The difficult thing about putting a list like this together is that I will inevitably look back at this in the future and realize its shortcomings or errors. This seems to happen as you go through life and keep learning. Nonetheless, I think it’s a good thing to reflect on the previous year’s lessons and growth.
1. There are great people out there who are willing to help if you’re willing to ask.
2012 was a big year for me that had a lot of lessons both professionally and personally. I’m not going to go into much detail about what I learned from opening a business; I couldn’t do it justice in a paragraph or two. I’ll just say that with most start-ups, at some point you just have to “jump,” you can’t prepare for everything, and there will be unknowns. This doesn’t mean you shouldn’t plan as much as you possibly can. I wouldn’t have been able to start a business and pursue my passions without the help of several key individuals and the encouragement of several others.
2. Pain-free movement has several components
Of course, I knew this, but my understanding grew enough to warrant it as a new lesson.
Taking the SFMA (Selective Functional Movement Assessment) course was a large jump in developing a useable understanding of the human movement system. There are three main categories to consider when assessing movement dysfunction: MOBILITY, STABILITY, and MOTOR CONTROL. Different professions have tended to specialize in specific components of each category, but the best in the physical medicine profession are addressing each component, as each component tends to play a role in pain and dysfunction.
I think we all have a basic acknowledgment that there is inter-connectedness about the human body and that we are not just a bunch of separate parts that function individually without the other parts. The hard part is understanding and recognizing how things are connected and understanding the design.
One common example that demonstrates this concept well involves knee pain. Most biomechanical knee pain has little to do with the knee; treating the knee pain won’t address the underlying dysfunction leading to the knee pain. The ankle and hip are designed to be much more mobile than the knee; when you lose mobility and/or motor control in the ankle and/or hip, the knee can take on burdens it isn’t well suited for.
3. Tissue Sparing Strategies are a major KEY to treating biomechanical pain
What I mean by biomechanical pain is pain that is due to some kind of movement issue, whether it’s due to an activity or sport or due to a lack of movement such as sitting too much, or a faulty movement pattern, this is the type of pain that people most commonly experience.
I know that it’s nice to receive passive treatment, especially when it feels good, is relaxing, and doesn’t require much effort on our own part such as receiving a massage, adjustment, active release technique, Graston, electric stim, or various other manual therapy techniques. Those are all excellent and have their place, but the key to getting better and staying better typically revolves around addressing MOVEMENT IMPAIRMENT SYNDROMES. Often it’s a very simple fix such as learning to hip-hinge instead of using lumbar flexion, engaging your core when bending over to pick something up to give your lumbar tissues extra support, or sitting with a posture that doesn’t stress tissues as greatly. Other times people are performing activities and are limited by mobility, stability and/or motor control. Without a good movement assessment to hone in on the specific movement deficits, the above-listed modalities such as ART, Graston, stretching, adjustments, etc, are usually much less effective.
4. Crossfit is a fun way to get in shape and become more athletic
Crossfit has ruined me for traditional workouts in globo gyms where everybody puts in their headphones and tries to build themselves into a statue or stares at a screen while they try to burn some calories. Some people love that stuff. I loved that stuff for about 10 years before I found something I like better. But most people don’t. A good case in point is how full gyms get around the 1st of the year just to be back to normal about 6 weeks later.
The group atmosphere of Crossfit creates friendly competition that pushes most of us further than we would push ourselves individually. The focus is more on performance than purely aesthetics but guess what; when your performance increases, you also tend to look better. I’ve seen several girls/women who have stopped obsessing about calories and being teeny-tiny and started eating for performance and wanting to be strong. They look better for it and have more fun with the whole deal.
Some people may feel that they are “above” having someone else, like a Crossfit trainer, program their workouts. This probably doesn’t apply to most out there, but I can relate to it with my experience and credentials. It’s amazing how much you can learn from others when you forget about trying to be an expert and follow others for a while. When you let someone else do your programming, you can learn skills and get better at things that you would have never tried on your own.
