• Defining Moment

    When Therapy Packs a Punch

    The benefits of boxing to patients and a practitioner.

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    When I was younger—much younger—I became interested in medicine after sustaining a few injuries while participating in sports. It seemed to me that working with the human body and being able to fix it was one of the coolest things anyone could learn to do.

    At first, orthopedic surgery was my main interest. I was deeply involved in woodworking during high school, and I equated the 2 things. Both required great precision. But my mom, a nurse, had seen firsthand how stressful a surgeon's life can be. She urged me to explore other opportunities to help people through a health care profession.

    After I'd volunteered at a couple of clinics and had a few stints as a rehab patient, I was sold on orthopedic physical therapy as my career choice. Soon after graduating from college and becoming a physical therapist, however, I saw that I'd need to broaden my outlook. I realized that every patient or client—whatever his or her presentation, injury, or issue—might be dealing with an orthopedic condition, and that anyone with an orthopedic condition might face other issues, as well. So, it was back to the books for me, to learn more about neurologic physical therapy and developmental and acute rehabilitation. I needed to broaden my knowledge base in order to give my outpatient orthopedic patients the best care that I possibly could.

    So, fast-forward a quarter-century. About 3 years ago a boxing gym opened next to 1 of my clinics—announced to the community with a burst of marketing. Intrigued, I introduced myself to the owner, Tricia Turton-Arcaro. We talked, and I signed up for classes at Arcaro Boxing. I immediately connected with the sport.

    I loved the workouts. They simultaneously improved my coordination, agility, flexibility, and strength. Boxing ticked a lot of, well, boxes for me. But it was a personal hobby at first, with no ties to what I do as a PT. Until, that is, something quite unexpected happened. Tricia took me out for coffee to discuss a new program she was considering—noncontact boxing to help people with Parkinson disease (PD) manage their condition. She wanted to know if I was interested in serving on her advisory team.

    I'd been peripherally aware of the existence of noncontact boxing programs to help individuals with PD manage their symptoms. But when I looked into it, I found an impressive amount of evidence-based research on the benefits of boxing for this patient population, and I learned that PTs around the country and the world are right in middle of the ring, as it were. As the PT member of the advisory committee for the KO Parkinson's program at Arcaro Boxing, I would, I learned, be volunteering my time to work alongside an occupational therapist and a speech-language pathologist, as well as with Tricia—herself a boxer—and another coach. It sounded like a great opportunity for all of us—the patients, my therapist colleagues, and me.

    The program launched early in 2016. Our first participants were 2 individuals—physician-cleared and special needs-assessed—who presented different faces of the PD disease process. On the one hand, I had a certain comfort level with my role. I was, after all, in a familiar environment—the gym—and, being a veteran PT, I was a movement expert with the knowledge and skills to help people manage, and even overcome, a wide variety of physical limitations. On the flip side, though, I was new at helping people with PD. I felt much like I had on my first day on the job after graduating from PT school.

    Those early jitters quickly faded, however, as our work with our highly motivated patients began yielding results. Carl, an ex-wrestler, began KO Parkinson's with a pronounced tremor. But he has progressed tremendously over the course of the last year—from barely being able to jump rope at all, for instance, to performing "doubles" and "crossovers" better than I can. It's exciting and inspiring. He's told me that he thinks he's in better shape now than he has been at any point in his life.

    Peter has more-classic Parkinson symptoms, in that it's difficult for him to pick up his feet. He shuffles quite a bit, is very stiff in the trunk, and has difficulty opening up his hips because he feels as if his feet are glued to the floor. Working with Peter challenges me to come up with ways to get him to "unglue" himself. But he, too, has made an amazing amount of progress. He no longer struggles to nearly the extent that he did.

    Both of these men are extremely dedicated to managing their condition. They come faithfully together to the 2 weekly classes—both of which consist of 17 3-minute rounds, with 30-second rests between each. Flexibility, balance, and agility are emphasized in the early warm-up rounds. Punch sequences ensue in subsequent rounds—centered on arm, trunk, and hip movements, with the intensity steadily increasing. By the time the final cooldown round ends, Carl and Peter are tired! They're dripping with sweat. They're moving with notably greater flexibility and motor control, though. That's what we call a perfect hour!

    When we conducted a 6-month survey to ask these 2 men how they felt they were doing and whether their needs were being met, Peter called us all crazy for spending so much time with them without getting paid a dime. He added that he was thrilled, however, with the 1-on-1 attention. He told us that we'd made a big difference in his life.

    That was my moment of epiphany—when it came home to me just how right my mother had been. Thanks to her, my career has been all about helping people—without the stress I might have felt as a surgeon, had I pursued that, but with all the joys and satisfaction of service to others.

    My mom has passed away. I wish I could thank her, again, for guiding me toward the profession I love. But every time I help people like Carl and Peter help themselves, I feel as if I'm paying tribute to her, and the huge role she played in making me the person and professional I am today.

    I sometimes ask myself, if I wasn't a PT, what else would I do? The answer always is the same: I have no idea! There's nothing I'd rather do than help my patients fight—1 round at a time—the physical issues that limit their lives, so that they can emerge victorious.


    About a year ago I had surgery to repair a rotator cuff tear. I've made progress in getting better, mostly by weight lifting. But the shoulder got sore if I swung my arm the way you do with a tennis racquet. Several days ago I took an exercise class which included punching, and I discovered that this quickly improved my shoulder. I'm delighted by this, but how come I had to discover this by accident? Neither the physical therapist or the physician's assistant ever suggested I do this.
    Posted by Steve Beck on 1/28/2019 10:21:33 PM

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