Among the high-impact leaders I spend my days with, there is one singular epiphany that births the most spectacular businesses, innovations, outcomes, and lives. It is the awareness that in true reality, there are no such things as “problems.” There are only evolutionary invitations for us to enter the profound space where something new is created.

My clients often resist this new understanding at first, as it can come in existential conflict with their very framework of reality and even their identity. Achievement-driven leaders are conditioned to define, orient, motivate, and even create their identities around the illusion of problems. “I’m a problem-solver!”—bam, you just mandated a life of finding one problem after another, so you can keep solving them.

I offer them an entirely new way of being that’s just a thought away—one that is just as capable, even more so, of bringing forth amazing things. Here it is:

A relentlessly objective look at the universe, at nature, at reality before the human mind shrouds the fiction of meaning upon it, reveals there are actually no such things as problems. It’s never even true that “something is wrong”—not in original, naked reality. 

When a limb of a redwood withers because another tree has grown near and puts it in shadow, the redwood does not stop everything it’s doing and scream: “Problem! Something wrong!” It does not try to undo or fix the situation. Instead, the redwood simply creates new limbs up higher, closer to the light, and continues to thrive. And as a bonus, the new limbs create a bridge for a hungry family of squirrels to access the redwood’s cones and carry the seeds of the next generation of redwoods all around the forest.

A client of mine put this theory into practice when the pandemic virtually stopped his healthy-meal startup. Instead of seeing this as a problem that needed to be solved, my client looked for paths toward new creation and evolution. He pivoted from a business-to-consumer model (withering limb) to a business-to-government model (new limb), because government agencies suddenly had great demand to feed people whose lives had been disrupted. The company made six times the revenue, and ten times the mission, from the previous normal year.

This metaphor is easy for my clients to understand, but it can be hard for them to integrate it fully into their mindset and alter behaviors accordingly.

I understood why when, in 2022, I opted to amputate my left leg, which had been withering for years from the long-term impact of cancer. I had spent a lot of time and effort working with supremely talented doctors to solve the problem of that leg. But the outcome of all that mental and emotional investment was that I was sequestered in a hospital bed for months with a limb that no longer functioned. Letting go of it wasn’t easy until I chose to follow the advice I’d been giving for years. Only when I chose to let go of that leg, and let go of my determination to solve that problem, could I fully reengage with my life.

Within a week of my amputation, I was back doing my life’s calling, and actually doing it much better and more clearly than I had in years.

When you look out and interrogate the true, natural world, you see that there are no problems in the universe—just moments in which evolution asks for new creation. In fact, the only thing ever taking place in the universe is creation in service to evolution.

We make up everything else.

The Beauty of Perpetual Innovation

Problems are a very recent, illusory construct of the human mind. The mind becomes attached to an outcome, a preference for the way things should be. When reality goes a different way, one that does not exactly match our preference, our mind projects the made-up construct of problem onto that occurrence. The problem then feels like a real thing to us. As a result of buying into all of this, we end up having a negative experience. And because the universe so often goes a different way from our preference for how things should be with respect to jobs, money, relationships, health, family, etc., we delude ourselves into seeing problems everywhere. And that prevents us from seeing the potential for even greater things to emerge. Instead of pursuing creation in service to evolution, we have an enduring and recurring negative experience of life.

Only if the problem is “fixed” (yep, another made-up construct) can we allow ourselves to resume having a good experience—which lasts exactly one second before the universe diverges from our preference in some other way. Problem, fix, repeat. Problem, fix, repeat.

It’s incredibly easy to fall into this pattern after losing a limb. We should have four limbs, enabling us to do certain things in certain ways. Therefore, fixing the problem of limb loss means trying to reconstitute the life we should have—or did have. But what if we step back into reality, pierce the veil of thought that made us perceive a problem, and stop looking for a fix? What if we ask, instead: “If the universe is asking for something new to be created, through me, in service of evolution…what might that be?”

A recent article in the Harvard Business Review examined companies that achieve “perpetual innovation”—that continue innovating after an initial success. One of the surprising examples the author cited was Microsoft, which under new CEO Satya Nadella has changed the company’s posture from “defense to offense.” That’s another way of saying the company pivoted from a fix-the-problem orientation (defend the status quo) to a creation orientation (pursue a new status quo to score new successes).

“This reorientation was accompanied by a strategic shift,” the article noted. “Instead of protecting its assets in a defensive [problem-solving] posture, Microsoft went on offense [creation], ceding big investments in existing tech and looking to jump into emerging opportunities.”

