My reputation is that of a conscientious worker and hours spent in the office  consistently extend well beyond “normal business hours.” When, all of a sudden, it seems, I begin to leave the office before 5:00p twice a week – the whispers are way too loud. My entry into a subculture that thrives in our midst and entraps our citizens in silent aggression accounts for these early exits: PHYSICAL THERAPY – PT – “Pain and Torture.”

I’m told that I have an advanced case of encapsulitis with a bone spur coupled with arthritis in my right shoulder – basically an age-related condition (in the Asian  culture, it’s called the “Fifty Year Shoulder.” In my case, it’s more than a decade late). The condition is the consequence of wear and tear that comes with maturity (old age) but I like to say it’s the price to pay for being a better than average baseball player in my youth; heck, I played baseball in college – to be more accurate, I was on the roster, wore a uniform and watched a lot of games.

I let it go too long – my right shoulder had “elicited pain” upon movement for longer than I want to admit.  But the real impetus for my plunge into the world of Physical Therapy came a few years ago when I was engaged in a game of catch with my son and I was aware that I was “throwing LIKE a GIRL.”  (‘just checking to see if you are reading purposefully and comprehending, or just going through the motions).  So I break down and ask for a referral – I’m sent to see a Sports Medicine Therapist.  Stephanie, my Therapist, tells me at the beginning “You know what PT stands for, don’t you? ‘Pain and Torture.’” I didn’t believe her. I do now.

Given an appointment and an address, I drive with one arm (my left one – duh) and before I know how I get there and where I am, I’m sitting in a “Waiting Room” in silent anticipation.  Hands clasped between my knees, I find myself rocking forward and backward – I imagine, like beef cattle would do if they had arms and hands after a long train ride and they find themselves finally, in … Omaha.

Eyes open, I see nothing (there are others in the room but nobody makes eye contact – there’s an unwritten, knowing silence between us all – “Good luck – you did kiss your wife and kids and tell them you loved them BEFORE you came, didn’t you? ‘Just in case you don’t make it out.”)  There’s an eerie absence of sound in the room.  The “Sounds of Silence?”  No, the “Silence of the Lambs” – I’m feeling like one of them.

Minutes pass and I begin to think “maybe they’ve forgotten me, I think I’ll leave now.” Then:

“Mr. [  ] …?”

“Huh, who me?”

I “feel” everyone in the “Waiting Room” thinking: “He seems like such a nice gentleman – wonder what he did, and how long his sentence is?”

My initial session is a real “eye opener.”  When you are ethnic Korean (as I am) and no one has ever told you “what BIG eyes you have” – if I say I am like a “deer in headlights” when I see the apparatus and equipment in the “Therapy Room” for the first time, you get the picture.  In the “Therapy Room” there’s much going on. I recognize a bunch of buff football players from the University of Hawai‘i and a slew of high school athletes including a number of nice-looking young women, and they are doing a lot of the same things that I end up doing – all kinds of grunting and grimacing – in that regard, I fit in real well. Otherwise, I don’t.

To regain lost mobility and strength, Stephanie contorts my locked shoulder and the laggard arm attached to it, in all sorts of directions (it’s called active, assisted mobilization).  Although she’s slightly built, she holds my right arm in a vise grip above my head oblivious (seemingly) to whelps and whimpers that increase with every degree of movement beyond “impossible.” My right arm wants only to go back to where it belongs (down), but she won’t let it.  I see stars and flashes of lightning – her response? “You have to relax – and breathe – relax – RELAX.

Lying on my back, my right arm above my head by Stephanie, the manipulation and positioning of my right arm into locations and angles that have been heretofore unheard of in the course of human existence (mine, at least) is bad enough.  But sheesh, I have only recently met this young woman and I’m not comfortable letting on that I need to pass wind – somehow, however, I’m able to make it through the whole session.  But it really is difficult to relax and stifle at the same time.

Together, patient and Therapist set “goals.”  On one of the earliest days Stephanie selects “Diamond Head” as the day’s “goal destination” for my arm. Partway through the session, I croak: “Stephanie – you ARE my friend, yes? ‘Cause it feels like you are trying to hurt me ‘on purpose.’” She doesn’t answer.  The next day, our destination goal is “Pearl Harbor,” in the opposite direction. I ask the same question, again. Same answer.

