Why Do I Hurt?: Discover the Surprising Connections That Cause Physical Pain and What to Do About Them

Why Do I Hurt?

Discover the Surprising Connections That Cause

Physical Pain—and What to Do About Them

Copyright ©2018 by Erica Meloe

All rights reserved.

Cover and interior design by Frances Pharr

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopy, recording, or any other—without the prior permission of the author.

The author of this book does not dispense medical advice or prescribe the use of any technique as the form of treatment for physical, emotional or medical problems without the advice of a physician, either directly or indirectly. The intent of the author is only to offer information of a general nature to help you in your quest for physical well being. In the event that you use this information for yourself, which is your constitutional right, the author and the publisher assume no responsibility for your actions.

Paperback ISBN: 978-0-9989939-0-4

Hardcover ISBN: 978-0-9989939-2-8

Printed in the United States of America

In loving memory of my parents

Basil and Torleif Meloe,

my guardian angels.

And for Brooke, my ever-faithful book buddy.

Declare your superpowers, girl!

Acknowledgments

Where do I start?

I am deeply honored by all the physical therapy rock stars who have entrusted me with their bodies, their minds, and their hearts. You all know who you are. My patients, I honor and love you, forever and ever.

To the people who have entrusted me with their stories in this book, you have made me rise up. I am truly thankful.

I honor my sister, Margaret, who has the guts to tell it like it is, no holds barred, and certainly the truth. So grateful for you.

I honor Lloyd, who digs deep and gets to what really matters. And isn’t that the truth?

I love you, Brooke, to whom this book is dedicated to. Rise up, sister, and claim your truth. It is now or never, sweetheart.

And to Bob Rubin, who has written this foreword. I honor your honesty, your eloquence, your curiosity, and your trust.

To Beth Lottig, editor extraordinaire! Above and beyond, girlfriend, seriously. The top of your profession, to say the least. Not only do you understand writers, you empower them to a level like no other! I TRUST you, without doubt, to eternity.

To Frances Pharr, love your design eloquence, your sweetness and your extraordinary talent!! Your talents are at the TOP of your profession, truly! You propelled me to the finish line. Love you for that. You rock!!! #graphicdesignextraordinaire

To Debra Russell, where do I start? I cannot even begin to write to what extent you have helped me over the years. You really get it, don’t you? You have an extraordinary gift of pulling the best out of people. You are truly superb and that is an understatement.

To Christine Gallagher, who just always does the right thing at the right time. The epitome of a person who knows what it really means to rise up to the top and certainly much more. You give of yourself endlessly.

To Jane Austen, LOVE always. You are always my escape. When people continue to talk about you HUNDREDS of years after death, you know you have a legacy.

To Tony Robbins, listening to your Personal Power tapes gave me the courage to leave Wall Street!

To my fellow physical therapists, you all know your value and what our future holds. Let’s make a power grab like no other! Our patients are counting on us. Stand up for what you are worth. #donotholdback

To Erika, Jenson Smith. Holy Smokes!! You are THE BEST!!!! Future Emmy, Golden Globes, SAG, and OSCAR winner! Your production, direction, and writing exemplifies your true talent. Love you!!! Your absolutely graceful poses for this book make this extraordinary. You are truly a talent, bar none.

To Mom and Dad, I have tears in my eyes, every time I think of you. EVERY day I think of how you shaped me, how you would be proud of everything, your daughters and your granddaughter, Brooke, have done. Legacy is where it is at.

To Diane Lee and LJ Lee, who taught me how to evaluate and treat like a real physio. I honor your boldness, your compassion, and your grit to what really matters. You have made me rise up. Truly a game changer, to say the least.

x o x o

Erica

Table Of Contents

Acknowledgments

Foreword

Are You Ready to Discover Why You Hurt?

