Why Standard Rehab Doesn't Work for Everyone (And What to Do Instead)
The problem with 'one-size-fits-all'
When the "Perfect" Program Falls Flat
Picture this: You're in physical therapy, and everyone gets handed the same exercise sheet. Ten arm raises. Five leg lifts. Walk for 15 minutes. Done.
But here's what they don't consider:
You used to be a carpenter who needed grip strength
Someone else was a teacher who stood all day
Another person was a gardener who needed to kneel and reach
And you? You maintained three nursery schools - climbing ladders, moving heavy equipment, working 8-hour days
Yet somehow, we all got the same generic exercises.
That's the one-size-fits-all problem in a nutshell.
My Property Maintenance Reality Check
Before my stroke, I was constantly moving. Ladders, paint buckets, tools - I could carry them all without thinking twice. My job maintaining three nursery schools meant I was physical all day long.
After my stroke, the standard rehab exercises felt useless.
Sure, I could do the arm circles they taught me. But could I carry my toolbox from the van to the job? No.
And then, every afternoon, fatigue hit me like a brick wall. I'd crash so hard I had to sleep. Wherever I was. Moving equipment that used to be effortless now exhausted me completely and quickly.
The problem wasn't that I wasn't getting stronger. The problem was that "stronger" wasn't enough for my real life.
Why Your Stroke is Unlike Anyone Else's
Every stroke is different because every life is different.
Your stroke happened in a specific part of your brain that controlled specific functions you needed for your specific life. The exercises that help a pianist get back to playing might be completely wrong for someone who needs to lift their grandchildren.
Here's what standard rehab often misses:
Your actual daily activities - What do you really need to do?
Your energy patterns - When are you strongest? When do you crash?
Your motivation - What matters most to you?
Your limitations - What's realistic for your situation?
Learning to Listen to Your Body (Not the Protocol)
The biggest lesson I learned? My body knew better than any exercise sheet.
When the therapist said, "Push through the fatigue," my body said, "Rest is not optional." I had to choose: follow the protocol or listen to my body.
I chose my body. And that's when real progress started.
The Spoon Theory Game-Changer
Let me share something that revolutionised how I managed my energy: Spoon Theory.
Imagine you wake up each day with 12 spoons. Each spoon represents one unit of energy. Every activity costs spoons:
Brushing teeth: 1 spoon
Getting dressed: 2 spoons
Making breakfast: 2 spoons
Going to an appointment: 6 spoons
Grocery shopping: 4 spoons
Healthy people wake up with unlimited spoons. Stroke survivors? We get a set number, and when they're gone, they're gone.
This isn't weakness - it's reality. And once I understood this, I stopped feeling guilty about needing rest.
What Actually Works: The Custom Approach
Instead of following someone else's program, I started building my own:
Step 1: Honest Assessment
What do I actually need to do in my daily life?
What's my energy pattern throughout the day?
What movements matter most to me?
Step 2: Real-World Practice
Instead of generic arm exercises, I practised carrying lighter toolboxes
Instead of standard walking, I practised climbing one step at a time
Instead of ignoring fatigue, I planned around it
Step 3: Meaningful Repetition
I didn't just do exercises - I practised activities that mattered to me
Hundreds, even thousands, of repetitions of movements I actually needed
Each practice session focused on something I wanted to get back to
The Five Principles That Actually Work
1. Use It or Lose It. Your brain will stop prioritising pathways you don't use. Keep challenging your affected side, even if it's hard.
2. Consistency Beats Intensity. Better to do 10 minutes every day than 2 hours once a week. Your brain likes predictable patterns.
3. Make It Matter. Practice movements you actually care about. Your brain pays more attention to things that are meaningful to you.
4. Rest Is Part of Recovery. Pushing through exhaustion doesn't make you stronger—it burns you out. Rest when your body says rest.
5. Progress Looks Different for Everyone. Don't compare your recovery to anyone else's. Your stroke, your life, your timeline.
Tools That Actually Help
Forget the shame around adaptive equipment. These tools aren't giving up - they're getting smart:
Button hooks for getting dressed independently
Weighted utensils for steadier eating
Shower chairs for safe bathing
Jar openers for kitchen independence
I resisted these for months out of pride. What a waste of time that was. Use them.
The Bottom Line
Standard rehab programs are starting points, not finish lines.
Your job isn't to fit into their program. Your job is to take what works and throw out what doesn't.
Listen to your body. Respect your limitations. Focus on what matters to you.
And remember—the goal isn't to get back to exactly who you were. The goal is to become the best version of yourself now.
Let’s talk about it,
-- Ian Grindey
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Next up: We'll dive into what I wish I'd known about building a daily routine that actually sticks - the 10-minute secret that changed everything.
