Caring for the Body and the Spirit

As many of you know, I teach at an acupuncture college where an eleven week 22 hour taijiquan class is a requirement. This last quarter I had an amazing student.

The administration called me to say there was a student coming to the first class who they had not yet let register because she had a disability. They felt she probably wouldn't be able to do the class but she wanted to try so they sent her to the first class to see if I thought she could do it.

She had been through some major injuries in the past 10 years and walked with a cane. One side of her body tends to tighten up so that one leg and one arm are often restricted. For instance she often has to use her able hand to manually open her disabled hand.

I asked her to stand without her cane and to shift her weight from one leg to the other. She could do it, but with difficulty. I said she could take the class. I advised her to practice everyday and not to worry, I would assess and teach her according to her ability.

While her injuries are severe, and perhaps some aspect of them can be considered permanent, there are clear signs that healing is still taking place.

There are optimists in the world, and there are pessimists, but it is truly unusual to meet someone who so clearly acknowledges hardship while meeting every new challenge with glowing optimism. And I do mean glowing. This woman beams.

Having worked with disabled people my whole adult life I've learned a few things to watch out for. Many people unconsciously treat disabled people like they are not very smart and need constant kindness. The constant sweetness of people around them sometimes causes one of two effects. The disable person is so used to having things done for them that they sometimes become personally so weak they don't stand up for themselves. On the opposite polar end, the disabled person can become mean, rude or objectionable, because people are too embarrassed to honestly tell them when it's time to shut up.

The student I had in my class this last quarter has neither of these traits. She has a sophisticated, charming, and positive outlook. She worked hard, she concentrated, and she brought warmth and sensitivity to her interactions with other students. She was a model for all of us. I have no doubt she will make a wonderful Chinese Medical doctor.

For the final exam, I have half the class do the form with their eyes closed while the other half watches, and then they switch. When she was doing the form, and she did do the entire form, It was obvious to me that she had learned more than many of the other students. Parts of the form looked difficult for her, but looking around the room, some students weren't even sure how a particular move was supposed to be executed. I wish every student had her stick-to-it-iveness. Heck, I wish I had her stick-to-it-iveness.

I think everyone's excuses for not having met their practice goals just fell away as they watched her do the form. Do what you can do right now. Is there anything more inspiring than that?

And all this was a great reminder that we aren't practicing for some future health, or some future fight. An accident can happen to anyone. It seems rather foolish to prepare for such a thing when all the benefits of practice are immediately available. It is only through the expensive maintenance of fantasies (about what we are, and what we can become) that we put off the fruition of our practice.

The reason we care for our bodies is not in the future-- if we do indeed care, we care right now.

Ailerons

Many people have pointed out that Taijiquan may be an art designed to keep the dynamic quality of our sea legs, while on land.  It is at least designed to get us to give up the predictability of our land legs.  The image often repeated in both martial arts and Chinese medicine of the dantian being an ocean would somewhat support this thesis to.  Shirley seamen realized that the gentle pitching and rolling of the ocean was good for the internal organs.  Perhaps they wanted to keep that quality of health once they gave up the sea life.

So naturally I recommend people try doing their taijiquan on a boat sometime.  I would recommend you try it on an airplane too, but now-a-days that will likely get an over reaction from your fellow air travellers.

Still, if we were making up a new martial art today we would have to consider that by far the most potent images of balance and power are fighter jets.

The first attempts at making an airplane had to solve the problem of creating lift and steering, but once those problems were solved the airplanes still didn't stay in the air because air is not even.  In order to keep an airplane in the air one must constantly correct the pitch and the roll.

That's what ailerons do.  And that is what internal martial arts must do too.  To generate continuious power while maintaining circular motion requires constant correction.  To have unbroken balance and power we must always have an active correction mechanism which allows for adjustments of up and down, front and back, left and right and spiral twisting.  These adjustments must all be simultaneous, we never sacrifice one dimension for another.

Are ailerons a good metaphor for this?

Gaining Control

A female friend of mine was recently attacked by a crazed crackhead half block from her house.  He was big and he kicked her in the ribs.

She thought her ribs were broken, she feared for her life, and she thought about the lives of her two new born infants who were thankfully not with her at the time.  Then she "went crazy on him," and he ran off.

