Paradoxical Shoulder

When I moved into my cottage there was a garage / carport / workshop in the backyard. The roof, a heavy boarded felt roof, was held up with 2 x 2 uprights. For those of you not English, or too young to know inches, that’s 50 x 50 mm lengths of wood, incredible flimsy for the job. The whole thing was leaning so I anchored it to the Laurel hedge, winched it upright and braced it up. Years later in 2015 it was time to replace the uprights and build a decent side to my workshop. I laid a footing and a row of blocks, inserted much stronger wooden posts, built in a window and then came the job of cladding. I used 16 foot lengths of 8 inch feather edge, not too heavy until you have to hold them up with one hand to get the first nail in. The following morning my left shoulder was in agony.

Before

….and After

When I broke my back I also broke my collar bone to which the consultant’s answer was that collar bones mend themselves. The two halves were so overlapped that it was only possible for them to join fibrously and the more active I became the more the two halves moved. Two and a half years after breaking my back I finally persuaded a surgeon to bolt the two halves back together, but the damage was done. Having to use a wheelchair with catastrophic collapse of the core structure of your body is bad enough. Top that with a broken collar bone and you end up with serious weakness and deformation of structure. Amazingly, for nearly 20 years my left shoulder rarely troubled me, until I built my workshop wall.

The body has an incredible capacity to compensate and had locked in the weakness using the outer muscular shell to provide the necessary stability for the use of the arms. The shoulder blades, that should play a substantial part in stabilising the arms, were sunk into the body and floated around playing no functional role and yet I could use my arms for strenuous activity, albeit not in a good way. As we slowly but surely improved the structure of my trunk we opened up the collapsed structure and exposed the weaknesses that had been buried for so long. The alignment of the structure was improved but the connections so weak that all of a sudden I had to be so careful as to how I used my upper body. Nailing up the cladding to the workshop wall was too much for the newly exposed weaknesses.

Since then my shoulder has gone through so many stages. We have worked deeper into the body exposing and strengthening level after level, little by little getting to the core of the problem. Strangely, the more we rebuild the structure the more strength I find to lift my weight and move my body around while at the same time small movements can become difficult. At one point I struggled to lift a dinner fork to my mouth. The shoulder blade is so much better anchored these days and we are now exposing weakness in the connection of the humerus, at the ball and socket, and the upper arm. Although stronger than ever sometimes when sitting still my arm will lock at the shoulder joint and I physically have to lift it with the other hand to free it off. The paradox of improving strength on one hand and difficulty with gentle movement on the other is fascinating, but the great thing is I continue to improve and one day my left shoulder will cease to trouble me.

Sacrum

I had a job to do today to screw a hook on an internal door in my cottage. There is a bench in front of the door which is part of how I move around indoors (see blog post ‘The Heart of the Home’) . I thought maybe I could sit on the bench, but needed to be higher. I could have found something to put on top of the bench to sit on, but with nothing to hand I decided to try doing the job in high kneeling.

High kneeling is a position that has been possible for many years, right from the early days of injury, although it has never been a functional position. I used to have little quality to the trunk in general, even less in the lumbar region, virtually none in the pelvis and a definite disconnection at the lumbar sacral junction. Even sitting used to involve propping my body on top of collapsed pelvic structure, so the more demanding position of high kneeling was nothing but propping myself up. My lifeless pelvis would tilt drastically forwards resulting in severe flexion of the lumbar spine and discomfort in the weakness (disconnection) at the lumbar sacral junction. It would take all my effort with both arms just to hold myself there.

This type of structural weakness, with tilted pelvis and arched back, is common in many people with varying disabilities and is also notable in a significant portion of the able bodied population, to a lesser degree. I caught the news the other day where a disabled child had undergone a miracle operation (so to speak) to enable him to walk for the first time in his life. He was wobbling along using crutches with the arching of his back so severe that it was painful to watch. Having never been on his feet the kid thought it was great, although in reality he had simply swapped one struggle for another that was potentially even harder. It was only the use of crutches that kept him on his feet and the importance of ensuring there is sufficient underlying structure to support the bodily position cannot be over emphasised. It is often the case with disabled people that they attain to positions and actions that are beyond the structural capacity of their bodies; mainly through endeavour to live life, the best they can, but also through a desire to push beyond their boundaries.

