Injury Symptoms: Chicken or the Egg
As fitness enthusiasts and endurance athletes, we push our bodies hard for fun. At times, this will lead to all kinds of aches, pains, and weird body symptoms. Too often, movement and medical professionals get caught up on the symptoms of injury, ignoring the root cause. Now that may sound confusing so let’s look a bit deeper into the difference between a symptom vs the cause of injury. For purposes of this blog, I’ll refer to any ache, pain, or other musculoskeletal dysfunction as an injury.
Like so many things in sport in life, we get used to doing a certain way and forget to question why. As an athlete I was always told when you get injured,the gold standard of treatment is, RICE: Rest, Ice, Compression, Elevation. It makes sense. All of these techniques will reduce swelling (a major source of pain). They’ll also get more blood flow to the inflamed area and potentiate the healing process (inflammation helps heal as well but that’s a discussion for another blog). As a symptom treatment, there’s no doubt that RICE is a great way to feel better and ready to get back to play, quickly.
What caused the injury though? Here’s the secret… It’s seldom the area that we feel symptoms. Simply put, the injury is “the straw that broke the camel’s back.” Somewhere else in the body, something wasn’t working exactly the way it should. Specific to your sport or task, a joint stopped working the way it should. Because of that, the other joints in a successive chain reaction had to work a little harder. Whichever area of your body was least prepared for the change in biomechanics gave way to an injury.
Here’s an example. The outside of your foot hurts after running. Your coach suggests you RICE to get back to running quickly. You go get an x-ray and nothing is broken. The doctor tells you RICE is the best idea to fix the injury. Everyone you talk to about it says, “RICE.” Proactive as always, you even do some exercises to strengthen that foot and go buy orthotics because someone said maybe your foot just doesn’t work quite right. And, you RICE. In two weeks, your foot feels great. Running feels better than ever. Your feet are stronger and the orthotics give more support so that nagging injury never comes back. But what, if anything have you done to treat the cause of the injury?
Did anyone examine your hips? What about your shoulder? Were you examined or treated on a table in isolation? Were you in a position that resembled both your front leg then your back leg during your running stride? If not, you’ve treated a symptom and ignored the cause of the injury. While it might have been a foot that didn’t work quite right, you have to explore the whole body to find out what wasn’t working quite right. It may have been your hip not extending quite right as your body goes over your foot, mid stride. This could force your foot too “stretch” too much to compensate for the limited hip motion. Maybe as you land in the front of your stride, your upper leg doesn’t roll into your hip the way it’s designed to. That roll should, turn on your butt and other big muscles, helping you decelerate against gravity. In that case your foot takes a disproportionate load on impact for a variety of potential reasons. Your hip didn’t have the room to roll in or your butt didn’t turn on for some other reason. So, all of the muscles connecting to the foot try to slow you down but just weren’t strong enough.
No matter what the symptom, treating the pain is a very important starting point. However, without out finding and treating what caused the area injured to work a bit harder than it should have, we’ve failed to treat the cause. Without understanding the specific motion that was restricted or uncontrolled, we can’t understand the cause. By not addressing the causes in parallel with symptoms (ideally before), you will have more injuries. You won’t be able to perform to your potential. The cause of the injury still looms, looking for another area of your body that’s can’t take a disproportionate load.
What injuries or nagging pains do you struggle with? How do you identify and treat the causes?