"Only in the frictionless vaccuum of a nonexistent abstract world can movement or change occur without that abrasive friction of conflict. --Saul Alinsky

Physical movement saves me. I have no background in a health field of any kind. All I know is that if I run, I feel better for the rest of the day. It has been three years since I have been able to run.

I've substituted non-impact movement found through swimming or on the elliptical machine. After my surgery I've been able to walk again and I've been taking very long walks. These help, but they are not the same. I want to run again.

I keep reminding myself that running is not a lifelong exercise. Thirty years from now my body might not tolerate it anymore. Also, it doesn't help the life of my new hip. My surgeon makes me laugh. Each time I see him, he goes over precautions necessary to heal completely. Then he tells me all the things I need to avoid so the hip will last as long as possible. Then he looks me in the eye and says, "You're young. Live your life. Do the things that make you feel happy. If we have to repair the hip a couple of times before you die, that's better than reducing your activity level to that of a 70- or 80-year-old. You need to be aware that you have a replaced hip but not base your life on that fact."

I plan to follow his advice.

In the years that my movement has been restricted I have experienced a great deal of pessimism about my future. It has also been incredibly difficult to manage PTSD symptoms. Movement is necessary for my emotional well-being.

I have found that I feel the most optimistic and emotionally strong when I utilize both short, intense workouts and longer workouts of more moderate exertion. When I was at my best, I would run in the mornings for 30-45 minutes, then go for a walk in the evening after dinner. The walk was usually about an hour in duration. The combination of the two types of movement helped me sleep better and manage stress problems that cropped up during the day.

I would add three days of strength training each week. This is not for PTSD management, but because I have a condition called benign hypermobility joint syndrome. This condition brings some benefits--I'm extremely flexible and I heal from injuries very quickly. But it also has drawbacks: my joints dislocate very easily and multiple sprains to the ankle and wrist are common. Shoulders and knees are key points of dislocation and poor posture can cause vertebrae displacement if my back is weak. Strengthening all muscle groups keeps my joints in place even when I engage in impact activities.

While I say the strength training is not a focus for PTSD management, it still provides a benefit. The strong muscles allow me to engage in the cardio activities without fear of injury (provided I don't fall down any big, rocky hills). There is also a subconscious belief that if I am strong, no one can hurt me. It's a false belief, but it helps me have the emotional stamina to engage in some social activities I might otherwise avoid.

The problem with using movement for PTSD management is that sometimes (often) I just don't want to do the things I know I need to. Or I'm traveling and I don't have the facilities or equipment necessary for my workout regimen. And sometimes I feel tired.

I used to be so rigid in my physical exercise requirements that I would go running even if I felt terrible. I remember having the stomach flu once, and still taking a 20-minute run (it actually took about 30 minutes because I kept puking). Therapist told me that was extreme and taking health to an unhealthy level. We worked for nearly a year, preparing me emotionally and mentally to allow myself breaks and days of rest. It wasn't easy.

When I injured myself, Therapist thought that would be a good thing. I would have to take time off to rest. Except I didn't. I still ran. The fall had detached the cartilage in my right hip. It should have been terribly painful to walk and run. But the only thing I felt was that something was wrong with my gait and my stamina seemed considerably less. Three miles was the longest I was able to run. My doctore believes I was confusing fatigue with pain. It's not impossible. I have difficulty still, even after years of therapy, understanding how to feel and process physical pain.

So I had surgery to fix the cartilage and I had to stop running. Three years later, I've still not been able to start running again. In August, my physical therapist believes I will be running. We're working towards that now. She's adamant that my muscles be developed enough to support the joints, that my form be absolutely correct, and that I drop at least twenty pounds to reduce the impact before I begin. I'm working like crazy to jump through all her hoops and I'm not taking shortcuts. This is important to me and I don't want to start running, only to be injured again, or find out that it's not something I'll be able to sustain long-term.

In the meantime, I'm marking how my body responds, emotionally, to the different types of physical activity I'm able to do now. Thirty years in the future, I want to have options if running is taken off my list. Elliptical running seems to be fairly effective and I believe (if I'm ever able to become good at it and stop hating it) swimming might also be on that list. Walking is good but I might have to change how I do it--add some fast/slow pacing and more hills.

Someday I want to be able to write about this and feel empowered and courageous. I have PTSD and I'm doing what's necessary to help me have a "normal" life. Right now, though--today--I just feel aggravated that I'm writing about it at all. I don't feel empowered--I feel like a victim of circumstances. And I definitely don't feel courageous--I feel desperate. The last few months, as my movement has been restricted due to the hip replacement, I've endured some difficult emotional CRAP, with no real way to manage what has presented itself. I'm still battle feelings of failure and listlessness, and motivation is far away. I feel defeated before I even begin.

That being said, I'm going to the gym. Just because I feel this way, does not mean I have to buy into it. And when I get home I'll feel better (and if I don't, I'm having cookies for breakfast).