“Could my bursitis be hereditary? “
That question was asked by a client.
Me: “No, It’s not!”
OK- it’s a Friday afternoon and we’re one doctor short for the 2nd week in a row. The office has been slammed busy and for reasons that can only be explained by the BLACK SUPERMOON, we have had the strangest, toughest cases we’ve had for the entire year.
Friday has come and gone. We’re done. It’s finally sitting time around the office time with the docs after a stressful week. Time to discuss our week and go over cases as we wind down and get ready for the weekend.
And believe me, we’ve got gripes. That’s right, as doctors, therapists, specialists, rehab assistants and staff, we all have our complaints too.
There is a tremendous amount of misinformation, denial and just straight-up fallacy that is hindering our ability, as doctors, to make you guys, as patients, better.
To let you understand the inner workings of a doctor’s office, I feel like I need to let you in on something.
If you say certain things, as a patient, it just puts you in a different category as far as our expected outcomes.
That’s correct…what you say to your doctor can affect how fast you get better OR even if you CAN get better.
To state it another way, you may inadvertently say something that flips a switch in our minds and labels you, as “cannot possibly ever recover.”
This is especially true for things that we find funny. Not funny that you’re feeling pain or hurt or discomfort, we’re not jerks. Funny, in that…
Patients are sometimes oblivious to the obvious.
Things like this,
Patients often, and I’m serious here, more than 50% of the time often, will ask, “So what is it?” after we’ve explained our diagnosis to them in depth. So, we (sigh) explain it again. There is lots of nodding of the head in the assurance that a patient is understanding. There’s eyebrow movement, subtle signs of comprehension, and acknowledgment. And then… “So what do you think I have? Is it bad???”
And then we explain it again with a handout sheet, a referral to SportDocDC, and even greater explanation of this condition to the macro-molecular level. And then the patient asks, slower this time, with a one-eyed squint and slight sideways look…“Sooooo. What do you think it is?”
Yeah…that. It’s an Easy cure: pay attention. You’re never going to get better because you aren’t hearing it. For whatever reason. (You have a choice)
Also, there’s this classic, “How did I do this?”
What? If you don’t know how you did it – how on Earth should I know?
And really by the time you get to my clinic, “how you did it” doesn’t matter, let’s just fix it already.
And then there was this week…
Dozens of patients with musculoskeletal conditions telling us it is their hereditary condition. As if a strained rotator cuff or blown knee is a genetic trait. Their family burden to bear through life.
You’re crediting the wrong cause for your injuries.
So let me set the record straight. There are genetic conditions. There are blood factors that are real. Rheumatoid factors, chromosomal conditions, antibody-antigen anti-things. I’m not denying the existence of these.
These are just things that happen. They suck, They Hurt, they make you come to the chiropractor, doctor, PT therapist, etc. but…
They. Are. Not. Because your grandma had it. This has to stop.
Why has nobody ever brought this up before?!
Wait wait wait, before you try to stop me and go off, I get it – your grandma, your mom, and probably your aunt and sister all sprained their ankles at some point in their life. And I understand that you have now as well. But it’s not a genetic weakness, it’s not hereditary and it’s not your crutch to bear for the remainder of your life because of millennia of passed down weak ankle genetics. It’s just not.
Everybody sprains their ankle. It’s 100%
It’s neither causative nor correlated it’s just a fact of freaking life. So yes, I’ll work on it and get you better but seriously, You have to understand this now. Injuries happen and people get hurt.
If you want to keep from spraining your ankle there is actually a ton you can do for it that is significantly better than NOT doing something to help your odds out. Blaming it on the “O’Malley Genes” that great uncle Ebenezer brought across the pond during the Revolutionary War isn’t helping anything. (“Doc, That’s him, in the painting walking behind General Washington…see the limp?”)
OK, but how about that bad back…Strained a disc? Yeah, I know. It’s also called a herniated disc, others call it a disc bulge, and even is often called annular fiber tears. It may have been described as stenosis because it was posterior and came into the canal a bit. I’m here to tell you, Nay, To preach to you. It’s all the same thing and it will get better and you’ll be normal. Soon.
