Dear Boss…A neurodivergent’s plight and expression of gratitude

Dear Boss,

There are so many things in my head that I want to say to you but can’t find the words to express them verbally. I’m putting it on paper so you could take your time to read it, digest it and not look at me like I’m just making excuses while I say these things to you. You probably don’t even care but I want to say it anyway.

I want to start with this because it’s the most important one to me. Thank you for hiring me despite knowing about my neurodiversity. It’s not a secret, but it’s not something I disclose to people readily especially at work. You stuck your neck out and hired me through the gross underachievement and resume gaps plastered all over my CV, you managed to see something in me.

It may be just a routine thing for you but it meant the world to me. It’s always been a dream for me to be here and the fact that you were willing to look past that murky layer of flaws made me respect and admire you.

My neurodivergence has always slowed me down, but I have never allowed it to stop me. I have always gotten glowing recommendations from my colleagues and previous bosses because when I feel safe and appreciated, I never hesitate even for a second to give everything 110%. I only ever commit to doing things that I love and trying to be a useful person in doing so. I guess I chose the right job in that regards.

This is where things become complicated because when you hear good things about me and see my enthusiasm, it’s only natural that you would want me to go further. Be better. Achieve more.

You will forget for a second that I was born with a disorder, nay three disorders (ADHD, ASD, dyslexia), that makes learning (and life in general) difficult. You will eventually start feeling that I’m always making excuses and trying to avoid doing things. You might even start thinking I’m pretending being helpless or stupid for attention. You will start becoming disappointed in me.

Yes, I know that despite having these learning disabilities I can function at par with most of my peers. I will look and act no different than the average worker. I have learned throughout the years that turning the volume up on my anxiety allows me to blend in with the crowd. It destroyed my self-confidence and self-worth completely but escaping being called lazy and disinterested made everything worth it.

In fact, I will always be better than your laziest employee. I will never be the worst person you work with for sure, but I will also never be the best and I need you to accept that. I know this sounds so negative but all these years of striving for the impossible just ended in multiple burnouts that set me back years.

 While my colleagues continued moving forward I had to hit the reset button several times and relearn how to walk, run then sprinting to catch up with them only to fall into another burnout and starting all over again.

Even if you see that I have the potential to rule the world, I beg you to abandon that notion. I don’t want to rule the world, or be the best at what I do. I just want to do what I love and be useful to people around me. To not be a burden to anyone.

Yes, I’m condemning myself to a life of mediocrity but such is the nature of my neurodivergence. It’s not only a struggle at work. I struggle with every other aspect of life. While other people take leaves to rest and recuperate, days off only throw me into more chaos.

The strict routine that I set up to scaffold my disability just crumbles to dust when I’m not working. I’m not a workaholic. Work is exhausting physically and mentally. I truly wish I could just rest but days off disrupts the rigid structure I need to survive. Continuing the routine is the lesser evil I have to contend with and I have learnt to accept that.

I struggle with understanding non-verbal and social cues. I grew up compiling data on what facial expression, language and gestures represent what emotion. When people make certain expressions or show body language that doesn’t fit what I had stored in my database, I get confused and easily flustered. Especially if I sense anger or dissatisfaction when I didn’t intend to invoke it.

Talk to me. Be direct. Tell me what you are feeling. Don’t give me looks or silent treatments because it weighs on my conscience. I would rather you call me “stupid” or tell me “no” to my face then leave me wondering. People have called me worse things, I handle insults and rejection better than I handle uncertainties.

I know I need to show initiatives to learn but I find it hard being in places I’m not invited to or assigned to be in. When I have to approach you to learn something I always feel that I’m burdening you with my presence and slowing you down. The guilt is often crushing that I always end up avoiding it in the end. Please don’t mistake that for lacking interest to learn. When you personally tell me to be there at a specific time or place, I feel reassured to some extent that you have enough time and mental capacity to deal with me so I don’t feel so bad.

My brain processes things differently. Not only for cognition but for my senses. I have visual and auditory processing issues which makes me appear careless and disinterested at times. There are certain days where I look but can’t see, hear but can’t listen. Sometimes I will even appear disrespectful but please know that none of that is intentional. I can try to compensate for these to a certain extent but at the end of the day, it will still be impairing. This would not be a disorder if I can hack it completely.