I am fully aware of the several valid criticisms of Crossfit. I have found that most are situational, and the rest seem to be based on preferences.
Many of the movements in Crossfit will expose you for movement dysfunctions; you can either address those issues, or give up and go back to bench presses and barbell curls, and live with poor movement quality.
5. Bacteria are fascinating
You probably don’t believe me that bacteria are fascinating, but this topic is going to be coming up more and more.
There is something referred to as the human microbiome. Researchers are exploring and studying how bacteria live in us, on us, and among us in a synergistic, sometimes helpful, sometimes harmful way. We have more bacterial cells in and on us than we have human cells. Some are even referring to this relationship as essentially another organ. It appears that this relationship is most profound in the intestines.
Don’t think this doesn’t apply to you. Here are a couple quick facts:
Streptococcus mutans is a gram-positive organism that is the primary causative agent in the formation of dental cavities in humans.
Harmful bacteria can create intestinal damage and cause or contribute to intestinal hyperpermeability (aka leaky gut). When this happens, partially undigested food molecules can escape the intestines and get into the blood stream where the immune system sees them as foreign invaders and mounts an immune response. This can lead to an over-sensitive immune system, and you can end up with a very allergic type of person. Ever wonder why someone is allergic to so-called healthy foods like strawberries or cucumbers? This likely has something to do with that.
Oh, and NSAIDs are also very good at damaging your intestinal lining and creating intestinal hyperpermeability. Don’t freak out about that, but just don’t take them every day for the rest of your life like the commercials indicate is safe.
Researchers have found a link between intestinal microbial balance and obesity. I’m not sure what to make of this yet, but there are some interesting findings. We’ll see what future research discovers.
You have a significant impact on your microbial balance living within you by what you eat. Different kinds of bacteria prefer different foods/nutrients. And no shocker here, promoting a healthy microbial balance includes eating low sugar and lots of vegetables. There’s a bit more to it, but those are two big factors.
6. Shoulder pain is extremely common
If all a clinician was good at treating was shoulder pain and low back pain, he or she could have a very busy practice. Even if they were only good at treating one of the two, they could still have a very busy practice.
I’ve had to deal with my own shoulder pain this year due to a lot of overhead lifting from starting to work on the Olympic lifts (snatch and clean & jerk). This motivated me to spend a lot of time learning and relearning about shoulder function and how to more fully assess it. I’ve changed my shoulder assessment and treatment strategies about three times this year as I have restudied the shoulder about three times this year and each time built upon my previous understanding.
There’s way more to this area than I realized and most clinicians are not assessing it very well. It’s too bad because the return on investment for this area of the body is much greater than almost all other areas.
A lot of clinicians have a few tools in their bag, and you know the saying, “When all you have is a hammer, everything looks like a nail.” A surgeon’s going to cut. A chiropractor’s going to mobilize. A physical therapist is going to strengthen and stretch. This area requires a lot of tools for accurate assessment, unless you’re ok with just getting lucky occasionally.
Check out these previous blog posts for more on this:
Shoulder Pain & Impingement, Part 1
Shoulder Pain & Impingement, Part 2
7. Low Back Pain is often easy to fix, a little harder when it’s chronic
I am finding that low back pain is more straight-forward and easier to fix than many other areas of the body. I’m finding that it’s generally quite a bit easier than fixing shoulder pain. To have a high percentage of success, it takes a multi-faceted approach in which the likely pain generator(s) are identified and treated accordingly. Mobility, stability, and motor control are addressed, and exacerbating factors and tissue sparing strategies are all addressed. This is especially necessary if it’s a chronic problem. If it’s acute, it’s usually easier.
I keep having patients who have been told by a previous doctor, whether chiropractor or medical doctor, that they need to stop exercising and be more sensible. “Just walk for exercise,” they’re told. I think walking is great, but most people can engage in much more vigorous physical activity (if they want to) if they get help from a doctor that understands what foundations may need to be rebuilt and what movement strategies to incorporate to regain strong functional movement.
