The task is not so much to see what no one has yet seen; but to think what nobody has yet thought, about that which everybody sees. – Erwin Schrödinger
Draft 2026-03-26
Plateau may be a waypoint rather than an endpoint
This is a technical site for wellness and rehabilitation professionals. It documents the recovery of functions stalled in a plateau having a low expectation of improvement.
In rehabilitation terms, the improvement could be described as a recovery of action-oriented body schema and motor planning rather than a change in the body per se.
Photos of actual people show a graphic portrayal of how their lives would have remained for a lifetime if their progress had not resumed. Notice to the general public: the images and videos may be disturbing.
Click the image to jump to the example. Images are after exiting their plateau.
Beth had a C5-C6 spinal cord injury and rode an electronic wheelchair
Luis required his wife or family to translate his attempts to speak after a stroke 10-years prior
Margaret chose not to die after total paralysis from a motor vehicle accident
Accepting the maladaptive status quo
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Many patients plateau even after good care. In some cases, the limiting factor may no longer be strength, flexibility, or tissue healing alone. The body may remain organized around a persistent protective state, such as guarding, that continues after its original purpose has ended.
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Plateau often marks the endpoint of rehabilitation efforts. Often traumatic, the focus shifts from the optimism of what might have been to the reality of a diminished quality of life that is not expected to improve.
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Under accounted for, ending attempts to restart functional improvements sets up a self-fulfilling prophecy that has commercial and societal implications.
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Restarting functioning may be the antidote
Beth, Luis, and Margaret improvements demonstrate that their plateau was a waypoint, a time to wait for a signal to get going again. Outcomes-driven, the interactive methods present different environments for the body to select what it needs and ignore the rest.
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Some events are challenging to comprehend, such as when Luis resumed his propositional speech (thoughts to speech) after two sessions. Other times, progress is incremental, but measurable, as experienced by Beth and Margaret.
What my work is about
My goal is to develop methods for clinicians to restart difficult cases that seem stuck. The methods aim to help the patient achieve greater progress before reaching a plateau or to restart progress sufficiently for standard rehab methods to "work" again.
Real-time recordings work like nature videos to show ordinary events, progress, and outcomes from new perspectives.​ The recordings help answer new questions and can teach how to adapt the interactive methods to achieve outcomes that challenge the notion that a plateau is an endpoint.
Examples show a restart of progress from a plateau
I began working with clinicians to test and develop methods for relieving pain that had not responded to conventional interventions. The team and I sponsored feasibility studies in different specialty clinics that led to finding guarding of persistent protective patterns as a common factor.
Sometimes the guarding state appeared to be the last step in the recovery process because the person's pain and impairment could vanish. Less complete, other physiological impairments appeared to simply restart their ordinary progression such as persistently cold hands beginning to warm and regulate temperature again.
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The feasibility studies focused on people who had exhausted conventional interventions and therapies without lasting relief. The anesthesiologist and neurologist advisors called this state "unrelenting treatment-resistant" pain and impairments. I prefer plateau terminology because the methods can gently ease the person off the plateau rather than the implied forcefulness needed to dislodge a "resistant" maladaptive state.
A rapid-pace noisy environment did not prevent exiting a plateau
​I served in the Healing Hut at the 2025 DOD Warrior Games in Colorado Springs that provided holistic health support to veterans, families, and caregivers. My role focused on relieving PTSD and phantom pain. https://dodwarriorgames.com/
The military environment of droning background noise and people meeting outside the tent was a contrast with my previous testing in quiet medical office environments. Fortunately, the noise did not appear to affect the efficiency or efficacy of the methods.
Prompting the return of thoughts-to-speech by two veterans who had aphasia/apraxia was a highlight for me. Luis arrived with phantom pain where his leg had been amputated and had aphasia/apraxia for 10 years after a stroke. Both men regained the ability to intentionally say at few words by the end of the first session.
Phantom pain is not limited to missing limbs but may be present in scars, reconstructed skin and other body parts, implanted hardware, and sites of trauma. The interactive methods aim to prompt the body to recognize and release errors in body representations and sensorimotor mismatch.
Aphasia/apraxia limits the ability to process intentional thoughts-to-speech. Stroke and traumatic brain injuries are frequent causes of aphasia/apraxia to varying degrees.
Luis came to the Warrior Games to compete in several sports designed for veterans having limitations. The games are intense to watch but you forget the limitations.
