All too often we are asked to work on more than one injury at a time. For example, a patient comes into the office and wants us to fix his neck and his back at the same time.
Typically they are confused when we say we need to focus on one injury at a time.
I understand, you’ve been dealing with this pain for months or even years, and now that you have finally showed up to get some help, you want it all fixed at once.
Oh, and it should only take 1-2 visits to do all that too. I understand your desires and wants, but you are living in a fantasy world.
First of all, truly fixing injuries is difficult. Getting rid of pain is the easy part. Anybody with a degree can manipulate the human body to feel less pain.
Feeling less pain does not mean the injury has been fixed. It simply means your body is feeling less irritation.
If the problem that caused the pain is still present you better believe that pain will be back very shortly, and you will be right back where you started with no sustained improvement.
Diagnosing the Problem
To truly fix a problem, you need to diagnose what the problem is in the first place. In order to be as accurate as possible we need to concentrate on one set of symptoms at a time.
In addition, we need to concentrate on relaying what you are feeling throughout the diagnostic process.
If we are trying to diagnose a shoulder problem, and you keep referring to your knee instead of concentrating on the shoulder, we will get nowhere.
This is how a patient can prevent a doctor from treating them successfully. So, we generally ask a patient with multiple problems “what is impacting your life the most”.
“What is the one thing that finally got you to pick up the phone and call us for help?” And we proceed to focus all of our attention on fixing that problem.
What Goes Through the Mind of Your Doctor
I know sometimes it looks easy. It appears as though, we ask a few questions, ask you to move in a certain way for 3 seconds, and then fix the problem right? WRONG.
Here is what is going through the mind of the doctor as you are walking into the treatment on your first visit.
- Watch how the patient enters the room and sits down
- Are they visibly in pain, certain difficulties in motion
- Go through a thorough history to identify when, how, why, the injury came about
- Find out if there are any previous injuries that could have contributed to this or is this a brand new injury
- What causes the pain, what does the patient do on a regular daily basis
- What are the goals of the patient? Pain relief or do they actually care about their bodies, want to fix the problem, and want to live an optimal healthy life?
- Now we can get into an exam, and by exam i mean a specific biomechanical analysis of the human body directed by the previous history pertaining to the area of the body that we took a history on
- Pay specific attention to what the patient feels through these ranges of motion
- Cross reference all the biomechanical analysis with the patient’s symptoms and the initial history to narrow down where the problem is
- Palpate and feel the problem in order to specifically diagnose the injury
- Decide what type of plan is needed to fix the problem
- Explain all your findings to the patient in the most simplistic way possible so that the patient understands what is wrong and what needs to be done to fix it (ex: your heart surgeon doesn’t give you details on how he’s going to fix your heart, he simply says “we are going to go in there and fix your heart”) simple as that.
- Please don’t expect to understand exactly how we are going to do our job, fact of the matter is, you could really care less. you are simply asking because it appears to be so easy and simple and you have reservations about our profession.
All of that takes place in 20 minutes on the first initial visit. All that is taking place and we’re not even treating you yet.
We don’t treat on the first visit because it’s important to us to (1) get as accurate a diagnosis as possible and (2) make sure you understand what is wrong and how we are going to fix it.
We understand that we make this look easy, but in fact there is a lot going on behind the scenes that the doctor needs to consider for implementing treatment.
Your injury is never going to be fixed in one treatment.
We sincerely appreciate the compliment that you believe we can fix things quickly, but realistically speaking there is only one person in the world that can fix things with the snap of his fingers and that is GOD himself. It’ll take us just a little bit longer.
This brings us back to treating one injury at a time. The only way to fix something is to truly diagnosis, dissect and fix piece by piece. We need to focus on one injury in order to be successful.
Every detail counts, every symptoms matter.
Why We Don’t Treat Two Different Injuries
When we start treating two different injuries, the patient and the doctor get confused. The patient tends to only focus on where they are experiencing pain and not on what is getting better.
We jump from one injury to another injury chasing pain and symptoms instead of working towards a common goal of fixing the problem.
This is a recipe for disaster. Both the patient gets frustrated because they feel as though nothing is changing due to the concentration on where the pain is that day.
The doctor gets frustrated because he’s fallen into chasing symptoms instead of truly fixing one thing at a time.
So we choose to fix one thing, and then when that is under control we move onto evaluating, assessing, treatings, re-evaluating, and accomplishing the task of fixing another injury.
The only time we make an exception to this is when we have seen a patient for a while and have moved onto a maintenance type care plan where we address certain injuries in order to keep them in check, mainly degenerative joints and discs that we can not permanently fix and need continuing treatment to keep from getting worse.
I Care About YOU
I’m a doctor, you can trust me. I’m simply interested in getting you as healthy as possible.
When you ask me for my advice, I’m not only thinking about the quick improvement of your pain but I’m also thinking about what you are going to be experiencing 10, 20, 30 years down the road.
I have your best interest at heart.
I understand you have that half marathon that all your friends are doing next weekend, but the fact of the matter is you have a bad hip and it is really beat up right now for multiple reasons.
Reasons that we can fix if you take some time off and let me help you. I want you to be able to enjoy your 40’s, 50’s and 60’s.
I don’t want you dreading the walk from your car into the grocery store. I want you to be able to walk around the mall without pain, and play with your grandkids.
That simple 12 mile run next weekend that you are so focused on right now will come and go and you will still be in pain if you don’t follow my advice.
And we will be sitting here in 2 weeks with the exact same problem we had before, and then you will be thinking about getting fixed again before the next race or whatever activity you want to participate in.
Bottom line is, when you get injured you need to take a step back and evaluate the situation. You need treatment at this time, and you need to identify what got you injured in the first place.
Injuries are simply you performing more work(load) than your body has the capacity to handle. When work exceeds capacity things break down. Simple!
Make sure if you are putting in the work you are keeping track of all your recovery too.
And when that injury creeps up on you, remind yourself that you have not recovered enough to put in the amount of work you are doing. Get help, get treatment. Treatment is recovery on steroids.
We speed up the recovery process with our treatments. Let us help you.