Eyes on the Brain

A neurobiologist explores the amazing capacity of the brain to rewire itself at any age

No Pain, No Gain?

Regaining the use of my hand.

After I broke the radius bone in my right arm, my forearm was put in a cast for six weeks. I couldn't wait for the cast to come off, and, when it did, I assumed that I'd quickly go back to my right-handed ways. But that's not what happened. I had gotten into the habit of protecting my right arm and had learned to use my left hand, clumsily at first but with increasing skill, for most everyday tasks. What's more, my radius bone hadn't healed quite right so that it was no longer in perfect alignment with the wrist bones above it.  My right wrist felt stiff and my right hand weak. Even without the cast, I continued to comb my hair, brush my teeth, open doors, and eat with my left hand. I had gotten out of the habit of using my right hand. I had learned not to use it.

Fortunately, my orthopedist sent me to a hand therapist, an occupational therapist with special training in rehabilitation of the hand. I loved some parts of the therapy, especially when my hand and forearm were dipped into warm paraffin wax, then sandwiched between hot towels, and finally massaged. These procedures helped to soften the scar tissue, and made my arm and hand feel great. But, the exercises that followed did not.

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My hand therapist instructed me to rotate my wrist so as to turn my hand palm up and palm down. Although she asked me to make an entirely natural movement, it felt as if she had just told me to do something forbidden, like bending my elbow backward or my knee in the wrong direction. After two months of protecting my injured arm, my whole being seemed to scream "No!" So, when instructed to turn my hand palm up and palm down, my entire body got into the act. I hardly turned my wrist at all but moved my arm and shoulder instead."Turn only your wrist," she said. So, I sucked in my breath and began grinding away at the exercise. I could feel my stomach clench; I felt a bit woozy. Almost immediately, the therapist told me to stop. "Breathe." she said, "Relax." With a great deal of conscious effort, I released the tension throughout my body and focused on slowly turning the wrist. As I relaxed, the stiffness seemed to melt away. With much less effort, I gently rotated the wrist.

At home, I practiced many stretching and strengthening exercises daily and, always, I had to tell myself to release tension throughout my body before working the wrist. As I went about my everyday tasks, I had to remind myself to use my injured arm. But all that effort paid off. Gradually, I began to use my right hand spontaneously again.

I should not have been surprised by my experiences with hand therapy. Ten years earlier, I had encountered something similar with optometric vision therapy. During vision therapy, I learned to straighten my crossed eyes, fuse the input from them, and see in 3D. With both hand and vision therapy, I had to break existing habits and establish new ones. This required me to become keenly aware of how I used my hands or eyes. With hand therapy, I had to break my habit of protecting my right arm, and with vision therapy, I had to abandon my habit of looking through one eye and turning in the other. These pre-therapy habits had value. When my arm was injured, it needed protection. By turning in one eye, I could suppress its input and avoid double vision. That's why it was hard to abandon my former patterns. But, the therapies provided me with more efficient and effective ways of moving and seeing, and with keen self-awareness and a great deal of practice, I could learn these better ways.

 

Susan R. Barry, Ph.D., is a professor of neurobiology in the Department of Biological Sciences at Mount Holyoke College and the author of Fixing My Gaze (June, 2009).

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