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Avoid Unnecessary Surgeries

Sunday, January 07, 2024

Health to Vitality Blog/Physical Well-Being/Avoid Unnecessary Surgeries

In the last 3 months, I have had 5 clients come to me saying that an orthopedic surgeon told them they needed surgery.

One was neck surgery.

Two were meniscus tears.

Two were rotator cuff repairs.

Today, none of them have needed surgery and can perform activities of daily living with no pain. The plan is for each of them to begin their favorite activities inlcuding weight training, tennis, and yoga, within the next 4-6 weeks.

I only had a conversation with the young man who was told to replace two discs in his neck. I never touched him; just offered him a new perspective, and he avoided major neck surgery in his mid-forties. One that I will be sharing with you.

These 5 individuals represent a minute number of the millions of people who are getting unnecessary procedures.

An estimated 7 million orthopedic surgeries are done annually in the United States. Individuals between 50 and 64 make up the most of that 7 million.

I contend that most of these surgeries are unnecessary and could be avoided.

Why is this happening?

The current model of working out, injury prevention, rehabilitation, and pain management is a flawed system that will lead you to 1 of 3 places:

  • You need surgery
  • ​You must give up an activity you enjoy
  • ​Sometimes both

Let me say I do believe there is a place for orthopedic surgery. There is a time when the injury is bad enough for repair. But, this is the minority of the cases, and the proper intervention would have prevented most from becoming "bad enough” to need surgery.

The Vicious Cycle of Soft Tissue Injury Care

In this article, I am going to focus on the areas of traditional rehabilitation and pain management. I call it the "Vicious Cycle of Soft Tissue Injury." In part two of this article, I will share a way to address soft tissue injury,

The average person who comes to see me is at one of the phases listed below. Unfortunately, it is usually around Phase III or IV.

Phase 1 - Discomfort When Performing an Activity

In this phase, most people find ways to work around it, shake it off, do a quick stretch, and keep doing their thing. It usually isn’t bad enough to stop them from doing what they want. The better you compensate, the longer you can last in this phase, but the bigger price you pay down the road.

This is the ideal place I'd love to intervene with my clients. As I say at my clinic, “Yellow flags are much easier to address than red flags.”

Phase 2 - You Give in and See an Orthopedic Surgeon

On your first visit, you will get an x-ray. Unfortunately, an X-ray doesn't tell you much. You can't see any soft tissues - you only get a picture of your bones.

95% of the time, the injury is in the soft tissues. Only an MRI can provide a picture of the soft tissues. If you want more valuable information, always push for an MRI.

More often than not, there is not enough damage to justify surgery so pain management is the approach. This looks like prescription medications or some type of injection, like cortisone.

The best-case scenario is that this buys you some more time.

Inevitably, the pain returns, and you are back to not being able to workout or perform your activity. This can lead to a second or third cortisone shot that is less effective than the first. If you got months of relief from the first one, you will most likely get weeks or days out of the second and third.

SIDE NOTE: When I was in my early 20s, I received pain medications before being offered my second elbow surgery, and it was AMAZING. I popped a few of those pills and went right back to working out with ZERO pain - miraculous!

Unfortunately, the medication caused cardiovascular problems and was pulled off the shelves. A good thing because all it did was allow me to continue to damage my elbow without the pain stopping me. This eventually led to the ulnar nerve in my elbow being completely damaged and losing 33% of the muscle in my right hand.

During Phase III, a more direct approach to physical therapy can occur. Getting to a good physical therapist who operates outside of the traditional physical therapy paradigm can be super helpful. I will dive deeper into this topic in Part II. For now, just know if your Physical Therapy sessions include some ice, electrostimulation, and a print out of some isolated exercises, you are at a traditional PT.

Phase 4 - It's Bad Enough That You Need Surgery

It is now months later, if not a year, and you feel like you are back at square one or worse. This time, when you return to your orthopedic surgeon, the surgeon presents a stronger case for surgery. The idea that you have tried "everything else" and it hasn't helped becomes proof that surgery is the only option.

I have witnessed hundreds of individuals fall into this cycle of soft tissue injury care over the last 20+ years. In the worst cases, I've seen this cycle play out multiple times with the same individual.

Once you are in this care loop and continue to stay active, it is not uncommon to have other injuries. One of the most common scenarios I've seen over the years is people who have low back pain and knee pain.

For reasons I will go into in Part II of this article, having knee and lower back pain simultaneously is very common because they share the same joint - the hip. This is a major signal that your hip is the cause.

Since the traditional model of care only focuses on the broken parts and every orthopedic doctor has his/her part they specialize in, nobody is looking beyond the injured area.

I have had clients ask the knee specialist if the hip pain they’ve had for years may be contributing to the knee pain. The responses they receive are mind-boggling. A few of the doctors tell them that

"The hip has nothing to do with the knee. If you have hip pain,
see the hip specialist down the hall."

This is not a jab at orthopedic surgeons; it illustrates their training and perspective. They are part specialists, NOT movement specialists. A knee specialist who will do knee surgery needs to focus on the knee. Studying the knee and the different types of orthopedic repairs for the knee is a lifelong study.

Understanding chain reaction biomechanics and the intricate play of the foot, ankle, and hip and how it influences the knee when walking, jumping, hiking, or playing golf is not something they need to know to perform the surgery.

But, YOU must understand that none of these things are even considered when inside the "Vicious Cycle."

I'd also like to reiterate that orthopedic surgery has a place. I have supported some of my clients to get surgeries. However, this is the minority of my cases.

I'd also like to say that I don't blame orthopedic surgeons for offering orthopedic surgery. When you ask a surgeon how they can help, surgery will be an option - that is their training. As Warren Buffet said,

"Never ask a barber if you need a haircut."

In Part II of this article, I will introduce a new soft tissue care model that breaks this vicious cycle. A model that has prevented over 90% of my clients from avoiding a "necessary surgery."

This model is one that I have recently refined over the last year after re-engaging with a mentor of mine. It has 4 Phases.

  • Phase I: Acute Inflammation Care
  • Phase II: Joint & Region Strengthening
  • Phase III: Integration into Movement Patterns
  • Phase IV: Activities of Daily Living (ADLs) & Sports

I will break down each phase and share the core principles that differentiate it from the current model.

The three core principles of the new model of soft tissue care are:

  • Addressing Connective Tissue vs. Muscles
  • Tension vs. Compression in Manual Therapy
  • The Cadaveric Anatomy Lens vs. The Lens of Chain Reaction Biomechanics

Here is a quick checklist that you can go through when and if you have a soft tissue injury to avoid the "Vicious Cycle."

  • Ask your body what the discomfort is communicating to you. Assume your body is on your side
  • Consider the regions around the are that is symptomatic. Start addressing adjacent areas with stretching and self massage.
  • Do your best not to mute the pain to work through it. Your body's ability to compensate is incredible but it never considers that long-term impact of the compensations.
  • ​Only go to the orthopedic surgeon if you are considering pain meds, injections, or surgery. After all, that is all they can offer
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Who is Matt LaBosco

I am a integrated holistic health professional that has empowered thousands of individuals over the last two decades to optimize their physical, mental, emotional, and spiritual well-being, I am obsessed with empowering myself and others to embody the principles of vitality and no longer settle for the current traditional models of "health."

You can work with me virtually or at my office located in Palm Beach Gardens, FL.

Services include:
* physical rehabilitation
* fitness programming & training
* life coaching

I offer private coaching as well as my weekly small group coaching program

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