Guest Post from Dr. Todd Riddle, Director of Education —
Stories that are fraught with pain, terror and anxiety as the evil villain exacts their misguided deeds on the innocent and hard-working victims.
All of these stories have a hero in them; one that fights against all odds to conquer evil such as in Beowulf, Odyssey and Iron Man. There are interesting similarities to these stories and to musculoskeletal practitioners.
There are victims (the place a patient hurts), there are villains (the sneaky, unsuspecting place causing the pain) and the hero (you). Like many good hero’s journey stories, the hero is often unaware of their calling and capabilities or they willfully deny that they can save the day. After encountering numerous practitioners from various professions through the years, I have come to view practitioners that chase chronic pain around the body as heros who have just begun their journey…still not sure how to fight.
They are unaware that there is a better way or they willfully deny that they have the capability to save the day…..by catching the TRUE villain.
So often we get caught up focusing on the area of complaint that we don’t stop to realize that it’s being caused by something else. We listen to our patients and we recognize that our job is to get them out of pain and back to moving better as quickly as possible, but if all we focus on is pain, we are merely treating a symptom.
Take, for instance, the Joint by Joint Approach. (Click this link and go read it if you are not). It hypothesizes that the joint systems of the body have certain roles, to be mobile or stable. When they become injured, they essentially reverse roles in order to accommodate. An ankle sprain causes this joint that prefers to be “mobile” to lose ROM and become “stabile”. The knee must make up for that loss and become “mobile” (it doesn’t like it, but it does it). To control the extra motion in the knee, the hip must try to “stabilize”, making the low back “unstable”.
The practitioner ONLY focused on the patient’s “low back pain” (victim) would miss that the villain is actually a bum ankle. Nursing the victim and not catching the villain only creates more victims up or down the road (in this instance, the kinetic chain).
If you feel like you’re constantly nursing victims instead of slaying villains, the first and most important step is assessment–taking the time to evaluate and assess to determine who the true villain is. We are the “detectives” in these instances with our patients–the diagnosticians who realize that the presentation of pain is just one clue to unlocking the whereabouts of the villain.
So how do you identify the TRUE villain? That’s through assessment…which we will be covering in future posts. Stay tuned and we will unpack that topic next.