Installing boilers involves getting into lots of awkward positions. David, a heating specialist who installs and looks after boilers around Exeter, in England, hurt his back one day. He fractured the base of his spine. His lower back was in debilitating pain and he suffered extreme bouts of sciatica.
I don't do rehabilitative work anymore. When I did, my job had less to do with anatomy, and more to do with helping people navigate the new relationship they have with their bodies.
Trust is a big part of what people lose when their bodies are injured. We take these incredible machines for granted and then one day they turn against us. I feel it's important to know that sometimes these relationships can be mended. With a little guidance and some support, you can learn to trust your body again.
When I first met David he'd worked with a number of doctors and therapists. His recovery was at the point where he was returning to work.
The problem was he still had acute pain in the mornings. He couldn't work like he used to. His sense of trust in his body and his ability to lift and move things had been drastically undermined.
In our first session, we worked through a series of movements together. It was important to understand where the boundaries were. Our bodies have six primary movement patterns. People can push, pull, bend, squat, balance, and rotate. David was in good shape, except for his ability to bend and balance.
Fixing a complex movement pattern is about more than just stretching tight muscles and strengthening weak ones. Our job was to gradually reintegrate each of the pattern's muscle groups in the right sequence so that the whole movement chain coordinated smoothly.
We started each session by tilting his pelvis forwards and backward. Then from side to side. It was slow work. We were greasing his hips with fresh movement. He'd been in pain for so long that flexibility around his pelvis was severely restricted.
We could combine all the stretches so far in a small hip circle by our third session. The stretch was slow and jagged at first. The circles gradually got bigger and smoother as David began to trust his body again.
As we were stretching the hips, we were also retaining his breathing. He could either brace his stomach or breathe, but not both. The muscles connected to his breath needed to be able to support his spine as he moved.
Every session David and I found the limits of what he could do and then gently pushed the boundary.
Once David could resemble a full range of hip motion and his breathing was no longer entangled with how he supported his spine, we started to bend. Just his body weight at first. Then we worked up to using weights. And then we began doing things on one leg.
When we started, I asked David how much pain he was in on a scale of 1 to 10. 10 was breaking his back.
He started at a 4.
For one month, we worked together for 30 minutes, twice a week. At the end of the 8th session, we managed to get his discomfort down to a 0.
Luckily for both of us, David's sciatica did not flare up during the process, allowing us to do the work that was needed.
In the before and after photos above there are yellow stickers at the base of David's lower back. I drew a line along the bottom of the stickers to show how much we were able to reset his pelvis over the course of the month.
David left pain-free.
I respect David for not going at it alone, seeking help, and being open to change at the edge of his comfort zone.