Patients arriving for aquatic therapy walked like corroded tin soldiers, a slow gait interrupted by deliberate pauses; back pain had conditioned them to think before they stepped.
``All your body remembers is the pain,'' said Jim Silva. His 55-year-old body knew two kinds of pain in the lower lumbar - the sudden shock, like hot coals against the spine, and the persistent knot of twisted tree roots that pulled tighter with every flinch. Both kinds can prematurely age a person and make him elderly before his time.
For Silva, an electrician often climbing ladders, hauling tools and worming into small spaces, back pain was an occupational risk. His back finally quit him in January, while he was helping his wife clean the house in East Providence. Last time he'll ever do that, he likes to joke.
At Lifespan in Providence, he changed into a swimsuit and eased into the rehabilitation pool, sort of an oversized Jacuzzi with an artificial undertow for balance drills. Water puddled on the floor around the pool, and the humid air had a tang of chlorine. Ellen Gardner, a physical therapist in aquatic therapy, and Chuck Staton, a 51-year-old bad-back sufferer were already there. Gardner was the benevolent drill sergeant, pushing her patients through exercises to retrain their bodies to lift and to pull without straining their backs.
Standing rib-deep in the artificial current that was trying to push him over, Staton pulled floating dumbbells underwater, the opposite of a biceps curl. The movement works the abdominal muscles.
``Get your shoulders back,'' Gardner ordered. ``How's your stretching at home?''
``I'm stretching every day.''
``We're trying to teach those abdominal muscles to hold the spine steady.''
how to use them properly.
The drills retrain the ankles, the knees and the hips to keep the body balanced. Like many men with sore backs, Staton was ``arm-strong'' - his arms were more developed than the stabilizing muscles of his trunk. For years, the flexibility of youth had compensated for the back stress caused by outmuscling every task with his arms. But like a green twig that dries over time, his body lost flexibility.
For many people like Silva and Staton, back pain is predictable. ``We have designed a world,'' Gardner said, ``to give us back problems in our 40s and 50s.''
We sit in chairs that don't fit, lean forward to read from our computers, hunch over the steering wheel to drive. We ignore our powerful legs and lazily use our backs to lift things, and to lever ourselves from our cars. Sofas as soft as sponges offer no support, yet we spend 12 hours slouched on a couch on any good NFL Sunday. Around the time our bodies start losing flexibility, we are accepting more important jobs that leave less time for exercise. We cherish the inventions that contribute to sloth. ``When was the last time you got up to change the channel?'' Gardner asked.
Back pain is often from cumulative stress. We have done it to ourselves.
Silva performed his stretches, his floating dumbbell drills, then moved to the deep end of the pool for his cardio exercise, running in place against the current as if he were suspended in space.
Ben Boyle, he focuses on the motions he makes
as an electrician.
Two weeks later, he had graduated to therapy on land, in a Lifespan gymnasium that simulates work, under the direction of therapist Ben Boyle. ``Last Monday was my first day,'' Silva said, as he pumped himself into a sweat on a stationary bike. He chewed gum in time with the revolutions of his feet.
``Ben is an honest guy. He told me I'd be pretty sore, and I was.'' Silva's back had kept him out of work for months. ``I don't know how anyone can stay out of work and do nothing but watch TV. It would be like being in prison.''
At home he read books, clicked channels, drowned his sore back in hot bubble baths. He sounded weary just talking about being laid up.
Around him, patients pitched weighted balls against trampolines, carried plywood boxes laden with iron weights, dribbled balls against the walls, balanced on inflated pillows.
``Sled or ladder?'' Boyle asked.
With sweat droplets gathering on his forehead, Silva replied, ``Uh, let's get the sled out of the way.''
He leaned into a wooden sled loaded with concrete blocks, pushed it slowly across the room, and then pulled it back. With the right form - power from the legs, not the back - he would not hurt himself. Bad form would bring pain. He smeared the sweat on his forehead with a sleeve.
``Work looks easy now doesn't it?'' Boyle said.
Silva's rehab program was designed to mimic an electrician's workday. He climbed repeatedly up and down an eight-foot ladder. He screwed bolts into a metal plate suspended above his head. He threaded rope through holes in a board, sewing giant stitches - as an electrician might pull wires through conduit. He pedaled a bike with his arms. Pushed a leg press. Lugged weights around the room. Two hours of hard exercise simulated eight hours on the job.
``Tired yet, Jim?'' Boyle asked.
``Oh yeah.''
Silva balanced on a wobbly ball-and-disk contraption shaped like Saturn. He quivered on it. The unsteady footing forced him to use neglected muscles. ``I want you to use your butt,'' Boyle told him. ``It's not just strength, it's how you recruit that strength.''
Next, Silva tried walking with a giant rubber band around both ankles. Boyle told him: Step forward and away from your body at the same time, like the crazy sidestep from the TV show The Monkees. Staggering back toward health, he chopped the air like an actor in a kung fu movie, bared his teeth, and howled.
Your turn: What do you do to ward off the aches and pains of aging?
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