Comments & Curiosities: Physical therapy: pain, gain, some tears

"I Am Joe's Aorta"; "I Am Joe's Brain." Remember those? If this is your first rodeo, you don't. If it isn't you do. It was a series of articles in Reader's Digest years ago in which a different body part each month would tell you what function they performed for Joe. Other than the fact that he owned all the parts, you never knew anything about Joe – just "I Am Joe's Aorta" or "I Am Joe's Spinal Cord." Things got a little dicey when they got to "I Am Joe's Lower Intestine," but they were very popular. Anyway, this week is the second installment of "I Am Buffa's Rotator Cuff."

Once you stumble out of surgery for whatever part they overhaul – shoulder, knee, back – you are supposed to start physical therapy right away if not sooner. Physical therapy is very important. If you are experiencing pain, soreness or swelling, a physical therapist will be able to make that worse in just one visit. I have learned that it all has to do with something called "range of motion," which is a measure of how far the affected limb can be moved or twisted before it reaches "optimum extension," which is apparently just before it breaks off. Is physical therapy new? It is not. In fact, physical therapy has been around for a very long time.

Ancient medical practitioners like Hippocrates and Galenus used therapies like massage, manipulation and hydrotherapy to help people recover from injuries or treat certain conditions. Personally, I believe the father of physical therapy was a 15th century Spanish monk named Tomas de Torquemada, which is where the word "torque" comes from. During the Spanish Inquisition, if suspected heretics refused to confess, they would call in Torquemada to check their range of motion. After about four minutes of physical therapy with Torquemada, they would confess to anything, including causing the Great Flood. But most experts think the father of modern physical therapy was a Swede named Per Henrik Ling who founded the Royal Central Institute of Gymnastics in 1813 for "massage, manipulation and exercise." To this day, the Swedish word for physical therapist is "sjukgymnast," which means "impossible to pronounce."

I have also learned that physical therapy is essential for the success of shoulder surgery and effective physical therapy depends on finding the right physical therapist and doing the exercises they recommend religiously. I've been to a number of physical therapists over the years as various parts were damaged, failed, or fell off, but my current physical therapist, Diane Koch, is the best ever, anywhere, anytime. Diane's office is on Hospital Road just across the street from Hoag, which is handy. She is the consummate professional and a pretty, petite woman with a million-dollar personality that puts you totally at ease before she tortures you. Diane is from the Midwest – tough, hard working people who call 11-degree mornings "chilly" and have never heard of my personal motto – "No pain, no pain." You never feel like you're being rushed with Diane, as she carefully explains what she's doing at each point and why she's doing it, some of which is hard to hear while you're screaming but the parts I do get are very interesting.

In this first six weeks, it's all about passive stretching exercises, which means Diane carefully guides your arm through precise motions that are intended to gradually increase your range of motion and make you whimper, scream or sing "Take Another Piece of My Heart" like Janis Joplin only louder, depending on the motion. In this stage you still can't wash yourself or dress yourself and the terminal bed head just won't quit, but by this time you're so used to looking bad you could care less. At home, you're supposed to do something called the pendulum swing exercise. You lean forward and let your wimpy arm dangle while you rotate your hips to make your arm circle in one direction then the other. I do it to Donna Summer's "Bad Girls" and change direction every time she says "toot toot-beep beep." It makes the time pass.

From six to 12 weeks, we graduate to strengthening exercises, which means I can use small weights and a Pilates machine to cause the pain myself but with Diane's careful guidance. There is the isometric towel squeeze cry me a river exercise, the straight-arm flexion what was I thinking exercise, and the supine triceps extension this is insane exercise. From 12 to 16 weeks, your shoulder is stabilized and much stronger and you can begin lifting sheets of paper and almonds. Twelve to 16 weeks is a quantum leap forward and you should now be able to lift a coffee cup and open a door by yourself. By 24 weeks you are large and in charge with a shoulder of steel, and you can go back to the life you had before all this started, which is a lot like the life you have now but without the sore shoulder.

I think that's it then – rotator cuffs and sjukgymnast's, Diane Koch and Torquemada. It's a holistic approach. If you have a part that doesn't work right, especially one that has just been taken apart and reassembled, just Google "Diane Koch, PT, Newport Beach." In a few weeks, you'll be as good as new, sort of, and your body part will thank you. I gotta go.

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