Gary Shapiro: Looking Back

In the past, I’ve written some articles for Plum detailing my Tai Chi adventures on cruise vacations. After nearly 40 years of work as a physical therapist, I decided that it was the right time to take a permanent vacation.

On Aug 4, 2017, I made my last patient visit, went to the “big” office, handed in my laptop, cell phone, ID badge and did the obligatory farewells and hugs. A week later, my wife and I flew to our new home, in the “ land of enchantment” or as the late fashion icon Millicent Rogers described it–”The last stop before infinity”–Taos, New Mexico.

I’m slowly phasing out of wearing a watch . The only event that leaves me with any calendar awareness is the regularly scheduled trash pickup every Thursday. This new sense of peace and calm has afforded me the opportunity to reflect back on my career and to examine the role that Tai Chi played in shaping it.

Over the years I worked in a variety of settings. The most satisfying was home care. I eventually specialized treating patients who underwent hip and knee joint replacement surgeries. Through a variety of circumstances, IE trauma, faulty body mechanics and repetitive stress injuries, the cushion (cartilage) between joint surfaces wears away, resulting in a bone on bone condition. This often causes severe pain and immobility. Surgery is performed, implanting an artificial joint to restore mobility and decrease pain.

Unfortunately, in some instances patients experience more pain and less mobility post-operatively. Although surgery is supposed to be corrective, it can often further traumatize an already compromised system. The brain is hardwired for protection. Pain causes the brain to go on high alert. Nerve impulses(messages) are sent to the muscles that surround the joint to limit motion in order to protect the area. The physical trauma of surgery may cause the hyper sensitized system to assume an even higher state of alert.

I had to figure out how to restore mobility and decrease pain without causing the brain to go “code red”.

Early on I thought that mobility problems were “hardware” malfunctions. Like most of my peers I employed a “Shaolin” approach. If a muscles were “tight” they had to be vigorously stretched. Patients were told to do the best to endure the subsequent pain and to make sure they took their pain medications an hour before the therapy session.

I began practicing Tai Chi at the same time I started physical therapy school. It took a while after graduation, but the practice began to exert a subtle influence on the way I interacted with patients. I started to understand that mobility problems were “software” malfunctions. If the unconscious part of the brain was trying to protect the joint, it made little sense to threaten and further traumatize the area with aggressive handling.

My form practice and push hands began to change the way I moved and heightened my tactile Tai Chi Chuansensitivity. My touch was no longer perceived as a threat. The alert level was lowered. When I moved limbs there was far less muscle guarding. Obeying the Tai Chi dictum, “The arms don’t move”, I began to use my center to move limbs, rather than employing my arms. If I lost focus on my center, I often felt a heightened sense of resistance. The patients nervous system perceived this inefficient handing as a greater threat.

This approach resulted in greater joint mobility and interestingly improved weight bearing capacity. Patients felt that their limbs were stronger, without having done any strengthening exercises. This can be explained by the brain’s ability to “rewire” itself, often referred to as “neuroplasticity”. The gentle handing provided a safe environment for the brain to come out of the “protection” mode, and begin to send normal impulses to the muscles.

My patients were very satisfied with their results. They progressed rapidly. Within a week after hospital discharge they were able to discard their walkers and ambulate comfortably with a cane. Prior to surgery they were told to expect a grueling/painful rehabilitation course, which did not prove to be the case.

I evolved into an “internal” therapist. The “Shaolin” approach became very foreign to me. Prof Cheng Man Ching was asked if he thought that Tai Chi changed his disposition. His reply was that he couldn’t be sure, but he liked to think so. My patients often remarked that I had a very calming presence that put them at ease, and instilled more confidence and trust in me. Like Prof Cheng, I’d like to think that Tai Chi was responsible.

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