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Medical Imaging – A Clear Picture That Is Very Unclear

You have pain long enough and eventually go see a physician.  Imaging is typically ordered – x-ray or MRI most likely – and the results are given to you.  Many times, the way the results are explained to you, it sounds like a death sentence – eminent surgery, an end to your racing career, an end to the things you love to do.  It isn’t like this in all situations, but many conversations I have after someone sees their physician is calming their nerves and helping them to understand why the images they are seeing is not a death sentence to their training, racing, or quality of life. 

Here are the main points of discussion… 

Physicians recommend what they know and do 

In life, it is normal for us to recommend what we know and what we are familiar with.  We do it every single day in normal conversation.  We can’t expect anything different from orthopedic physicians and surgeons.  In their training, they learned to treat the painful areas and the damage present with three primary methods: pain medication, cortisone injections, and surgery.  That is what they know so that is what they advise. 

With their training, they look at an image, they see damage, they treat the damage.  Most of them don’t look into why the damage occurred in the first place or why the pain is actually occurring.  It tends to be assumed that because damage is present to a structure that the damage is causing the pain. 

This isn’t always true.  Yes, it is in some situations, but not all. 

The next two ideas explain why… 

Imaging does not tell us why the pain is present when you move 

Most imaging is taken when we are completely still.  (Yes, there are some scans that are done with movement, but these are not performed as often.)  Last I checked, very rarely do we experience pain when we are still.  It is normally occurring during specific activities or movements.  Only by assessing what is going on with the structures during movement can we get an accurate assessment of what is going on in the joint, tendons, ligaments, and/or muscles. 

Many pain free people have similar images 

A number of studies have been completed that have found people who are pain free have similar images to people who have pain. 

Along with that, I have spoken with and worked with a number of people whose images were taken of the same joint on both the right and left sides and the side that shows up worse on the imaging is not the most painful side. 

Let me be clear, I am not discounting the fact that you have pain.  The pain you are experiencing is real.  I am also not discounting the fact that your imaging shows damage or degeneration.  That is very real as well.  And yes, you may need surgery at some point in your life because of that damage.  What I am saying is that if you compared your images with those of all your friends and training partners who don’t have pain, you would see a lot of similarities. 

If you are experiencing pain and have been told you are requiring surgery or need to stop training, I highly encourage you to seek out more answers, to ask yourself or other clinicians why this is happening.  The more curious you are and the more willing you are to dive deeper into why you are experiencing the pain, the better off you will be in the long run. 

Not sure what the next step is for you and your training? Let’s chat! Schedule a call with me to figure out the next steps in YOUR journey!  

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