SOUTH KINGSTOWN, R.I. — Spinal stenosis stole the final years of Dr. Mark Coppes’s career as an orthopedic surgeon, but it didn’t end his days of helping others.
“You don’t always have to operate on people to get them better,” said the physician, debilitated by a congenital condition bringing early onset of the disease and forced into retirement by it.
Starting as a personal recovery journey in 2018, his mission now focuses on helping others’ rehabilitation from spine and joint ailments. Through the South County YMCA, he has designed for himself a tough aquatic physical therapy program. Since earlier this month, that program is being offered to others seeking relief from pain and an increase in mobility.
And if this pilot of his aquatic therapy program is successful, it could soon be sponsored in other Rhode Island YMCAs, according to Greater Providence YMCA officials and Coppes, whose practice, Ortho Rhode Island, is behind the effort.
The journey began for Coppes, 61, with the diagnosis of the stenosis condition and problems that developed in his late 50s. A serious sign appeared while walking on the beach when he started tripping because his toe would catch the sand. He knew that was the signal for a dropped foot, which can arise from his condition.
“That was the first symptom I had. My neurologic function was starting to become impaired,” said Coppes, a self-described extreme athlete who played hard in the sports of soccer, rugby, wind surfing, snowboarding, snow skiing and hiking. His work was also physically demanding, as he would stand on his feet for many hours doing surgery, some days for 10 hours or more.
These medical issues in 2018 resulted in two spinal fusions. However, complications in the operation left him with severe neurologic damage in his right leg, he said.
“I was basically practicing, up until the last surgeries, by sitting on a stool moving around. After the two (fusion) surgeries I decided enough was enough. There was no way I was going back to standing 10 hours a day,” Coppes recalled.
Stopping surgery was one fallout, but another was needing intense physical therapy to regain more use of his leg and help adjust his spine. Regular approaches were not working for him.
As a trained doctor in spinal issues, he set out to create his own program that used the features of water, gravity and resistance to help him.
“My strength was crappy, my balance was bad, so I literally just got in the pool at the YMCA,” he said, and started walking back and forth. This, too, did not bring the results he wanted.
“I got a few books. I looked at some of the stuff that was out there. There was little guidance,” he said. Using his medical knowledge, he decided to design his own program, which included a variety of exercises five times a week for 40 minutes during each visit to the pool starting in September 2018.
“I’d add some things, then I got to the point where I’d run in deep water with a flotation belt,” he said, adding, “You ask me to run right now on dry land, no way.”
He explained that when standing in waist-deep water, 50 percent of body weight is taken off joints. When going to chest height, it’s almost 90 percent.
“So you can do more things in the water, then on ground. You’re not fighting gravity. But since water resistance is 12 to 15 times more than air, you’re getting a better work out and getting less beating on your body,” he said.
The doctor said that he saw the rehabilitation value in this approach years ago and often suggested it to patients, but only about half tried some form of it. The others did not like water or to wear a bathing suit, so they declined to follow his advice.
But his pool partners, seeing the progress he made, jumped into the water with him. In December he started a class at the YMCA for about 11 people, ranging in age from their mid-60s to 80, who meet twice a week for 30 minutes to attend his sessions with them.
“There’s this one lady, she’s only come three times. She was always afraid to walk because her balance is poor. But after the third time she was walking backwards with dumbbells in her hand in the water,” he said, adding, “The first time I couldn’t even get her to even walk at all. So her self-confidence has improved.”
“The best is that she said that ‘I’m not afraid’ now to walk,” Coppes added.
He called his program the neutral spine technique. He designed it to alter body mechanics to help compensate for stresses on the back.
“There are so many things, like a hip inflection contracture or a hamstring contracture,” he said about these conditions shortening and hardening muscles, tendons, or other tissue, and often leading to deformity and rigidity of joints.
“These will alter the way your body mechanics are. Even though it’s subconscious, you don’t know it. People are walking and because they are tight in certain areas, they might flatten out their lower back which increases wear,” Coppes said.
“The whole point,” he said, pausing, “is to try to go back and balance it so you decrease this risk of damage and pain.”
This program has caught the attention of Steven O’Donnell, former Rhode Island State Police superintendent and now chief executive officer of the Greater Providence YMCA.
“The quality of one’s life can be enhanced by this and many of our other programs,” he said. Thomas Noret heads up the South County YMCA and praised Coppes’ efforts to provide an innovative solution to spinal health.
“Some of the program participants have come by my office, stopped me in the hallway and on the pool deck, just to say thank you for bringing this member benefit to them,” he said.
O’Donnell explained that the program’s participation numbers and results will be evaluated in six months to determine whether to offer it in other participating Greater Providence YMCAs.
For Coppes, the program still remains as much about helping himself as others. Offering it at other YMCA sites would sustain his continued desire to use his medical training.
“I’ve been grappling with the loss of my work for a while,” he said. “I can’t do what I used to do, so I have to work with what I’ve got left.”
He grew silent again, as he often did, when recalling his days treating patients daily.
“I think it’s an extension of what I used to do. I don’t know anything else. I don’t want to do anything else,” he said. One of only a few smiles, as he talked about his disability, suddenly broadened on his face.
“I think any physician who sees a patient walk out better, you live for those moments. It gives you more personal satisfaction than other people realize,” he said with eagerness and through the smile that didn’t let go.