Luis arrived having volitional speech (singing only) from years of repetition but not propositional speech (getting his thoughts to come out.) I met Luis to see if we could relieve his phantom pain.
The staff recorded the session as I worked with Luis to relieve his phantom pain and to reactivate propositional speech.
Figure 1 Luis arrived with burning phantom pain, but his aphasia/apraxia made communicating his sensations challenging for the staff while his wife visited other veterans. (Left) I was pleased that his pain had reduced as interpreted by his wife. (Middle) Later in the session, he was able to intentionally speak single words. On the third day, his propositional speech was clear enough for a security guard to understand him. (Right)
The video shows a brief overview of our encounters. Luis learned quickly to touch his lips when trying to speak to help restore functional sensorimotor mapping of the actions. The mask presented varying wavelengths and frequencies to the visual system for a few minutes during his volitional singing and attempting to speak his thoughts. Similar to the experience with the other veteran, who was available for only a single session, the initial recovery of function becomes measurable during the session.
Figure 2 Luis demonstrates his ability to sing after years of melodic intonation therapy. He attempts to tell a staff member about his burning phantom pain where his leg is missing. His pain relief was most important to him at the time. No one, except me, thought that he might resume speaking his thoughts as shown on Day 2 and Day 3. On day 3, I met Luis in the dining area where he showed me his "new" abilities. We asked a security guard if she could understand is speech. 3:03
Renewed motor and functional gains after plateau in C5–C6 SCI
"Beth" sustained a C5-C6 cervical spinal cord injury in a motor vehicle collision. She reached a plateau in neurological and functional recovery after her initial course of rehabilitation. At the time, her injury had been regarded as complete
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She participated in one of PhotoMed's feasibility studies developing the variable-wavelength therapy methods. During this period, she demonstrated renewed gains in motor function, including muscle activation, coordination, and strength. These changes were followed by a return to more active physical training, including additional therapy that became eligible for insurance coverage.
Beth's course was notable for her functional improvement after an apparent plateau sufficient for greater independence and community participation. In 13 months, she was able to transition to riding a manual wheelchair. Beth's injury was regraded as incomplete following her renewed progress in motor and functional recovery.
Figure 3 "Beth" arrived at PhotoMed's feasibility studies to learn if the variable-wavelength therapy methods might experience neurological and functional improvements. Her improvements enabled her to resume more active rehabilitation therapies eligible for insurance coverage. Beth began transitioning to a manual wheelchair about 13 months after her first session.
A second young participant with a C5-C6 incomplete spinal injury, following a football-related head injury, appeared to show a broadly similar pattern of delayed functional improvement. He progressed to a manual wheelchair after about one year.
Decreasing sustained involuntary muscle contraction after plateau
Margaret's case reflects a common rehabilitation challenge: achieving a plateau having persistent spasticity, limited voluntary control, and poor functional use. Her impairments suggest that the barrier was not simply weakness, but an unresolved sensorimotor problem limiting further recovery.
Margaret was a personal friend who had been a counselor to police and fire department workers starting the day of the 911 tragedy. Her husband called to say that they had been in a motor vehicle accident but rather than die on the gurney, she had decided to live despite being presented with likelihood becoming "locked in" and unable to move her body.
Margaret had made significant rehabilitation progress before she plateaued, and her insurance coverage ran out. A year had passed without progress. We applied the variable-wavelength therapy methods to decrease her sustained involuntary muscle contraction. Logistics limited our sessions to sometimes months apart. Fortunately, any progress achieved continued after each session. Margaret was pleased to be able to move her thumb and fingers again sufficiently to grip a rod and hold a cup handle.
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Covid prevented my coming to her facility. Margaret reported her continued progress by using her hand. She confirmed many times that she had made the right choice to live. I could not to see her before she passed.
Figure 4 Margaret was a personal friend who became quadriplegic from a motor vehicle accident. Her rehabilitation therapy ended in a plateau with her left hand essentially being a club. Pressure from her thumb had deformed her index finger during the 2 years before our first session. Our sessions were widely spaced yet each was productive. Pictures from our last session (ended by Covid lockdowns) show her ability to intentionally move her thumb, grasp, and hold an object being forcibly moved.
Margaret, Luis, and Beth contributed to my understanding of life's challenges and important feedback on how my methods worked for them.
Please use the contact form if you do not have my phone or email address.
Website Note
The cases describe the experience of individual participants and do not establish expected outcomes for other people having similar injuries or limitations. Response to the methods may vary depending on characteristics, timing, concurrent rehabilitation, and other factors.