It has been almost a year since I have reported on muscles and bones. That is because I have been working hard on a related topic that binds the musculoskeletal system together–ligaments. In their classic form ligaments span from bone to bone and allow joints to move in some directions and not in others, akin to hinge pins in the built world.
The manuscript is now at the publisher. Whew. As part of doing research for the book, I decided to “walk the walk” and give my ligaments a workout by taking a contortion lesson. Contortion is the performance art where extremely limber individuals showcase their flexibility in a choreographed set of moves and poses, often to music and while smiling continuously. For example, Cirque du Soleil features contortionists who dazzle audiences with their seemingly impossible postures, sometimes braced on just their hands, and then perhaps supporting one or more other performers on top of them. Some of the artists can also knot themselves up so that it is nearly impossible to describe how their various joints are positioned to achieve the pose.
A quick internet search provided the ten best contortion training facilities in Los Angeles, and I chose the Cirque School in Hollywood. Their website indicated that their performance-art classes included flexibility, handstands, trapeze, as well as aerial sessions for hoop, straps, rope, and fabric. Their website also had words of encouragement. “For anybody with any body.” That convinced me. After observing their Flexibility 101 class one evening, a week later I took a private lesson with the same instructor. Both times, other classes were going on in this large warehouse, which except for the entry area, was completely decked in thick squishy mats. Ropes, trapezes, and large rings dangled from the rafters. All the other students, predominately but not entirely women, were decades younger than me. To my surprise, not everyone was wiry; some approached stocky. (I consider myself in between.) I talked briefly to several students after class, to my instructor at length during my private session, and later to the owner, who formerly performed in the Cirque du Soleil. Here is what I learned.
Most contortionists discovered at an early age that they had some joints, particularly spine and hips, that were particularly “bendy.” (At age four, one famous contortionist could jump off the top of a bunk bed and land in a full split. Yow!) With the discovery of their unusual flexibility, they accentuate it by stretching daily for at least several hours. Contortionists generally are either “back benders” who can lean over backward and put their head between their knees or “front benders” who can lean forward and put their head between their ankles. However, that degree of suppleness in the spine ligaments in both directions is unusual. Hip flexibility is gained and maintained by prolonged positioning in a split-leg posture and performing “oversplits,” where the performer’s heels rest on two chairs with the body otherwise unsupported. It is not supposed to hurt, and apparently it does not, because I have seen people in that position blithely studying their cellphones or fingernails while the collagen in their ligaments is remodeling.
For me, even approaching 50% of a split position on the mat was what I describe as “sweet agony,” almost intolerable. My instructor said that it takes a month or two of regular work to stretch the muscles and keep them from reactively contracting and resisting the stretch. Then over the following months, the ligaments will begin to respond. During my hour-long session, I think I stretched every joint in my body except for my jaw and some toes—far deeper stretches than I have ever attempted or achieved in yoga or Pilates. I was perspiring at the end of my flexibility session, felt great for the rest of the evening, and, much to my relief, was not sore the next day. I continue to do some of the stretches, but I have no plans to run off and join the circus.
You are too old to contort brother!
Hi Randy,
Never too old to stretch a little, easier mentally these days than physically.
Best wishes,
Roy
this was absolutely fantastic to read! and kudos to you for even attempting it……I remember you as the best hand surgeon I ever worked with at the VA……..whenever I was assigned your OR I knew I was in for a great day……a skilled surgeon with a lovely temperament ……a rarity!
thank you for this terrific story……deborah frutkin, CRNA, MS
Hi Deborah,
How nice to be remembered this way. Thanks.
Ligaments are really interesting but basically ignored until one goes sour. I have many more stories to tell. Stay tuned.
Best wishes,
Roy
Great inside info for the orthopedic surgeon!
Hi Ann,
I am glad you enjoyed it. Remarkably, as integral as ligaments are to our musculoskeletal well-being, they are overlooked until one goes bad. We can feel and see our muscles and have an awareness of our bones through imaging; but ligaments are unseen, not easily imaged, and get cooked to oblivion in the oven and therefore are unavailable for tabletop study. Lots to know about them.