I’m not saying all these to escape work or responsibility. I want to be able to do things everyone else does but at this level, there is little tolerance for incompetence and those who are slow will get swept away by the tide.

I’m telling you this because I need you to be my anchor. So that every time I am swept away, I don’t stray too far from the shore and can try to get back on track and with any luck, move forward. I will be very frustrating to deal with most of the time but you have to trust that I am working just as hard, if not harder, to keep up.

I am confident that with time I will prove to be a valuable person to have around but I just need you to be patient with me and stick around long enough to see it manifest.

Sincerely, Your Minion

It’s More Than Just Being Clumsy: Sensory Based Motor Disorders (Part 2)

Sorry about the detour we took on the last post. I felt that I needed to set the stage for the main point.

As with all my posts, it is always triggered or inspired by something I saw or read. This one was inspired by a video of a non-verbal autism advocate named Payam.

When people talk about Sensory Based Motor Disorder, they usually think of clumsiness, abnormal posturing and repetitive behaviors. Payam brought up something that not many people are aware of, there are many other body functions that rely on your motor system and in his case, speech.

Autism is believed to be a problem in connectivity between different regions of the brain. The poor connectivity then manifests in many ways producing the spectrum of sensory, motor cognitive and emotional symptoms seen in ASD.

For Payam, he has so much he wants to say but can’t get it out of his brain into the motor movements required to speak. When people see him and other non-verbal Autistics, it is immediately assumed that they do not have the intelligence to produce speech. Just listen to his words in this video and you will see that he is far from having a low IQ. His vocabulary could put many native English speakers to shame.

If not for aids and accommodations provided for him, he would not have been able to thrive and live to his fullest potential. People would assume that he was intellectually impaired when being measured with standards set for neurotypicals.

I’d also like to link the lecture that introduced me to Payam. It was a lecture given by Dr Clarissa C. Kripke about Autism and Sensory Movement Difference.

 She mentioned that we need to stop seeing Autism as behavioral problems and start thinking of it as neurological. When we see it as behavioral, we focus on trying to change the response rather than creating accommodations to the deficit that minimizes the distress and anxiety associated with it, enabling the Autistic person to thrive.

This is one of the reasons why most Autism advocates reject the widely used ABA program as it aims to teach people with Autism to overcome their traits by punishing it rather than accepting it as something that cannot be changed, but can be managed.

The traditional understanding of Autism needs to change. New research has uncovered so much but the understanding of Autism is still lagging behind. People still prefer believing that people with ASD just need to practice and habituate to “overcome” their symptoms instead of accepting that accommodations go a long way to help make life more bearable.

It’s More Than Just Being Clumsy: Sensory Based Motor Disorder (Part 1)

When I received my ADHD diagnosis, so many questions were answered. Things that I found difficult could now be explained with symptoms rather than just “being lazy” or “unbothered”. While my ADHD diagnosis explained many of my struggles, some remained unaccounted for.

I noticed that I have difficulties telling my body what to do. How to move, when to breathe. I used to think that it was because I was a sedentary kid who didn’t exercise and the lack of “practice to move” my body made it difficult.

In elementary school, I forced myself, against my natural tendencies, to join dance performances and even joined my school’s hockey team. Months and months of practice went by and my body still moved the way it always does. I endured being made fun of because of my clumsy movements and lack of grace but pushed forward believing the one thing drilled into my mind by neurotypicals; I could do it if I tried harder and longer.

I remember once, being a hefty 70kg 11 year old, after all the practicing I did, I raced and beat the school track and field representative in a casual run back to class after PE class. Something which shocked everyone seeing that I sucked at pretty much every sport. Too bad I didn’t make the correlation that I may have been better at running than team sports. Until now running remains the only form of exercise I engage in.

Anyway, back to the point. I have always noticed that moving is difficult for me. When I drop something I will have a mini meltdown because I have to bend and pick it up. The drawers and cupboards in my house all remain open because I dislike the extra movements I need to open them. All my shoes are slip-ons and the soles must not slide out when I take them off. I hate going to places that require me to temporarily take off my shoes or jacket or leave my bag somewhere before entering, because even simple movements like that are difficult.

