31 Dec 2015

Weakness is the Opposite of Health

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Weakness is THE most important diagnosis, everything else is secondary.

In musculoskeletal medicine we find the same injury often given different labels depending on where is in the body. To use just a few common examples: RSI, carpal tunnel syndrome, tennis elbow, golfer’s elbow, rotator cuff tendonitis, frozen shoulder, neck pain, whiplash, bursitis, osteoarthritis, sprain, strain, muscle tears, pulled muscles, disc bulge, sciatica – ALL mechanical, all caused by weakness and inhibition.

If weakness is the cause of so many problems, it would seem reasonable to presume that the more weakness someone has, the more fragile/sick/vulnerable they would be. Turns out, that is true.

In a landmark study published in the BMJ in 2008, Ruiz and colleagues reported on a study in which they measured the strength of 20,000 men and followed them up over 20 years. The differences in longevity were startling. Men in the weakest third were 33% more likely to die from all causes than men in the middle and strongest third. Half a dozen other studies have confirm this association between weakness and morbidity.

The weakest third is a fascinating group. You DEFINITELY want to be able to identify them when they walk in your office.

They have a specific type of weakness we call SYSTEMIC weakness. It’s not the case that EVERY muscle is weak with them, but EVERY AXIAL muscle usually is – that is spine, trunk, shoulders and hips.

These people are terrible candidates for chiropractic or any other type of physical medicine. They have been to 10 specialists, 20 doctors, 5 chiropractors and spend their lives obsessing about their health and trying to get their life back. They don’t present with just one problem like in all the RCT’s you’ve read, they have a cascade of problems that have been ruining their life for years. They end up on antidepressants, endless painkillers or having useless surgical procedures. They are also the ones most likely to be injured by anything you do to them. They are your nightmare patients and THEY ARE SICK, even if nobody else can find out why. Many doctors (and some chiropractors) are happy to write these patients off as psychosocial and see them until their money runs out but I’m trusting that’s not your way. If only we could recognise them and remove whatever it is that’s making them weak, we could help them feel better, live longer and be happier.

Well the good news is, you can. Not only can you recognise them, you can easily find out what is really wrong with them.

There are three different levels of SYSTEMIC weakness. The worst one is the patient who is weak everywhere just lying on your table. These patients have no physical stress on them at all, but they are still weak when you test 5 major muscle groups. As you would expect with a global weakness, the solution to these patients is not a spinal segment. If you think you can adjust these patients better you need to have a re-think. These patients usually have a NUTRITIONAL deficiency, generally one of the macronutrients (calcium, magnesium or iodine, usually). The only SPINAL problem that can cause this is a cervical disc lesion (annular tear).

Two more levels of systemic weakness are uncovered when you start to put a little stress on the body and then repeat the basic tests.

Until you can recognise SYSTEMIC weakness, you are risking sleepless nights, guilt, embarrassment and frustration as these patients confound and confuse you. Worse still, you might end up hurting them.

You can find out how to identify and treat SYSTEMIC weakness in The Afferent Input Solution.

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