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Why a diagnosis doesn’t solve the problem of chronic injury

May 6, 2024 by Paul

In this post we discuss why a diagnosis doesn’t solve the problem of chronic injury. 

We can spend a great deal of time searching for a diagnosis in musculoskeletal (MSK) conditions. 

This is particularly true with injuries of an ongoing or chronic nature. 

You understandably want to know what this thing is that’s continuing to cause you discomfort and preventing you from enjoying your activities. 

In many cases the real problem isn’t the area that hurts however, but finding a viable solution. 

Once anything serious has been ruled out, giving something a name usually has little bearing on the likely solution. 

There are two reasons for this: 

Firstly a name doesn’t tell you why this situation has occurred in the first place.

Second, we know the longer something has been hurting, the less representative of tissue damage it’s likely to be. 

This reductionist approach can also lead to a narrow treatment focus and more relevant contributors are missed. 

A diagnosis doesn’t necessarily lead to a solution 

MSK health care is not like other areas of medicine where, if you’re lucky, a diagnosis will lead to a tried and tested treatment plan. 

Whilst efforts are made to neatly categorise issues and establish protocols to treat them, the number of variables involved makes this near impossible. 

Take for example patellofemoral pain, or pain at the front of the knee. 

If 100 people visit a physiotherapist for this issue, they will have a similar experience. 

They’ll be instructed to stretch certain muscles and strengthen others. These will be the same muscles for everyone. 

This is because most practitioners follow a protocol for this issue. 

Can it really be that 100 individuals have arrived at the same point the exact same way? 

This is like giving 100 people instructions on how to get from Cambridge to London. What if some of those people don’t live in Cambridge? What then?

What’s required is a method to accurately locate where somebody is, so a road map can be provided from their present location.

This involves a thorough assessment of the muscular system, not just local to the issue itself, but more broadly across the entire body. 

It’s not just about the muscles

Pain is an output that’s dependent on more than the function of your muscular system. 

It’s more accurate to think of it as an assessment of how much danger your brain thinks you’re in. 

As such it can be influenced by more than how well you move, or how well your muscles are functioning.

For example, the way in which a diagnosis is delivered can make all the difference to how you feel.

One that’s delivered in a calm and reassuring way can reduce pain levels. 

Conversely one that’s given without proper context can cause alarm and make the situation worse. 

Summary

Once you have a diagnosis for your particular ailment, it’s natural to think that a reliable treatment plan will follow. 

This isn’t necessarily the case due to the wide variety of potential influences on your unique situation. 

You will increase your chances of success if you consider the broader picture. 

This includes how you think about the issue, the overall function of your muscular system, and lifestyle factors such as nutrition and recovery.

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