Thursday, January 31, 2013

Heal Thyself: Part Three

In Part One I touched briefly upon disorders, treatments and an admonition to find another way to heal oneself other than traditional treatment.  In part two I talked a bit about movement of the wrists (dorsiflexion, ulnar deviation, radial deviation, etcetera) and the body in whole.  Here I'd like to talk briefly about why some people will never heal.

If an injury is the result of improper movement or from extensive stretching of the tendons, to the point that they have micro tears and consequent layers of scar tissue, the only way to heal is to cease creating micro tears and break up the existing scar tissue.  Imagine if you cut a three inch circular hole in your favorite sweater then without replacing the missing swatch, simply sew up the hole.  The knot that ensues and the stretching and pulling of the fabric is sort of what happens to your muscles when they are hog-tied by scar tissue.

In order to cease creating micro tears one needs to stop moving and bending incorrectly and stop stretching the tendons to the point where the body needs to create scar tissue.  Coaches and physical therapists prescribe stretching to warm up muscles when really, all they are doing is creating micro tears in the muscles and tendons.  The body's response to this minor damage is to rush blood to the damaged site which makes the body feel warm.  The  body is not technically warming up, it is rushing blood to the site to immobilize the tissue:  Nature's cast.  If coaches really want to warm up the body of their athletes they would make them sit in a sauna and give them a massage.  Just ask Olympic trainers.

In order to break up the scar tissue created by over stretching, you need to, well, stretch.  The solution to this conundrum is actually very easy; allow the body to move naturally in its mid-range of motion.  That is why I am a strong opponent to the use of braces because they inhibit the body from moving in its mid range of motion and also forces the wearer to overcompensate by using other unnatural movements on areas of the body which will only strain new joints and new tissue.  This new misuse and overuse will facilitate a downward spiral of repetitive motion disorders.  I have heard many stories where the inital pain started as a twang in the forearm, then a sharp pain, then numbness of the hand, followed by constant pain in the wrist, then elbow and shoulder pain, back pain follows then it become bilateral. Revisit that old song, "The hip bone's connected to the knee bone."

Most injuries occur because the athlete (or musician) had something not in proper alignment in the first place and over or under compensated with another part of the body which wasn't intended to move that way.  Proper movement promotes healing, plain and simple.  Once the body is trained to move properly, scar tissue will begin to break up, inflammation will go down and symptoms will disappear.  The body will begin to work as efficiently as it was designed while it is slowly freed from the tether of scar and pain.

Have you ever been buried in snow or sand to the point where you couldn't move?  Brute force will not free you from the  mass piled upon you.  However, if you gently move up and down, left and right, forward and backward, you will create little air pockets.  As the pockets increase in all directions, not just one, you will eventually obtain enough space where you can use more and employ larger muscles to displace greater mass and eventually break free (unless you are in a ten foot deep avalanche).  The person with over and misused tendons must start out the same way; free to move effortlessly in every direction and expand from there.   After meeting with my practitioner for the first time, during the following week I experienced painless snapping sensations in my forearms.  That was the scar tissue breaking and releasing my tendons as they began to move as nature intended.  I was no longer overstretching but moving just enough to entice the scar to release its hold on my muscles.  Much like the Chinese finger torture we all experimented with as kids.  The harder you try, the harder it is to get free.

Unfortunately, when there is a glimmer of hope, that is where many people give up on their training and begin moving "normally" again.  At that point, the ailment comes back with a vengeance because they are no longer creating micro tears but tearing the whole mass of scar tissue.  Those are the type of people who never heal, much like a yo-yo dieter.  Many people won't even get that far.  Musicians are the worse.  I had one student who dutifully practiced the exercises that I prescribed to him then he practiced other music he was interested in but, without employing the new movements I was unconditionally demanding of him.  He was using his motor memory which was flawed and ingrained in his muscles and brain from the first day he touched a piano, causing his problems of today.  He was in a downward going from one step forward to two steps back.  There was no hope for him to heal and I dropped him as a student after three lessons.  Another woman wanted to heal NOW!  I told her it would be six months of moving ONLY as I instructed her but that prospect was too difficult.  She opted for the quick fix of surgery.  Two years later, her carpal tunnel syndrome reasserted itself and she had a second surgical procedure.  This time following her surgery her fingers no longer responded the same and she no longer plays the organ in church and still has pain.  A third student with the discipline much like I had did nothing but the exercises I prescribed to him and after a few weeks he was pain free.  He continued working with me and very soon he was playing much better than he did before his injury.  His symptoms were gone and he was able to transpose his new found discipline to other parts of his body where he told me his walking, driving, hiking and skiing drastically improved. 

A friend of mine complained most of his life of knee pain.  His physical therapists dutifully treated his knee pain symptoms.  After over twenty years of icing, exercising and resting his knees he saw a new doctor who told him that his knee problems was in his hips.  Because he had a hip problem he unnaturally over compensated each step which put unnatural and misaligned strain on his knees. With very simple sleuthing, the doctor discovered that his hip problem was caused by an old shoulder injury.  The shoulders and hips work together when we walk.  His right shoulder was frozen in tandem with his right hip which caused stress problems in both knees.  The bulk of the damage was in the hip so he had a hip replacement and the knee pain practically disappeared.

The difficulty in trying to help someone to help themselves is that they need to give 100% of their effort and dedication toward the healing process.  Anything less is unacceptable and doomed for failure.  There can be no deviation from the course.   With the insidious disorder of tendonitis, in the words of Yoda, "There is no try, only do."  There is no option for cheating, no break from dedicated effort, no shortcuts and no going back.  The only way to heal is the hard way - by making movement easy and effortless as the body was designed.  It is really simple.  But, we flawed humans want it now.

Buddha said "Before enlightenment there is chopping wood and carrying water.  After enlightenment, there is chopping wood and carrying water.  The differences are tremendous but not visible."

-Malcolm Kogut.

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