Saturday, November 23, 2013

Heal Thyself; An Ounce of Prevention

ARRGH.  I recently went hiking with a couple of friends and one of the hikers is a high school gym teacher.  I hiked in silent horror as he offered endless advice to his teenage son, daughter and the rest of us  about technical issues and body mechanics.  This man has a Masters in PE and is professionally teaching kids - to harm their bodies. 

The first bit of bad advice he gave was regarding warm ups.  He led our group in unsolicited stretching exercises.   I stood by and watched.  He admonished me to participate saying that if I don't warm up, I will injure myself.  This is true.  However, after getting out of my toasty bed that morning, I sat in my sauna for forty five minutes, took a hot shower, ate a hot breakfast and drove to the mountain base with my car's heat on full blast.  My entire body was warm to the core and raring to go.  But I waited patiently. 

When you stretch muscles, you are tearing tissue so the body has two defensive actions.  The first is to rush blood to the area of damage to begin repair.   This sudden rush of blood gives a feeling of warmth.  You are not really "warming up" the existing tissue (nor the whole body).  You are actually destabilizing isolated parts with micro tears which CAN lead to injury.   It is better to warm the entire body with heat rather than isolating body parts and foolishly think you are warming up by tearing muscle tissue.  The second defensive action of the body is inflammation which leads to the next bit of bad advice.

While hiking, his son sprained his ankle - despite being "warmed up."  Dad, without looking at it immediately told him to "walk it off."  Provided there were no broken bones or torn tendons, walking it off does have some merit. 

If you overuse or injure a body part such as a tendon, the body's response is to do a quick fix by putting scar tissue there.  This however, could lock or freeze up parts which were designed to move.  In the old days doctors would put your body part in a cast, splint or brace.  When the immobilization device was finally removed, the body would be stiff and it would take weeks, months or even years to get full mobility back - if.  Many doctors today favor using simple tape on the injured limb so that the body can still move in its mid range of motion and not to the extreme range of motion where further damage can occur.  A stretch for instance is an extreme range of motion. 

Maintaining gentle mid range movement keeps tendon sheaths lubricated with synovium fluid, prevents scar tissue from forming and tethering a tendon to its sheath and, promotes circulation so that blood can carry away toxins and damaged tissue which are created by our injury or stretch.   Most people can recognize this simple fact after sitting in a car for a long time or resting in the middle of some physical activity.   When they get back up, their body is stiff.  Our circulatory systems are designed to circulate.  Why do you think a "deer longs for flowing streams?"  Flowing water is fresh.  Stagnant water is, well, stagnant.   So, walking it off is good provided there is no serious damage.

Both a friend of mine and myself fell around the same time and both of us injured our right wrists.  Both of us had swelling and bruising.  He wore a brace and I decided to take advantage of the wonderful pain to work on proper body mechanics.  Although my wrist hurt and was tender to the touch, I was still able to play the piano without pain and playing actually made my wrist feel better because I was able to use it and not aggravate it.  Here is a link to a video of me playing a recital just two weeks later.

Flight of the Bumblebee
http://youtu.be/A1FHmgkwi2U 

I admit there were a few problems in my performance but the reason I was still able to play was that I wasn't using my wrist but moving my fingers by using my long flexors and employing the rotation of my forearm.  I am pretty much pain free right now but I still can't dorsiflex but, why would I want to do that to my carpal tunnel?  My friend is still wearing a brace today and has limited mobility and great stiffness.   The difference between us is that I used my body mechanics to promote healing and he is using the stagnation/immobilization method to heal.  I offered some advice but some people won't listen.  He's gobbling down ibuprofen and wearing a brace. 

Back to the hike.  When we returned to the parking lot, our teenager took off his shoe and sock to reveal a purple and swollen ankle: a gorgeous example of nature's cast.   Dad told him that when they got home he could ice it and elevate it.  That's fair.  Treating symptoms can make you feel better but doesn't fix problems.  If your car's tires have uneven wear, getting new tires will treat the symptom but not the problem of the car's alignment.   The first thing this boy needed was an x-ray to ensure there was nothing broken or fractured.   I suggested that the boy put both his feet in a contrast bath and Dad, who has a Masters in PE asked, "What's that?"

If my kid's teacher or coach ever suggested stretching and warm ups in this manner, I'd find a new coach.  Sure I could try to educate them but some egos are too big to admit they are wrong or to change.  That is the beauty of making mistakes but only a few of us can learn from them.  Touch a hot stove and you may never do that again.  Get caught stealing and maybe the shame will make you never do it again.  Sprain your wrist and maybe you will analyze what hurts and what doesn't and you will discover your body's optimal alignment and be better at everything you do - or you can wear a brace and heal in time.

We've all heard the stories of a seeker who ascends a mountain to get an answer from a Zen Master at the top.  When the seeker arrives at the top, finds the Zen Master and asks his question, the Master doesn't answer.  That is because if you don't discover the answer on the journey, you won't understand the answer if it is given to you.  The answer is:  Don't seek the truth - just drop your opinions and the answer will come to you.  A friend of mine is a great songwriter but he is not a musician.  The reason he can come up with beautiful melodies is that his mind is not cluttered with theory, style, propriety or technique. 

Ultimately the newly minted resilience of youth is powerful.  Kids will heal and come back.  But when they turn fifty, and their joints begin to stiffen and become sore, they move and exercise less, they begin to put on weight which stresses the joints further, they develop arthritis and tendonitis, diabetes, clogged arteries and shortness of breath - know that it all started thirty years ago with a stretch and a warm up.  

"When the task is done beforehand, then everything else is easy."
-Zen master Yuan-tong.

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