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Pain Don't Hurt: Scenes from PT

8 February 13
by Austin Kelley

Illustration by Marshall Hopkins

A year ago I tore my rotator cuff, and ever since, I’ve been going to physical therapy, two or three times a week, so I’ve become a bit of an expert, like any middle-aged man, on “recovery.” For example, I’ve noticed that in PT some patients, other middle-aged men mostly, love to brag about their injuries. They like them to sound special, almost heroic. One day I was standing in front of the mirrored wall in the therapy room, squeezing my scapulae together for five seconds, three sets of ten, when a stocky guy, about my age, said to me in a knowing way: “Rotator cuff?” He was doing pull downs with the blue Theraband. Between reps, he launched into his story.

“I did it playing softball,” he said. “Slid head first into second base.” He sounded nonchalant or like someone trying hard to sound nonchalant. “I played the rest of the game, too. Waited two days to go to the doctor. Didn’t think it was a big deal.” He pulled the bands down and released, breathing heavily. “Doctor said, ‘You have an amazing tolerance for pain, but you totally shredded your shoulder.” He looked up at me. “Tore it in two places,” he said. He looked so proud. He bragged about his range of motion, lifting his arms above his head (nearly) as if he was Atlas. It’s amazing how simple movements, things that everyone can do, can seem valiant. He pulled down the blue band again and grimaced in pain.

I would like to tell the story of my shoulder injury too, but it’s not much of a story. It would go something like this: I got old.

Here’s what I told the softball guy instead: “I was playing soccer.” He looked confused, just like everyone does when I tell them this. Rotator cuff tears are baseball injuries. I answered his inevitable next question. “No, I don’t remember falling on it or anything. It just started to hurt.” He looked at me like I was an idiot. I shrugged. I always forget that it hurts to shrug.

I don’t think of myself as a person who has a high tolerance for pain or who even wants a high tolerance for pain. I would rather just avoid the whole question of pain. But it turns out that even I like to grin and bear it sometimes, and then talk about grinning and bearing it. I too like to think that my injury marks me as some kind of tough athlete, and that my ability to recover says something about me in some deep ontological way. I like to compare. I remember, just after the injury to Redskins quarterback Robert Griffin III, all the PT students and assistants were standing near the examination table — I’d call it a massage table, but I’ve never felt much pleasure on it – where I was doing a passive arm stretch (Use the good arm to crank the bad arm over your head, then hold ten seconds, ten reps). They were counting out the weeks it would take RGIII to heal in a way only PT geeks can count time, and speculating whether he’d be ready to play for the start of next season.

“Adrian Peterson did it,” said one of them, “and he had the ACL and the MCL” I pushed my arm a little harder and felt it tense up. “But Adrian Peterson’s a monster,” said Anthony, who’s just a kid really. “Did you read that article about him? Every goal they set for the week he’d meet it in a day. They kept having to change his regimen.” I pushed my arm near vertical. It burned. I pushed harder. I wanted to be a monster.

Of course I’m not. Most times I know that my recovery and my injury have more to do with time and gravity and all kinds of unseen forces over which I have no power. I know I’m just a guy who turned 40 the other day without feeling any change. I once thought turning 40 would be a big deal and then like all landmarks, it just slid by. My mind adjusted, just as it adjusted to six weeks in the sling, four more months of PT. I count out time so differently now. Eight weeks after surgery, you can wash your hair.

Rather than feeling some sympathy with pro athletes, I now feel a new pity for them. Once upon a time, when an athlete went under the knife, it didn’t seem like a big deal to me, except insofar as it hurt my team — or helped! (RGIII vs. Eagles next year?) I once worked on a photo essay for the NY Times about football injuries. I had to track down NFL players who had undergone multiple surgical procedures. The photographer was going to shoot their scars, and I would simply list their injuries. Mark Schlereth, the former Broncos offensive lineman, had 28 surgeries on various body parts. He had his knees “scoped” after just about every season, he told me. At the time, I thought of arthroscopic surgery as nothing major. They stick a little hole in you, probe around. You’re in and out the same day. Schlereth once had surgery once and played the next night.

Then I got scoped. My wife said the surgeon came out of the OR, drenched in sweat like he’d just played an overtime hockey game. There were many holes in my arm. For weeks, I had to sleep in a chair sitting up. Nothing did not hurt.

*

Most of the folks who work in the PT are young, and spending all this time there struggling to move, I get a strange entrée into other lives. One day I was lying face-down on the table, my right arm hanging over the edge. I had to pull up my fist like I was rowing a boat, keeping my shoulder relaxed, elbow tight, squeezing my scaps together, three sets of ten. Kieran and Anthony, two amiable students, were at the foot of the table, playing the “jelly bean challenge.” They had a container of Harry Potter jelly beans, which included flavors like “vomit” and “booger.” The vomit, Kieran said, actually tastes like vomit. He couldn’t speak for the booger. Anthony shook them up and grabbed one at random. He pulled soap. “Oh, man! That tastes like detergent,” he shouted. They giggled. “Disgusting.” He pulled another one. A pain shot through my biceps.

