In Romeo and Juliet, Juliet asks, “Wherefore art thou Romeo?” She’s not asking where is Romeo; she’s asking why is he Romeo. Their families are sworn enemies, and if he had any other name, their love would not be star-crossed nor make their parents cross. Shakespeare would have no tragedy to tell. So, why am I in pain is a much better question than where am I in pain.
Why ask why? Because, with EDS, pain is generally par for the course. It will happen nearly everywhere, whether in your joints, muscles, organs…anywhere your defective tissue goes, and it goes….everywhere. No need to truly ask where, and doctors definitely don’t want to know more than ONE where. They won’t discuss all your pains, just your worst at the moment. Obviously they can’t deal with more than one pain, why should I? 😛
But really, I ask myself why so I can understand cause and effect. Clearly I know where the pain sharpens its claws. But, why is it clawing its way through [insert your where]?
Example, the where of my recent pain–between back of the neck and shoulder–didn’t exactly give me any reason to consider anything other than my neck or shoulder. I have both cervical and shoulder instability. The where didn’t help me, or Shane, or my son, resolve my pain, though. My son had even reset my shoulder, much to his dismay (“gross” was his exact reaction), but I still hurt. However, my physical therapist knew why I hurt there. Turns out my second rib was lifted, most likely from me lifting the boxes for my move to the camper. In the summer, he had already treated me for the subluxation of my second rib after I’d gone to the gun range with Shane (metal dueling trees are so fun! DING!). The recoil from trying a larger caliber rifle actually pushed my rib backwards. During that event, the ligament that holds the second rib on my right side had become stretched and will not spring back to a natural taut state. It’s forever overstretched, and now my second rib is forever hypermobile.
That’s part of the why too. Why does injury to a joint lead to recurrent injury?
And here’s where we get into genetics and physiology. A faulty gene caused a defect in my collagen, the protein that adds flexibility and strength to connective tissues. With weakened or insufficient collagen, my connective tissue cannot support my muscles, joints, organs, or other tissues (think bleeding gums, think my perpetually swollen left foot because the fragile tissues are leaking). Hence, I am “loosey-goosey” as my ortho said. “Wibbly wobbly” as one physical therapist said. Laxity leads to hypermobility; hypermobility leads to inflammation (pain), arthritis (pain), and tears (pain). It fundamentally answers wherefore art thou in pain?
So, why am I in pain today? I hiked a difficult trail yesterday. I haven’t trained my brain well enough yet to be more mindful during the steep ascents and descents. See, ever since my hip surgery for FAI impingement, I feel a clicking in the back of the hip with certain movements. Hours later I’ll feel pain. My physical therapist had assigned an exercise that elicited this click and pain response, an abnormal response in his experience. He’d spent a half hour trying to determine the why. In his opinion, though without MRI confirmation, he suspects a tear in the tendon because the femoral head slips slightly out of the hip socket. My joke is the extra bony growth the surgeon removed had been holding my hip into place. 😛 Regardless, I’m bound for a hip replacement someday. 😦 What am I’m getting at is I’m supposed to avoid any movement, such as a hip extension or deep flex-extensions, that will exacerbate the possible tear. When I climb stairs, I’m supposed to “put my head in my butt.” 🙂 Not literally. I need to concentrate on tightening the glutes, pulling my abs in, and holding my pelvis straight. On the trail, I need to do the same as well as lead with my left when I ascend and lead with my right when I descend. Except I wasn’t 100% in keeping to the measures to protect the joint. Now I feel the angry clawing at the back of my hip, and would probably welcome the entire leg being ripped off.
Sitting with this pain kills me. Resting with this pain kills me. It’s like adding fire ants to the wound.
I have fire ants in my pants. 😛
At least I accidentally popped my second rib back into place with an impressive pop! That’s one less pain. Just wish I knew how I reset it. That’s the crux of it all!
Still, I loved my time chasing waterfalls. I’m pretty sure the way down to view Breakneck Falls is the main reason why I hurt. I felt the sink of claws then.
One caveat: sometimes you do need to ask where. For me, the only pertinent where question is where is my TMJ disc? My oral surgeon nor the physical therapist I saw for TMJ dysfunction (disc dislocation, closed lock, limited mouth opening) know where it is. Therefore, without knowing where, they cannot know the how. As in how to possibly fix it.