My work in bio-mechanics has led me to expand the boundaries, through improving structural capacity, rather than to seek to push beyond them, although I am guilty at times of exceeding those boundaries and screwing the hook on the door, in high kneeling, is one such example. What surprised me this time, though, was the involvement of the sacrum. I’ve never known that feeling before, nor such capability. I wasn’t sure it would work, but found I could use my left elbow, against the door, to hold myself up and still use my left hand to hold the screw, while using the screwdriver with my right. With new structural capacity in the sacrum the right side of my body held well and only the weaker left side wanted to collapse.

I have been improving my body for years and for a long time now the sacrum has played a functional role in sitting. Now for the first time it is strong enough to begin playing a functional role in the more demanding position of high kneeling. I have every reason to believe I will continue to improve, while finding new strengths never ceases to amaze me.

Multi-Layered Creatures

I was logging last Friday. I do love a real fire and, since my Rayburn packed up, logs are my only source of heating this winter. I always have the dilemma, though, of finding the balance between enjoying the vibrant, hard working activity of collecting cutting and splitting logs and going easy on my body. My left shoulder is the weakest link and if I work it too hard it will never come good despite the therapy work I put into it. By the time I finished working I was a little concerned, but then all of a sudden, by Friday evening, my body felt fantastic. Any shoulder aches were gone, I felt solid, trim and mobile. It’s not the first time I’ve had such feeling of physical well being. It wasn’t the result of hard work logging, but a phase in the cycle of wave after wave of development as we build up layer upon layer to reconstruct a depleted, collapsed and damaged body.

To explain I’d like to use the onion analogy. If you cut an onion in half you’ll see it has many layers just as our bodies do. However, if the onion is allowed to rot then the layers become lost and the flesh turns to mush. That’s a way of describing one aspect of a body post spinal injury. You become an amorphous mass lacking structure, divisions, connections and layers. As we work on my body we build volume and attachments. When you get to the point in the cycle of a wave where the wave reaches further up the beach, in the incoming tide, then you have that new found form, strength and articulation to a degree not experienced before, at least not since being able bodied. Then the wave recedes.

The wave has to recede and draw back into the main body in order for the next wave to reach even further up the beach. This is the building of a new layer. That outer experience of increased strength and volume becomes lost as it descends deep into the body to become consolidated into another layer. That new layer improving the foundation upon which the next wave of development is based. I say ‘becomes lost’ as that’s literally how it feels. You’ve worked hard to gain that increase in volume or improved articulation and then all of a sudden it’s gone. Volume can disappear overnight, be it volume at the top of the chest, engulfing the collar bones, disappearing to leave the collar bones protruding again or muscular bulk to the legs disappearing to expose the bone once again. This latest wave of development was characterised by a real trimness to the body and improved pelvic articulation. Another recent wave brought greater strength in the head neck junction giving a wonderful sense of uprightness.

The latest wave is receding now with the seeming return of lacking abdominal quality and awareness of the weakness at the lumbar sacral junction. However, the perceived loss isn’t really a loss at all. You never return to where you’ve been, but instead to a state of increased inner development, greater intrinsic capacity and you know that the next wave will bring even more exiting development. As the tide comes in, wave after wave, and the onion is built up, layer upon layer, the body is transformed from mush to the multi layered creature we truly are. Eventually those feelings of strength, volume, trimness, articulation and uprightness will not leave me and my rehab will be complete.

Chance or Fate

I was friends with a guy called Ziggy who lived in the main house at the Cheshire Home. He was severely disabled with cerebral palsy. One day he was going to have some hyperbaric oxygen treatment at a centre in East Grinstead and I was asked if I would go along to hold his hand in the chamber. The treatment is to breathe oxygen under pressure in a compression chamber, the sort that divers use when they get the bends; the idea being that the oxygen then manages to penetrate parts of the brain normally not accessed, encouraging rejuvenation of damaged tissue. While I was there, the woman running the centre talked me into having a course of treatment myself. I wasn’t that interested, but was intrigued by the Russian gentleman working there and wanted to know what he was up to.