Finding the Source vs Treating the Symptom 

Neck

1. Really? My neck pain is coming from my shoulder blade? 

2. Really? My neck hurts because of a tight pectoral muscle? 

Back

3. Really? My low-back pain is coming from my neck? 

4. Really? I have low-back pain because of a tight hip and foot? 

Hip

5. Really? My hip pain comes from an old abdominal scar? 

6. Really? My hip still hurts because of my pelvis and foot? 

Sacro-iliac Joint

7. Really? My sacro-iliac joint hurts because of my foot? 

8. Really? My sacro-iliac joint is not getting better because my abdominal muscles are overactive?

Shoulder

9. Really? My right shoulder pain is due to an old shoulder issue on my left side?

10. Really? My shoulder has not improved because my neck is stiff?

Knee

11. Really? The source of my knee pain comes from my hip and foot?

12. Really? My knee pain is not improving because of tightness in my low-back?

Foot

13. Really? My foot hurts because I have poor muscular control in my trunk?

14. Really? My foot continues to hurt because of an overactive abdominal muscle?

Wrist & Elbow

15. Really? My wrist pain is coming from my shoulder?

16. Really? My elbow STILL hurts because of an issue with my neck and shoulder?

What to Do Now

About the Author

End Notes

Foreword

I first picked up a fly rod about thirty-five years ago, and I’ve been addicted to every aspect of fly fishing ever since—reading the water, casting, managing the line, and setting the hook, despite how often I mess it up. I’ve had the opportunity to cast a fly in some of the wondrous waters of the world, from the bonefish flats of the Bahamas to the rivers and spring creeks of Montana to the Atlantic salmon waters of Canada.

About ten years ago, I was fly fishing in Montana and did something that caused me tremendous pain. It affected me a lot, and was very limiting. No one could figure out what the issue was or, more importantly, how to make the pain go away. I was examined by distinguished doctors at distinguished hospitals. I had MRIs. The doctors catalogued a long list of potential problems. Maybe you need a spinal fusion, one mused.

At the same time, I consulted my physical therapist, Erica Meloe. Erica diagnosed the problem as soft tissue. I can feel it in my hands, she said. And it’s not difficult to deal with.

My doctors were dismissive. She’s a PT, they said. What does she know?

I’ll tell you what Erica knew: She knew what was wrong and how to make the pain go away. That’s what she did for me, and I’m forever grateful.

With this book, Erica shares her problem-solving, can-do approach to physical therapy, as well as her experienced view that all parts of the body are connected and that your pain can come from unexpected places. She dispels misperceptions about the profession, and gives you the information you need to find the PT that’s right for you. Chronic pain affects more people than diabetes, heart disease, and cancer combined; that’s why we need people like Erica more than ever. The book is not only instructive—with helpful case studies from her decades at the highest levels of the field—it’s also an interesting and fun read. And that’s unsurprising, because those are the traits that contribute to Erica being so successful at what she does: She’s focused, effective, and a joy to work with.

Erica worked for some years in finance after receiving her MBA from the NYU Stern School of Business, and then she decided that she wanted to more directly help people. And I am grateful that she made that decision, because, thanks to her, I have many more years of fly fishing ahead of me.

Robert E. Rubin

Former Secretary of the Treasury

Are you ready to discover why you hurt?

What is this book about?

This book is about helping save people from suffering unnecessary persistent pain by providing them with the knowledge and resources that put them back in control of their own body.

Why did I write this book and what should I expect?

I always wanted to read a book like this, actually. As a patient, student, and a practicing clinician, I was starved for case studies and real-life examples of how other people were resolving their pain issues. I love to read stories, and getting a patient’s history and their eventual treatment is the best story of all. You get to hear the whole story, and that’s what makes case histories so interesting and relevant to my profession. As a matter of fact, the stories contained in this book provide the reader, patient, clinician, and researcher with much-needed information revealing other potential sources of typical pain patterns.

My hope is that this book will both inform and enlighten you as the reader and motivate you to advocate for yourself. I designed each chapter as part of a toolkit, meant to empower you to solve your own pain issues and help you discover the source of why you are not moving the way you want to.

To further reinforce the idea that we treat the cause of your problem and not just the symptoms, examples of creative and integrative treatment ideas are presented at the end of each chapter. These pages are highlighted in Tiffany Blue. You can refer to these treatment plans as needed, subsequent to your initial reading of the main body of the book.

Truthfully, I got fed up with the misguided reputation that the physical therapy profession has in the eyes of the consumer, the medical community, and the government.

I use the term physiotherapy and physical therapy (PT), as well as physiotherapist and physical therapist, interchangeably throughout the book. The United States is the only country, as far as I know, who uses the term physical therapy. The rest of the world uses the term physiotherapy.¹

Honestly, sifting through the myriad of information on the Internet can be mind-boggling for sure. People look for clarity and answers on the web when it comes to their health problems, and oftentimes they end up confused and scared. Talk about ramping up the nervous system. Whew!

