Hidden mobility disabilities are challenging to manage because the limitations they create are variable day to day. To help us understand what we need to manage, keep in mind the three components of disability from the definition given by the World Health Organization:
- Impairment: a problem in body function or structure
- Activity limitation: a difficulty encountered by an individual in executing a task or action
- Participation restriction: a problem experienced by an individual in involvement in life situation
The impairment is a given and, for those with degenerative (joint) conditions, will worsen over time. But the extent to which that impairment limits our activities depends upon the self-care that we exercise. When we experience an activity limitation, we are vulnerable to being restricted in how we can participate in community and social life … unless appropriate accommodation is available.
We cannot control a physical degeneration process or whether or not accommodation is available. What we can control is the self-care that affects how much activity limitation we experience. That self-care takes vigilance and creative!
First we need to be alert to signs that we are beyond, or about to be beyond, our comfort zone. We know from both research and lived experience that, if we push too far or too long beyond our comfort zone, it may take days to recover minimal functioning. So we need to learn the boundaries of our comfort zone, especially because the effects are variable. We can practice good self-care and also help those who care about us if we develop the habit of assessing ourselves each morning and communicating our “score” to others, using this HMD Self-Monitoring Tool.
Here are some common clues that we are pushing ourselves too far:
- Getting easily irritable with friends and family (due to pain)
- Having trouble sleeping because of joint pain
- Not attending parties or open houses where everyone is standing
- Avoiding activities that involve walking or standing
- Postponing shopping until absolutely necessary
Once we are aware of our comfort zone boundaries, we can find ways to avoid pushing ourselves too far, such as:
- Sitting down to rest briefly before having to walk more than a short distance – e.g., inserting a brief period sitting down in between walking around one’s home and walking out to one’s car
- Sitting down to rest briefly before having to stand for more than a brief period – e.g., before taking a shower
- Alternating standing and sitting when doing routine activities – e.g., sitting down part of the time while brushing one’s teeth or brushing one’s hair
- Interrupting pressure on knee and hip joints by leaning for support when having to stand – e.g., leaning against the wall of a shower stall, leaning on the counter at a store