The athlete to whom I am currently devoting more time to analyzing input, giving feedback, exhaustively reviewing the research literature on is my mother. She is a 93-year-old scientist, former athlete and forever full-time problem-solver and mother.
Her motor issues are complex and involve severe scoliosis and several falls, with different types of sustained injury, some of which became irreversible. Her scoliosis is congenital and according to several excellent orthopedists, the fact that she was functional all her life (except in the past three years) is so rare that they offered no explanation other than she is “extremely strong” – both inside and out. Her falls are a mystery. Our geriatric neurologist, whose Ph.D. was on brain image analysis, has told her again and again: “D. Lila, I am at a loss: there are no other clinical or test indicators, there is no time or trigger pattern and all we know is that there is a coincidence of you losing very little time and falling. We don’t even know which comes first.”
Lots of people failed her. Her father was probably the first, forbidding her to become a competitive swimmer because, according to him, “this is for whores”. The list is long but by the mid-1990s, a physical therapist obsessively insisted in engaging her in Global Postural Reeducation. She was around her 70s. I remember her telling me she felt uncomfortable. After the (very well paid) sessions, my mother developed a devastating and fast arthrosis of the right femur head. Her pain levels were extremely high and the images led the surgeon to attach a prothesis to her femur right away. That’s the third person on the list of significant failures: he failed to let her know that she could never, ever, stop strength training, for the rest of her life.
Her levels of physical activity dropped suddenly and with it, her pain levels increased, her scoliosis evolved fast and her falls started to produce serious injuries.
That’s when I feel I failed her. I was still a full-time researcher at the university and knew nothing about strength training. I’d learn that ten years later, too late for my mother. But I had the same research skills I had today: I was already a senior researcher and principal investigator. My priorities were in the wrong place.
In 2012, her fall resulted in damage to her rotator cuff that caused permanent impairment in certain movements on her right arm combined with the loss of grip strength. From then on I had my friend and great trainer Monica Pimenta (Espaço Funcional ) work with her three times a week. She made miraculous progress.
Her last fall, about three years ago, resulted in the loss of her ability to walk. Things got more complicated.
I have a whole library of published work on spinal nerve impingement. We actually don’t know what’s impinged where anymore. There’s the scoliosis, there are the multiple falls and the images are very hard to interpret.
I do supervise her physical therapy work more or less (emphasis on “less”, given that I live in the USA and she still lives in Brazil).
With a sudden decrease in contractile activity on the large muscle groups, the whole brain-everything-else endocrine cross-talk, mediated by the muscle tissue, was compromised. She is dealing with serious health challenges and new ones on a monthly basis.
My siblings and I work together as a team. My role is to analyze the input from her health exams, from my siblings who live in Brazil and, most of all, from my mother, and offer possible alternatives.
Below is my recent study on pressure ulcers because she is developing one at the coccyx region. The doughnut cushions may alleviate a little but cause two concerning side-effects: with the maintenance of the bodyweight vertical force vector and the new horizontal stretching vectors on the skin around the affected pressure area, in opposite directions, the pressure ulcer may actually be evolving. She feels pain. She also feels more sciatic nerve pain.
So I came up with a varying trunk angle solution with a reclining armchair. It sounds simple but I am having trouble explaining the biomechanical aspects of all this to some of the immediate professionals handling her, who are supposed to have this covered with their four-year-degree. Sadly, as expected, our health professionals are lacking in technical education.
I failed again, but that’s a long story about a project I was developing at the Panamerican Health Organization on the delivery of evidence-based information to front-line health professionals.
Below is a dropbox folder with everything I learned about the evolution, treatment, and physiology of pressure ulcers. There are 28 files in the folder, including several textbooks, manuals and, of course, research articles.
… because my athlete may be movement-impaired but she is still and will always be the most important athlete.
Enjoy
PRESSURE ULCERS
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