Will This Exercise Fix My Pain, Injury, or Dysfunction?

Disclaimer: this is not medical advice. And seriously, who looks for medical advice on a fitness blog?

physical therapy

I get an iteration of this question. All. The. Time.

Hey John, I have a specific pain/injury/dysfunction and I’m wondering if such-and-such exercises will help?

I’ve been asked if planks will help cure lower back pain, if squats will fix cranky knees, and if yoga will cure gastrointestinal disorders, along with many other questions along those lines.

To which I usually respond in two ways.

1) I tell them something they usually don’t want to hear, but need to hear.

2) I also give them an idea they probably haven’t thought of yet, which virtually always works to their benefit.

So, here’s how I generally respond to these types of questions:

  • I’m not a doctor. And so, I have no idea. You should really talk with your doctor.
  • There’s no way for me to know the answer to that question. But your doctor may. And if they don’t, they probably know someone who does.
  • Those exercises could help or they could make things worse, and your doctor would be the best person to analyze the risks.
  • You need to talk to your doctor – not ask a random person on the Internet.

That’s basically what I tell these people over and over and over again.

But John, I hate going to the doctor, can’t afford a doctor, don’t believe in conventional medicine (etc.).

Well, that doesn’t change the fact that you may need medical advice – advice that I’m not able to provide.

But John, I don’t like what my doctor told me.

Then get a second opinion (or a third!). I know it’s a pain, but that’s just reality. And finding a good doctor is time well-spent. And by the way, doctors tell us what they think we need to hear – whether it’s good news or bad news. Of course, they may be wrong, which is why it never hurts to get another opinion.

The #1 Thing You Need Your Doctor For In These Situations

doctorNow, asking a fitness professional – like me – for medical advice is a bad idea, and especially if it’s done in a blog comment or an email. Here’s why…

Let’s just say, for example, that you’ve got back pain and you think that if you strengthened your core with planks, it might help get rid of it. Hey, you read it on the Internet. So, it must be true!

So, you ask your friendly neighborhood fitness pro, who happens to post free information online, if they think you should be doing planks. Maybe they’ve been really helpful to you in the past. Plus, they’re really nice.

But here’s the thing. Unless that fitness pro is also a doctor who specializes in treating that particular injury (i.e. lower back pain) and has a history of successfully doing so, they probably have no idea what is:

a) causing the pain/injury/dysfunction/etc., and thus:
b) what the proper treatment should be

Which is exactly what YOU need to figure out.

So, what caused the lower back pain in the first place?

Was it your poor posture? Are you seated most of the day? Do you carry an awkward/heavy bag with you often? Do you workout with poor technique (and how do you know that you use proper technique?)? Is it a muscle/ligament/joint strain, sprain, or tear? Sciatica? Degenerative discs? Herniated discs? Bone spurs? Osteoarthritis? Is your spine misaligned? Do you have tight hips? Short hamstrings? Weak glutes? Excessive anterior pelvic tilt? All or most of the above?

These are the types of questions a good doctor, chiropractor, or physical therapist will ask you as part of your evaluation, which brings me to my next point.

If you’re asking a fitness pro for medical advice online, then not only are you asking the wrong person, this also involves almost zero evaluation whatsoever. I mean, how on Earth am I supposed to know if planks will help you with back pain without being a doctor, seeing you in person, looking over your medical history, performing some diagnostic tests, etc.?

I can’t possibly know those things. And so, I can’t possibly – in good faith – give medical advice. Not to mention that I can’t do it legally either!

Obviously, nobody wants to hear that. They’re asking these questions because they want answers. They may be asking the wrong people, and doing so in completely the wrong way. But at least they’re trying, aren’t they?

So, what I CAN do is educate and inform people of certain facts that may be helpful to them. For instance, planks are a useful tool for increasing your core strength (i.e. a proven fact). And most people would benefit from an increase in core strength. And in some cases, an increase in core strength correlates with less back pain – and we have a lot of evidence to confirm this. So, it is possible that doing planks could eliminate back pain. Or, squats may help your knees. Or, yoga may help your digestion. And if you can perform the exercises without pain, then they are probably a safe option.

Of course, any exercise could also make your issue worse, which is why it’s so important to work with your medical team to deal with this medical issue…if it is, in fact, a medical issue. Speaking of which…

The Bottom Line

You need to figure out what is causing the problem before you try to treat it with some random exercise. In other words, you need to identify the source of the issue (i.e. not the site of the pain/injury/dysfunction/etc.) so that you can determine if you require medical intervention or not.

You see, not all pains/injuries/dysfunctions are medical issues. Sometimes, you’re just having back pain because you sit at a desk all day long, and with poor posture. You don’t need drugs, surgery, or physical therapy. You just need to sit less, move more, and improve your posture. That’s a lifestyle issue – not a medical problem.