Anyone who hears this will have a hard time believing I’m not just being lazy and making excuses.

After my ADHD diagnosis, I tried searching around for links between motor difficulties and ADHD. Are there any and what kind. I found many journals talking about clumsiness and increased muscle tone but what piqued my interest were not the journals itself, but the reference list which all had some references borrowed from studies about motor dysfunctions in Autism Spectrum Disorder(ASD)!

Reading further, I discovered something called Sensory Based Motor Disorders(SBMD) which are common, and part of the diagnostic criteria of ASD. At that time, with my outdated perception that an autism diagnosis could not possibly have been missed in childhood, I didn’t think much of it. Despite relating to so many of the criteria, I continued on researching motor issues in ADHD.

One day I stumbled upon a lecture by Prof. Tony Atwood about missed diagnosis of autism in people who learn to mask and my mind was blown. If ADHD explained so many things, ASD explained EVERYTHING! That was what triggered me down the path to getting an Autism diagnosis and 1 year later, I finally did.

Continues in next post…

Is it ADHD or Just Terrible Personality? Part 4/4: (Probably) Unpopular Opinion

From this series, I have a few things I can conclude. I am of course not an authority on this so the best I can do is try to present what I know and let you decide what you want to believe. To me medicine is a science and while personal experiences help to shape how we view things, it is too anecdotal to be used as fact.

https://www.transformationmarketing.com/different-personality-tests-and-how-they-can-help-your-team/

1) ADHD is not a personality flaw that can be easily changed

So there is no definitive link from the many studies and meta analysis done that can tie ADHD to bad personality traits. It’s easy to draw conclusions based on what little knowledge we have when we do not know how extensively people have researched this.

While temperament cannot be altered, we can change how it affects personality and that means emphasizing early detection and treatment during childhood before the person develops  dysfunctional coping mechanisms and irreversible cognitive errors in adulthood.

If relatives, friends and teachers know that what is happening is something that cannot be changed, it may change how they respond to the child’s traits. Instead of constantly reprimanding or invalidating, they would probably try to assist the child to overcome it.

2) Do not confuse personality traits with ADHD traits

The dangers of being able to easily share knowledge online means there are too many people with superficial knowledge passing off as experts. You can’t do that in medicine. Before a doctor becomes a surgeon or a psychiatrist, they have to go through all the medical specialities in order to make sure while they can diagnose diseases in their field, they do not miss other diagnosis not involving their speciality.

For example if a jittery, anxious person goes to a psychiatrist, they have the knowledge to pick up hyperthyroidism and pheochromocytoma before slapping the patient with an anxiety disorder diagnosis.

So, having knowledge about ADHD alone without knowing the full complexity of anatomy, physiology and psychology doesn’t mean we know more than experts. Fundamental attribution error can cause people to jump to conclusions too easily which is why, as much as the healthcare system is flawed, experience trumps what you read online.

3) Getting Treatment is Not a Weakness

People with ADHD get diagnosed and treated not because they are a little bit quirky or different and cannot fit in. We get treated because these differences cause impairments to our functions much like how high blood pressure can destroy your kidneys.

We don’t tell people with hypertension that they should try yoga and go gluten free. Or that taking antihypertensive medications equals taking the easy way out.

Like I said, ADHD is not a personality trait. It is an innate neurobiological deficit that cannot be easily altered especially when late diagnosed. Trying harder is doable but logically, not sustainable long term.

Is it ADHD or Just Terrible Personality? Part 3/4: The Five Factor model

https://blog.adioma.com/5-personality-traits-infographic/

The Five Factor Model (FFM) or the Big 5 Personality traits is a group of traits that were classified to broadly describe the differences in character of all humans. It was started by Sir Francis Galton in 1886 when he tried to create a sort of database of terms to describe human characteristics gathered from self description and reports by others. The collection was refined over the years by grouping them into categories describing similar aspects of the characteristics.

Over the span of many years the lexicon was whittled down to 5 broad categories which is now what we know as the FFM we know now.