Another day Keiran was hooking me up to the stem machine, which sends an electrical current into my shoulder. I noticed for the first time a tattoo on his inner biceps, peeking out of his shirt. He pulled up his sleeve to reveal a large elaborately decorated script that stretched from his shoulder nearly to his elbow. It read simply, “Family.” “It’s my first one,” he said. “I wanted to honor what’s really important to me, and family is really important to me. Next I’m thinking of adding to it.” He pointed to his muscle. “I want to give each person a little area around it.”

There are a few young patients, too. They’re the ones whose tissues haven’t just disintegrated naturally, the ones who will actually recover. I watched one of them, maybe 15 years old, doing balancing exercises for his ankles on a teetering platform one day. He was wearing a Notre Dame t-shirt, which I noticed because it was the day after Alabama destroyed Notre Dame, 42-14, in the national championship, and I admired him for wearing the t-shirt right after the shellacking. The kid was telling his mother, who was sitting next to me about his quarterback friend, “Yeah, he’s like Tom Brady,” the kid said. “He’s a scumbag like Tom Brady too.”

I yanked up my arm with a pulley, ten reps, ten-second hold.

“A scumbag?” the mom asked. She pronounced the word in a slow, exaggerated way. She didn’t look up from her crossword. “Why is Tom Brady a scumbag?”

“He, like, totally left his pregnant wife for a supermodel.”

“They weren’t married,” the mom said. “And I don’t think he knew she was pregnant till later,” she added legalistically. “I know all about her. She’s on the show Blue Bloods.” I tried to relax my shoulders and ease into the pain. “Anyway, I thought he was your friend,” the mom added. “Now he’s a scumbag?”

The Fighting Irish fan blushed. “Yeah,” he said, “a little bit of a scumbag.”

“By the way,” I said to the mother, strangely bragging, “they are filming Blue Bloods in front of my apartment tonight.” I hoisted my arm up like a sail until the pain set in.

*

PT. That’s what you call physical therapy if you’re in the know. We are a nation of abbreviators. We like to seem like insiders and experts. I’m headed to PT, I say, to work on my scaps. Some of my fellow patients like to share their expertise. If we’re not toughing it out like athletes, we are identifying with doctors. “Oh just wait till you get to eight weeks,” one told me while he was doing an exercise in which, lying on your back, you use a pole to push your hand away from your body. “Your range of motion, your external rotation, will really jump between six and eight weeks. Look at me.” He pushed his arm backwards. His face clenched in pain.

My own machismo usually takes this clinical guise too. I like to think I have very good form, that I am an exemplary patient, engaging just the right muscles and holding my stretches for a little longer than others. Sometimes I do 11 seconds, 11 reps. I do it slow, controlled.

I met another expert patient one day while pressing my fist against a wall and holding it for ten seconds. It was a surprisingly painful and frustrating exercise. It made me feel like Sisyphus.

“I’m so much better now,” he told me while sitting with his shoulder wrapped in ice. “But, you know, I work out every day,” he said. “That’s the secret. I work with weights.” He rolled his eyes and talked a little softer, as if he was suggesting that he didn’t want the PTs to know about his extra activities. “I got the double,” he said, “two tears. And I’ve got pretty much full range of motion now.” I looked at the guy, wrapped up in bandages, thin hair, a little fat, bragging about his abilities.

“I can do 10 – 15 pounds now,” he said.

We talked about sleeping and pain. “What are you taking?” he asked.

“Just Aleve,” I said.

Illustration by Marshall Hopkins

“Oh, you have to take Soma,” he said. “That’s the other secret. It’s a muscle relaxant. It’s great. Kind of like Quaaludes. You ever take Quaaludes? I loved Quaaludes,” he said. “I mean, I really loved them. You remember those four guys who were busted with the Quaaludes? I was one of those guys,” he said.

I was still pushing against the wall, but by then I’d lost count.

*

The other day I headed up to my PT office, which is on the third floor of an Equinox gym at Grand Central Station. As I walked up the chrome stairs by the glowing plastic walls – it’s like s sci-fi B movie there — I saw gray-haired men boxing. I see this a lot. They jab and duck and sweat through their expensive gym wear. It’s like a Viagra ad. Once I suppose I would have thought this ridiculous. Now my mind has adjusted.

When I started my exercises, I noticed a new shoulder patient. I walked over, and in a knowing way, I asked, “Rotator cuff?”


Great article, Austin. I had a great laugh.

Tom Farrelly    Feb 8, 03:52 PM    #

Aus, for some reason I searched for the spectator not knowing you were back. Good stuff.

— Ej    Feb 23, 04:12 PM    #

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