I’ll be posting more on this topic within the next couple of months. You can check out this one simple technique that can make a big difference with low back pain: Quick Low Back Pain Fix
8. Learning Useless things isn’t completely useless
This was a big one for me this year. I used to get frustrated by learning things that turned out to be a waste of time. But it clicked for me this year that learning useless things is an extremely important part of the learning process. It puts what you do know in proper perspective. There’s a lot of bad info out there, and sometimes you don’t fully understand what the good info is until you are also familiar with the bad info. And a person needs an awareness of what is out there in their profession.
I think it can also be hard to recognize what poor information is until you’ve been exposed to excellent information.
I think the bottom line for myself is that I wouldn’t fully recognize and appreciate good info, lectures, protocols, etc., if I wasn’t exposed to those same things in their lower quality forms.
9. Everything has worked for someone…
I don’t know if that statement is 100% accurate but probably at least close. Anecdotal case reports are very powerful for marketing but are not very helpful scientifically, other than to give new ideas for potential further inquiry.
You hear these reports all the time in health care and healing professions. Somebody says I did blank with blank patient, and they recovered 100%. That’s great for the particular patient because they’re better, and if you’re better, who cares about anything else? It’s potentially terrible for the clinician because there’s no protocol and no explanation. It doesn’t make sense, and it’s not going to work on most people.
Who knows? Maybe there’s something to these…
For the young clinician, these stories can drain your confidence and make you feel like you don’t know much. They can make you feel like others know things that you will never know. It’s as though the best function off of some kind of intuition that can’t be learned. These stories can make things seem like chaos, like there’s no rhyme or reason to anything. What’s the point of all the studying and learning chemistry, physiology, and biomechanics, etc. if it’s all a shot in the dark at the end of the day?
I now realize that clinicians and people in general that do this without giving proper acknowledgment to their lack of understanding in these cases don’t know what they are talking about. They live for the anecdotal cases because they don’t have protocols and objective measures to track in the first place. Their patients and clients that do get better, get better more out of luck than competence.
Nobody can know everything, win 100% of the time, or cure everybody, but I’d rather use and talk about protocols that work 80% of the time than talk about anecdotal treatments that work 10% of the time.
Something I’ve heard way too many times by my colleagues regarding adjusting techniques is that they all work. I know that is sometimes meant to be a peace-making statement, but it is also a terrible statement. There is a story and case in which every technique or system or treatment has worked, but some are far more effective much more of the time than others.
10. Power comes from the hips
When I say hips, I mostly mean the glutes and somewhat mean the hamstrings.
This applies to athletes as well as everyday kinds of activities. Whether you’re picking up your kids, walking, running, golfing, throwing a baseball, etc.
Anytime you need power or strength; the hips are your FOUNDATION.
How you harness that power and transfer it through the system, (your body) is specific to the activity or sport. This can take years to learn.
If you’re not an athlete, you might think this concept isn’t applicable to you. It is. Using your hips to lift and bend in everyday activities spares your low back tissues and other tissues that are not so well suited to handle the load.
It is very common for people to have relatively undeveloped glutes. A major contributing factor is our tendency to sit a lot and not use our glutes. Over time, all this sitting tends to lead to tight hip flexors which further shuts down our glute usage.
The general wisdom is to use squats, deadlifts, and lunges to train the glutes. Although these movements CAN do a good job training the glutes, there appears to be much more to the story. Unless you’re already doing a good job utilizing your glutes, those exercises can be performed using compensatory muscles like your quadriceps and low back muscles and tissues.
Bret Contreras has been working hard to advance the research on this previously very misunderstood body part. His website offers an abundance of information on how to develop your glutes and hip strength.
As he points out and I’ve discovered as well, most people need to start very light with these exercises and focus on making sure they are activating their glutes before progressing.
