Your scan may not be as exciting / devastating as you think
Let me start by saying - our body is an incredibly strong and robust structure, that is arguably the most valuable asset we will ever own. Evolution has seen humankind achieve incredible feats: covering 100m in 9.8seconds, climbing Mt Everest, and even tolerating sitting at a desk for 50+ hours in a week. The term invincible springs to mind.
All of this, until one day, you are told it is NOT.
Words hurt. And it has never been more true than in the case of diagnostic medical imaging, and how findings are being portrayed/explained to patients. As a physiotherapist, I am incredibly fortunate to be entrusted with a patient’s full medical history, and their understanding of what this actually means to them. It hurts me, hearing that someone gave up playing sport because of their “dodgy hip”, or no longer performs deadlifts because they have a “bulging disc”. I hear these cries almost daily from very normal, athletic and intelligent people (some of you may be reading this …).
There are plenty of myths out there – so let me share some facts:
80 out of 100 people over the age of 50 have some form of disc degeneration without pain. The infamous “bulging disc” is not as horrifying as we once thought! Most people will get through life carrying one of these, and be none-the-wiser. And if you once had a “herniated disc”, you can rest assured that up to 82% have been shown to spontaneously resolve with time.
97% of knees show abnormalities (with 30% being meniscus tears) without any pain or injury. Meniscectomies (surgery involving partial removal of the meniscus) are up there with the most commonly performed elective surgeries in contemporary medicine. A recent 5-year follow up, has shown that having surgery was of no more benefit than a SHAM (i.e. placebo) surgery, and may actually increase a patient’s risk of developing osteoarthritis. Hence, a graduated, conservative (rehab) approach to your knee pain may save you from an unnecessary surgery.
1 in 3 shoulders of people above the age of 30 will show an abnormal MRI finding, including complete rotator cuff tears. Shoulder pain is often described as being rather complex and difficult to diagnose – something that seems rather intuitive in the context of this fact. Most active people (especially those who participate in gym-based exercise) will experience a niggle in the shoulder department at some stage. So hold off on the scan, and explore your loading history and technique, and control the things you can control!
54.8% of athletes without pain have shown cam deformities of the hip, and 67% of all populations have pincer deformities. Cam and Pincer deformities are radiographic findings that are known to be present in Femoroacetabular Impingement (FAI) syndrome. FAI, labral tears and cartilage loss are known to be highly prevalent in those without any hip pain. On top of this, there were no differences in improvements made by patients who underwent a surgical versus a conservative approach to the management of FAI.
Up to 43% of adults over 40 years old show signs of knee OA without pain. Osteoarthritis – perhaps not the life sentence for pain we once knew it to be. This one I find to be particularly powerful, in response to the mantra: “Your body falls apart after 40”.
Unfortunately, at the point that the patient finds out this information, it’s too late.
Our bodies are not 60’s Series Landcruisers. We need to spend less time fixated on finding a mechanical cause of pain, and more time discussing our limitations and how we can best challenge them.
Perhaps there is something missing from your training, a biomechanical flaw or (even more commonly) over-training. If this is the case, an Exercise Professional can help you with this.
We know that factors such as mental health, stress and anxiety have an unprecedented correlation with many persistent musculoskeletal conditions. If this is the case, a Psychologist can help you with this.
You may feel that you are constantly low on energy, and unable to recover fully between sessions. If this is the case, a Dietician or Sports Physician can help you with this.
Help has never been more accessible than it is today. Listen to your body – it is strong, resilient, and (in most cases) incredibly honest. If something is off, bring it up. Don’t suppress your condition in the fear that you will be told you can’t train, or your body will never function at the same level it once did. We are here to help.
Jacob Lawrence
Physiotherapist
