Diagnostic Doomspeak
Let me make this clear: I respect all medical professional’s work, experience and knowledge. I respect their diagnoses and I respect their opinions. Whether it be a doctor, chiropractor, physiotherapist or voodoo priest, I always take other professional’s opinion into consideration.
But I fucking hate medical diagnoses for painful symptoms.
I fucking hate medical diagnoses for painful symptoms.
Let me make this clear: I respect all medical professional’s work, experience and knowledge. I respect their diagnoses and I respect their opinions. Whether it be a doctor, chiropractor, physiotherapist or voodoo priest, I always take other professional’s opinion into consideration.
In some cases, people need these medical diagnostic approaches; ACL tears, spondylolisthesis, rotator cuff tears, etc. The big nasties. Those have their places and can be long-term injuries that require careful planning and potentially surgical approaches. I like those ones.
But, for some reason, it’s SUPER TRENDY to diagnose people with sciatica, SI joint dysfunction, upper/lower cross syndrome, piriformis syndrome, scapular winging, and whatever doom-speak Instagram fitness gurus throw out. It doesn’t make sense and can be downright harmful to emphasize conditioning, instead of what they’re lacking and causing their condition in the first place.
Lets look at something like sciatica. Sciatica is a radiating pain that zings down your leg. It can be caused by:
Lumbar Stenosis
Disc Degeneration Disease
Spondylolisthesis
SI Joint Dysfunction
Pregnancy
Pelvic Floor Dysfunction
Hypermobile Thoracolumbar Junction
Bone Spurs
Hip Position
So, when someone comes in to see me and they say their chiropractor told them they have sciatica, I explain to them what sciatica is: a symptom of a greater problem. We need to dig deeper and find a reason, not a label, for their pain.
Lets look at a specific example of a client of mine. We’ll call him Harold. After a tragic surfboarding accident, Harold has a combination of rib and back pain on the same side.
Harold’s chiropractor told him he has SI joint dysfunction and gave him back stretches and lower body exercises to strengthen and stabilize his lower back. Good stuff. Pretty standard affair for SI joint dysfunction. Release the lower back and strengthen the hips to keep the SI joint pieced together. However, he was still having bouts of crippling pain and dysfunction. So he decided to book an assessment with me.
When Harold saw me, I found he had close to zero hip internal rotation and that he was missing a ton of segmental mobility at his lower back. We started working on the things I noticed, and guess what?
He started feeling better. His relief was lasting longer.
Did I do anything crazy, wild or out of left field?
Nope.
Do I think I know more than the chiropractor?
God no.
Am I motherfucking sorcerer?
Maybe.
All I did was listen to what he was experiencing, what felt good / what didn’t, and let him lead my assessment. From there, I created an individualized mobility and training program based off what I found
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An Open Letter to My Clients in Pain
I had a discussion with a client of mine the other day. She’s had tennis elbow for years. The physiotherapist she was going to prior had cleared her for exercise and she came to me. Still in pain, not feeling like her issues were resolved.
I had a discussion with a client of mine the other day. She’s had tennis elbow for years. The physiotherapist she was going to prior had cleared her for exercise and she came to me. Still in pain, not feeling like her issues were resolved. Nothing was working, and she felt hopeless. She used to love deadlifts, but due to her pain can’t pour milk into her cereal.
After 6 weeks of working with me, she said to me: “I feel frustrated.”
My heart broke.
Today’s post goes out to her, and extends to any one else in pain.
How are you feeling today?
It’s something I often ask you at the start of our sessions. It’s an important question because it helps me to modify the session and my energy.
Above all else, how you feel is important to me because I care about you.
Your pain is heartbreaking. I hate hearing how you struggle with daily tasks. It distresses me to see you see you melancholy and defeated. I care about resolving the pain and have emotionally invested myself into your success
When we train, I know I get excited about the seemingly simplest things. I celebrate when an indicator exercise feels better. I dance and joke when a perceptually easy exercise is difficult. I turn and combo-high-kick-fist-pump when you come in and say that your pain is less. You deserve to feel like a winner. You deserve to have your own personal cheerleader celebrating your successes and motivating you through the difficult tasks.
Your pain has become engrained into your identity. So much, that, pain and disability is your new normal. I want you to say this next part with me. Read it out loud to yourself and scream it to anyone around you:
“FUCK THAT. It is my right to be without pain!”
You are beautiful, strong and resilient. Now’s the time to start acting like it.
If you don’t believe me, I will remind you at every given chance. I will prove it to you, and I will force you to believe that it is your right to only feel like a winner. I will hire a motherfucking mariachi band to serenade you outside your office when you get off work.
Thanks for everything, and I’ll see you soon.
Your friend,
Kieryn
P.S. New homework next week :)