Menu
My first patient today said, “My doctor said I’m “swimming upstream.” He based his statement on the fact that I have a long-standing problem.”
What a troubling statement.
This led my patient to believe that his symptoms would be tough to get rid of, and might not be able to be changed. While that might be true, “swimming upstream” can actually lead to even greater achievements and gains.
However, the saying conjured up the negative for this patient. I actually gave a little chuckle and said, in fact, “That’s pretty much what we do here with people all the time. If you’re not swimming upstream, then your going with the current…and that’s not likely to change things.”
This patient had been experiencing trouble with his right shoulder for about 5-years following a “stinger” injury suffered when playing football in high-school. The “stinger” caused an injury to a nerve that very specifically controls a muscle called the serratus anterior. That muscle is of paramount importance for the shoulder to have a stable base to work from.
Shortly after the injury in high school, he had presented with tremendous weakness of the right shoulder because this base of strength was not available to him.
Don’t get me wrong, this guy was strong…think “Defensive lineman” strong.
But I could out match his strength easily…at least in the movements that muscle wasn’t stabilizing.
No matter how hard he tried, he could not win in those movements. It was like I was anchored on concrete and he was standing on ice. I could just move him, no problem.
Fast forward a year, and this patient found a doctor who was willing to take a different approach. The doctor suspected that the nerve was injured by the “stinger,” but that it was now entrapped in scar tissue. He offered to do surgically decompress along the nerve length to free that nerve from this compression. In other words, the surgical goal was to relieve the pressure.
There was really no way to prove the doctor’s hypothesis, except to do the surgery and find the scarred area.
My patient took the chance.
The surgery was successful, inasmuch as the surgeon freed the nerve from the surrounding tissue.
But that did not mean that my patient’s function was improved.
In fact, he continued with weakness in the same patterns as prior to the surgery.
He did a lot of physical therapy while away at college, which helped to restore some strength over the next year.
Then he returned to the Baltimore area to pursue his Master’s Degree.
Which brought him back to me…with the same weakness patterns, but definitely not as pronounced. He was much stronger.
But he still wasn’t “right.”
He had difficulty with lifting, reaching, and could not keep good posture. He also had “knots” in his shoulder blade region that were painful and limited his activities.
You can either go with the flow and let inertia drag you further downstream…
or like the salmon, you can swim upstream to attain your reward.
As we worked together, we have found that there were several other contributing factors to his difficulties. Some of these included tight muscles on the chest wall (the area where the nerve was decompressed), as well as along some of the large back muscles. These tight muscles worked in unison directly against the weakened muscle.
He was basically stuck in the same patterns of movement that caused some of the persistent pain to linger. To use the analogy a little further, he was still moving downstream. Inertia kept him dragging in the same direction. That inertia was caused by his learned muscle patterns following the “stinger” nerve injury.
If you can remember your high school physics, you might recall a little bit about inertia. It’s defined as “a property of matter by which it continues in its existing state of rest or uniform motion in a straight line, unless that state is changed by an external force.” That means that a body at rest will stay at rest, a body in motion will stay in motion.
Basically, it meant that his body had a tendency to do nothing or to remain unchanged.
That is not good inertia.
That’s the inertia that keeps a bump sitting on a log.
The key lies at the end of the definition, where it says, “unless changed by an external force.”
By putting in some effortful change in his routines, this patient has already seen improvements. But it has taken determination.
His efforts provide the external force he needs to start changing his inertia.
It takes effort to start moving after sitting still.
It takes still more effort to change your direction 180-degrees in the other direction.
That’s the sort of change that he needed to make.
Eventually, he could no longer “go with the flow.” That was the same inertia that had him stuck in the patterns he was in.
He had to start “swimming upstream.”
The analogy of “swimming upstream” comes from observations in nature. Atlantic salmon are the most commonly known about. And some of the fish swim hundreds of miles to get back to their spawning streams. Now that’s effortful.
But the reward is great. After all, if the salmon did not put that effort in, there would be no spawning, which means no baby salmon, which would lead to the death of a species.
What greater reward can be thought of that propagation of the species?
In addition, the upstream swimming insures that only the strongest of the fish will get to the spawning streams, which keeps the gene pool stronger. This is seen across many species in nature, where only the strongest animals are the ones that breed.
But what does this interesting little tangent have to do with my patient?
The effort of going against the current, that inertia that was keeping the patient from getting better, is what caused him to start making the changes he wanted to see.
His work to change his direction, to regain a positive “healing-inertia” takes effort.
It will take time, and focused work to go against the habits that his body has developed over the past 5-years. But he is already seeing the beginnings of those changes in just a few sessions.
He is turning his bodily habits around 180-degrees, and going against the flow of what he’s been doing since his injury.
He still has some ways to go, but remember that salmon swim hundreds of miles to reach their goal.
By being faithful and consistent in his work to change these patterns, he can restore his function to the levels he desires.
As I spoke with this patient, I explained that every patient has to swim upstream. That’s the nature of recovering from an injury. “Going with the flow” tends to just drag you further down into patterns of weakness and pain, leading to poor function.
However, that does not mean that all patients will have to “swim hundreds of miles” to reach their goals. It does mean you will have to put in effort.
But stay focused on the reward at the end of your effort.
You have a choice.
You can either go with the flow and let inertia drag you still further downstream…
or like the salmon, you can swim upstream to attain your reward.
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Vivamus feugiat placerat dolor, at dignissim ante vehicula vitae. Nullam sit amet nisl nec urna pulvinar euismod vel sed lacus. Etiam ac nibh vulputate, viverra dolor vitae, ullamcorper nunc. Donec ligula eros, ullamcorper eu eros nec, venenatis consequat justo. Pellentesque eget arcu nibh. Phasellus non venenatis quam. Cras sit amet nulla id ex consectetur mollis sit amet vitae metus. Cras volutpat dui at quam imperdiet, et volutpat urna luctus. Sed commodo hendrerit malesuada.
Maecenas lobortis semper ipsum, nec sodales odio ultricies sit amet. Curabitur dapibus elementum quam vitae aliquam. Sed aliquet, metus vitae luctus tristique, dolor sapien finibus ante, id luctus ex magna vitae mi. Integer quam magna, lobortis non gravida id, convallis at nunc. Sed tincidunt turpis a turpis suscipit varius. Nullam maximus ornare sagittis. Praesent convallis, quam sit amet imperdiet aliquam, sem mauris vestibulum felis, pellentesque bibendum purus metus vitae neque. Etiam pharetra sapien sit amet lectus efficitur, ut malesuada dui eleifend.
2 Responses
Scott Thank you for the up lilting I sight it think it is wright on and am going to start swimming upstream mind & body Thanks for being a Friend Ray Lewis
Thanks for reading, Ray. I’m glad to hear that you’ll be swimming upstream to attain your goals.