Always Look at the Big Picture
Updated: Dec 2, 2020
Sometimes, the more we learn and know about something, the more we tend to miss the forest for the trees.
A few weeks ago, I had a patient with joint pain who ended up in the surgeon's office after a referral from a concerned family doctor. The surgeon's advice? To stop lifting weights, because there was some wear and tear in the joint in question. The appointment was over in five minutes. This is a common story for physios to hear-- and a very problematic aspect of our healthcare system.
What the surgeon missed was that this individual was after losing a massive amount of weight, had type II diabetes that they were hoping to reverse, and was working hard to improve their overall general health and confidence. Weightlifting was also a meaningful activity that they enjoyed doing. So, what's more important, delaying a joint replacement surgery by 5-10 years, or dramatically improving your quality of life, reducing your risk for heart disease, cancer, and all the other health issues that come with an inactive lifestyle? Is giving up on exercise seriously the better option here?
Sure we can zoom in on the joint wear and tear (and take a dated and ultra-conservative approach in managing it by giving up weight lifting all together), or we can look at the entire person's health and well-being, and take the big picture into account. We developed a plan to work around the joint issue while continuing to lift weights and the patient is going to go for a second opinion.
Sometimes this happens with physios as well. The more fine details we know, sometimes the more we forget to take a step back. Using IMS to activate the right lumbar multifidus muscle from L3 to L5 in a person with chronic back pain probably won't mean much if they are chronically sleep-deprived, stressed out of their mind, or fearful about exercising their back. Yes, it's important to have the knowledge and skills to zoom in, but not before we look at the big picture.
Where in your life are you getting caught up in the fine details? Maybe you can take a step back from your problem for a while, get some perspective, and re-evalulate. The answers might be more obvious than you first realize.