Recently, I went in for a movement check-up. Or you could say I returned to physical therapy. I think I would prefer to describe it as performance therapy. I first learned of performance therapy as “an integrated system of rehab, fitness and performance” at a seminar given by Mike Reinold and the team at Champion PT and Performance, here just outside of Boston.
This concept was instrumental in developing my own thinking about the Performance Continuum and I think framing it this way is an important and vital part of the larger discussion we’re having about strength and conditioning for circus.
However, in contemplating sharing some insights from this experience, I arrived at a moment of choice: I could share my insights without adding the very personal notes that shaped the experience (which would feel much more comfortable) or, I could just be honest and share some pretty personal stuff with the internet.
[alert type=”info” close=”false”] As a brief aside, I have friends on the social medias who often share some pretty personal stuff through status updates and such. I admire them a great deal for this because my personal inclination is to be a rather private person (I suppose this rather lengthy bit of sharing counters that notion, but nonetheless). The willingness to be vulnerable (to whatever degree) in front of people is something I have a great deal of respect for. I have long thought that this is a part of the magic of circus, actually: there comes a point for just about everybody, where you encounter the edge of your current physical capabilities and you just can’t really fake your way past that, nor can you hide it. And so, as you work your way towards a new level of physicality, the work along the way is out there, in the open, for all to see. The fantastic thing is that, more often than not, the people around you end up cheering you on.
Of course, I have spent more time in recent years as the facilitator of such experiences rather than as the student…so suffice it to say this makes me nervous. [/alert]
Truth be told, I would love it if I could tell you about how I—just your regular ol’ friendly neighborhood athlete/former trapeze artist—went to see a physical therapist for a checkup to make sure everything was working ok. However, it’s not quite that simple. Or maybe I’m not that simple.
My body—with all of the compensations that come with having an arthritic shoulder—and my mind—with all of the feelings I’ve struggled with since learning about why my shoulder has so little cartilage left—made this anything but a simple movement checkup.
So, what’s going on with you?
My initial assessment with my new physical therapist was about a month ago. I’m excited to share how it went and the insights from the experience since then that have inspired this writing, but before I do, I think some backstory might be useful.
Living in the Boston area, I am incredibly fortunate to have access to the world-class physical therapy team at Champion PT and Performance. When you get on the phone with their scheduler, they ask “So, what’s going on with you?”
My answer was probably not the shortest on record. (My answers rarely are).
My shoulder doesn’t have a healthy crop of cartilage to absorb force and stuff. (The phrase used by my surgeon on my 2013 post-operative report to describe the state of my glenohumeral joint was “end-stage osteoarthritis”).
Prior to that, my restricted range of motion was accompanied by pain and while the surgery improved my ROM, I was still technically deemed a candidate for a complete shoulder replacement.
And here’s where I get real with whoever might be reading this:
From surgery one to surgery two, I was fiercely and consistently determined to get back into flying shape (with occasional moments where the frustratingly slow pace wore me down). I was so obsessed with making sure that I was not only ready to get back on the flying trapeze, but that I would be as strong and mobile and durable and whatever else I needed to be to bulletproof myself against some sort of re-injury.
This, by the way, is why I’m here now: I decided to look into how the world’s top performers and coaches train bodies to be strong and resilient.
I even got myself a coach and put on almost ten pounds of muscle.
But I never got my full range of motion back.
And then surgery two happened. That one came with the news that my shoulder wasn’t really going to ever get ‘better’, because cartilage doesn’t regrow.
The basic advice was ‘don’t get too crazy so that we don’t make the arthritis worse’…
That kind of knocked the wind out of my sails.
After a lifetime of thriving on the challenge of pushing myself, it began to seem to me that pushing was no longer an acceptable strategy because if I accelerated the degeneration of the cartilage in the joint, I would have to get that joint replacement sooner.
It is my current understanding that the hardware in shoulder replacements doesn’t handle loads in excess of 25 lbs. particularly well…which is probably why the educational videos about them only show people playing golf and cross-country skiing.
(Of course, it’s also worth noting that those videos all feature people who are way older than me and who seem to have some very different ideas about what constitutes an active lifestyle. Golf, cross-country skiing and being able to reach the jars on the top shelf in the kitchen are not things that excite me.)
There’s room for a tangent on shoulder replacements and such, but I’m going to leave it for now, because that’s not where I’m heading just yet.
