The psychology of exercise

Posted by Allen Rucker in Life After Paralysis on January 23, 2019 # Health

This blog begins with a lesson to myself that I seem destined to learn over and over again like I had the attention span of a gnat. The lesson – every time I overcome the psychological obstacles to getting up, getting on the street, and wheeling at a hardy pace for thirty minutes or so, I feel instantly better. Better both in terms of bodily strength and flexibility and in mental calmness and confidence. Every time. Without fail. I should be doing it every day but if something else pops up – a meeting, a phone call, a pending work assignment, a household chore – that something always registers as more important than mere exercise. In my Calvinist-indoctrinated brain, exercise isn’t “work.” Work is doing something productive, seemingly more urgent, and usually tied to making money. Exercise is something you get around to when you have the free time to do it. If in college, you’d think of it as an elective, not a required course.

A step back into history: before World War II, the primary method of ensuring that a person with paralysis maintain maximum health and minimum complications was confinement and bed rest. Men paralyzed in the war were kept in hospital beds, often sedated, to conserve their energy and monitor their condition. Once a day they were loaded into wheelchairs and steered out to the veranda for a touch of sunshine and fresh air. Most of the time they just lied there in bed, getting depressed and breeding bedsores, under the watchful eye of a stern but caring nurse.

Then along came a German neurosurgeon named Ludwig Guttman, a Jewish refugee who escaped to England and was asked to open a spinal injury center at the Stokes-Mandeville Hospital outside of London in 1943. He immediately saw that treating a paralyzed patient like he was chronically infirm was both cruel and counterproductive. Over the loud objections of the staff, he got his patients out of bed and outside, where he engaged them in chair-friendly sports like archery and javelin. He’d also take them down to the local pub for a pint. Before long, these helpless, lethargic “cripples” found a reason to get up in the morning, became less anxious or depressed, less passive, and lo and behold, physically and mentally stronger. Soon “Papa” Guttman, as he was known, turned these sports into the first “paraplegic games” in 1948 and by 1952, staged the first international Stokes-Mandeville Games.

This was not only the roots of what became the permanent quadrennial event called the Paralympics. It was the early rumblings of the modern, wholesale social integration of people with paralysis into the world at large. Guttman became knighted by Queen Elizabeth and hailed as the father of enlightened physical rehabilitation.

Sounds so simple, doesn’t it? Go outside, throw a javelin, get a life. That’s how much we chair-users today take for granted our status as generally acceptable human beings in a generally accessible world. We are no longer objects of shame, embarrassment, outward pity, or benign segregation as we were in 1943. We are no longer considered weak and useless, confined to circumscribed, sedentary lives. Most of us can’t even imagine that anyone would ever dismiss us like that. Well, think again. There’s a reason why Franklin Roosevelt was never photographed using crutches or in a wheelchair? If he ever fell or showed a weakness of any kind, his political career would be over.

Exercise. Sports. Athletics. That was the essence of this historic turning point. Not anything as grand as Martin Luther’s “95 Theses” or the Declaration of Independence. Just a headstrong German doctor who conspired to get paralytics outdoors and shooting arrows or down to the tavern for a game of darts. The idea was elementary. The result, profound.

For paralytics, even more than ambulatory, Big-Mac-eating Americans, exercise is central to a healthy existence. It’s not an option. It’s a necessity for every level of well-being and a constant, self-reinforcing reminder that though you sit in a chair all day, every day, you are not an invalid. If you don’t exercise or commit to some other form of physical exertion, you will begin to feel like an invalid, just like those paralyzed patients at Stokes-Mandeville felt like invalids, shut in and ever weaker from inactivity.

Tomorrow morning, as I nestle in bed, not wanting to get up and go wheeling in a light drizzle, I’ll think about old man Guttman and his simple but brilliant insight that the psychological antidote to physical immobility is physical mobility. As the paralyzed actor, Chill Mitchell, once put it succinctly, “Get up and get out!” Even I can remember that.