In telling me about the incident she said she wished she had studied martial arts because she wanted to make sure he didn't hurt anyone else.  That, I think was the rational explanation, the more spontaneous explanation, I'm guessing, would be that she wanted to kick his ass.

A few days later while we were sitting at an outdoor table at a local bakery/cafe, she asked me how much martial arts training would have helped her.  I dodged the question and talked to her a bit about self-defense and what kind of training we do.  Then a 300 pound guy sat down next two her on a large green wooden box which had a sign saying please do not sit here.  The purpose of the box was to guide the flow of foot traffic around the tables and chairs, and thus, not for sitting.   It promptly toppled over onto her--bruising her arm.

The guy was naturally embarrassed and apologetic.  But that prompted her to ask me if studying martial arts would have prevented her from getting hit by the box.

So I was cornered.  Would martial arts training help with a surprise attack or a surprise accident?  Yes, probably, maybe, I'm not sure, I don't know,... how could I know?

Hexagram 10 of the Yijing (I Ching) is about just such a situation.  The title reads Treading (Lu):

Treading on a tiger's tail: one is not bitten.  Auspicious.

The image is of an innocent, perhaps a 10 year old child, stepping on the tail of a tiger and not getting bitten.  Why?  We don't really know.  Perhaps it is because the tiger isn't hungry and 'though surprised, it doesn't feel threatened.

Chinese Internal Martial Arts cultivated with a Daoist perspective achieve quite the opposite results of what most people think.  These arts are not about gaining control.  They are not about preparing for some monstrous future attack.  They are not about trying to control or predict the future.

To the contrary, they are about giving up the effort to control.  The basic  assumption or experiment of internal martial arts is that other options will present themselves effortlessly when we give up trying to control.  Does this really happen?  Yes, probably...maybe...How could I know?  I don't know, I simply have the experience that being less aggressive reveals other options.  I certainly don't know in advance what those options will be.  I keep repeating and simplifying the experiments because having options sometimes seems akin to freedom.

In Buddhism they have the expression, "Skillful Means," to describe brilliant techniques on the road to enlightenment.  But it's also kind of a Buddhist joke because the end result requires no skill at all.

In my opinion, this friend of mine who got attacked, did everything right.  She did get some bruises on her ribs, but frankly a couple of weeks training in martial arts could easily produce the same injuries.  After she chased him away by whatever crazy moving, screaming and raging she did, she even had the peace of mind to record all the details about his clothing and appearance for the police.

Her innocent response was good enough.

And that is the point of this post.  Not only are we cultivating weakness, we are cultivating innocence.  The skills we develop in all the Internal Martial Arts involve discarding our learned responses, discarding our preconceptions about what our body is and how it works, discarding our ideas about how events begin and how they come to a resolution.

Discarding pretense, embracing innocence.

Cutting Off the Head of the Hydra

Some of my readers and students wonder why I'm always talking smack about some other "modality."  (Some of my dear readers, on the other hand, probably love it.)   There is a simple reason for my conduct.

The basic subject I'm trying to communicate (Daoism and Internal Arts) is actually characterized by the dropping of preconceptions.  To get someone to drop a preconception is no easy task.  One way people drop a preconception is through having an experience which does not fit into their world view.  Unfortunately, most people, most of the time, will discard the experience rather than drop the preconception.

So the task falls to me to point out just how outrageous and in appropriate a person's preconceptions are.

In a very really sense, our conversations use our preconceptions as a base from which to accumulate knowledge.  That is why Daoism and Daoist methods of cultivation seek to return to simplicity, to actually lose knowledge, to discard knowing in exchange for not-knowing.  It is not a total rejection knowledge and knowledge accumulation, it is rather a recognition that preconception is the basis for accumulating knowledge.

So if we are talking about the body, or the body mind connection or how something internal moves, we are going to have that conversation from our preconceptions.  If you've practiced Yoga, that's your door into the conversation.  It's not that I totally reject yoga (I'm actually happy people enjoy it so much), it's that in order to get you to understand what I'm saying I can't just let you think of it like a Yogi would, I have to do something to get you to drop that preconception.

I think of this like Hercules fighting the Hydra.  As he cut off one of the heads, two more would grow back in its place.  To beat the Hydra, Hercules had to smash each head between two rocks!  The heads of this Hydra are all different "modalities."  The ever growing vicious heads of this Hydra are Yoga, Pilates, weight lifting, physical therapy,  dance, the ever evil qigong jock, MMA, the Karate Kid, Mellow Zen Flow Tai Chi™, Boot Camp,  personal sports trainers,  the Olympics, and yes, your fist grade teacher who kept telling you to stand up straight!

