Episode 87: Helping patients address the actual issue

Um, you, do you, uh, do you want to describe the, we talked a little bit about this in the runner zone, um, the pattern, a pattern that you've noticed a lot with patients over the years, which is I'll say taking an avoidance strategy to the area that hurts bones, tendons, muscles, whatever it is.

When, you know, when did you first notice that? And maybe how did that present itself? And then we can, we can go from there.

Yeah, I mean, when I was in New York City, naturally you're people watching just because you may be sitting there having a coffee, sitting on a park bench, and you just have droves of people walk by.

Or maybe they're standing, you know, waiting to catch the subway.

But clinically, you know, A lot of the times I think to a person I consulted yesterday who came in and was dealing with signs and symptoms consistent with a proximal hamstring tendinopathy.

But there's probably also some degree of an arthritic process going on at their hip.

Hopefully they're not listening to this because I didn't really get in the weeds with this because they had a loss of internal rotation of the hip.

And it was kind of a it was a hard end feel.

Definitely felt bony.

So when I was talking to them, we were standing for a good portion of the session.

Right-sided involvement in the entire duration of that appointment, they're shifted away.

So they're kind of hanging on their left lower extremity, unloading or offloading that right lower extremity and letting it tow out.

And we always talk about, hey, load the tissue with the issue.

Let's make sure we get some load going through the involved extremity.

But it dawned on me.

I'm like, here we are trying to get this person to do exercises to load that region.

But I know that if this is how I'm seeing them during the session where they're unloading throughout the duration of the appointment, they're doing this with life.

And they'll say, oh, I have a standing desk.

And I'm just thinking, yeah, but you're sitting there hanging on your left leg.

your left side.

So I just started realizing probably that, you know, the entry point to loading that person is awareness first, just making them aware of this tendency.

I think that can be an adaptive strategy early on, you know, so if someone has a bone stress injury and ankle sprain or some kind of acute injury, yeah, you expect them to offload that side.

They're trying to shield it to sort of, you know, get things to calm down.

But I think that oftentimes people start to adopt that as, you know, a normal pattern as they're going through life.

And I think that, you know, They never really address that or restore capacity on that side.