I love the phrase “perpetual innovation.” In nature, where there is no misperception of problems, perpetual innovation is the prime directive. In fact, the natural universe is so maniacal about innovation that it hasn’t repeated itself once in 14 billion years. That’s perpetual innovation. Not even the same snowflake twice—ever. Everything you see is an absolutely new thing. You—yes, you—your form and persona have never existed before and will never exist again, ever. You are simultaneously ordinary and infinitely unique and precious.

You, yourself, are the outcome of, and evidence of, nature’s perpetual innovation. Your existence is the culmination not of nature’s constant problem-solving but of its undaunted, constant creation of the new. You and everything in your life directly refute your mind’s made-up lament that there are problems everywhere.

Anything’s possible when we wipe our perceptual lens free of the fictional smudge of problem and look at every moment as our universe does: “What new is to be created here?” Bucky Fuller said it irrefutably: “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”

Amputees Thrive on New Creation

In my practice as a leadership coach, I have seen “build a new model” in glorious effect again and again among organizational leaders. And as a new amputee, I’m also seeing it manifesting everywhere I look within the limb-loss community.

One example is Cassandra Quave, who required a right below-knee amputation due to congenital factors, then needed follow-up treatment for complications from an antibiotic-resistant infection. This experience gave rise to Quave’s lifelong investigation of plant-based medicinal approaches in cultures around the world. Instead of trying to “fix the problem” of drug-resistant bacteria, Quave saw an opportunity to create an alternative class of medical tools. Her approach may give humanity a new model for battling infection, making the old antibiotics-based model obsolete.

Albert Yu-Min Lin was creating new branches of evolution long before losing his leg in 2016. Renowned as a scientist, innovator, technologist, entrepreneur, and National Geographic Explorer, Lin developed a platform to resolve geographic mysteries by crowd-sourcing vast amounts of satellite imagery. The Engineers for Exploration program he launched at the University of California, San Diego (UCSD), sent hundreds of students into field expeditions around the globe. When an accident forced the amputation of his right leg, Lin alchemized that problem into new creation with UCSD’s Center for Human Frontiers. This interdisciplinary, project-driven research institute promotes an array of revolutionary technologies, including one that can improve access to prosthetic limbs among the world’s 40 million amputees. Fittingly enough, Lin’s middle name, Yu-Min, translates to “citizen of the universe.”

A third amputee who broke free of the problem-solving trap is Erica Cole. She lost her left leg in a car accident while completing a university degree in chemistry, and her new disability left her unable to accept the prestigious job she had been offered as a scientist at Los Alamos National Laboratory. But, inspired by the difficulty in finding jeans to accommodate her prosthesis, Cole made a rapid and profound pivot to become an adaptive clothing entrepreneur. Her startup, No Limbits, is rapidly rising within the industry, fueled in large part by Cole’s successful partnerships with Mark Cuban and Emma Grede on Shark Tank. Instead of dwelling on the losses of her limb and career as problems, Cole instantly recognized the opportunity for new creation, building a thriving business that brings her joy and fills a glaring need for functional, fashionable adaptive clothes.

All three of these individuals acted exactly like the redwoods: When they lost a limb, they chose to create new ones up higher, closer to the light. They chose to not orient around problem-solving, focusing instead on “What is to be created through me now?” All answered the call mightily.

We Can Only Go Forward

I can hear the clamor building, so I will articulate it myself: “I call bullshit, Souder. Limb loss brings real problems. Loss of mobility. Pain management. High healthcare costs. Loss of income. Ruptured relationships…Souder, mental health—are you telling me limb loss doesn’t cause problems?! I call bullshit.”

I hear you.

Back pain, knee pain, shoulder pain, and wrist pain are all common issues for amputees, regardless of which limb or limbs is affected. These parts of the body are often asked to bear extra weight, are required to perform tasks at angles they aren’t intended for, and carry loads they aren’t exactly equipped to carry.

For acquired and congenital amputees, adaptations shouldn’t harm the rest of the body. Overuse injuries are cracks in the amputee’s autonomy—especially as age contributes to loss of strength and flexibility.

Attention to symptoms of overuse needs to start when the amputation occurs or soon after. For congenital amputees, it needs to start during childhood. Self-sufficiency needs to be the goal for both the short-term and long-term.

Laura Clubok, a pediatric occupational therapist, is a congenital amputee and owner of On the Other Hand Therapy in Columbus, Ohio. She is part of a growing group of amputees who advocate for early intervention to prevent overuse injuries in amputees. Laura was born with a left below-wrist difference. She earned her undergraduate degree at Harvard University and her master’s degree in occupational therapy (OT) at the Boston School of Occupational Therapy at Tufts University.

“Instead of adapting you to the world, adapt the world to you,” she tells others with amputations. “I feel strongly about spreading this message as an OT and as a person with a limb difference. It’s on my generation to share this with children and families.”