Now that you have been prepared, dear reader, I would like to briefly repeat my injunction against Core Strength.  As far as I can tell, the idea of Core Strength came from Pilates and started spreading to other modalities from there.  The previous two posts have been about internal flexibility, and the post before that was about carpal tunnel syndrome.  As far as I can tell, Core Strength is internal tightness.  It is the systematic loss of internal flexibility.  It is the exact opposite of what we want to do.  180 Degrees.  It will increase your chances of repetitive stress injuries like carpel tunnel, tennis elbow and the like.

Was that the sound of a Hydra's head crunching?

The Rubber Band Effect

This is a continuation of yesterdays post on Internal flexibility.

Human beings are like rubber bands.  If you spend all day with people and come home to a crowded house and don't get any days off for months at a time...you will crave retreat and alone time.

And the opposite is true, if you go off in to the woods by yourself for two weeks, you'll be wanting to party.

I've done a lot of food experiments over the years.  At one point I was using my programmable rice cooker to make rice porridge (jook, bai jou, congee) every morning.  I varied the ingredients a lot.  First I would consider the season and the weather, then I would take my pulse and look at my tongue in the mirror.  For this time of year I might have ground sesame with a little bit of white fish, salt and a small amount of fresh green onion (scallions).  In Chinese medicine this recipe cools the blood while also strengthening it (also recommended for women who have recently given birth).  The green onion  helps with the transition to Fall, invigorates the qi, and releases the surface of the skin (helpful for  staying cool).

But everyday I would change the recipe, perhaps the next day my rice porridge would include  roasted pine nuts in chicken stock (Tonify qi, calm wind).  The variations were infinite but for about a year I was very strict  that every morning I ate rice porridge of some kind.

The results were great, my digestion was wonderful, I loved it.  The problem was the rubber band effect.  I couldn't go out to eat without feeling terrible the next day.  It all came to a head when I went to visit my sister in Seattle.  We had pad thai and something else fried two nights in a row, and breakfast was whatever, eggs, toast, cereal.  My tongue turned black.  I felt terrible.  My body was craving the regularity I had taught it to expect.  I realized that although I could get great results from strictly regulating my diet, it also made me really inflexible about what I could eat.

The rubber band effect is important for understanding stretching and flexibility.  If you stretch a lot in one day, you are likely to wake up tighter the next day.  I've known many yoga teachers who were really stiff when you met them for tea on a foggy afternoon, but in yoga class, after a warm-up, they could get into some serious pretzel shapes.  This is one of the differences between internal and external flexibility.  Internally flexibility is available all the time, external flexibility requires a warm-up.  (Bikram Yoga is the worst because they super heat the rooms, making the rubber band effect even stronger.)

I've found that I can reduce the rubber band effect by gradually increasing my stretch over a week or two so that the change doesn't happen all in one day.  But the long term results will still be external.  Internal flexibility is just a different animal.

So you might now be wondering, can I have both internal and external flexibility together?

To answer that question I should start out by saying, some people are naturally internally flexible.  It is rare, but I have a friend in Australia who can do the splits anytime, anywhere, and I lived with him for a while so I know he never stretches.  I've also known a few people who were naturally externally flexible, their joints are always loose because their ligaments are long.  These people (mostly women) are 'floppy' and often want to develop muscle tone in order to simply hold themselves together.  They really don't need to stretch but sometimes find themselves in jobs as Yoga teachers or even contortionists because it's so freaking easy for them.

Chinese have traditionally given a lot of attention to training people before puberty because the body you have during puberty is remembered as kind of a stable state.  It is what you will tend to rubber band back too if you have enough exercise, qi, sleep, and a modest diet.  If the body you had through puberty was flexible, you'll tend to find that flexibly easier to keep or to recover.

Now that I've got that out of the way, the answer is yes, you can have both internal and external flexibility in the same movement.  It just requires that you don't create the rubber band effect by stretching past your internal threshold.

