to reenter the pool and dust off my triathlon gear upon my return to The Great Lakes State. I targeted race dates many months off, setting reasonable goals as key motivators on the path back to full fitness. One week ago, on a rainy night that would prove paradoxical to an earlier comment I made regarding the reliable dryness of middlest and littlest, a momming moment of mattress changing illustrated the incomplete healing of my midsection as a familiar, and most unwelcome, searing pain reemerged.

Day of (gentle) first run

In disbelief that after such disciplined recovery and rehabilitation and while feeling so strong, such a simple action could send me back to square one, I was quite literally rocked to my core. Was I really that weak? So vulnerable that I couldn’t handle a simple task of sheet-changing without re-injury?  I was defeated and deflated – overwhelmed by a rush of anxiety that couldn’t be quelled by the release of running. I turned again to friends, family, community and was met readily with encouragement and understanding. I realized that injury was not synonymous with weakness and vulnerability can actually be a marker of strength because only in the acceptance that follows can we truly heal.

Running by the lake = happy place – there again soon!

While my core muscles might be far from perfect, my core values are reinforced and my core people as robust as they come. I will continue to optimize the mechanics of my body, strength of my spirit and flexibility of my mind, but as it turns out, for me support is simply needed, for now, for longer than I’d like to admit and maybe even forever. I am appreciative to have the external resources and will provide them for others with a more gracious spirit when called upon. Function. Structure. Foundation.

May we embrace our own needs as we seek to help others and trust that we truly are stronger together.





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