Laura says occupational therapy approaches are specific to every individual, depending on their amputation, size, gender, activities, and other factors. Overall, she recommends consulting with your doctor and OT to help you carry out these six important steps toward preventing overuse injuries:

1. Set Up Your Medical Care Team: Establish relationships with and lean on your primary care physician, specialists, occupational therapist, and physical therapist. Consider adding add acupuncture, and massage, and chiropractic care.
2. Reduce Fatigue and Manage Pain: Learn how to conserve energy, treat your pain, and simplify your work.
3. Maintain Posture and Exercise Regularly: Aim for flexibility, strength, and symmetry.
4. Adapt Your Home Base: Reduce strain by choosing tools that can help you accomplish essential tasks.
5. Hack the World Around You: Find out what accommodations are available to you, and take advantage of them.
6. Focus on Emotional/Social Awareness: See a therapist to discuss ableist beliefs and body image issues, and join a support group.

For many amputees, especially congenital amputees, overuse injuries hit them in middle age and force them to reduce their activities and build entirely new sets of adaptations. The amputee who has been working at a desk faces carpal tunnel syndrome in their dominant and only hand; surgery to repair it is not a simple option. Amputees who have been physically active need shoulder repairs, a prospect that is much more daunting when it immobilizes their only arm. Hip and knee injuries for unaffected limbs may require surgery, rest, and/or physical therapy, reducing activity and decreasing muscle strength and stamina that can be difficult to regain.

“When I was born many years ago, physical differences were not celebrated,” Clubok says. “I felt uncomfortable when people noticed or drew attention to my hand, but I also wanted to do everything that my ten-fingered peers could. These competing desires created an unbearable bind: wanting to fit in while often standing out.”

Those feelings of insecurity led her to make adaptations in order to be able to do what her peers did and look just as “normal” doing it. She developed a mindset that overachieving and working herself to the point of physical pain would make her feel accepted.

“I am so thankful that I no longer feel and think this way, and I hope that no child or young adult feels this way either,” says Clubok. “Children and young adults with upper limb differences still make exhausting physical and mental compensations in their daily lives to function in a two-handed world. There is too little awareness of how cumulative strain can hurt bodies with asymmetries while they are ‘trying to do it all.’”

Clubok recently relaunched ontheotherhand.org, a website that supports individuals with limb difference, their families, and occupational therapists who have limb differences themselves.

“There are too many things that families raising children with upper limb differences—and the children themselves—still have to figure out on their own,” she says. “And there still are too many mainstream messages pushing children with differences to be superhuman overachievers.”

Clubok has also formed a practitioner group for occupational therapists with upper-limb differences with Amber Jenkins, assistant professor and doctoral capstone coordinator in the department of occupational therapy and health science at Rockhurst University in Kansas City. Jenkins was born with Poland Syndrome, which included a right-hand difference. The group’s members have a variety of upper-limb differences and are either occupational therapy practitioners or occupational therapy graduate students in master’s degree and clinical doctorate programs.

Clubok’s connection with other amputees on the Lucky Fin Project’s online support group for adults changed her trajectory by giving her the opportunity to talk with others about the physical and mental compensations she made as a child hoping to fit in.

“Meeting other adults like me over the past few years—people with beautiful souls who happen to have differences like mine—has profoundly changed my life,” she says. “I no longer see bodies like mine as defective or deficient, just different.”

Establishing an exercise routine is difficult whether or not you have a disability. Time, money, motivation, and confidence can pose hurdles for almost everyone. But additional obstacles confront people with limb difference and other disabilities. And that is unfortunate, because it’s especially important for us to stay active. Exercise can reduce social isolation, depression, pain, and other problems that amputees commonly face. So even though we face high barriers to fitness, we have a strong imperative to try to overcome them.

Here are the five biggest obstacles to physical fitness I’ve faced as an amputee—and how I got past them.

1. Setting realistic fitness goals

At a time when there are new approaches to fitness being promoted every day, navigating the resources to get started can appear daunting. As a starting point, I trust the CDC’s recommendations for adults with physical disabilities or chronic conditions: 150 minutes of moderate-intense aerobic physical activity each week, with two days a week of muscle-strengthening activities. Aerobic physical activities include walking, wheelchair rolling, biking, running, and swimming, among others.

Start with a realistic goal: Try to walk one mile several days a week. You can build this into your daily routine, so it’s not an extra time burden. Log the mile while walking your pet, catching up with a friend, running an errand, or just getting a dose of fresh air and sunshine. When I want to get a cup of coffee in town, I ride the bus in and walk the mile home.

