How to Get Moving 2

Chapter 2
​SECRETS OF THE UPPER EXTREMITY

There is more than one way in which my second post, the comic Dream of the Magic Remotes (7/25/18) gave me grief.
 
Back in the summer of 2017, the work on Magic Remotes was going so slowly I decided to set a deadline to complete it for submission to an online contest.
 
It seemed like a good idea at the time. What I didn’t realize is when you compress writing a long post into a short time, you create the chronological version of a “blivit,” which is ten pounds of s—t in a five-pound bag.  (blivit doubters click here)

When blivits explode, bad things happen, like precipitating my second obscure neurological disorder, Repetitive Strain Injury (RSI).
 
RSI is a condition in which the prolonged performance of repetitive actions causes pain and functional impairment.
 
In other words, if you write and draw hour after hour, day after day, the nerves and muscles of your arms and neck get aggravated and exhausted.
 
When they can’t take it anymore, they rebel.  
 
This is how you get RSI:

​This is how I got RSI:

If I had only seen the flow chart soon enough, I might have escaped my fate as depicted in the lower right corner. 
 
Or if I had followed the example of my wife Hope, who lives comfortably within the limits of reasonable exertion.
 
Except for her unbounded devotion to family. 
Which is why you will find her at 3:00 a.m. assembling IKEA furniture whenever one of our children moves into a new apartment.

It’s easy to avoid RSI:
Use good posture, take breaks, and optimize your work station ergonomics.

It is hard to treat RSI.

The treatment for RSI is occupational therapy (OT).
That’s not what I had in mind.
I was hoping for something quick and definitive, like

​These were the actual facts on the ground:

If you like quick and definitive treatments, don’t get RSI.
​
It took many months of OT  to get me back in shape.
 
When I started, I hurt too much to
-lift a bag of dog food
-crank a can opener or twist a doorknob
-write or draw for more than a few minutes
 
I can live without dog food and doorknobs, but not without drawing and writing.

I cried a lot.
I didn’t want anyone to see, so most of the time I cried inside my head.
A clever tactic, but not without its drawbacks, e.g.

​Feeling too despondent to cry was another flawed tactic:

​​I also felt

It took many months for me to get back in shape.
I felt my progress was so slow, I’d never be able to function like I used to.
 
Rebekah and Marion, my occupational therapists, disagreed.
They were surprisingly optimistic.
 
They said, "All you need to do is follow this prescription:"

I fell under their infectious influence.
 
A straightforward, non-invasive treatment!
No blue pills with dreadful side effects!
No terrifying surgical procedures with unpredictable results!
 
Overnight my whole attitude changed.
 
I wish!  Actually, it took a long time.
 
Following their simple prescription turned out to be a lot harder than I thought.
 
Exercises included stretches and glides.
 
Under their guidance I performed 6789 stretches the first year, a challenging task for someone not known for his visual-motor coordination or spatial relations aptitude.

I particularly enjoyed some of the more expressive stretches, such as:

And

I also performed more than 1376 nerve glides.
Nerve glides are exercises that aim to restore mobilization of inflamed peripheral nerves.
 
I came to enjoy the novelty of nerve glides that required me to navigate my upper extremities into weird positions:

You might not realize there is an intellectual side to OT.  
​
How many people even know what a nerve glide is, much less how to perform one?
 
Or that, ergonomically speaking, your head is the equivalent of a ten-pound bowling ball.
​
Which is why it’s important to try to keep your head on straight:

That’s hard to remember.
And that’s only the physical part of keeping your head on straight.

​Fortunately for me, Hope helps me keep my mental head on straight.

Another physical intervention I “enjoyed” was trigger point release.
Trigger points are tight bands of muscle you get from too much strain. 
 
Your therapist presses on your trigger points till they hurt.
When she finds one that is particularly painful, she presses harder and longer.
 
Rebekah is a firm believer in the therapeutic value of trigger point release.  She executed at least 779 of these between August 1, 2017 and July 30, 2018.  For example:

And

After a half hour of trigger point release, you ache so badly, you forget all about the tightness in your arm and shoulder you came in with.
 
Marion favors dry needling for trigger point release. 
 
You get to experience two kinds of sharp pain,
1) when she inserts the needle
2) when your muscles jerk uncontrollably
 
Dry needling feels awful, but you do get immediate relief – from these iatrogenic pains –after the needle is withdrawn.

Marion would have dry needled me every day if I had let her.
I didn’t let her.

As for Rebekah, I discovered I could get her to stop pressuring my trigger points by asking her an academic question.

For example, what is the structure and function of the brachial plexus?
Some OT’s would have shrugged off my question and continued the torture.
​
Some might have answered, 
“The brachial plexus is the network of nerves that sends signals from your spinal cord to your shoulders, arms and hands,” and let it go at that.
 
Rebekah would respond by grabbing a white board and markers and delivering an illustrated mini-lecture:

A double bonus for me.
1) Interrupts torture for a few minutes
2) I’m incapable of absorbing anything anatomical without a multicolored diagram.
 
Week after week, the same routine: appointments, assessments, exercises, ergonomics…
For a long time, I could barely sense any progress.
 
Nevertheless, thanks to the devoted ministrations of Hope, my OT team and my analyst, Mel,
I persisted
And
Inadvertently learned many of the moving secrets of the upper extremity.

What’s that you say? I just thanked my analyst, but you can’t find a trace of him here in Chapter 2?
Isn’t this blog supposed to be about psychoanalysis?
 
My apologies.
Analyst Mel has never had a role in a blog before.
He’s a little anxious about his debut.
I’ve suggested a remedy, but he has a different idea:

​I hope he knows what he’s doing, because I’m planning to feature him in an important scene in my next post, Chapter 3 of How to Get Moving, Richard’s Wager, coming soon to Square One and a Half on a browser near you.
 
Thank you for your patience.
Stay tuned to this space!