Here are a few closing thoughts presented by our favorite memes of 2015:
Happy New Year!
Here on the West Coast we are on the heels of 2016! In some areas of the world they are already there! As we move into the New Year, I thought it might be fun to recap a few points that have been discussed in the worlds of fitness and rehabilitation over this past year. Some of these have been longstanding, but it seems this year many of these topics have come up rather frequently, and some with rather fierce debate. Enjoy!
Ah, yes. Happy New Year my people!
It's time once again for the New Year's Resolutions to be make. I do love this time of year for reflection on what has gone on over the course of the last 12 months, how did I do on meeting the goals I set last year at this time, and I always ask myself: "What would it take to do even more this year?!"
I my opinion, it starts with setting good goals and then taking action to achieve them. If you have a goal related to fitness or becoming pain-free and getting back to an active lifestyle, then odds are you are going to need help doing so. Check out our last post: Top 5 Reasons You Missed Your Fitness Goals in 2015 for more information on this process, and some great resources to help get you there!
My doctor said I just "slipped a disc."
Then either your doctor missed a major medical emergency, or discs don't actually slip. The intervertebral disc is firmly attached to each of the bodies of the vertebrae above and below it. Phrases like "slipped disc", "back went out," etc are all poor choices of how to explain to a patient why they have back pain -- and in most cases is totally incorrect as most of time the exact pathology or tissue at fault is unknown.
As our imaging meme touches on below, the picture is not always the cause. Lot's of classic studies, round up a 100 people, scan their low back in an MRI, and you will find something notable in over 80%, while the vast majority to do not have any pain.
So, while you should be careful on the ice this winter, feel reassured knowing that discs don't slip. For more great info on this topic, check out The Manual Therapist discussion on Explaining SI Joint Pain.
Boy were people butt-hurt when those studies came out...
Here's the crux of this post in general -- it's not always that what we are doing is wrong or bad, it's that the information being disseminated is outdated and not keeping up with what the research is showing.
Manual therapy can be very powerful, and while there are some good working theories out there, the harsh reality is that we just don't definitively know the mechanism of exactly how & why it has an effect. Does that mean we can't or shouldn't use it because it's not evidence based? Of course not -- at least that's my opinion.
Manual therapy, foam rolling, self-soft tissue mobilization with a lacrosse ball -- these are not stretching fascia or breaking up scar tissue. What you are doing is giving input into the nervous system, which is then driving a change in the ability of the the tissue to relax, release, elongate more...however you want to phrase it.
For more geat info on the topic, check out this write up by The Barbell Physio: Why Foam Rolling Isn't Helping You Like You Think It Does
Another favorite question from our patients: "How do we know what to do or work on if we don't have an MRI?"
This is where we then educate the individual on the pitfalls of imaging, the value of our training & education, and the usefulness of a through examination.
Yeah, while I don't think this needs too much explanation, it seems that the debate between squats, deadlifts, and the good old leg press still rages on. Which is best, which is bad, which is harmful, which produces the greatest "Gainz."
The answer is actually simple -- there is no right answer.
Ughe! Seriously, I don't know when we are going to learn. There is so much wrong with this statement, and yet we continue to hear things like this regularly as our patients recount their visits with other providers.
Your words matter! They can do just as much good as they can harm, so be mindful of what you are saying, how you are saying it, and that the information you are conveying is actually correct.
One of the greatest accomplishments of 2015 for me at Athletes Physiotherapy was finally getting through Adriaan Louw's courses on Pain. It's really helped in addressing the issue of pain and putting it in a way that patients can relate to and that also helps to alleviate a lot of their anxieties and concerns, especially in our athletes!
For more great information on these topics, check out the Stop Thought Viruses webpage!
I wholeheartedly believe in self-treatment strategies. I also give self-soft tissue techniques to our athletes and clients on a regular basis. But here's the rub, and I see this almost EVERY day:
If you have to continually smash out your shoulder or hip with a ball or foam roller between every set because it's painful, and you have been doing that for months at a time...it's time to actually get evaluated by a healthcare professional.
If smashing it was going to work, it probably would have at some point earlier on. Again, we're not talking about using these as warm-up/cool-down or self-management strategies to keep you progressing in your workouts or to aid in your recovery. If there's pain, and it's persistent, then you owe it to yourself to get it looked at.
An ounce of prevention is worth a pound of cure!
Thank you for stopping by the Athletes Physiotherapy Blog! Kristopher Bosch founded Athletes Physiotherapy in Las Vegas, NV. He is a Father, physical therapist, athletic trainer, pilates teacher, & perpetual student!
EDGE Mobility System
John Rusin - StrengthDoc
Sue Falsone - S&F
Systemic Dry Needling