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the down stroke, followed by elbow flexion and supination of the hand and elbow on the return part of the stroke. Many deep- tissue/myofascial techniques, such as muscle stripping or sinking through superficial tissues to reach deep areas, require a lot of elbow flexion, as well as using the elbow to apply pressure. Others require full elbow extension. To treat trigger points, pressure is applied to the point of the elbow when it is used for ischemic compression, and full flexion is also required. Since my expertise is in Swedish, deep-tissue, and trigger-point massage, elbow problems would have permanently ended my ability to use my arm in my massage work. It also wasn't clear I would have normal hand function. The ulnar nerve runs down the back of the elbow (in a groove directly behind the shattered medial epicondyle). The nerve could have been damaged by the fall itself, during surgery, or later, by adhesions developing around the nerve, gluing it down to other structures and compromising its function. Since the ulnar nerve makes it possible for us to type, grip, pinch, make a fist, work buttons, etc., damage to this nerve can have a profound effect on hand function. Numbness or difficulty with coordination of the fingers and pain in the hand, wrist, or elbow were also possibilities. 3 During a three-hour surgery, two surgeons worked together to repair my elbow, installing two metal plates, eight screws, and 11 pins to hold the fragments in place. The arm was then placed in a cast, with the elbow bent at 90 degrees. Although after one week I could take the cast off three times a day for a few minutes to exercise, and after three weeks a physical therapist would stretch it during therapy sessions that frequently brought me to tears, the arm remained mostly in the cast for eight weeks after surgery. The day the cast came off, my elbow was very crooked, with 90 degrees of flexion (140 degrees is normal) and 40 degrees of extension (0 degrees is normal). At this point, I decided to do more than just the standard physical therapy program for a shattered elbow. I was aware that my doctor and physical therapists had low expectations for my ability to return to massage, yet I was buoyed by many cases of wonderful healings I knew about—instances when determination and a willingness to use additional therapies had achieved amazing results. For example, Meir Schneider, PhD, was born with cataracts, certified permanently blind in his homeland, and did all his schoolwork in Braille; yet, he overcame congenital blindness with diligent practice of the Bates Method of vision improvement. 4 Normal range of elbow flexion and extension. Image courtesy www.jerushaellis.ca. Novelist Paul West suffered a massive stroke that did not respond to standard therapies. In One Hundred Names for Love, his wife Diane Ackerman describes her own mix of therapies that healed him— intensive brain workouts, daily swimming, and specially designed speech therapy. 5 When he was 48 years old, Catholic priest Mark Neary suffered spinal cord and traumatic brain injuries in a fall. Before beginning alternative therapies, Neary laid in a hospital bed in a fetal position 24 hours a day for two years. Using osteopathy, qigong, acupuncture, Feldenkrais-style physical therapy, chi nei tsang, and Egoscue therapies, Neary began to slowly improve, and made huge progress toward healing. Today, he walks on his own, lives on his own, and enjoys a rich and interesting life. 6 Arthur Boorman, an obese veteran with knee and back injuries acquired as a paratrooper, was told by physicians that he would never be able to walk without crutches. However, through diligent practice of yoga, he is now able to not only walk without crutches, but to jog without pain. 7 Given these inspirational examples, I felt an intensive, integrated program would give me a much greater chance of success than standard physical therapy alone. I added many other natural techniques, including active isolated stretching, acupuncture, hydrotherapy treatments, massage therapy, pool exercise, and vitamins and herbs. This program, followed diligently, greatly improved my outcome. Improvement came slowly, as I worked on all possible movement C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 75