The cartoonist, RSI and a broken injury rehab model.

By November 14, 2017Rehabilitation, Training

Andy Riley is a scriptwriter, author and the cartoonist responsible for the Bunny Suicide books among other things. He recently posted an honest, funny and troubling account of his experience attempting to recover from RSI or Repetitive Strain Injury. 

RSI broken injury rehab model

Below is my favourite paragraph to give you a flavour. 

“I took lessons in Alexander technique, which was like trying to learn advanced driving skills while your car is still wrapped around a tree. Not harmful, but you kind of need to get the car back on the road first. A nerve surgeon gave me steroid injections; no effect. A shoulder consultant examined me for all of three minutes, shrugged, billed me for £195, showed me the door, then flew his gold helicopter to a consultant golf course where the bunkers are brimful of rubies, where the buggies are drawn by mane-tossing unicorns, where a gentle shower of Champagne falls at quarter past three, where instead of going to the toilet they shit in Ming vases then smash them over the servants’ heads for a laugh.”

You get the idea. Suffice to say that Andy had a relatively negative experience. 

Like any consumer who is left unsatisfied with the service they received, he has some very insightful feedback for the rehab professionals he encountered along the way and the health care industry as a whole. 

The most pertinent observation, because it cuts to the very heart of the issue, is that the current business model of most clinics puts the consumer and the professional at odds with each other. 

Whilst the consumer wants to get better as quickly as possible, it’s in the rehab professionals business interests to continue treating them. To a point. 

That point surely comes when in Andy’s case the rehab clearly isn’t working. What then?

The hope is that ethics will prevail and an appropriate and considered referral will take place. This clearly didn’t happen in Andy’s case. 

Why you can’t really treat an injury better.

It’s extremely difficult to treat any injury better. The best that any clinician can hope for is to reduce their patient’s pain and educate them as to what is likely occuring with their bodies and the best course of action going forwards.

To make any meaningful long term changes requires exercise. 

In Andy’s case, as with any other injury, the fundamental issue is that of a mismatch between what is being asked of the body and what it’s currently capable of producing. 

Sure you can get the car back on the road again after you’ve unwrapped it from the tree (to use his analogy), but if you want to drive it fast and for long periods, you need to make sure it’s capable of performing. 

You can’t do this on a treatment table. 

Laying down getting things stretched and massaged for a few minutes each week isn’t going to get you far. 

You have to apply force to create tissue adaptation. This is the key to both feeling better and getting back to doing what you wanted to do in the first place. 

This is also the crux of the matter and where continuing to treat without any intention or ability to train somebody begins to look like a business decision. 

What to look out for if you think you might be in this situation.

First up, how do you feel? Remember in most cases injuries should begin to feel better with time as your body heals itself. If you’re feeling worse or are experiencing symptoms in other areas of your body, all might not be well. 

How does your therapist respond to things not going so well? More of the same but harder? More of something that didn’t work too well in the first place is not usually the answer. 

What’s the plan? Although this can be subject to alteration, there should be some kind of plan in place that’s clearly communicated to you. 

Take a look around the environment you’re being treated in, does it have resistance training equipment? If not, where will you do the work that’s required to get you back to your best?

Take a look at your therapist, have they ever set foot in a gym? If not how are they going to instruct and programme your exercise effectively?

Lastly always have in mind the fundamental issue, the mismatch between what you’re asking your body to do and where it’s currently at. 

Any treatment approach that’s not closing that gap is not going to get you better in the long term. Take a read of how we do that here.