Most mornings following therapy I wake amazed that there is a right arm still attached to my body – I swear, on so many nights before, Stephanie has removed it against its will.  It’s the darnedest thing – she HURTS me but I like her.

It’s like when I was a little kid, my mom used to give me and my brother “the belt” (only with her, it was a wooden clothes hanger (she was from Indiana).  Bless her in Heaven – “You want the hanger? You want the hanger?” she would say.  Although we were still quite young at the time, we both thought “… say, that’s grammatically incorrect,” but when your Mom asks you a question THAT way, she already knows the answer and she’s in no mood to stop and make the correction. Too, we both knew that “yes” and “no” would mean the same thing.

Even when we protested, we’d get it on the thighs and she’d say “I only spank you because I love you.” Eh?  It’s been more than a half century and now it’s the same line, only a different person is saying it, and I’m expected to accept it all over again.

I’m into my third month of twice weekly therapy.  My “check-in” procedure is now routine – I somehow “appear” at the Reception desk and a squeak (my voice (?)) translates to “I’m here for my 5:00 appointment.”  I need not be told, but I am invited to “wait in the ‘Waiting Room’” and I find a hiding place where I am easily found moments later. Same drill each time, except the other day when the assistant came to get me, she said she found me in the corner, in a fetal position, thumb in mouth.

There’s a whole series of self-punishment preliminary “exercises” for my right shoulder that I am programmed to do before I see Stephanie. So I do as I have been taught and shriek unabashedly as I tear my right arm off as if to preclude her from doing it at the end of the session.  I’m unsuccessful.  Stephanie arrives to complete the job later.

She knows from our earlier “history” consultations that I do/did some yoga; she does/did, too.  So as she is administering a “Full Nelson” and it’s apparent that I am well past submission stage she says ”… ujjayai breaths (deep, rhythmic, cleansing breaths through the nostrils) – I don’t see your diaphragm moving.” Heck, she is relieved that I respond – my suspicion is that she checks periodically just to see if I have stopped breathing, fearing that she has killed me.  Maybe next week.

At the end of one of our recent sessions, having placed the back of my hand to my face to see if I can feel a puff of air coming from my nostrils (I do!), energized, I’m surprised that I am able to stand upright. “Steph, tonight we (me, and her, and my right arm/shoulder) went to places we’ve never been before, huh?” “Uh huh.”

Not merely empty words – the “goniometer” confirms my assertion – we were both proud of “our progress.”  Note the plural possessive: Stephanie works hard during these sessions – she deserves my gratitude as it is absolutely clear (this is the serious part) that she is invested in my success.

As I head toward the front door I say my “good-byes” and give Stephanie a grateful “high five.”  Stephanie says: “That was five, but ‘high’ is a bit generous.” Excuse me?  Moments before, she performed a surgical procedure on my right shoulder without anesthesia, without precision instruments and with only her “gorilla hands,” and she wonders why the right arm can’t go higher?  She’s like the (here, insert your favorite ethnicity) mother who grumbles “5 A’s and one A-; how come not all A’s?”

You’re intrigued by the “goniometer” and wondering when I might explain what it is, you say?  From “Wikipedia”:

goniometer is an instrument that either measures angle or allows an object to be rotated to a precise angular position. The term goniometry is derived from two Greek words, gonia, meaning angle and metron, meaning measure.

Your introduction has been faster, and far less distressing, than mine.  Yours: (see above).

Mine:  It’s the end of my session and Stephanie has my right arm nearing a “Goal Destination” for this session that is somewhere in the Western Hemisphere, and it’s been like that for a loooong time. Finally, I “hear from the corner of my eye” (I always liked that malapropism – ‘actually said it once in a court proceeding):

“Galen, can you get me the goniometer?”  (It’s Stephanie, speaking to one of the

Assistants – I know that because when I checked in earlier that afternoon, I

was “Dale” and I’ve never heard the word “goniometer” before).

(Galen)  “Huh?”

(Stephanie)  “Can you get me the goniometer?”

(Galen)  “Where is it?”

(Stephanie, pointing) “Over there, someplace.”

(Galen, looking)  “I don’t see it.”

(Me, screaming under my breath)   “Geeze, Galen, FIND the blessed goniometer already, or I’ll find it myself!”