Many martial arts teachers teach stretching routines like 'chin to toe.'  I believe that some of them are both internally and externally that flexible.  I don't want to give the impression that internal flexibility is permanent or that it requires less of a time commitment.  Like my external flexibility, my internal flexibility changes from day to day.  For instance, after getting sick for a few days my internal flexibility can shrink down to almost nothing and I'll feel internally tight.

Internal Stretching vs. External Stretching

I wish there was a simple way to explain this.

I'm not genetically flexible and although I did train martial arts before puberty, I didn't do enough to make me significantly more flexible than an average guy you might meet on the street. So at seventeen when I really got into dance for the first time, I started stretching a lot, everyday. And when I say everyday, I mean, everyday--I didn't miss a day of stretching for probably 5 years.

All that yoga prop junk is just for people who are short on time, if you have the time to stretch you don't need a prop. (There is one exception; sometimes a coach will advise a prop because someone is stretching unevenly, for that it is an extremely good idea.)

Stretching the same muscles day after day while doing kicks and jumps that use your maximum range of motion is painful, but it's muscle pain, it's the kind of 'hurts so good' pain that all athletes love. It's not debilitating pain, it's not nagging pain. Who am I to tell people not to do it?

I'm nobody. If you do it and you like it, keep doing it. But I have a duty of another order. I'm here to be a voice for another way of thinking and experiencing life. I'm here to represent the unique study of Chinese Internal Martial Arts and their relation to a Daoist view of what a human being is.

About 13 years ago, the idea of internal flexibility started to take root in my body. It did not come from stretching, nor did it come from standing still or meditation. It came from doing what most people these days would call qigong. Specifically I was doing Tiandifu (Heaven Earth Contract) style of qigong. Most Taijiquan classes include this type of movement; expanding the dantian in all directions while extending the arms over the head and then drawing everything back in. The thing is I did more than most people do and I was really focused on lengthening the spine.

At this time in my practice I could do what they call in gymnastics a back walkover. But in order to do it I needed to do a lot of stretching, especially bridges. From doing the internal spine lengthening, the quality of my flexibility totally changed, I was able to do a back walkover cold. Cold means without warming up, without stretching out first.

Then about ten years ago I was on a backpacking trip and I fell with a heavy backpack on. I really hurt my arm and my back. For the first time in my life I was waking up in the middle of the night in pain. It took a long time to heal and I've never gotten back to the point where I could do a back walkover cold. Bummer huh?

The plus side is that now I have a lot of expertise about spine injuries. Also I've thought about and tried a really wide range of stretching routines.

So what is the difference between internal stretching and external stretching?

External stretching is when you put pressure on a joint or a muscle or a muscle group in order to get it to relax and/or lengthen. When we do this type of stretching we cut off the connection between our dantian and our limbs. If we do this kind of stretching we have to do the same stretches everyday because the dantian will automatically try to suck our limbs back into itself while we are sleeping. (If you don't sleep for 24 hours you will likely be really flexible but also at higher risk of muscle/tendon/ligament tears.)

Internal stretching may not look like stretching. To stretch internally our arms and legs have to be a part of the dantian. Once a person has this feeling in motion, the stretches are easy to find or invent.

The dantian expands, condenses, rolls and twists. As it moves, so must the limbs move with it, as one continuous whole. You've probably heard that before, but are you doing it? Is the movement of your thigh the same movement as the movement of your belly? Is it simultaneous? Does it have the same quality?

This is one of those things which is so simple most people miss it. In order for a person who is flexible by training to develop internal stretching, he or she will have to give up what they are already good at.

Su Dongchen and Luo Dexiu

Su Dongchen and Luo Dexiu are gongfu brothers from Taiwan.  They both teach Gao style Baguazhang, 5 Element Xingyi and some Taijiquan.  I've taken workshops with Luo and he is great.  I've seen a lot of video of Su Dongchen (someone gave me 4 hours worth a few years ago) but I've never met him.  Because they are both so good, both into fighting, both do the same stuff, and...yet have differences...they are interesting to watch and compare.

While most of these videos are designed to communicate basic stuff, I hope it is obvious that there is no way anyone can get this good without lots of spontaneity and experimentation.

Essence of Evolution is Su Dongchen's site.

Watch his videos here.

Some of Luo Dexiu's videos are here.

This is his site in English, in Chinese. Enjoy.

Bagua in Nanjing?

A Baguazhang student of mine has a job teaching Clowning to acrobats in Nanjing starting September 15th for six weeks.  Does anyone have information about martial arts schools or teachers currently in Nanjing?