The mnemonic OCEAN is commonly used to remember the FFM:

Openness to experience

People with high traits are usually described as creative people who are always curious and adventurous. The opposite spectrum is where people tend to prefer being conscious and consistent.

Conscientiousness

People who are highly consciencious are usually efficient and organized with the other end being impulsive or careless.

Extraversion

High traits are those who are outgoing and preferring company of others. The other end are those who are more reserved and prefer solitude

Agreeableness

People who have high traits are seen as compassionate and easily to get along with. As opposed to those who are highly critical and rigid.

Neuroticism

People with high traits are sensitive and easily anxious where those on the lower end are seen as resillient and adaptable

I’m sure after seeing that you think you can guess which end of the spectrum people with ADHD tend to be on. If I were to guess I would say that people with ADHD score high for openness and neuroticism and low for conscientiousness, agreeableness and extraversion. Boy, did we get the short end of the evolutionary stick or what!?

But as I have said, personal opinions and inferences count for nuts in science, especially medicine. Like every other thing in ADHD, some mad scientist has done a study on it.

Studies actually show that when taking into account ADHD as a whole, it is associated with lower conscientiousness and higher neuroticism. When separated, impulsivity is associated with lower agreeableness and hyperactivity was associated with extraversion. Neither one of these was independently associated with neuroticism, even the inattentive subtypes.

So despite thinking I know everything about ADHD I assumed that I could attribute it to certain personality types, I was wrong. It’s because like many people, I have come to associate ADHD with the personality traits people share of themselves online and as mentioned, personality is influenced by external factors growing up. ADHD traits are not. So the “I do that too, so I must have ADHD” argument is often not a valid one.

Which is why self diagnosis should not be something so easily encouraged if a person has the access or options to proper assessment. Because you need a second person to help remove your personality from your temperament. Of course that is easier said and done but that is again, a topic for another day.

Is it ADHD or Just Terrible Personality? Part 2/4: Personality Vs Temperament

What is personality? (Yes, I did just start my article in the most clichéd way possible LOL).Personality are traits that predict an individuals behavior. It is a set of emotional, behavioral and thinking patterns that evolve from biological and environmental factors. It is shaped early in life and is relatively stable throughout your adulthood.

Personality is often wrongly used interchangeably with the term temperament;  traits that are biological and therefore  relatively uninfluenced by learning, values and attitude. Temperament affects personality but it is something innate and not learned. Meaning it is not something we can change. It’s something we are born with.

http://expressingyourtruth.blogspot.com/2013/07/temperament-personality-mood.html

Temperament is associated with neurobiological differences in the brain and most mental health conditions, ADHD included, are believed to be the extreme spectrum of temperament.

This of course brings up the argument as to where normal ends and pathology begins? In medicine, the answer is simple; if it impairs your daily functions, it’s pathological. Much like blood pressure being  numbers on a bell curve and a pathological BP cut off is decided at the point where it starts destroying your organs.

The reality on the other hand is not so simple. People tend to doubt things that have no concrete proof. If you can’t show me a test or a scan to prove it, you’re just making things up. Especially when it seemingly gives people an excuse for their so called “bad behavior”.

While you can change your personality, you cannot change your temperament. Knowing your temperament however will allow you to develop coping skills and also adjust expectations to avoid developing maladaptive coping skills as you grow older.

This should be a two way street. We can’t expect neurodivergents to change everything about themselves without assistance. We all know how exhausting it is to have to continuously be mindful.

Is it ADHD or Just Terrible Personality? Part 1/4

If you are a late diagnosed ADHD-er I bet you have heard at least one of these comments?

” ADHD doesn’t exist”

“Everyone does that!”

“You can’t use ADHD as an excuse for everything!”

As much as these statements are hurtful, I guess we can’t blame people for thinking that way because our ADHD symptoms and traits cannot be justified by just seeing it as what we do. Instead we need to understand neurobiological basis of why we do it.

If I tell a person that I have ADHD because I’m always late and I always forget birthdays (which, by the way, I am not known for doing out of anxiety. But that’s a story for another day), the natural response will obviously be, everyone does it! In fact, I know many neurotypicals who are more tardy or procrastinate more than me.