Now, we all know that lifestyle problems can and do often lead to medical problems. So, this is one of those grey areas. Do you really need a doctor? Or, do you just need to sit up straight? There are many situations where it’s not clear what the best solution is. That’s why I think it’s a wise strategy to have your doctor help you determine if you have a medical problem or not – just to rule it out – and then go from there. That’s a much safer strategy than figuring out you do have a medical problem down the road.

What You CAN Do (Usually)

Now, something I often tell people who ask me for this kind of advice is that they should consider a form of gentle, restorative exercise as part of their rehabilitation. Things like joint mobility training, yoga, tai chi, and others. I make this suggestion for a few reasons…

a) Most people would benefit greatly from this type of training, whether or not they need it for rehabilitative purposes. Simply put, it’s a good idea anyway.

b) Most doctors are in favor of this type of exercise and will approve some or all of it, and may even encourage it as part of your recovery. That is, it’s an easy sell to your medical team.

c) These types of exercise come with many benefits, and yet, very low risks – and particularly joint mobility training. So, you can do a lot of good with very little risk of causing more harm.

d) Most people who are looking for this kind of advice want to be proactive in their recovery process, and giving them something to do in the mean time is usually received positively.

e) I really, truly want to help anyone who comes to me for help – and this is one little thing I can do as a fitness professional to get them headed in the right direction…without having to “play doctor.”

And you know what? I’ve had several people take that advice to heart, and start doing some joint mobility exercises or yoga, and then tell me that their pain/injury/dysfunction went away on its own. That’s most likely because they had a lifestyle and/or fitness issue – not an actual medical problem – and it could be solved with a restorative form of exercise.

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Wrap-Up

If you’ve got an ache, pain, injury, or other health problem, the best thing you can do is work with the right professionals for the job. That means working with a doctor for medical problems and a fitness professional for fitness problems. And if you’re not sure what kind of problem you have, going to your doctor first is considered the best practice.

Now, if I haven’t been crystal clear about my eligibility to diagnose and treat your medical problem, please read the Medical Disclaimer. And regardless of who you are, ask your doctor if Joint Mobility Training is right for you. You can thank me later.

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6 Responses

  1. You are spot on here. I’ve had some off-and-on shoulder pain for years that finally got so bad it was interfering with my workouts. I first went to my PCP, who was able to assess that it wasn’t a tear or impingement, but a muscular imbalance from working on a computer all day. His assessment allowed me to get an ergo consultant in to evaluate my workstation and gave our office manager the budget justification to pay for the recommended adjustments (I work for a large institution – may be more difficult for smaller businesses). While the exercises the doctor gave me weren’t so effective (I was just exercises muscles that were out of alignment), a follow up with a chiropractor confirmed the doctor’s assessment and getting the structural adjustments started making the exercises more effective. Also, providing the doctor and chiropractor assessments to a trainer at my gym allowed him to design a program to help rehab my shoulder – which my chiropractor supports. I’m still not 100% (it took years of bad habits to create the imbalance) but I feel like the progressive approach made it possible for each person to give me the best care and advice possible, based on their expertise.

    • Thanks for sharing your story, Suzanne. You are an example of someone doing this RIGHT. You went to your doctor first, then saw the right kind of specialist (i.e. chiro), and finally worked with a fitness trainer using the knowledge you gained from your doctors. I hope more people follow in your footsteps when they run into these kinds of problems.

  2. Timothy K

    Right on with the advice John! So many people go online and ask questions about exercises and get bad advice from someone who isn’t qualified. If someone asked me about doing the right exercises etc. I would say see a fitness trainer in person rather than taking chance with someone who may not have the education to back up what he or she is saying. I’ve read some outrages advice and can’t help but laugh and shake my head at. Last year I had issues with lower back and saw physical therapy for a few months. It didn’t get me anywhere because in therapy they were reeducating me on weight training. I found out pull ups was a much better choice for me. I do mostly eccentrics with a neutral grip to get my back stronger to do pull ups. I went from struggling to do one pull up to doing 7 pull ups!!:) The pull ups also make the rest of my body much stronger as well and this exercise has given me my life after months of depression of not being able to do things I like to do. I choose neutral grips because its the safest for my joints and more effective when doing pull up negatives. The other grips hurt my elbow when doing eccentric training even with good form so that is why I stick neutral grips for the exercise.:) Keep up the good work John Stifferman!!:)

  3. Timothy K

    Sorry, I meant sifferman not stifferman typo.

    • Haha, you’re not the first! And besides, Mr. Stifferman doesn’t sound so bad. I’m not a fan of Snifferman, though. And I’ve been called worse :-)

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