Thriving After a Stroke

client: Gary | personal trainer: Tracy Markley, owner, Tracy's Personal Training | location: Florence, Oregon

Surviving a stroke. In May 2014, 65-yearold Gary had a stroke so severe his doctors were skeptical he'd survive it. Fortunately they were wrong, but he suffered so much damage that physical therapists were initially convinced he'd be wheelchair-bound for life. Another physical therapist was able to get him strong enough to use a walker, but thought that this would be the extent of Gary's improvement.

Dissatisfied with that evaluation, Gary's sister drove him to a local gym the following November. She hoped a personal trainer could pick up where the PT left off. Gary waited in the car while his sister went inside—he believed gyms were for ego-driven people looking to build muscles. She returned with two business cards, and he reluctantly agreed to meet with one of the trainers.

"I remember that day and moment so perfectly," recalls personal trainer Tracy Markley of her first encounter with Gary. "He was using his walker and moving toward me with his sister, brother-in-law and two neighbors. It was so touching."

Markley knew immediately that she would do everything in her power to help Gary regain his physical independence. "In my 20-plus years in the fitness industry, I had never worked with a client in such a fragile state."

Understanding the challenge. Markley says that when she met Gary, he had a laundry list of limitations. "He had a rotator cuff injury, a brace on his leg and foot, and weakness and numbness throughout the right side of his body," she says. "He could not walk, sit or stand normally" and, despite his best efforts, he had very little ability to control his movements. "He often said it felt like he was a stranger in his own body."

Markley knew that her mission was to help Gary regain the mind-body connection. One of her first steps was to assess his control—or lack of it, She had him sit on a stability ball, flanked by herself and Gary's neighbor, who assisted during the session. If either one had let go of him, she recalls, Gary would have slid onto the floor. "This helped me understand his challenge," she explains. The trainer knew she had her work cut out for her.

Focusing on movement. Markley believes whole-body stabilization is rooted in the pelvis, so she targeted this area first. "I had him sit upright with a Bender Ball™ between his knees, and I coached him on how to connect and engage the pelvic floor and abdominal muscles."

An emphasis on extreme focus, she explains, is essential to helping stroke survivors regain physical control; they have to concentrate to perform even the simplest movements that most people take for granted.

The next step was to improve neuromuscular awareness while standing. When she believed Gary was capable, she asked him to stand on a balance disk while she assisted. Eventually, he progressed to standing on top of a BOSU® Balance Trainer and then to stepping up onto it while holding a bar.

Overcoming the Odds. Now, 2 years later, Gary's progress has surprised everyone. He no longer uses his walker and is able to move around the gym comfortably and safely without much hesitation or thought. "Before, Gary would have to stop and make at least a 3-foot turnabout to get turned around," she says. "He is now able to turn around without thinking."

And the progress continues. "Just 2 weeks ago, he sat down in a chair normally. I said, 'Did you just see what you did?' He said, 'No, what?' I explained spatial awareness and how, as a person approaches a chair, the feet turn around and the body knows the distance of the chair and its height in order to sit successfully. He got all of that back."

Markley says these victories only scratch the surface of how far Gary has come. "There are so many amazing gains and moments I've shared with him that I could write 100 pages on the exercises we did and when and why we did them," she says. "He is a walking miracle. Every man in his family who has had a stroke died from it. He really is a miracle."