Take the example of judging the punishment for crimes. Motive plays  a big part in determining if we perceive the perpetrator as a bad person or a good person who was forced to do something bad for a good reason. We judge a murderer as a monster and a person who murdered another person in self defense as a hero.

The same goes for ADHD symptoms, or any other mental health condition for that matter, you need to dig deep and see the reason behind the symptom. In the case of ADHD, it’s how your neurological difference drives a particular trait.

I got the idea for this post after watching this video on YouTube. It was shared to me by a dear friend and fellow ADHDer. Our immediate comment to this video was, “Wait? aren’t those ADHD symptoms?”

So this post is mainly to highlight two things. Why so many people “relate” to ADHD posts and why some people refuse to believe that ADHD is a real impairing disorder but rather consider it a variation of human behavior.

  The reason behind it is that people often have superficial understanding basic human psychology and assume things based on limited personal experiences and assumptions. Little do people know people have studied personality extensively and we know more than you think we know about human behavior.

In psychology, personality has been extensively studied in attempts to understand and how to better ourselves. There are many ways people classify human personality traits. I’m sure everyone has probably done some form of personality tests like the MBTI, Enneagram or many other tests online.

The one I will talk about on this series is The Five Factor model or the Big 5 Personality Traits that is widely studied and has been around since the 1880s. This is going to be a long one so ill break it up and hopefully can make  a point on distinguishing ADHD from bad personality.

ADHD and the “Gifted Child”

Source: https://www.kinbox.com/how-to-raise-a-gifted-child/

Does this sound familiar? When you were a child, you were “mature for your age”. You started doing everything earlier than your siblings and peers of the same age. You would read pages and pages of books and your hobbies were different and beyond your age. As you grew older, the world demanded more and more of you and despite being a relatively “chill” person, you started falling apart. Burnouts, depression and anxiety consumed you and you became nothing more than a memory of your “old self”.

This is the storyline of almost all of the people I know with ADHD diagnosed in adulthood. The burned out child genius. By neurotypical standards, a has been.

Where did we go wrong? What did we do wrong? Did we simply burn out because we bit off more than we could chew? We were so gung ho and now we are paying the price of overdoing things?

That would be the explanation if we didn’t know that we were actually neurodivergent. An explanation so full of self blame and self gaslighting. No wonder we grew up so self conscious and anxious. We didn’t understand that our brains simply worked differently and that judging success by a standard set for neurotypicals would just make us failures

I came across this interesting postulation about executive dysfunction while reading on the neuroanatomical basis for autism. I’ve always been intrigued about the autism spectrum because it was such a vast spectrum that arises from a core pathology. Much like ADHD but more complex.

This paper was meta analysis of previous research into the anatomical basis of people with “high functioning” Autism. Several studies they looked into showed that there is a difference in the developmental pattern of the areas identified to be associated with ASD (autism spectrum). One of the areas involved is the prefrontal cortex which is responsible for the executive dysfunction seen both in ADHD and ASD. Mind you, I’m not saying that ADHD is a subset of ASD but it’s something I find relatable.

The pattern observed is an early brain overgrowth in childhood followed by arrested growth in adolescence and an accelerated decline of function in adulthood. Just reading that made me feel like they were describing my life. But I have to mention again that those are just among many postulations about the neuroanatomical basis of ASD.

The studies analysed showed that the brain of children with ASD were in fact bigger than their typically developing peers. Bigger doesn’t always mean better because the function of the brain is also dependent on the folding, thickness and the neurotransmitters of the brain, so having a bigger brain per se doesn’t make you smarter and having a normal sized brain does not mean that you aren’t neurodivergent.

This is one of the reasons why there is no reliable test to diagnose ASD/ADHD. Your brain scan could come back normal but that in no way reflects its function. It is merely an assessment of structure.

This could also be the reason why so many of us are diagnosed at adulthood because our previous compensatory mechanisms are disrupted by the accelerated decline in function in adulthood. But I’m really going out on a limb here so please don’t take this as gospel. Rather as something interesting to ponder.