Candidly, not sure how I might find the goniometer – I surmise that “meter” means that something is going to be measured but as said earlier I’ve never heard the word before in my life, much less seen a goniometer (it looks innocent enough, a little like a protractor, and is employed to measure the range of motion).  At the time all I know is that a goniometer sounds like it has something to do with the gonads and I remember the word from its use decades ago (popular with college age guys as I recall).  Whether it was the mere thought that mine might somehow need to be measured as a segment of my therapy OR it was the pain in my right shoulder that caused me to “pass-out,” I cannot be sure.

As I regain my awareness, my right arm is still above my head, still being held hostage “there” by Stephanie, and I’m feeling what is surely a nine inch dagger in my shoulder joint plunged to the handle as I lurch toward 16 on a 1-10 pain scale.  I hear: “140 degrees.”  My temperature?  “No, the angle of your extended arm above your head tonight – NORMAL is 180 degrees. We’re gonna get there,” Stephanie says. That’s when I pass out, again.

It really is remarkable how much pain the human body can endure – it helps if one is motivated to block out the pain, or at least has an unnatural belief in the saying “No pain, no gain.” I once read that to help endure the tests of their physical limits during Hell Week of training, Navy Seals chant: “If you don’t mind, it don’t matter.”  Truth be told, I’m no Navy Seal, I mind, and geeze, to borrow from a phrase, “Pain does matter.”

Heretofore, I’ve held the notion that a “High Pain Threshold” was some sort of a “Badge of Courage.”  Now “experienced” I know that it simply means that you lose your voice after you reach the point where IF you could, you would cry out “UNCLE!  Somebody, HELP!”

Still, there’s status that comes with being able to “take it like a man” so I’ve done my best to remain conscious as Stephanie has warped my right arm/shoulder into unnatural directions and taken it/them to uncharted territories. Too, I have developed my own coping mechanism and strategy, drawing upon a recollection from an experience while a senior in college, more than a few decades ago – serendipitous how all of the “knolidge we lirned in collage,” is actually useful.

One particularly dull weekend, my roommate and I took a road trip around and about New England with a few bottles of “refreshment” in the back seat.  Miraculously, we were able to “hold it” because we knew the locations of the next pit stops and approximately how long it would take to get to them.  There’s that saying: “history repeats itself.” Curious, now that I am a different kind of “senior” that same kind of planning and perseverance is becoming more and more important.  But I digress.

Urged to communicate, I summon the courage to tell Stephanie that it seems to help me to “hold on” when she has my shoulder in a mobilization posture that is registering on the pain scale above ten, if she tells me for example “… fifteen seconds more …”

If I know how long I have to last, I know how long I have to last,” I announce with overwhelming clarity.  Stephanie commends me on being a participating member of the “team” – after all, she did say that communication is key, and besides, my restatement of the obvious seems to make sense.  We agree to try it “next time.”

“Next time” comes all too soon and the scenario is a familiar one:  Stephanie is doing her best Ultimate Fighting impersonation, applying a Half-Nelson this time. I am well beyond submission but as she is both Contestant and Referee at the same time, the Contestant goes for the kill and the Ref doesn’t see (or ignores) my efforts to “tap out.” Still, I’m comforted as she commences a planned “countdown. “Fifteen more seconds – fourteen, thirteen, twelve.” Between forced ujjayai breaths I think to myself, “I think I can, I think I can. I can do this – I can hold on – I think I can.  Geeze, UNCLE!”

“Ten, nine, eight …” I count along silently and urge myself “hang on, hang on.” “Seven, six, five … five … five ” Then, like Charlie Brown lying on his back looking up at the sky after trying to kick the football that Lucy has pulled away from the ground fronting him, I figure it all out. “Hey!” “Heh, heh,” Stephanie heh, hehs, “I promise, I won’t do that again.” Me (not answering): “Heh, heh yourself.”

At the start of the next “set” she says at the beginning “OK, HOLD this time for thirty seconds.” I count the first ten seconds but when my body begins to shake uncontrollably, concentration and counting and trying to maintain ujjayai breaths at the same time is simply physically impossible.  Finally, a faraway voice is heard: “OK. Good job.”  I congratulate myself, “Now, THAT was doable – Whew.”  Stephanie: “Heh, heh, actually, that was more like forty seconds. Now, where’s that goniometer?”


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The Fifty Year Shoulder by Dale Lee

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