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What’s going on upstream?

By Dr. Michael Cerami

If you found a bunch of dead fish washed up along the shoreline of your favorite river, what would you think?  This is a suitable analogy for how I view patients that come to see me; no, not that they are washing up into my office; but that their symptoms are an indication of something going wrong elsewhere-upstream.

Patients usually present with at least one problem or symptom. For many of them there are a multitude of issues that must be addressed. These usually fall into 2 categories: Symptomatic- what the patient feels, and Functional- what the examinations reveals. I find that going upstream to find the source of the symptom is the most effective way to help people get well and then to sustain that change. Otherwise we are just pulling dead fish out of the water all day long.

Treating only symptoms can be very seductive. It’s pretty easy to find (Where does it hurt?), cheap (take some anti-inflammatory meds), provides some instant relief (thanks doc I feel better) and allows the patient to continue to do the same thing that caused the problem.  This approach is similar to painting your house without sanding, scraping and priming first. It looks great for a while- then the paint starts peeling off and it needs to be done right which adds additional time and costs.

The good news is that with an effective analysis and examination the body can repair much faster than people realize. This is true whether you see a professional or not. The place to start when you are injured or have a problem is upstream.

If you are injured, try to take into account not only what has happened recently (twisted your ankle, pushed too hard while you were dehydrated), but look at a broader scope, over the past few weeks or even months and be honest with your assessment. It’s likely that many things contributed to the injury, not just the most recent event.

Try and not get locked into thinking about your issue only one way; either with a certain time frame or by being stuck on the area that is hurting. Expand on the possible causes and give each one of them equal leverage. Think multiple possibilities. This may not be easy, but it will give you a much better understanding of your body. The longer a professional is in practice (Doctors, Moms, mechanics, builders, nurses, technicians, etc) the more they understand the value of working through multiple possible causes and solutions simultaneously because it saves time and effort. I’ve recently had a few athletes with knee injuries where the solution for correction was in realigning the hips and the feet and had nothing to do with the knee itself. If I had gotten locked into thinking just about the knee, we might not have been able to solve their problems as quickly.

Because you are going to have your body for a lifetime, you should practice observing and understanding how all of the pieces of your life, health and exercise fit together. You don’t need to overdo it and blame all of your problems on your parentsJ, just try and observe with a bigger perspective regarding time and think more globally regarding your body. Once that’s accomplished, use your intuition to implement some possible solutions and see what you notice.

If you can create a better map for your life by looking upstream a bit more every year, you’ll start understanding your body better, stay healthier and avoid injuries.

Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available for a no change consultation one Saturday per month at The Salt Lake Running Company (Salt Lake store) by appointment. He can be reached at 801-486-1818 or online at www.utahsportsandwellness.com

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