מה שהיה היה – מאמר שישי ואחרון בסדרה.

זהו, אנחנו במאמר האחרון בסדרת "הגורמים הבלתי משתנים". הפעם נדבר על נושא שמטריד מטופלים רבים – העבר שלנו.

כשמדברים על העבר יש שני דברים שבמבט ראשון נדמה שמשפיעים על התפקוד הנוכחי שלנו: שימוש ופציעה.

נתחיל בשימוש – סוג אחד של מטופלים נוהג להאשים את השירות בגולני בעובדה שהברכיים שלו "גמורות", סוג אחר של מטופלים חושב שהברכיים "גמורות" דווקא בגלל שלא עשו מספיק ספורט… מי משניהם צודק?
בנושא הזה לעתים אנו חושבים על עצמנו כמו על מכונית. ככל שהקילומטרז' גבוה יותר, הערך יורד. בגוף האדם זה לא ממש עובד ככה..

מחקרים מראים שאנשים שרצים למרחקים ארוכים באופן קבוע אינם מפתחים יותר שחיקה של הסחוס, וגם אם קיימת שחיקה היא אינה מוחמרת על ידי ריצה. אז נניח לשירות בגולני, הוא כנראה לא אשם בכלום…

נעבור לפציעה – בדרך כלל אחרי שבר אנחנו נוטים להשתמש בצורה מופחתת או בזהירות יתירה באבר שהיה פגוע (גם אם עברו כבר כמה שנים טובות). האם זה נכון?

כיום, המדענים יודעים לומר שהבעיה העיקרית עם אבר שנפצע בעבר באופן משמעותי היא – איך המוח שלנו מתייחס לאותו אבר.

קחו למשל שחקני כדורגל. אחת הפציעות הקשות והשכיחות ביותר אצלם היא קרע ברצועה הצולבת הקדמית של הברך (ACL). לרוב הם עוברים ניתוח המשחזר את הרצועה ואחוזי ההצלחה של הניתוח הזה הם אסטרונומיים. כמעט תמיד הניתוח מצליח, גם בגלל שמדובר בספורטאים צעירים עם מוטיבציית שיא לחזור למגרש.

נו, אז הניתוח הצליח. אבל האם הוא עזר? לא ממש. בפועל אחרי פציעה רק פחות מחצי מאלו שעברו ניתוח חוזרים לשחק כמו לפני הפציעה.

מדהים. הרצועה שוחזרה, הברך חזרה לתפקוד מלא, אבל השחקן עולה למגרש והברך כאילו לא נשמעת לו… מסתבר שהחוויה הטראומטית של הפציעה משאירה רושם חזק על המוח, והוא אינו מאפשר לשחקן לתפקד כרגיל. העבר שלהם תוקע אותם למרות שהוא כבר לא רלוונטי.

שוב אנו חוזרים לנקודה שאנחנו לא יכולים לשנות את העבר שלנו, הפציעה הייתה ולא תמחק, ולכן אין לנו טעם להתעסק בה, היא רק מגבילה אותנו מלהתקדם.

היה אצלי לאחרונה מטופל שבגיל צעיר נפצע ממשחק ספורטיבי ונקרעו לו כל הרצועות בקרסול. מאז הארוע עברו 35 שנה (!) שבהם הוא סחב את הפציעה הזו, לאורך השנים כולם הלחיצו אותו והמצב שלו הלך והחמיר עד ששלחו אותו לעשות ניתוח… כל העבודה שלנו יחד התבססה על שחרור מהעבר והתחלה של חזרה לשגרה. ב"ה הוא ביטל את הניתוח והמצב שלו הולך ומשתפר.

גם במקרה של השחקנים – אחרי עבודה קוגנטיבית יסודית, ניתן לחזור ולשחק כרגיל. צריך רק לנסות.

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