This is the link to the article for those interested

https://www.frontiersin.org/articles/10.3389/fnins.2016.00237/full

ADHD and Phineas Gage

This is so funny cause it’s such a coincidence that I got the idea to write this on the eve of the anniversary of the unluckiest day in the life of Phineas Gage; September the 13th.

The year was 1848 (I just had to 🤣). A 25 year old gentleman named Phineas Gage was impaled by a large iron rod through his skull while working on the railway. He miraculously survived the ordeal and was fully “functional” save for his prefrontal cortex which was irreparably damaged. The doctor treating him commented that while he had retained his intellectual faculties, his ability to control his impulses were gone. He was described as being “fitful, irreverant, indulgent and impatient of restraint”.

If you have ADHD and found that the description hit a little too close to home, let me tell you why.

The core pathology of ADHD involves the prefrontal cortex and while our prefrontal cortices are not completely damaged, we are unable to regulate its functions at will. This essentially makes us, just like Phineas Gage, appear like we are people who have no willpower.

What is willpower? ( source: Americal Psychological Association)

• The ability to self effortfully regulate the self
• The ability to ignore short term desires in favour of a long term gain.
• The ability to override an unwanted thought, feeling or impulse

Willpower and the Prefrontal Cortex

The prefrontal cortex is the area of the brain responsible for our executive functions (I have written about this before). It helps us kick start and follow through on a task, holding us back from reacting to every impulse or temptation and reminds us that we need to ignore distractions in order to focus on the bigger picture.

Willpower and Executive Functions

This is where the hot and cold EFs play a role (read here). The cold EFs are the rational part of the brain that reminds you of the goal while the hot EFs are the emotional and impulsive part which reacts to triggers.

When you look at desserts, your hot EFs jump into action telling you to do it. The cold EFs would then remind you that you shouldn’t because you’ve already had a piece of cake earlier. So the two parts of the EF will battle it out to determine the outcome.

Finally get to use my own pics haha

Willpower and ADHD

So where does this leave people with ADHD who have deficits in both hot and cold EFs? It’s a tough one but there are a few things you could try depending on your resources and support.

• Medications to power the prefrontal cortex

Stimulant meds work by increasing dopamine to certain areas of the brain, including the prefrontal cortex. It doesn’t work for everyone but this is one of the options you have to boost the function of these areas

• Outsource the cold EFs to someone else

For those who don’t feel any improvements with meds, try getting help. This of course depends on family/friends support and sometimes money. Find a coach, get a PA, ask a friend or family member to help body double or monitor your progress. If you have poor family support and struggle financially, reach out to the many ADHD communities online. There are many who are willing to help. Especially in body doubling, because it benefits both people. Probably should mention ahead that I don’t like the idea of body doubling so please refrain from asking me…hahaha. Sorry, I like working alone.

• Practice mindfulness

This is also a little difficult especially when you’re burned out and at your wits end but it does help to take a minute to pause before making decisions. Before taking meds I used to be unable to practice this because you really need your cold EFs for this.

Notice that all the “solutions” I offered up there comes with some form of caveat? I’m not being negative but just being realistic. If it was so easy, I’m sure most of you (me included) won’t struggle with our ADHD.

All self help strategies involve heavy use of executive functions that we can’t easily regulate, but there are always ways to hack it. So don’t feel bad if you bought a self help book and failed to practice it. It’s not you. That book was written for neurotypicals and would require some tweaking for it to work for us.

The online ADHD community is full of hacks for people at all levels of resources. Just keep looking for what fits you. It’s out there somewhere.

Do This, Not That

I’ve written about motor disinhibition causing chronic pain in patients with ADHD previously. This article is something I have wanted to share from my own observations and hacks to overcome it. One of the perks of learning human anatomy is that when I have any pain, I am able to pin point which joint or muscle is involved…so I thought. Turns out what I thought was the culprit was actually not the actual culprit.

Upper back and neck pain

When I’m having pain at my upper back and neck, massaging my neck and shoulder would make things worse. Mostly because the masseuse is trying to force my muscles to relax, but my brain won’t let it. Turns out I was targeting the wrong muscles.