Best wishes,
Roy
Roy,
I have not heard from you for quite some time. I was concerned that your circumnavigation of Los Angles might have ended in disaster. Did you complete it? I’m seeing Sohail Shayfer for some arthritis in my thumbs. I think they are the only hand appendages which you didn’t operate on. He said he remembers you. Nice to learn that you’re well and active. Thanks for all your compassionate care all those years ago and best wishes.
Hi Al,
Nice to hear from you. Yes, I have completed my LA city limits walk. I had a great time. I have a book pretty well drafted and am presently looking for a publisher. I will intersperse some blog posts about the walk in with musculoskeletal topics.
Best wishes,
Roy
Hi, Roy…This will become a valuable addition to the first-ever published musculoskeletal trilogy. As the editor of the Journal of Hand Surgery you were known for your rigid adherence to good journalism. It is now pleasing to learn that you are loosening up as you prepare for the imminent publication of “Ligaments”. I am looking forward to supplementing my education in orthopedic surgery by reading your book!
Best…Dave Lichtman
Hi Dave,
Nice to hear from you. Ligaments are the Rodney Dangerfields of anatomy–no respect. Lots to know and love, however. I’ll continue to post snippets of the book.
Best wishes,
Roy
Roy – you are “one in a million”. You curiosity, creativity, energetic drive, and great writing skills all combine for a wonderful read on subjects most of us could never imagine. Whatever is next on your list will, I’m sure, be just as interesting and “out of the box”.
Susan Reuben
Hi Susan,
Thanks for the compliment. “Have fun” is my mantra.
Best wishes,
Roy
Hi Roy,
I did my first contortion exercise when I got to participate in a little helicopter accident off the coast of Vietnam back in 1972. It did not end well for me. I think of our VUSM class of 1971 a lot nowadays. Thanks for keeping me updated on your continued activities both mental and physical. You truly are a gifted “readable” writer.
Sid
Hi Sid,
Nice to hear from you. The helicopter and gravity probably did not adhere to the slow, steady, gentle stretch that your ligaments respond to appropriately.
Best wishes,
Roy
Hi Roy –
Loved reading this and greatly looking forward to your book on ligaments. Like you say – it’s something we take for granted until one or more goes south/sour (so often the case with so many body parts!). But oh my, how very very necessary they are!!
It would be interesting to find out how many hyper flexible athletes (dancers, cheerleaders, gymnasts, etc.) have Ehlers-Danlos or other hyper flexible collagen disorders. Often with that ligamentous laxity comes muscles working overtime to provide the stability the ligaments are not providing tho.
Glad to hear you’re doing well! Dave and I are also – just got home from a day of skiing. 🙂
Thanks again for all you continue to do for the field of orthopedics and medicine!
Ann and Dave Labosky
Hi Ann,
It’s nice to hear from you and know that Dave and you are doing well. Susan and I are too.
It is my impression that the Circ du Soleil performers do not have hyperextensible EDS, but rather just naturally bendy backs and maybe hips and then they work hard to accentuate their flexibility in those joints and design their performance to showcase the flexibility in the bendy joints. If they had hyperextensible shoulders and elbows, for instance, I do not think that they would have the strength to do handstands without the joints wobbling off.
The patients I have had who do have hEDS find it a burden and have to limit all activities. Several I know wear Kinesiotape across their knees to get some feedback from their skin because their ligaments are not giving them messages that enough is enough. They tend to get early arthritis. I did not get that impression from talking to people at the Circ school–some of the performers continue well into middle age, a few beyond.
Say hi to Dave.
Best wishes,
Roy
Greetings Roy:
Are you aware of the Chinese dance group called Shen Yun? They are based in the US and perform all over the county. It’s not classical ballet but just as graceful. Glad to see that you are still having fun. Best to your wife.
Tom
Hi Tom,
Nice to hear from you. Yes, we have seen Shen Yun–most impressive, but I will remain an observer..
Best wishes,
Roy