If you’re traveling by wheelchair or bicycle, pick a distance that feels right. Or turn the walk into a jog or a run, if that’s what you prefer. The point is to make the time to move on a regular basis — and to strike a balance that doesn’t leave you exhausted.

If, like me, you love to swim for exercise, try an online search for local community pools that offer pool passes. I take advantage of the pool hours at my local YMCA. There are often options for private/group swim lessons or club practices.

2. Feeling self-conscious about your body

One major concern that held me back from pursuing physical fitness was poor body confidence. As a higher above-knee amputee, I walked with a limp, felt unsure of my strengths and weaknesses, and was intimidated by fitness spaces and workout culture. I did not know how to adapt my body to exercise.

I could have continued holding myself back out of fear—fear that I would look silly in any workout, fear that I would not be able to adapt to workout equipment, fear that I would embarrass myself at sports clinics. But who was left behind in the end? Only me. The only person responsible for reaching my fitness goals was me. Consider this: No one is thinking about your body as much as you are. And your body is only going to do what you challenge it to do.

I follow the social media accounts of various people who compete in adaptive sports, and I’ve always been impressed by their ability to keep showing up to competitions and pushing their bodies to new capacities. I knew I could never match their athletic ability, but I could match their persistence and keep showing up—at the pool, at the climbing gym, at the fitness center, or at the park with my running leg. I gradually moved further outside my comfort zone, gaining more confidence in my body as I discovered what it was capable of. I learned to love that process. I even started to feel proud of my body.

You don’t need confidence to show up. Show up first, to whatever fitness opportunity excites you. The confidence will come later.

3. Lacking motivation to maintain a workout schedule 

Growing up, I didn’t want to dedicate a lot of time to athletic training and competition, but I still wanted to be physically active. Sound familiar? But you don’t have to be training for a marathon or an Ironman triathlon to find motivation; you don’t need to have a coach or a nutrition team. Just start with one reasonable fitness goal that excites you, and compete against yourself. That becomes your motivation.

For me, I wanted to challenge myself to run and swim several times a week. I had to do it near home, at times that fit into my work schedule. It couldn’t be a major priority for me. But I could still take it seriously. I did that by attending Challenged Athletes Foundation running clinics and incorporating their tips and feedback into my at local park. I did the same with my swimming.

Finding recreational athletic groups that meet consistently can also be helpful for sustaining your motivation. When I became interested in rock climbing, I joined the Adaptive Climbing Group. The group gathered at the same location at the same time, every week; that schedule held me accountable. Consistency doesn’t need to be a strict daily regimen. You can focus on manageable weekly routines. (And having friends that check-in on those helps, too!)

4. Getting the right equipment (and the knowledge to use it) 

For a long time, I avoided working out because I wasn’t sure what equipment I needed or how to use it. Eventually I reached out to my local recreation center and set up a consultation with one of the personal trainers. She showed me how to use dumbbells and resistance bands, and we created sets of exercises and stretches that I could do on my own. I purchased the bands so I could use them at home, and I visited the gym for access to the dumbbells.

If you are interested in learning more about how to use gym equipment with your disability, I recommend having a conversation with one of your local gym’s staff members. Even if you do not plan to pursue personal training sessions, a one-time meeting allows you to learn how to safely use treadmills, rowing machines and other equipment on your own. Alternatively, you can ask for lessons from friends who are comfortable with gym equipment.

For some fitness pursuits, regular workout gear won’t work for amputees. But various organizations provide grants to help you obtaining the technology you need to run, bike, ski, or participate in wheelchair sports. I received Challenged Athletes Foundation grants to get my first running leg and bike, and there are many other opportunities out there. Start with Amplitude’s Community Resource Directory, which lists more than a dozen organizations that help amputees acquire sports-related prosthetic technology.

5. Dealing with pain and discomfort 

Workouts push our bodies into uncomfortable territory. We are exercising different muscle groups that aren’t used to working as hard, so it is common to feel sore. But workouts should not be painful. So if your workout habits are causing you pain, it is important to speak to your prosthetist, so they can check the fit and alignment of your prosthesis to ensure it’s meeting your needs. It might be that some portions of your workout are easier to do without your prosthesis.

Similarly, you might find certain seated or standing positions to be uncomfortable during a workout. If so, work with your prosthetist or PT to find adaptations that allow you to push your body with more ease. I have adjusted parts of my workouts to be completed while sitting, as opposed to standing, to put less pressure on my knee and lower back.

If you make adjustments but continue to experience pain during workouts, you should consult your physician. They can determine if you have acquired any injuries that need to be treated.

Alexandra Capellini is a resident physician at the University of Michigan Hospital in Ann Arbor.