I’ve been living with pain for a long time now. I guess it was about six or seven years ago that it started: a persistent ache deep in my left shoulder that, at its worst, spread from my upper arm to deep down within my shoulder blade. I’ve spent the last half-dozen years trying to figure out what to do about it, and during that time, the pain has evolved. At various times, I’ve experienced tight, burning or gnarled sensations running along specific muscles, to the point where I’d have to limit my activity or just live in constant discomfort for long stretches at a time. There’ve been times it’s gotten so bad that I’d envision myself tearing off my armthe way a hungry, impatient kid might rip a drumstick from a chickenas the only way to get some relief.
I’ve paid visits to, oh, nearly a dozen different health care providers and healers of all kinds, and each had a pretty good idea they could fix me. But after all the consultations, the adjustments, the X-rays, the MRIs, the massage therapy, the physical therapy and everything elsenot to mention the billsmy upper body only started feeling better a few months ago. It’s been a curious experience, to spend that much time trying to cure something so seemingly simple. Each time I’d get a recommendation or referral for a new chiropractor or massage therapist or orthopedist, I’d go in with the bright-eyed certainty that this time they’d figure out the answer to my problems. Looking back, I’m amazed that I didn’t just give up at some point. But that’s the funny thing about pain: As long as it’s there, you keep trying to figure out how to live with itor cast it off.
I don’t think my convoluted odyssey makes me all that special or different from anyone else. There are many people out there in a lot more pain than I am. Hell, if anything, I’m lucky: However bad it gets, the pain has never actually immobilized me. And the process of trying to get better has led to plenty of knowledge about how the body worksspecifically, about how my body works, and how much responsibility I have to bear for that.
At first, I thought it all had to do with swimming. I used to swim laps almost every day, and that’s how the pain started, when I was in the pool. Looking back, I can see that swimming contributed to my problems, but it really comes down to what I do for a living: staring at a computer and typing all day. (This is where I’m figuring someone out there can relate to this story.)
For most of my life, it never even occurred to me that slouching at a desk might not be so good for me. And it didn’t necessarily occur to the orthopedist either, since I’d told him my problem had to do with swimming. That’s simple enough, he suggested; you’ve got a rotator cuff injury. But after weeks and eventually months of physical therapy and daily exercises, I wasn’t getting any better, and I gave up for a while.
Over the next few years, as the pain got worse and shifted around, I bounced back and forth from the orthopedist’s office to a whole string of chiropractors, and nothing ever seemed to help. I tried acupuncture, herbal and mineral supplements, more exercises, taping a magnet to my back, all kinds of stuff. You’d think at some point I would’ve at least found some inner peace or something. Last year, when I visited the orthopedist for the third go-roundor was it the fourth?he was as frustrated as I was. He sent me to get an MRI of my shoulder, which revealed nothing much, and it was at this point he readily admitted there wasn’t anything he could do for me. He referred me to a physical therapist, Susan Underwood, and said she seemed to help a lot of people who couldn’t find relief anywhere else.
If I’ve ever thought of myself as a pessimist, I now know that’s not true. Here I was, politely being shuffled out the orthopedist’s door, sent once more to another specialist, and yet I couldn’t wait to give this woman a call.
Underwood, I learned, works with the Tracy Caulkins Physiotherapy Centers, a company with some dozen locations throughout Tennessee. Anyone who’s been around Nashville for any length of time will recognize Tracy Caulkins’ name: She’s a three-time Olympic gold medalist in swimming who grew up in the area. In the late ’70s and into the ’80s, she dominated the sport, setting an Olympic record in the 200-meter medley in 1984. After that, she retired and eventually married an Australian Olympic swimmera union that would lead her to her current enterprise.
A standard practice in Australia, physiotherapy is different from American physical therapy, taking a broader look at the patient and employing a greater variety of methods. As the Caulkins Centers’ Web site puts it, the idea is “to identify problems of human movement and restore full function through an integrated, clinical reasoning process. This process takes into account a total view of the patient’s condition, treatment and lifestyle.”
That sounds awfully vague, but in practical terms, it means that a physiotherapist sees a problem as stemming not just from a specific area of the bodyi.e., the part that hurtsbut also from how the body as a whole functions. This is an idea I’d already picked up on from a previous practitioner I’d visited, but at the Tracy Caulkins Center, it came together in a way that made perfect sense: The therapists here were able to look at my problem as I described it, examine my body and offer up a set of workable ideas for addressing it. Basically, I’d spent far too much of my life slumped over, which weakened key muscles in my mid- to upper-back, while straining others. Every time I sat at a desk and tried to type, I only made it worse.
The solution? More exercises, of course. As always, these were designed to strengthen the weak parts of my physique that needed stabilizing, the idea being that the stronger I’d get, the less stress I’d be putting on the parts of my body that hurt. For the first time, possibly ever, the exercises have been helping tremendously: Even on a bad daylike right now, when I’m typing for extended periods of timeI can take a minute to run through a few repetitions and feel the difference.
In addition to determining the best possible exercises for their patients, Underwood and her fellow physical therapists Stella Phelps and Leila Aboulhosn offer a variety of therapies designed not just to offer relief, but to get at the underlying causes of a problem. Underwood specializes in craniosacral therapy, which focuses on gently manipulating the membranes and fluids of the brain and spinal cord. The idea is to improve the operation of the central nervous system, which not only registers pain, but also plays a crucial role in the functioning of the entire body. Underwood also works with the fascia, the body’s connective tissuei.e., tendons and ligamentsto encourage smoother, less restricted movement. Taken together, these approaches are designed, she says, “to get the body to identify its own problems.”
The other therapists at the Tracy Caulkins Centers’ Brentwood office, Phelps and Aboulhosn, focus more on manual therapy: working with joints and muscles in an effort to loosen them and release some of the tension. Still more therapies involve the use of electrical stimulation such as ultrasound waves and interferential current to promote healing of tissues and pain relief. Aquatic physiotherapyexercise and treatment in a heated poolis another, key specialty at the Caulkins Centers. (Patients come to Caulkins for all kinds of reasons, it should be noted, from athletic injuries to fibromyalgia.)
There are, in other words, many different ways of getting at one problem, but given how dynamic the human body is, and how intricately it’s tied in with the workings of the brain, they all make sense. More than anything, though, all three of these physical therapists regularly remind me that the greatest responsibility for getting and feeling better lies squarely on my shoulders, so to speak. Maybe that’s something I understood all along: If nothing else, I’ve at least been willing to pursue every possible solution until I could find something that worked for me. And with this latest stop on my frequently pain-ridden journey, I’ve got a deeper understanding of just how much I can do for myselfand what to do when I can’t.
This is something that Underwood especially works to communicate, though she does so as much through her therapeutic work as she does with words. The goal is not just to identify “faulty patterns,” as she puts ite.g., my tendency to slouch and slump. Underwood also strives to attain a nonverbal understanding of a patient’s overall well being, something she does with remarkable skill simply through using her hands and through quiet listening. And in an age when we get shuffled through doctors’ offices with all the care of a customer being hustled through a checkout line, that’s a rare and wonderful thing indeed.
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