Other interesting contacts would be welcome too.

Emptiness

Appetite and desire, what's the difference?

Yes and O.K., what's the difference?

Jing and Qi, how can we differentiate them?

When we give a name to something which is subtle and difficult to discern, we risk obscuring it, even losing it, because the hardness or fixedness of the name shines light on something which only exists in the dark.  This isn't an argument against naming, only a reminder that naming is a kind of aggression.

Chapter 15 (Wangbi numeration) of the Daodejing,

The ancient masters of the Way

aimed at the indiscernible

and penetrated the dark

you would never know them

and because you wouldn't know them

I describe them with reluctance

they were careful as if crossing a river in winter

cautious as if worried about neighbors

reserved like guests

ephemeral like melting ice

simple like uncarved wood

open like valleys

and murky like puddles

but a puddle becomes clear when it's still

and stillness becomes alive when it's roused

those who treasure this Way

don't try to be full

not trying to be full

they can hide and stay hidden

This translation is by Red Pine and I think it is great.  He also translates commentaries on all the chapters, like this one by Ho-Shang Kung, "Those who aren't full are able to maintain their concealment and avoid new attainments."

What a contrary piece of advice:  Avoid new attainments.

What does someone who is "empty" look like?  Well, like they are walking on slippery thin ice without breaking it--very light, very delicate, precise with out being confident.

I think the phrase, "worried about neighbors" means attentive in all four directions.

Guests wait to be invited into action but help out generously if they are needed.

Melting ice is always becoming less.

The uncarved wood here is like big pieces of lumber, it is very useful but it is in a potencial state, uncommitted.

To practice being empty is a Daoist precept.  In martial arts emptiness seems like a pinnacle of achievement, but then I read this I'm reminded that fullness is hard to give up.

Empty and full, what's the difference?

Carpal tunnel syndrome

The other day in class I remarked that the cause of Carpal Tunnel Syndrome is that people don't extend and contract their fingernails when doing repetitive motions with their fingers or hands like typing. Needless to say, this led to an attack on my authority. Have we entered the era of: 'Everyone Is An Expert?' To modify something my Indian Dance teacher was fond of saying, " A little Google is a dangerous thing." Of course, it is reasonable to ask a teacher, on what basis they are making a claim. Unfortunately, thirty years of martial arts experience seems to be about on a par with one feisty Google search. Beware of any problem ending in "syndrome." That means it is difficult to diagnose because there are many things which could cause the same symptoms. In this case what we are talking about is a narrowing of the Carpal Tunnels in the wrists accompanied by swelling, pain and numbness or tingling. 9 tendons along with nerve flow and blood pass through each Carpel Tunnel. Surgery for "fixing" this syndrome involves the cutting of the ligament(s) that contain the underside of the wrist. I've never had Carpal Tunnel Syndrome myself, and I've never cured anyone of anything. (I have offered suggestions for treating problems in which it was later reported back to me that, due to having followed my suggestion, the problem went away-- but I will always remain skeptical of my own ability to invoke healing.) I have had students who were diagnosed with Carpal Tunnel Syndrome before coming to study with me, but it is very hard to say with any confidence that a recommendation I made was more important than the 20 other things they were doing to try and cope with the problem. One student I recall was convinced that wearing wristbands with magnets in them completely cured her Carpal Tunnel Syndrome. This all came up because I was teaching a two person partner exercise called joint pulsing (kaihe), the opening and closing of the joints. When I first started teaching this years ago, nobody had seen anything like it. Then one quarter a student who was an assistant chiropractor said his boss had an expensive machine that he hooked people up to which did the same thing. Another quarter, a student said she worked with autistic children and the staff had been taught to pulse the children's wrists and elbows because the compression was calming. This quarter a student said she had already learned joint pulsing as an assistant physical therapist. Ugh!  Of course, nobody had been told that this information came from Chinese internal martial arts. Nobody had been taught that the purpose of pulsing the joints was to have a passive experience of what one's body can do naturally, on one's own. That is, that the manual experience of having one's joints pulsed reminds us of how we moved in the womb, as toddlers, and even up until age 5 or so. Once we are reminded of the experience of this quality of movement, we can recover the ability to move this way at will. The ability to move and animate our bodies the way we did in the womb is sometimes called Yuan Qi, or original qi. While becoming a human rubber band is a cool trick, the purpose here is to make our movement simpler. Simpler movement is more efficient. Efficient movement is more sensitive. Sensitivity to the ways in which we habitually waste qi, allows us to conserve qi. Conserving qi, is the equivalent of non-aggression- wuwei. Needless to say, none of these student "experts" had learned the easiest part of of joint pulsing which is extending and contracting the fingernails. In Chinese practical anatomy, the nails are considered the ends of all the tendons (Perhaps sinew is a better term because it is more general but tendons works fine for this example.)

