#26 – Think about your muscles

In today’s episode, Matt lays out the risks and rewards of thinking about muscles instead of focusing on problems inside your joints.

Hey everybody, it’s Matt Hsu from Upright Health and welcome to episode twenty six of the Upright Health Podcast. Today is going to be a short, sweet podcast. So today, we are talking about muscles again and namely, the risk-reward ratio of working with your muscles.So we deal with a lot of people who have a lot of different issues. We have clients come to us with knee problems, hip problems, shoulder problems, neck problems, back problems. And usually, these people have been told, by one professional or another, that their problems are being caused by joint degeneration, disk degeneration, a meniscus tear, a labral tear, rotator cuff tear and all these different things. And so all the focus starts going in on the joints, going in to the joints spaces. The focus starts really narrowing in on something that, unfortunately, can’t be changed. Or if it can be changed, it’s changed with a very drastic invasive methodology, whether it’s injections or surgery or whatever it is.

I just wanted to highlight today the risk involved with those things and their possible rewards which are obvious. Possible rewards will start with you know, you should feel better. Doing things like injections or surgeries, you know, you are hoping the reward is that you will feel better and hopefully that’s what happens. Doesn’t always happen. And I’m very excited to see a book coming out soon from an Australian orthopedic surgeon that talks about orthopedic surgery as the ultimate placebo. That’s coming out in a couple of months. You should definitely Google around for that. It looks pretty interesting. Anyway, so surgeries or injections, whatever it is, these invasive things hopefully help. The risks however are that they don’t help and do damage, especially in the case of a surgery, you could have mistakes made, there are infections that can happen. Also, there’s the recovery time from surgery that it varies… the recovery time varies based on you, based on the actual surgery, all kinds of things. So there is the possibility that during the recovery time, you get weaker in other parts and cause other problems elsewhere.

With injections, particularly the anesthetic injections, you’re looking at the possibility that you’ll have relief and you’ve numbed the pain successfully. But then, you actually don’t know if that part of your body is feeling better or is doing better or moving better because you can’t feel it. And I think that’s really a risk not worth taking because then you don’t know whether or not you’re actually getting better. You just know that it’s numb. And that’s not really a solution. It’s like putting on a blindfold and saying, “There is no tiger in this room with me that could rip me to shreds. I’m wearing a blindfold so it’s not here.” So that’s kind of the risk-reward situation to think about with injections and surgery.

Now, those have possible upsides. So those upsides are there. We should think about those, but they do have some serious downsides. A lot of times, people, when they’re really focused on a joint, will say like, “I know you’re talking about muscles. I know you’re talking about stretching and proper exercise and all that but wouldn’t I just be damaging the joint more? Wouldn’t I just be just kicking the can down the road and just waiting for more pain to come into my joint?” And the answer to that is, well, that’s assuming you keep moving poorly. And if you’re doing the right things for your muscles, you won’t be moving poorly any more.

The risk-reward situation, the risk-reward calculation you can make is very different too with the muscle-focused approach. First of all, the risks are very low. If you’re thinking about risks, you’re thinking about maybe this long term idea that you would hurt the joint more. But like I said, you’re probably not going to be hurting the joint more if you are careful in doing the right exercises. You might pull a muscle, you might feel really sore, you might potentially exercise the wrong muscle and for a short term, actually make things feel worse. That is totally possible.

Now, the reward is you can potentially move much better and remove the initial problem that’s causing you all this pain. And let’s say in a worst case scenario that you spend a bunch of time working on your muscles and really try to get things to work well. And just for some reason, you couldn’t figure it out, you couldn’t figure out what had to be done to improve the situation. Or maybe it is possible it’s gotten to a point where it’s just not going to be fixed by dealing with the muscles. You spent two years, three years, four years working at it and working at it, and you know, you just don’t have it in you to keep going. That could happen. It could happen. There are situations where sometimes the pain is just so constant and you just, you know, your life doesn’t allow for you to do what it takes. Things like that happen. At that point, you can still get the surgery, right? So it’s not necessarily an all or nothing calculation that you’re making. So if you address your muscle, you spend a ton of time addressing muscles, you learn things about your body, you experiment and you discover all these different things, you get some improvements. Or let’s just say in the total worst case scenario, you see no improvements (which rarely happen) but at that point, you could still go back to the other option of having somebody perform a surgery or do an injection on you.

I think the point I’m trying to make is there’s no rush to go attack your joints with injections or surgery. It’s not something that should be looked at as a first option… it’s a terrible first option but that is unfortunately sort of the status quo. And as I’ve talked about in other episodes, the evidence that what you see in an x-ray or an MRI is definitively identifying the cause of your joint pain and motion problems is pretty weak. The evidence on that stuff is very, very, very weak. And so using those things to justify the idea that you need to go attack your joints or attack this problem inside the joint, none of it is well-founded. It’s just not well-founded.

So here, we do encourage people to start thinking muscles — think muscles, think muscles, think muscles. Yes, there’s a thing that shows up in the x-rays. Yes, there’s a thing that shows up in the MRIs. But the thing that you can control as an individual is what you’re muscles are doing. You can reteach muscles what to do and then see how your body feels. Muscles are known to move bones. They are responsible for repositioning your bones and moving your bones in space. It is then, by definition, totally sensible to think that if you address your muscles, you can change the way your joints move in the way they are positioned in space. So, do it. Address your muscles. Think about your muscles. Don’t freak out about X-rays and MRIs. Just deal with your body in a safe, kind of conservative way. Learn to stretch. Learn to exercise well, do things in a wholesome way and see how your body feels. The risks of doing that are really low. Rewards can be huge. And if dealing with your muscles didn’t work, the the worst thing that could happen was you learned something. You gave it a try and then you still have the more drastic options available to you if you really still want to pursue them.

Anyway, those are my thoughts for today. So that’s going to be it for episode twenty six. Think about your muscles. Think, think, think about your muscles. And remember that pain sucks, life shouldn’t.


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