Tai Chi Journal

My Physiatrist Said ...

I visited Dr. Collins, my physiatrist, today about the soreness in my back, right knee, and right shoulder.

First, the shoulder: he said it's a rotator cuff injury. The rotator cuff is the name of the large muscle that emerges from near the neck, travels down over the shoulder bone, and then is inserted through other soft tissue to join the big bone of the upper arm. Having a torn rotator cuff puts me in the same category as any number of famous baseball players and pitchers. Dr. Collins' advice: continue to strengthen it just as I have been doing.

The knee problem is probably chondromalacia patellae, a wearing down of the cartilage at the end of the thighbone, meaning the patella or kneecap rubs against it. I've had that problem before in my left knee — had arthroscopic surgery for it — and now it's cropping up in the right. Again, I should keep doing the Tai Chi to strengthen the quadriceps and so hold the parts of the knee more firmly in place.

As for the lower back, I found a record I had made that Dr. Collins had diagnosed both spondylolisthesis and spondylolysis in it some 10 years ago. I had forgotten that. He told me today that, loosely speaking, both are kinds of arthritis. Beginning to do exercise aggravated it/them.

Dr. Collins said it takes anywhere from six to sixteen weeks before problems like mine go away, after beginning an exercise program. I should keep at it, because in this case the cure is more of that which caused the symptoms in the first place.

I trust Dr. Collins' predictions, because a decade ago when I was having more intense back pain, he told me that as I got to be over 50, the pain would diminish — and it did. The reason was that at that age the vertebrae of the lower back do a sort of "auto-fusion." That eliminates a source of back pain, but at the cost of increased stiffness and soreness upon undertaking an exercise regimen.

Dr. Collins approved my doing the lower-back exercises in Backache: What Exercises Work, and he heartily endorsed continuing to use Tai Chi to build up my body. He was noncommittal about whether incorrect Tai Chi Walking posture set me up for my onset of stiffness/soreness, when I demonstrated the right way and the wrong way of doing it to him ... but he didn't say I was wrong about that, either.

He recommended painkillers like Advil, Tylenol, and Aleve, and also icing trouble spots after aggravating them. He did not say I should stop exercising and rest.

I mentioned the "bump" along the back of my spine, near the waist, which causes discomfort from contact with the floor when I do my back exercises. He said the feature was normal, and showed me his handy-dandy model spinal column to prove it. He said it is called a "something process," I believe. I forget the exact terminology. He also said it was most likely the one on my "L3" or third lumbar vertebra. Several of the vertebrae in this region have such protuberances.

So, all in all, a very favorable result.

posted by eric @ 3:08 PM