I did a fairly cheesy seminar at the university last week for the athletic trainers and a few of the team docs. I feel the addition of these simple analogies helped a lot with the understanding of how and why my decision-making is done.
I use analogies in my clinic all the time as it just helps to visualize a lot of information. The problem with analogies for medical use is they get oversimplified to the point that they often offer little value. Cute Quips like, “Your knees are like car tires and only have 50,000 miles in their lifetime.”
and “You can never run again after surgery.” – “I hold all my tension up here.”, and “slipped discs”
These analogies straight up stink and are just plain misleading.
My cheesy analogies, however, are different! Why? Because I made these up, so obviously they are legit.
Cheesy but effective Analogy #1
Be like a detective with your health.
Seriously, Imagine yourself as a two-brim hat-wearing, huge magnifying glass holding, British accent, aloof silly detective. It’s called a CLUE.
I will take this approach as a doctor often. I think all good doctors should.
So should you.
Look for clues. What can you use to help yourself with decisions regarding your health?
If doing “X” seemed to make the pain 50% better for 3 days? – wow, that’s a good clue, pay attention.
Running seems to make it worse? Now we’re on a solution path. Get out the magnifying glass and ask why… was it the distance, poor mechanics, could it have been a 50 mph gale and freezing rain in your face and not actually have anything to do with the running.
You need to push the envelope here and be smarter –
Eating the #8 at the drive-thru left you feeling like you ate a shoe and you were on the toilet 5-6x the following day? That’s a clue – this tells you stuff so pay attention here, you are Sherlock Holmes here. A classically trained, highly intelligent world-class detective. You’re not Mr. Magoo.
Now look, you can’t use…”it just feels good” – that’s a misleading clue. In Agatha Christie novels, often a creepy, evil-tempered guy with perhaps a questionable past is one of the neighbors. This guy is always implicated and looked on with the stink eye…but his character is written in the novel to throw you off the trail. Don’t buy it!
We use crappy clues all the time in our health and follow in the wrong footsteps in the mystery. Pain is often misleading. “Feel good” is often misleading. Eating a gallon of cookies and creme to drown your sorrows in sugar-laden chocolatey-ness is just not helping.
Absolutely stretching the hell out of your IT band and lying on a shot-put to roll out your quads on your sore legs….agh.
This brings me to cheesy but effective Analogy #2 –
Healthcare Therapy and treatment should often be looked upon as a little kid’s bike lock.
The example means: You can do all the right stuff but if it’s in the wrong order it won’t work/open. Just like you can put in all the right numbers and the lock still won’t open.
It needs to be in the correct order.
I use the bike lock analogy often.
In the clinic and in lectures I occasionally take flak for not offering a bunch of exercises and rehab on an initial couple of treatments. This ‘bike lock’ idea is why.
Because despite doing all the workup and treatment options, if it’s done in the wrong sequence it doesn’t work – or doesn’t work as well as it could.
Routine real-life examples: For a lot of injuries, the inflammatory complex needs to be taken care of first. Nothing really heals or starts the healing process while inflamed.
This is why I don’t offer exercises right away and typically tell my clients NOT to stretch and roll and exercise a lot immediately on low back pain injuries.
“Doc, do have any exercises I can do?”
“Not yet, you’re going to have to get the fire put out first. – You’re just not THERE yet.”
As a patient, if you are at the inflammatory, “put the fire out” stage, why would I then offer you exercises that just irritate the whole area again?
The cart is in front of the horses. Do this, THEN, this, THEN this – often it may come on the same visit, but in the right order. For help on this see my infographic on the road to recovery.
It’s the application of the ideas – the application, the “why” is even more valuable than the idea itself.
And the One thing I will always have is a “why.”
It drives my wife nuts, but I have a reason for almost everything I do. If I didn’t have a ‘why’, then for what reason am I doing it?
Because some dude on YouTube told me to?
Because it’s what my PE teacher told me back in High School?
Because your friends told you what to do?
It’s just not good enough for me.
So now we go full circle to the Sherlock Holmes idea again.
You can often create your own clues or reactions by trying something the guy on YouTube says. You have to have the experience to get ideas for what works and what doesn’t.
If YOUTUBE ANDY tells you to roll your quads out and stretch the hell out of your IT band with a ball. Try it. But be true to yourself…
Did it help, hurt, or no change? Look for clues!
Remember you can’t use:
“It felt good.” – that’s a poor choice and a liar.
Also, You can’t choose, “Well it hurt so bad it must be doing something good.”
Aside from that being straight up crazy that’s a poor clue.
You can’t use – “I just do the same stuff over and over for months without ever looking up out of the sand because that’s YouTube Andy and my girlfriends said to do – maybe eventually it will do something.”
that’s an actual definition of insanity.
You can’t use, “that’s what I did back in ’97” – well wait for a second, you can.
Have you tried something that worked before? For sure, try it again. But beware, it could be a different issue this go around, so pay attention. Did it work this time?
“Oh Chad, This is just all so confusing, you run the sports med site, just tell me what to do.”
That’s just lazy doctoring and terrible self-treatment and dammit…it’s not good enough – I may not know exactly what you have. Aside from that, you know your own body way better than any outside doctor, therapist, or well-meaning friend.
I’ll tell you some ideas I have – doctor advice to be viewed as “some ways to make clues.”
“OK, how long should all this take? I’ve been stretching for 3 months now and no help….”
3 months? Sigh
How about 4 applications? say 4x in a week. Yep, for most non-surgical, injury-type issues, 4 treatments should give you a clue. It should be promising and give you a direction if you are headed on the right path.
Looking for clues and creating scenarios where you can gather information to make better decisions lets you take control of your own health.
Just trying anything with the hope of “to get better” isn’t enough. You need to do something, make a decision based on the response, and act accordingly. You need to try stuff and try stuff in a logical order.
If it doesn’t work, try the opposite.
Have you noticed how many of my articles suggest contracting tight muscles, not stretching? How many use ice not heat on a spasm?
The “why” is…because I learned from experience. I stopped doing the same thing over and over because some professor in my past told me that’s what to do. I paid attention to what worked clinically and what didn’t. Now I even focus on, with nearly as much attention, what works better.
I advertise most injuries take 3-4 visits to my clinic. For resolution. The national norm is 3-4 visits per week for 6 weeks. I can beat the norm. There’s a reason!
Doing the same thing over and over again and expecting a different result is a classic definition of insanity!
I don’t see patients and go immediately to a preconceived treatment plan. Not only do I not treat every client exactly the same, I rarely do the same treatment on back-to-back visits. Maybe I’m not a better doctor. Maybe I’m just a better “body detective.” Or maybe I pay attention to the clues better. Maybe I put treatment applications in better order. What I’m certain of is that it’s an ongoing experiment – All I care about is the end result. Get your life back!
There’s a chance that this article was just all over the place. Maybe the Sherlock Holmes and the Bike Lock analogies would have fit better into two separate articles. I’m not sure – I’m just all about the maximum effect with quick results.
So I’ll just go ahead and press “publish” on this article as is and then pay attention to the feedback. I’ll watch to make sure I’m on the right track knowing that by monitoring and being able to change my ideas, I’ll be better the next time. Test and ReTest. Exactly how you should run your health.
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