I agree with your therapist. Muscle pain is often caused by a combination of underworked and overworked muscles, if you define underworked muscles as those weakened or paralyzed by polio and those that are newly weakened. Overworked muscles are your stronger muscles that-while trying to take up the slack for their weaker compatriots-hurt, ache, cramp and spasm.

I have never seen muscles go from overuse abuse to underuse abuse. Many doctors claim that polio survivors' new weakness and fatigue result from deconditioning. They say muscles and nerves get "lazy" and weaker because you don't do enough exercise. Some polio survivors believe that their muscles will deteriorate unless they keep pushing to prevent deconditioning. But beware-deconditioning is one of the red herrings that doctors who know nothing about PPS try to feed you. Deconditioning can occur when a polio survivor is confined to bed for a month. But in 23 years I have seen only two polio survivors who were somewhat deconditioned, and both were severely depressed.

You shouldn't exercise to try to strengthen weakening muscles and prevent underuse abuse, since you'll just make them even weaker. And if you exercise stronger muscles, hoping that they will better compensate for the weaker ones, your stronger muscles-also affected by polio-will get weaker. We see this all the time when survivors report that, after exercising, their "good" leg is now weaker than their "polio" leg. And of course, there's the poor guy who went to the gym to pump up his good leg and it stopped working altogether (PPS Forum, June 2004).

The exercise you can do to decrease pain is gentle stretching. You may have stretched your "heel cord" when you first had polio to allow your foot to land flat on the floor. That's still a good stretch for calf muscles that burn by day or cramp at night. Stretching the hamstring muscle in the back of the upper leg, your low back muscles-and especially the neck muscles-is also helpful.

Ask your therapist to work with you to find a small number of stretches for the specific muscles that hurt. Remember, it's better to stretch a few specific muscles for a few seconds many times throughout the day than it is to stretch many muscles, many times, but only in the morning. Think of stretching as the oil that keeps your muscle "motors" moving. You wouldn't put oil in your car only when you start it up in the morning. Like your car, your muscles need lubrication all day. But with stretching, as with all things, polio survivors need to follow "The Golden Rule:" If stretching causes fatigue, weakness or pain, DON'T DO IT! (Or do much less of it.)

As for finding a happy medium, try Madam Olga at the Minnesota State Fair. She always seems chipper to me.