Eighteen years of treating patients has taught me that you "the patient" is the best tool in getting you better. Yes "you" are full of good information that leads me to find the answers to get you better. I have to ask the right questions to move in the right direction and put you on the road to recovery. One goal is to change the way you think. Yes that's right. Help you help me but understanding what your body is saying to you. To stop, to listen and assess what is happening to you because of your environment and your habits. I have to ask the right questions to move in the right direction and put you on the road to recovery. One goal is to change the way you think. Yes that's right. Help me help you by understanding what your body is saying to you. To stop, to listen and assess what is happening to you because of your environment and your habits.
Example Back Patient complains of lower back pain that started this afternoon Patient: I had pain at 3 pm today that start in my back and now down my left leg. Me: What where you doing? Patient:Nothing. (they always say this) Me: No, I need to know all the details of specifically what you were doing, for example, sitting, standing etc. Patient : Oh, OK, I was sitting at work.
This is one of the methods employed to gather information that leads me to test for a directional preference or which exercises will be most beneficial to a speedy and permanent solution to your issue.
"I'm worse sitting" means - I'm worse bending forward(what we call flexion) "I'm better walking" means - I'm better with bending backwards (what we call extension) Me: How tall are you? Patient: I'm 5'2
If you are 5'3" or below or over 6'0", I know that you don't fit in the average chair (average chair height is 5'4" to 5'11"). I also know that pressure over time wins, every time. Typically, 5'3" and below have the similar types of chronic injuries and 6'0" and above have their specific types of injuries because they live outside the normal environment created for people of average height. Every wonder why these tall basketball players with six-pack abs have back pain? Weak core? No!!!!, The answer is because the average world for them is like me living in a kindergarten classroom where everything is too small.
A 5'3 patient is unable to sit all the way back in the chair and be comfortable (see picture). Why?, because their feet don't touch the floor. The chair gradually begins to dig in the back of their legs (like when parents scold their 3 ft tall kid for putting their feet up in a 5'4 chair which they don't fit it-- hmm). This pressure becomes uncomfortable and you start to sit on the edge of the chair and lean forward. Pressure over time wins!! Every time!! That 12lb head now becomes 32 lbs of pressure on your neck/upper back. Can you say "neck pain?" and "headaches."
See most people only want the pain to go away. I think that's the easy part. Keeping it away. Now that's art! For this to happen I need you to help me. I have to help you catch all those bad habits that will beat you over time. This is often why surgery is not a long term solution, because surgery does not teach you anything. You go back to the same habits, same environment and pressure beats up on you, Typically, you end up having a 2nd or even 3rd surgery,
Think about this scenario for a minute. 5'3 patient that sits on the edge of a chair gradually creates a disc herniation resulting in discectomy surgery. What happens if you go right back to the same sitting posture. Pressure over time wins again and now you herniate the disc above or below. Because you didn't learn or change anything. Posture is 50% of the equation so if who ever treated you didn't address posture you have to ask if they really fixing the issue or merely a symptom of the issue?
How do you help me help you? You learn to listen to your body.
It looks like this, patient sitting at work at 3 pm gets back pain and thinks "I must be doing something wrong." They decide to change the way they sit, use a lumbar roll. The patient reports, "I did the prescribed exercises and then I was fine. I actually did it all by myself. I didn't have to go see anyone, I treated myself."