#13 – Sloppy thinking down a slippery slope

How important is terminology to solving your problems? Poor use of language can trap you in pain.


Hey, everybody! Welcome to Episode 13 of the Upright Health Podcast. This is Matt Hsu. And today, we’re going to be talking about “sloppy thinking down a slippery slope.” So I had a discussion with a guy a couple weeks ago in the locker room about some of the issues he was having with his hip and knee. A couple of us were in the locker room after a pickup game, just talking about how we’re going to be stretching our hips in different ways. And we were all very excited to be stretching in different ways and another guy chimed in and said that he had been working on different ways to stretch his hips because he had been having some knee and hip issues. And basically, the doctors had said, “Well, might be some Tendinitis near the knee. It might be Piriformis. It might be your SI Joint.”

And when he said “SI Joint,” I said, “That doesn’t even makes sense.” And then we got into a debate about whether or not terminology is really that important when you’re discussing things like this. And my contention is that you need to be very, very, very, very clear when you are using language about cause and effect, and you’re dealing with the human body. So you know, he was saying it might be the tendon. It might be Piriformis. Both of those, I could say, “Okay, let’s make some sense. Those are soft tissues that can affect things. That makes sense.” And then when he said “SI Joint,” I said, “That doesn’t make sense. The joint doesn’t control anything.” And that’s when he said, “No, no, no, no, it is the joint but blah, blah, blah.” And I said, “Look, the joint is just two bones meeting. The joint is the space where two joints meet. It doesn’t include the muscles around the joint.”

Sometimes when we’re just sort of talking casually, we may say, “Oh, yeah, SI Joint includes all muscles around that joint.” But when we’re trying to be very clear, the joint is simply where two bones meet. And when we think about it that way, we need to realize that that is not going to cause you any issues, right? Even if you have signs of joint degeneration in any joint, it’s not, not, not, not, not a sign that the joint degeneration is causing you pain. Quite to the contrary, right? There have been many studies that show that signs of joint degeneration do not correlate at all to whether or not you have pain. So when we say, “Oh, a joint is causing you pain,” we have to actually back up and realize that the joint is probably not doing anything. If you have a skeleton lying in the dirt with no muscle, no soft tissue and no brain sending any commands to anything, you have a skeleton that isn’t moving, right? It’s not going to do anything. You’re not going… that skeleton is clearly not experiencing pain, whether from joint degeneration or from the lack of a brain.

So we got into this discussion about a concise use of language and that’s an idea that is extremely, extremely important to me as somebody who has studied literature and tried to learn a number of languages in my life. I think the clearer use of language is fundamental to having a good discussion on anything, and to solving any problem. You just have to be very clear about all the words to you use. And so this whole discussion got me thinking about how sloppy we can get when we start talking about a cause of pain in our body.

And I’m realizing I’m going back to the whole arthritis idea again, and I hope you are not tired of me beating this horse but the idea of arthritis is that we’re looking at signs of degeneration in the joint where you have pain and we say arthritis is causing you pain. To even get the diagnosis, you already have the pain and then you have the joint degeneration and then you say you have arthritis, then you say the arthritis is causing you pain. This is not really true, right? We’re looking at arthritis with its pain and degeneration as an entity and then we say that this entity is causing its own characteristics.

So for me, the best metaphor I could come up with this is to say, a puck in the net causes a goal in hockey. Or if you are overseas and not in North America and you watch soccer — or football, I believe it’s called – you know, does the ball in the net cause a goal?  Would you say that? It’s a very weird sentence. It’s not a ball in the net, a puck in the net, those don’t cause a goal; those are goals, right? The puck is in the net, it’s a goal. If the ball is in the net, it’s a goal. You would never say the ball went into the net; it caused a goal. It’s just not how you would structure your sentence and it would not be a correct way to describe the situation. In the same way with arthritis, you can’t say you have this condition that causes its own characteristics. And in fact, like I’ve said before (I’ve covered this already) with things like arthritis, it’s not even related to the joint degeneration signs that show up in x-rays.

So this kind of sloppy thinking though can get you really stuck. So we start looking at things like, you know, like Tendinitis or Plantar Fasciitis or whatever. We start giving names to the experience of pain somewhere. We find an idea that may or may not explain it, and then we say, “Boom! This is causing the thing we’re describing!” Plantar Fasciitisis is a really funny one to me because we say, “Oh, Plantar Fasciitis, you have pain on the bottom of your foot. It must be inflammation of the soft tissue at the bottom of your foot. So inflammation at the bottom of your foot is causing your pain. We’ve got this thing. Boom. Now you have your diagnosis. That’s your cause.”

That’s not really. And what’s great is recently, I mean in recent years, for sure, the way people approach Plantar Fasciitis is to work with the muscles higher up the leg. You’ll do some stuff around the feet but you’ll definitely wanna work up into the lower leg. And I’ve also personally seen work even up into the psoas, even up to the hip flexors can actually be hugely beneficial for people with Plantar Fasciitis and other kinds of foot pain. But you can only figure out that stuff so far away from the location of pain is related to the pain if you’re willing to abandon the idea that the location of the sensation of pain is where you need to put all your attention. The problem is we start naming stuff and then we think that because our name is anchored to this specific point, that this specific point is really the problem.

And I think in recent years, we are starting to get over that, but the more you, as an individual, get over that kind of thinking, the better off you’ll be. We’ve just got so many examples of these kinds of issues, right? You have like knee pain if you just think, “Oh, it’s either Patellar Tendinitis or it could a weak Vastus Medialis Obliquus.” We start thinking, “it’s got to be here. It’s got to be here because the pain is here.” And we are starting to think in a very sloppy way and we’re getting basically seduced by our own words and thinking that the words that we’ve used have really encompassed the whole problem, when in fact, the problem is global.

So my invitation to you is to be thinking a little more globally about your body and thinking very, very clearly and concisely about the chain of events that causes you issues. It’s something that can be applied to weight lifting. It’s something that can be applied to rehabbing yourself. It’s an idea that can be applied to pretty much anything. Break down the thing that you’re trying to achieve into a very clear, concise… I don’t wanna say “puzzle”, but a very concise picture. You need to see all the pieces that are involved and then identify what you need to do. Don’t get caught up in terminology that seems to be simple and easy. Look at the whole picture and say, “Well, okay, if this simple, easy idea that’s based on some circular use of language isn’t helping me, how can I approach this problem differently?”

So I hope those ideas inspire a little bit of thought for the week, and I hope that you remember that pain sucks, like shouldn’t.


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