According to the article on motor disinhibition, one of the muscles frequently affected are the pectorals and scapula muscles. When you are having neck and upper back pains, try to grab the muscle at your armpit. It’s usually really firm. Try it to compare how its firmness differs on days with or without back pain.

Grab the part that says anterior axillary fold

This is usually part of what is known as a Upper Cross Syndrome

So how to I release it? Usually I use a TENS machine and place the pads at these two areas.

Both sides of course…

If you do not have a TENS machine, what some massage therapists do is they release the trigger points. You can try this with a tennis ball or a foam roller but my muscles were so stiff I usually can’t even get the foam roller to where I need it to be.

Trigger points for pectorals

Trigger point for trapezius

Lower back pain

Lowe back pain is a little tricky. There are many causes but I’ll focus on those caused by pesky random muscle stiffness. For me when my lower back hurts, I will notice that my pelvic bone is tilted anteriorly. Usually you can detect it when you sit on a hard surface and your tailbone is grinding on the floor. Also if you’re having difficulties contracting your lower abdominal muscle or keeping your body “tall”.

Neutral pelvis Vs Anterior Tilt

The culprit for this, at least in my case, is something called Lower Cross Syndrome. This is caused by weak gluteal and abdominal muscles, coupled with a stiff spinal and hip flexor muscles.

Lower cross syndrome

A friend suggested this diagnosis to me when I started having something called pyriformis syndrome. I used to run everyday but stopped for a year during my second ADHD burnout while being undiagnosed. During that time I was so sedentary and would sit or sleep for long periods and not stretch. Once I got my diagnosis, I started running without properly stretching, causing my pyriformis muscle to be strained because the lil’ guy was compensating for my hip muscle tightness.

After injuring my pyriformis, stretching didn’t work because you can’t stretch an injured muscle. So what I did was use my TENS machine on each of these muscles until I could get my pelvis to tilt posteriorly. Alternatives are of course doing trigger point release using a foam roller or tennis ball at these points. Once my pelvis tilted the proper direction, the pain stopped.

Knee Pain

When I start feeling my patella grinding on my knee joint, it’s a sign that my calves and hamstrings need stretching. Sometimes it’s also due to my plantar fasciitis. For knee pain, you have to remember that your lower limb muscles are like a chain. A problem in any of the links will cause issues. The link starts at your gluteals, down to your hamstrings, calves and plantar fascia. So just try to figure out which ones needs to be released.

This may not work too well if you have arthritis of the knee joint, because the problem is in the joint space. However, making sure that everything is nice and loose will reduce the arthritis pain too!

Should I get a TENS machine?

I would certainly recommend one if you can afford it. Just get a small one with 2-4 electrodes. It’s a little tedious if you need to cover a large area and it requires some patience. The reason I love it is because I noticed that it’s difficult for me to stretch my muscles. It’s like my brain is fighting all attempts I make to do it.

The TENS machine delivers electrical currents that directly stimulates the muscle, bypassing your brain. Hah! Listen to that brain! If you don’t wanna help me, I can do it myself!! Haha..

I can’t say I have a preference as to what model etc but I could talk a little about the one I currently use ( this is not a paid review ya). It’s made by Medisana and costed me about 270 Malaysian ringgit or 70 USD. The good thing is that some of the preset programs makes it feel like someone is giving you a massage. I tried using it once in the dark and got scared because I felt like someone was punching me. Haha.

Its a palm sized device…convenient

Cons would be the small electrodes so I have to spend hours doing one part at a time. Also the electrodes need replacing ever so often. They cost about 25 malaysian ringgit or 6 USD. Also they run on batteries which needs replacement every 2-3 weeks depending on frequency of use.

An ideal device for me would be one with more electrodes and rechargeable.

I would prefer this over massages or foam rolling because it releases tense muscles without having to pummel or knead the effected muscles.

I hope this helps with troubleshooting chronic pain. It’s still a daily struggle because my muscles need no reason to be tense. They just become tense whenever my jerk of a brain feels like making it so. But at least I know how to override my brain and reduce the pain.

Also do remember that pain can originate from joints and nerves also. If it persists for more than 2 weeks or is associated with numbness and weakness, please get an opinion from a doctor or an allied health practitioner like a physiotherapist, chiropractor etc.