I know a thing or two about a ramped-up nervous system. After all, I sat on a trading floor for ten years with neck and back pain with no one able to help me resolve it. After graduating from NYU Stern School of Business with my MBA, I took a position at an international investment bank in their international fixed income research department, where I sat all day.

Shortly thereafter, I moved to the trading floor, trading and selling international bonds and their derivatives. Even more sitting, more phone work, and more stress.

After a successful decade of problem-solving with clients on trading strategies and portfolio allocations, I decided to use those same skills in the field of physical therapy to help alleviate my patients’ pain through a unique problem-solving approach.

And I got rid of my back and leg pain.

Back to why I wanted to write this book …

• I want you to realize there could be other sources to your problem other than where your symptoms manifest.

• I want you to know that I understand the experience and frustration of persistent pain.

• I want you to understand that you are unique and what works for someone else may not work for you.

• I want to educate you, the patient and consumer, about potential causes of your pain.

• I want you to understand that just because you have back pain and look up exercises for your low-back, they have the potential to make you worse or at the very least not help you if the back is not the source of the problem.

• I want you to embrace the idea that physiotherapy should be your first line of defense for musculoskeletal disorders.

• I want you to understand that not all physical/physio therapists are alike.

• I want you to understand the unique clinical reasoning process that physical therapists employ to diagnose patients.

• I want you to learn how to advocate for yourself.

• I want to give you HOPE that it can get better.

• I want you to realize that there could be other possible sources potentially causing your pain.

• I want to encourage you to not give up, as I am sure there is another solution.

We will figure it out together. Let’s get off the opioids and move on to getting yourself pain-free.

I understand that pain is depressing; it is cruel and unkind. It is also unforgiving at times. Pain appears when you least expect it and won’t go away when you want it to go. However, if you think about your pain all day, it will make you worse. Research shows that the more you think about pain, the worse it becomes.²

Let’s get off the opioids and move on to getting yourself pain-free.

You wake up in the morning and can’t move.

You can’t stand up straight.

You can’t put your foot on the ground because your heel hurts.

You have a migraine because you were grinding your teeth all night.

You can’t walk down the street because of your hip pain.

You can’t even step up onto a curb because your hip hurts.

Stairs just about kill you because they hurt your knee.

Sitting at your desk all day bothers your back.

You can’t go for a run because your ankle is sore.

You can’t play golf because your elbow hurts.

You can’t walk through an airport because your hamstring aches.

You can’t reach across to turn the radio off in the morning because your shoulder is locked up and you have radiating pain down your arm.

And to top it all off, you throw your back out after hitting a tennis ball, and you’ve played tennis all your life.

Do any of these sound familiar?

They are certainly familiar to me. I just described the many injuries I have experienced over the years, with varied causes, and I am sure I left a few out. Some were really ridiculous, like reaching over to turn off my radiator; others were not that benign.

I had a massage therapist drill her elbow into my shoulder blade, and then I could not move my arm the next day. Ouch. I love massage therapists—just not that one.

One of my patients started to faint, and I went to grab her so she would not fall to the floor. I tore my hamstring in the process, and then I went to the floor. That was a bad one. Took me out for months.

When I was in Arizona one Christmas, I hit with one of the pros at the resort where I was staying. I had played competitive tennis when I was younger, so I really got into it. The next morning I could barely stand up straight and then had to get on a flight back to New York. The flight was three hours delayed, which we found out once we got on the plane and then had to deplane. You can imagine how that must have felt.

One of the worst and most chronic ones is waking up every day with a headache and sometimes a full-blown migraine. Now that’s a nice way to start your day, right? Feeling like a Mack truck has hit you in the face.

When you sustain an injury, you want help. It seems that everyone is a doctor when you relate your story. They all give you advice—some you take and some you don’t. You’re desperate to feel better. I get it.

But you are special. You are unique. What worked for your friend may not work for you. What worked for someone on the Internet may not work for you, and you do not even know that person!

My purpose in writing this book is to educate you the patient, the consumer, about the potential of other areas of your body—areas you may not even have considered—that could