"What have you been doing to make it feel better?' I usually ask.
"I've been stretching it, every day," the client says. "But it doesn't seem to be getting better."
I don't know how stretching came to be, in the popular mind, the panacea for muscle and joint pain. But I have this conversation over and over. Athletes sometimes will surprise and please me by saying they're alternating heat and ice, which really is helpful, for a new injury. But mostly people say they're stretching it. If they admit to babying it and giving it rest, it's only with a certain shame. They know that what they really ought to be doing is exercising and stretching it.
Maybe it comes of a misunderstanding of yoga. To Westerners first meeting yoga practitioners, the striking thing about them was that they were extraordinarily flexible. Which they are. But they're not pain-free because they're flexible: they're flexible because they're pain-free. And they're pain-free because they move mindfully throughout their range of motion and relax thoroughly, not because they stretch.
Or possibly it comes of the mechanistic model of the body. We learned lots of wonderful stuff by thinking of the body as a machine. How the circulatory system works, for instance. It wasn't until someone thought mechanistically about it that anyone really understood what the heart does and how the blood flows.
But the body is not a machine, and you don't repair it like a machine. It's probably true, as your physical therapist will tell you, that you can't turn your head to one side because a neck muscle, maybe the levator scapula, is shortened. But we're not talking about a fan belt here. You don't fix it by stretching it out. A muscle is "shortened" because it's contracted, and it's contracted for a reason. If you try to stretch it you will simply tear it, and make matters worse.
A muscle is not a fan belt in another way, an even more important way: it's replacing itself, all the time. Muscle cells in particular have a short life span. And that means that the neck trouble you've had for years is not the original injury. It's a replicated injury. The muscle is pretty much brand-new: the pain you have now is one that's been recreated in new tissue. Fixing it is not like fixing an object. It's intervening in a system. A long-standing muscle injury is more like a bug in a computer program, causing an infinite loop of contraction, than it is like a fan belt that's too tight. Or like a snag in a current, distorting everything that flows past it. This is why surgery is so seldom effective for chronic pain. When everything heals up, the movement patterns that created the original injury will all still be in place, and they'll simply reproduce themselves. My guess is that much of the relief people get from surgery is the result, not of any changes the surgeon makes, but of the splinting and enforced rest the muscles get after the surgery. It's no simple matter to improve on the mechanical design of the body, and it's usually better not to try.
The four strategies I think are best, for dealing with chronic musculo-skeletal pain, are
1) judicious rest
2) trigger point massage
2) skillful physical therapy
3) skillfully taught yoga
First of all -- get some rest. Let the damn thing get better. I don't mean immobilize yourself. But move lightly and loosely, and stop doing whatever screwed you up, for a while.
I hesitate to recommend physical therapy and yoga, because they're such a crap shoot. It's hard to know how good the physical therapist or yoga teacher will be. Many of them are young people with perfect bodies who don't have the slightest idea what it's like to inhabit a sixty-year-old body, and they'll urge you to do all kinds of appallingly unwise things. There are terrific ones. If you find them, hang on to them! But there's a lot of bad ones too. Be careful.
Trigger point massage is also a crap shoot. You should expect to have to try a couple therapists before you find the right one. But the nice thing is, the bad ones don't usually hurt you. You can afford to try a couple. It's a much lower-stakes game.
A final note about stretching: damaging stretches can become almost addictive. It feels so good, sometimes -- like scratching a maddening itch. But it can be like scratching a rash: no matter how much relief you get in the moment, you're really just going to make it itch more. There's can be a temporary relief, and even a kind of pleasure, in tearing a muscle. But stretching should never hurt. Never. If a stretch starts to hurt, or you start to tremble with it, stop at once. Back off. You're doing too much.
If you must stretch, read Bob Anderson's book and learn to do it right. I don't even like the word "stretching," I do something in the morning that probably most people would call "stretching." But I'm not trying to make my muscles longer. They're a perfectly good length. My body looks after sizing my muscles, and I'm happy with the job it does. I'm exploring my range of motion. The idea is not to extend my range of motion, though that happens, sometimes. The idea is just not to lose it. If you never lift your arm over your head, you will, sooner or later, lose the ability to lift your arm over your head: that's why I move. Or, as some people might call it -- but I don't -- "stretch."