My physical therapist tells me I should be glad that I made it to age 49 before experiencing significant back pain. I am not glad. I am annoyed and hoping this isn’t a harbinger of more frequent lumbar misery to come. It started last Saturday morning after completing an unexceptional six-mile run. I felt fine until I got out of the shower and started dressing for the day. My back began spasming enough that I involuntarily audibilized my discomfort, and by the time I had dressed and walked downstairs to the kitchen, I decided moving was not a great idea. Each step was breathtaking, as I felt the pangs surge through my torso, causing me to stop, try to remember how to exhale, and wait for the agony to subside.
I didn’t know what caused my pain, but I was relatively certain, despite the presenting symptoms, that these were not contractions related to childbirth. I decided to sit on the couch and hope the pain went away. Stillness provided relief, but it isn’t a long term solution, so the rest of my Saturday was filled with pain whenever I rose from the couch and hope that it would subside after a good night’s rest.
By Monday afternoon, I was feeling better overall, but the pain was still present. I hadn’t worked out since it started, and when I ran a few steps in place to test my road readiness, I felt my back tense up. I messaged my physician to inquire whether it would be appropriate to make an appointment. She recommended a visit with a physical therapist, and I scheduled it for Wednesday afternoon.
While I had eschewed exercise for three days, I decided to give running a try before I went to the appointment, thinking it would provide additional data about how quickly I was recovering. The results came quickly, as each stride on the pavement brought a small wave of pain. I managed to cover 1.5 miles at a reduced pace, but I didn’t enjoy it. I knew the physical therapy appointment was not an event I should cancel. The road to better back health was longer than I anticipated, and I needed a guide.
The physical therapist was a stocky thirty-something man with facial hair and a kind face. He shook my hand and invited me into his exam room where he had me take a seat. After a series of questions, and related data entry on his part, to establish exactly why I was seeking his services, he asked me to stand and face the door. He had me bend to the right and lean back, which was pain free. I figured I was acing this test until he asked me to lean to the left and back, which sucked. At this point, I presumed he would suggest a few stretches and exercises I could employ to work out the kinks, but I was mistaken. Instead, he asked me to lay down on the exam table.
I have no personal experience with massages, chiropractic therapy, laying on of hands, or any other practices in which strangers apply physical pressure to my body. I grew up in a loving family, but we were not demonstrative. After about age ten, there was very little hugging happening in the Baker house. My body is a temple, and it’s closed to the public. Being unaware of my expectations for personal space, my physical therapist felt no compunction and spent the next fifteen minutes grabbing, bending, and pulling my arms and legs while laying across my body. It was a gentle bear mauling, which is why I mentioned his facial hair. I recognized his intent was to fix the problem, but I considered the possibility that my anxiety at being kneaded so forcefully might be aggravating the condition. Whatever the reason, he was unsuccessful cutting my Gordian Knot and told me what I could do to help untie it on my own. He gave specific instructions, but, as I was still reeling from having been, literally, manhandled, I forgot to ask some questions. For example:
- He told me not to sit longer than 30 minutes. I should have gotten clarity about how much standing is required between seatings. I made an assumption that he intended me to alternate in 30 minute intervals, but I discovered standing for 30 minutes is a long time even under ideal conditions. Since the appointment, I have been trying to stand for at least five minutes at a stretch. As a result, I have been that guy rising from his seat with a pained expression and looming menacingly in the background of meetings at work. At home, I set a timer so that I don’t, ironically, spend the entire weekend in a seated position while watching the world’s greatest athletes compete in the Olympics. I have also begun to wonder if this is a prescription for the rest of my life, or if the 30 minute limit will be extended as my back improves.
- He told me to avoid running. I refuse to accept the possibility this is a permanent change, as I am addicted to running. He said it is too jarring and causes the problem to worsen. I forgot to ask if any other workouts are verboten, but I’m assuming cardio is not a good idea for the same reason. Weight lifting might be an option, but there is often a back-component involved in raising heavy objects from the floor. For now, I’m going full couch potato, but for no more than 30 minutes at a time, until I can get some clarity from my therapist.
- He told me to walk a lot. I am trying, but as a long-time lunchtime runner, walking feels like cheating. I am not opposed to walking, and it provides a bit of same the mental relief from intellectual activities, but I hope I can pick up the pace soon.
- He told me to use cold or hot pads as desired. According to him, it doesn’t matter which as long as it feels good. This seemed arbitrary and capricious. How can both be equally useful? I would have expected a more definitive ruling on which approach is more therapeutic. He also told me I had a problem with what I heard was a “fa-SET” joint in my spine. When I Googled it later, I discovered the word is “facet,” (I.e., “FA-set) the same word for one side of a many-sided thing. I was concerned he was mispronouncing it, indicating he really didn’t know what he was talking about. Combined with his indifference to hot and cold therapy, I have lingering doubts about his qualifications, but I will follow his instructions; just not happily. If it doesn’t improve, I will be checking his credentials before I allow him to hug me again.
For now, I’m grounded, and it’s frustrating. Not being able to exercise makes me realize, and appreciate, how much I enjoy it. The good news is I’m feeling much better, and I suspect the twinges of back pain I’m feeling at the moment are mostly a result of my heightened awareness of my back. That is, I’m thinking about it so much I may be worrying over what would otherwise seem like normal aches and pains associated with aging.
I’m scheduled to meet with my ursine therapist again on Wednesday. I’m not sure I will wait that long before going for a trial run, but whatever happens, I will be bringing a list of questions to the appointment. I am not going gently into the good night of my advancing age.