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Itzhak Perlman and Polio

Itzhak Perlman is arguably the most brilliant and beloved violinist of the 20th century and so far in the 21st. He is also so knowledgeable and coordinated that he has conducted many major orchestras. This is incredible because both of his legs are paralyzed from an attack of polio contracted at age four. He can walk only with thick leg braces and crutches, and needs a scooter to go places. He is the only world-class violin soloist who performs while he is seated.

Before the concert even starts, you know that he is a magnificent person who has overcome unbelievable adversity to be the very best. He walks on the stage slowly while leaning on his crutches. He sits down carefully on his chair, places the crutches on the floor, unlocks the clasps on both leg braces and bends his knees to place one foot backward and the other forward. Then someone hands him his violin, he nods his head to the conductor and begins to play.

https://www.youtube.com/watch?v=dPgqfHYeI0Q

Early Life
Perlman's parents were both born in Poland and were smart enough to leave in the mid-1930s before the Nazis tried to kill every Jew in Poland. They met on a Kibbutz and married in what is now Israel. Itzhak was an only child, born in 1945 in Tel Aviv, then a British Mandate of Palestine. His father supported the family as a barber and they lived in a third floor apartment. At age four, Itzhak persuaded his father to buy him a toy violin. Soon afterward, he suffered an infection with the polio virus that kept him in bed for a year and prevented him from ever regaining the use of his legs. As he was unable to go up and down steps, his parents sold the barbershop and bought a self-service laundry in the suburbs, where the family lived in a first-floor apartment next to his elementary school.

When he was five, he received his first real violin. He practiced all the time and at age 13, he was good enough to be appointed first violinist at the Tel Aviv Academy of Music. That year he was chosen to participate in Ed Sullivan’s tour of the U.S. With his mother, he made the 23-hour flight to New York and they lived there in dire poverty. He auditioned for Dorothy DeLay of the Juilliard School of Music and was offered a full scholarship. He practiced more than five hours a day. At age 17 he made his debut in Carnegie Hall.

When he was 18, he gave a violin recital at Meadowmount summer music camp in the Adirondacks. A 20-year-old violinist, Toby Friedlander, came backstage after the recital and proposed to him before she was even introduced. Itzhak had never been out on a date and didn’t know what to say to her. She chased him for more than three years. They were married five years after they first met and have five children.

https://www.youtube.com/watch?v=oBDmAxSFt6A

Concert Basso and Conductor
Not only is he arguably the world’s premier violinist, he is also an accomplished basso singer and has sung with Placido Domingo and Luciano Pavarotti. He has also served as guest conductor of the Detroit Symphony Orchestra, Saint Louis Symphony Orchestra, the New York Philharmonic Orchestra, Chicago Symphony Orchestra, Philadelphia Orchestra, Boston Symphony Orchestra, National Symphony Orchestra, Los Angeles Philharmonic Orchestra, Saint Paul Chamber Orchestra, San Francisco Symphony Orchestra, Dallas Symphony Orchestra, Houston Symphony Orchestra, Pittsburgh Symphony Orchestra, Seattle Symphony Orchestra, Montreal Symphony Orchestra and Toronto Symphony Orchestra, the Berliner Philharmoniker, Concertgebouw Orchestra Amsterdam, London Philharmonic Orchestra, English Chamber Orchestra, and Israel Philharmonic Orchestra, Indianapolis Symphony Orchestra, and Atlanta Symphony Orchestra.

Today, more than 50 years after his debut and 65 years after he was paralyzed by polio, Perlman maintains a brutal schedule of performances, with 20 concerts in just the first four months of 2015.

https://www.youtube.com/watch?v=wEmbFSiJzEQ

What is Polio?
Before doctors were able to vaccinate against polio, that disease was a very common viral infection in children. For most, polio was a mild disease, lasting only about 10 days and causing mild, flu-like symptoms such as fever, sore throat, headache, vomiting, fatigue, muscle stiffness, pain and weakness. However, the virus can infect nerves and damage them to cause both temporary and permanent paralysis of any muscle in the body. Some people regain all of their muscle function while others remain paralyzed forever.

Post-Polio Syndrome
Anyone who has ever suffered from a polio infection can develop the post-polio syndrome. People can recover from polio and appear to have normal muscle function, but many years later, they gradually develop some or all of these symptoms:
• progressive muscle and/or joint weakness and pain
• general fatigue and exhaustion after minimal activity
• loss of muscle size and strength
• difficulty breathing or swallowing
• sleep-related breathing problems such as sleep apnea
• severe intolerance to cold weather
• loss of ability to concentrate and remember,
• depression and mood swings.
Post-Polio Syndrome occurs in 25 to 50 percent of people who have had polio in the past, It usually appears about 35 years after the original infection, but this varies widely,

What Causes Post-Polio Syndrome?
Every muscle is made up of thousands of individual fibers, and each muscle fiber is innervated by a nerve. Polio kills nerves, so when a nerve dies, the muscle fiber that is attached to that nerve lacks a stimulus to make it contract and that muscle fiber dies also. The paralysis in an acute attack of polio is caused by the polio virus destroying nerves so that muscle fibers controlled by those nerves cannot contract. The affected muscles either become very weak or they cannot contract at all.

Usually a single nerve can make one or a few muscle fibers contract. However, after an acute attack of polio, many muscle fibers lack nerves to make them contract. The body then “teaches” some of the remaining nerves to attach to many more fibers than they would normally control. A nerve that formerly caused a few muscle fibers to contract grows to be able to make many more muscle fibers contract. As a person regains function of many formerly-paralyzed muscle fibers, he gains strength and appears to have recovered the ability to contract that muscle. However, as the person ages, the over-extended nerves lose their ability to make many muscle fibers contract and the post-polio patient becomes progressively weaker. When these people exercise, their muscles have fewer fibers, so the remaining fibers have to work much harder, are weaker, fatigue earlier and take far longer to recover.

https://www.youtube.com/watch?v=6PfNnAs6C88

Treatment for Post-Polio Patients
All people who have had polio should check with their doctors to see if there are any exercises that they should avoid. Then they should join a gym and get instructions on how to use weight machines to make themselves stronger. Weight machines cause the individual fibers to enlarge and even post-polio patients can gain strength. Strengthening the fibers allows a person with nerve damage to do more work before the muscles fatigue during exercise (American Journal of Physical Medicine & Rehabilitation, 1996(Jan-Feb); 75(1): 50-58). A problem is that people who have had polio fatigue very easily and may have to lift less often with lighter weights than normal people do (Orthopedics, Nov, 1991;14(11): 1253-1256).

People who have nerve damage become extraordinarily weak on the day after they exercise. To avoid long recovery periods after exercise, they can start out by lifting very light weights in three sets of ten and stop exercising immediately when they feel burning, heaviness and fatigue. They can try again 48 hours later, provided that their muscles do not feel heavy or painful before they start. When they can perform three sets of 10 with a certain weight comfortably and feel fresh on the next day, they are ready to try a slightly heavier weight in their next workout.

Itzhak Perlman
Born August 31, 1945

https://www.youtube.com/watch?v=CTE08SS8fNk

https://www.youtube.com/watch?v=vLosUBnCAAs

https://www.youtube.com/watch?v=xUozVQVt1xI

January 11th, 2015
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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