September is Spinal Cord Injury Awareness Month and at I.P. we have a unique perspective on this topic. In 2004 Dr. John suffered a spinal cord injury while playing football that resulted in severe loss of function in his entire right arm. While many people may know bits and pieces of what happened, we thought sharing his story would help shine some light on what motivated John to start Integrative Physiotherapy and help others MOVE!
Tell us how your injury happened.
I was playing cornerback, in a semi-pro league, on the left side when I went to strip the ball. My arm was fully extended and the safety crowned me in the elbow as the back kept running with my hand. I sustained a grade 3 brachial plexus strain with medial ulnar avulsion and a complete rupture of my tricep, UCL ligaments and 6 forearm muscles. I was writhing in pain and shaking immediately afterwards. I don’t have a sweet tooth but I have never had such a craving for sugar in my life. At the hospital they tried to yank my arm straight to get an X-ray, I kicked the tech as a response because of the pain. They sent me home with pain meds and told me that I was going to wish I broke my arm because the soft tissue damage was going to be way worse. Correct statement knowing the recovery from breaking my wrist 3 times… but that’s a different story. I experienced chills, hot flashes, bowel and bladder symptoms, insomnia, nausea and vomiting for days and months, even the first few years after the event.
Did you undergo surgery?
No and I should have. My tendon and ligaments needed to be fully reattached for me to have full function of my arm. I had the opportunity to have surgery at the time. I still was on my mom’s insurance for a few more months and the surgeon had told me he had only ever seen one case worse than mine and that I absolutely had to have surgery. But because I had met some mentors who had shown me how often surgery could be avoided, I challenged myself to see how much I could get done without surgery. In retrospect, it was appropriate that surgery should have been performed, but I also wouldn’t know what I know now about rehabilitation if I would have gone through the surgery. As far as function goes, the surgery was definitely necessary. That is an aspect I contemplate any time patients ask me about surgeries while there are so many variables that go into deciding to have surgery or not. I always say once the knife goes in, it can’t come out; but it may be the right course of action depending on the person and situation. That’s why it’s important to know the current science behind the efficacy of surgeries – for long term benefit and considering the dynamics surrounding each individual. A patient’s co-morbidities and lifestyle are huge indicators of whether it would be possible for someone to avoid surgery. Respecting every profession and their part of the comprehensive care process is paramount.
What was the hardest part of your recovery process?
The mental aspect of how long it took to recover and the emotional changes that go into an altered self-identity post-injury… let alone the patience. The hardest part as an athlete with an injury that is that severe, is that you lose your ‘runner’s’ high’. You’re used to running and jumping and moving and competing. I’d been in an almost obsessive physical routine for the better part of a decade, and overnight I only had use of 3 limbs. I was injured; I wasn’t releasing my happy hormones from exercise. That emotional state really makes you question your motivations, who you are as a person, and how you decide what your new identity is going to be after experiencing something that traumatic.
How long did it take you to regain function of your right arm for daily activities, and then also for sport/fitness?
Took about a year for functional activities and about 2.5 years for sport. At first my arm and fingers were curled in a rigid position. I could only use the very tips of my fingers for the better part of 6 months. Couldn’t eat with that arm, couldn’t brush my teeth, couldn’t do basic self-care ADLs… The first time I tried to wipe my own a** and using my left arm was very humbling to realize my body had never turned the other way.
It was a painstakingly slow process of breaking down the whole system; the mechanical, chemical and electrical engineering. You have to take all the segments through the whole system – like trying to rewire a computer. Since the arm gets its strength from the legs, you have to take the arm all the way down the ankle. You keep going through this process..over and over again. Sometimes there are huge gains, and other times it’s the smallest little things that are battle victories. I keep working on each aspect of the journey…constantly looking for new and innovative ways to restore function. That rolls into being able to treat simple to complex cases with a lot of variability to pull from and push past plateaus.
How do you apply your personal experience towards patient care?
My injury has fostered my ability to keep being innovative and creative while empathetic and sympathetic in clinic; approaching the patient as a whole person, addressing each point of that pyramid (chemical/emotional/physical). Addressing the emotional distress that comes with injuries/ailments is so important to consider in the recovery process. There’s a lot of evidence that shows if you believe you aren’t going to get better, you’re not going to get better. Addressing people as a whole by checking each point of their pyramid has enabled me to better see what they are needing at that time. Re-integrating a person back into their life, if you will. You see stories of amputees or veterans that have gone through so much and are still able to play basketball or handstand with or without the use of prosthetics or assistance. A neurologic injury makes you focus on body entities rather than muscles, requiring a restoration of a certain harmony between the systems to become your best current self.
What symptoms do you still have to this day?
I’m still unable to fully straighten my right arm in a couple angles. I have difficulty with certain manual therapy techniques in clinic when I need to fully straighten my arm. I get occasional numbness and tingling and still have muscle atrophy from the lower motor neuron damage. There’s always something to work on, something that reminds you of what you once were, where you are, and where you are going.