Relating musculoskeletal INJURIES to genetics and family hereditary lines is like saying you have toe fungus because your granddaddy got trench foot off the coast of Normandy during WW2!
Mark Twain said it, “the problem isn’t because we don’t know enough, it’s that we know so many things that just ain’t so.”
Dr. Tower related a story he saw at a nautical museum in Australia when he was vacationing. A placard described a famous shipwreck and listed the deaths and survivors. One of the guys died at 95. “Due to complications from the shipwreck.” WTF? He was 19 when they ran aground. He lived to be 95! He outlived damn near everyone he ever met and probably every one of his doctors. Seriously!! Using that logic, I’d say the shipwreck was the best thing that ever happened to him. Gave him an extra 25 years from the standard of living of the time.
You don’t need to tell me 17 years later that you “have” a disc herniation. Or that your 8th-grade nurse once diagnosed you with scoliosis or that your sore shoulder that came on last week mowing the lawn is most likely from the car accident of ‘86. Or my clinic classic, “Because I played ball…”
OK, as your treating doctor, it probably is good that I know this info, it helps, but.. Online, I’m the guy trying to help your life on SportsDocDC….I can’t have you carrying around this symptom and named issue as a DISEASE. (see post on Osgood Shlatter and Sever’s) . You cant keep carrying this around like a 50-pound backpack full of brinks for the rest of your life.
This is why I stated earlier that when you tell us this stuff it will affect your recovery and outcomes. Not because it is severe or unique but because you will never get over something you can’t let go of.
This article is built so you can Unburden yourself. 95% of planet Earth has had the same thing you have at some time.
The 5% that have never had an issue, that’s not normal: it’s lucky, or optimal. Normal is what 95% have had and we’ve all had it.
I know I’m fired up but listen please!, I’m not mad. I’m trying to help you. To free you and allow you to just go on with your life. Don’t overthink pain nor musculoskeletal issues. Please, for your own sake. When it’s gone it’s gone.
Look, I do this daily. We all do as practioners.
We see the 300 lb man that hasn’t worked out in a generation, he smokes and drinks is depressed, and feels like absolute crap every day. This guy tells me he’s got his grandpa’s back.
No dude! You’ve done nothing to help yourself. You’ve got chronic “decondition.” That’s your freaking diagnosis. I know it’s not an official insurance code, so we cant use it on your billing, but it’s true. That’s your diagnosis. Also, It is treatable!
You want to fix the world’s medical problems. Fix chronic decondition and you’ve cleaned up 90% and saved trillions!
And Look, this goes BOTH WAYS!
I also see the super fit, super hot, lean muscular supermodel looking girl from the CrossFit gym that practically wants to give up on life, eating right, workouts, and relationships because she tweaked her shoulder 3 times over a year.
Please, fit chick. It’s not your weak genetics and it’s not that your gym and the instructors suck, you’re just a bit burned out and overworked. Change stuff up for a while, try a new approach.
It’s time for a reality check on health. I keep seeing the same things every day and I want to help! We all have got to get this right in our heads or nobody be helped. We, as doctors, know this.
You’ll never get active at treating these issues because you can’t yet face the realization that it in your control in the first place.
This article is simply my plea to take an honest look. Muscle skeletal issues are our wheelhouse and our strong point at this clinic. Our professions see them repeatedly all day long, all year long. All ages, sexes, nationalities, and morphologies. These issues happen to everyone and anyone and they are all treatable and fixable and when finished and gone, you are done with them.
Your shoulder doesn’t hurt because you played football. Your shoulder hurts because you hurt it in football back in the day and proceeded to do nothing for 3 decades to help it recover. It’s shredded and sore and doesn’t move right. You’ve got a long road ahead and today is a new day 1, let’s take a small step forward. OR not.
This isn’t about treatment and outcomes. It’s just me verbalizing my Friday Gripes. Simply, a wake up call on causes of pain so we can all just get past it and make better decisions about healthcare. It’s about having hope.
Or Not. It’s equally easy to “Not Get It” and have and excuse, disease no hope for the future.
It’s not up to me to decide. It’s your body.
But, being true to what you are dealing with dramatically affects your outcome and responses.
I just want us all to feel great and get back out there and keep making our world better. It’s all about amping up the positive and down playing the negative.