I spent an hour a day for a week sitting in the chamber with only a port hole in the door to see out of. Through that I watched Leonid Blyum, the Russian gentleman, teaching a group of mothers to work upon their young children, all of whom had cerebral palsy. The children were lying on benches with their bodies wedged with towels so they were firmly supported. More towels were then carefully folded and laid on the child one by one in a specific construction. The mother used the palm of her hand to slowly compress this construction, followed by a release of the compression, repeating the motion over and over again. The towels were obviously being used as an air cushion designed in such a way as to deliver a mechanical input into the body.

Every now and then everyone would stop while Leonid gave an explanation. I couldn’t hear what was being said, from inside the chamber, but he used a flip pad to draw diagrams that made sense. I realised he had knowledge that went beyond that of the medical establishment and I knew then that I had to team up with him. None of his clients had spinal injury although all had serious physical disability from neurological conditions. He examined my body, asked me some questions, told me I’d have to find someone to work on me and agreed to take me on.

I’ve always lived life my own way, never been good at being told what to do and never blindly followed anyone. After meeting Leonid I was having a drink with some old mates and told them about the therapy program I was embarking upon. My good friend Wayne, who knows me well, said to me, “Do you mean to tell me you’re going to let someone tell you what to do?” “Yes”, I replied. “I don’t believe you”, was Wayne’s response. There was only so much I understood when I started, but I grasped enough straight away not to be blindly following and I wasn’t so much being told what to do as ‘trusting Leonid to guide me’. That was the start of not only my true rehabilitation, but also a journey of discovery into a higher understanding of health.

In Memory of Ziggy

Without my dear friend Ziggy, who’s sadly no longer with us, I may never have met Leonid Blyum. Was it chance or was it fate fulfilling my destiny?

Years of Practice

Before I broke my back and became disabled ‘for real’ I had a previous accident. At the age of twenty I was knocked off a bicycle, left unconscious in the road and then run over by a car. It nearly tore my right foot off, damaged my left knee and my head and body went underneath the car with what must have been the sump hitting me in the side of the head. That’s three quarters of a ton of metal travelling at speed! The driver never stopped.

Being young, and thinking I was invincible, I soldiered on and threw myself back into life thinking it wouldn’t bother me. For two years I did well, at least well in terms of keeping my spirits up. Physically I tended to overdo things and my ankle, especially, would swell up at times and lock solid. I got back to college after only a term off and the following summer I moved to Wales to work for a year as part of the course I was doing. I had a fantastic year, although coming back to London after the wilds of Wales was a little depressing and physically I was starting to struggle. The reality of living with injury was starting to press home.

I finished the year at college and obtained my degree, but it was tough and I had little desire left to get a job in engineering product design that I was trained for. Manufacturing industry had come to symbolise all that I despised about our industrial civilization. Maybe I should thank the accident for ensuring that I don’t now go to work in a suit and tie and have never become another pawn in the machine. As it was I returned to Dorking, my home town, exhausted both physically and mentally. There was work to do to overcome what had happened to me three years previously.

I never lost my thirst for life and my twenties were good years. Motorcycling with a dog that rode pillion, camping, rafting down rivers and a great deal of partying. They were, however, tough years mentally. If I had spoken to a doctor I would easily have been diagnosed with depression. I drunk a lot and rarely went a day without being stoned. My twenty fifth birthday was one of the lowest days of my life. I arrived at a friends house for dinner, late and a little drunk and I remember saying to him that surviving quarter of a century deserved a month off, and that’s how I felt. It was also a turning point.

I didn’t have the month off. I got back to physio, joined a yoga class, took to walking barefoot and dramatically improved my physical condition. I restored an old lorry, had a go at running a business with it and really began to get my head round life. Three years later, though, I sold my lorry and was labouring to try and pay my way having no real idea where life was going and then fate decided for me. I had an accident with a dumper truck, got crushed underneath it and broke my back.

While I was lying in hospital paralysed from the waist down a friend came to see me and said, “That first accident was just preparing you for this one”. In many ways she was right.