Letter Re: Development and Maintenance of the First Weapon

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Hugh,

I appreciate B.C.’s points related to the majority of our population being poorly prepared physically to deal with increased levels of stress. As a physical therapist and athletic trainer for 24-plus years, I see it every day. I do want to make one observation and warning, for lack of a better term. There is a huge difference in “normal tissue” and “pathologic tissue”, or tissue that has gone through a process that is called secondary healing. Secondary healing is when there has been enough damage to a muscle, or ligament, or skin, or joint surface, (pick your tissue type), that “normal” recovery is impossible. This is most evident after severe burns. There is so much scar tissue that has developed in the normal skin tissue that normal appearance and function of the skin is no longer an option. The burn example is to create a visual that some injuries will not allow you to have the same recovery, back to normal Range-of-Motion, Strength, Function, Posture, et cetera. How does this apply? Let’s say you have a Labral Tear (rim of cartilage tear) in your shoulder that has been surgically repaired. There is hardware in your shoulder. There is scarring in that tissue. Due to this, you will not ever regain full Range-of-Motion in that shoulder. (It’s not necessarily a bad thing; a little less Range-of-Motion often means a little more shoulder stability.) If you attempt the Overhead Square Test with this previous injury, it will appear as a problem that needs to be “fixed”. It may not be. And forcing the shoulder to move into a “correct position” will probably cause compensation in your middle back, because you don’t have the ability to improve at the shoulder. Here’s my point: You may not be able to achieve a particular position. If you can’t, don’t get concerned. As we age, our connective tissue literally changes from “stretchy” to “less stretchy”. Don’t force something, and don’t think that not being able to achieve a particular position or movement indicates a deficit that needs “fixing”. As a physical therapist, I treat painful dysfunction, and 50% of the time it’s due to degenerative changes in joint surface (arthritis) or secondary healing (scar tissue embedded within normal connective tissue). You have to be careful thinking that if you force yourself to be able to achieve a full “Range-of-Motion”, that you have improved. Often you have now caused a new problem. (I treat late-blooming yoga patients all of the time who have fallen into this trap.) B.C. has excellent training points, but take your time, and don’t force an old injury into a new position, or you may make things worse. – D.W.

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