1. Place any finger tip on the side of the index finger of the opposite hand and then place the thumb on top of that finger nail.


2. The thumb needs just enough pressure so that if it moves it will not slip but will maintain traction on the nail.


3. Gently move the nail inwards for 3 seconds and outwards for 3 seconds, repeating continuously for up to 20 minutes per nail. The motion is gentle and fluid, not forceful. It should feel like you are a cat that can extend and contract its nails/claws, albeit, much less movement than a cat can achieve.

After practicing this for a while, you will be able to extend and contract your nails at will. This is fundamental to internal martial arts training. For instance, in Taijiquan, the fingernails extend during ji and an, and contract during lu and peng. (Note: This is Jin level training. At the next level up, kaihe is left in a potential state.) When extending the finger to push down on a typing pad, one's nail should extend out first. For most people this is normal, unconscious, and happens at lighting speed. Carpal Tunnel Syndrome is caused by unconsciously contracting (or drawing in) the fingernails while performing some repetitive finger motion like typing. I know this because when I contract my nails while typing I can feel my carpal tunnels narrowing. After a while they start to swell from the internal friction. But I'm not going to give myself carpal tunnel syndrome just to prove it to anyone else's satisfaction, and I don't know how to cure it once damage has been done to the nerves. So I'm not claiming curative powers here, just that I can teach people a skill that if maintained, will insure they don't get Carpal Tunnel Syndrome at some time in the future. Traditional Chinese long life practices have for centuries been a source for remedial knowledge about the body. Unfortunately the modern tendency to seek out individual methods, fractured from the source, results in a loss of information at best--and a complete obscuration of purpose at worst.

UPDATE: Jan, 2011:

Having just had an older student of mine go through a really bad case of Carpal Tunnel Syndrome, including surgical intervention, I've changed my views somewhat. I still maintain that kaihe (open/close) skills are key to avoiding this syndrome.  However, nail pulsing should really just be seen as an introduction to whole body shrinking and expanding.

I now believe that there are a whole host of inhibitory movement constraints which can wear out the functional uses of the hands.  Carpal Tunnel should be understood as part of a larger picture with many possible contributors, which is why simple solutions like magnets or massage might work some of the time.

I believe what happened in the case I watched progress is that the inhibitory factors on both the top and the bottom of the hand/arm were both activated at the same time.  This effectively compressed the joints, made stretching very difficult and painful, and slowly reduced all mobility.  (Imagine two pulleys tightening up on opposite sides of  a tent pole at the same time, or pressing on the gas and the brake at the same time.)

The reason the exercise I described above is so good is that it is passive, which means that you can see or attend to the movement without putting your mind into the hand.  Once the mind is in the hand, the inhibitory muscles are on, and if that is the cause of your problem, no amount of "trying" to pulse is going to help.  To get an effective release, the movement has to cut the controlling frontal cortex out of the loop.  I can theorize that unconscious typing like the kind that used to happen in typing pools is not a problem, it is linking up the thinking part of your brain with the action of typing which causes stress.  And simply practicing pulsing an hour a day is a losing battle if you are thinking with your fingers for the other 23.  Like all qigong, the method has to change one's everyday behavior to be effective.

Unfortunately it's a safe prediction that Smart phones are going to make this problem worse.  I imagine people are already "air texting" while they are thinking about what to say to their partner when they get out of the shower.

Post surgery, in the case I watched progress, there was immediate pain relief and increase in mobility.  Very positive results.  However, there is a very strong continuous pulling of the palm downward.  This is an inward contraction from deep in the torso which is causing flexion of the wrist.  It is of course inhibiting expansion of the underside of the arm/hand and inhibiting extension of the wrist.  In other words, the cause, what ever it is, appears to still be there.

(Also see Comment #10 to Belbe below in the comments section.)