And so, faced with what all of that, I have struggled with figuring out what being active and, more importantly, with what being athletic means to me. After all, I’ve always had a thing that I’m getting stronger for…but looking back, those things have almost always involved my shoulder.
My struggle to figure out a new version of athletic for myself lead to struggling to maintain a level of fitness that I was happy with. Sure, whenever I would see a doctor, they would tell me how fit and strong I am…but their measuring stick is different than mine. I used to be really freaking strong. Now, not so much.
The really honest bit is this: I did enough to maintain a relatively basic level of strength and mobility. But my fundamental stopping block was that after having spent two and a half years working my ass off in rehab only to arrive at a point where the outcome was you can’t push anymore because bone-on-bone hurts and it’s just going to degrade the joint faster, I became afraid to physically push myself. I used to love challenging myself. Flirt with the edges of what feels possible, and after a time, the edge expands. But with the new state of affairs in my shoulder, I felt like I couldn’t flirt with that edge—because that’s where pain happens and because there might not be room for that edge to expand after all.
Now, I must confess that I feel more than a bit embarrassed about calling my experience a “struggle” because I am painfully aware of how many people in the world are worse off. I have so much to be grateful for. It is a tremendously privileged thing to be able to say that this is how I struggled.
There’s also some version of imposter syndrome that plays into this for me, since, as a strength coach/trainer, there’s some expectation (whether it’s real or imagined, it’s almost certainly ridiculous) that I be a super strong badass who can lift all the things and do all the moves.
Injuries suck. Big injuries that impact your physicality when your identity is closely tied to your physicality suck even more.
And by “suck even more”, I mean “can be devastating”.
The physical and emotional aftermath of a big injury can ripple outward and onward for years—long after the injury has “healed”.
This is by no means intended to sound melodramatic, nor is it meant to sound bleak. And I’m sure it’s also possible to go through an injury and all that follows (possible surgery, subsequent physical therapy and then progressive strength and conditioning that leads back to a return to circus) without lingering physical or psychological trauma. I think that whether you have the ability/option of returning to your sport/art in a meaningful way makes a significant difference. There’s obviously so much more to it than just that, and I can now see how the team/community/village you have supporting you along the way is critical.
Nevertheless, in the name of being honest with myself and honoring my feelings, it’s important for me to acknowledge that I felt stuck…in various ways and to varying degrees, for about four years.
And then…it happened.
(Ok, that one was intended to sound a bit dramatic).
In the course of doing what I do, I recently found myself in a physical therapy clinic. Not as a patient, but as a visiting strength coach (‘cause I do that: go to visit PTs, see how they do things, learn stuff and develop relationships).
And, in a good-natured way, the PT put me through some testing. Simple little things that I did really poorly on. And, in a good-natured way, the PT made fun of me for my poor showing. Completely unbeknownst to the PT—I’m sure because it took me completely by surprise—it felt like an utterly humiliating experience. My utter lack of high-level fitness was laid bare, right in front of the intern.
It felt like hitting a sort of rock bottom. (Again, I really must stress that I am aware of how much lower any sort of real ‘rock bottom’ actually is and that the rock bottom that I am describing pales in comparison.) I just couldn’t deny it to myself any longer: I was continuing to struggle with training myself because I didn’t really believe I could make any significant progress or gains anyway. This is why it had for so long been such a struggle to actually go through with a workout on any sort of regular basis: I had already had the experience of having my hopes come crashing down and learning that no matter how hard or long I was willing to work, I just wasn’t going to get stronger or more able to do cool things and the possibility of experiencing it again scared the hell out of me.
As it turns out, I wasn’t ready to give up just yet.
After a week of feeling a hollow sort of horrible about my current state, a memory came back to me:
Last year, at a conference, I had the opportunity to speak with renowned physical therapist, Gray Cook. At one point, he said to me “I know you’ve been discharged from physical therapy, but that doesn’t mean there isn’t still work that can be done”.
I had put that idea on the shelf and since then, I’d been telling myself I would eventually go back to physical therapy but for whatever reason (probably no reason), I kept putting it off.
I guess I just needed this particular experience to spur me into action.
Yes. All of that was just the lead up, explaining why I thought it was time to go back to see a physical therapist. I keep reading about how people are more inclined to read blog posts that are about 300 to 400 words in length and I’m about 1200 words past that now, so I’m going to stop here and break this one into parts. I’ll post part two shortly.
4 thoughts on “Getting Uncomfortable: My Movement Check-Up”
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