Why We Need Prevention in Orthopedics.

Think about this for a second. You get routine screening and “check-ups” for your heart, lungs, eyes, ears, teeth, etc. But who is routinely screening your joints and your ability to express movement freely?

I was really curious, so, I went out, did the research and confirmed that unlike the other branches of medicine, Orthopedics and Sports Medicine are currently not performing any standard yearly screening process for prevention and early intervention. 

Why are we not doing routine “check-ups” for movement wellness & joint health?

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Some people have even asked "So, what's the big deal?" 

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our current problem

Just to give you an idea, according to The Journal of the American Medical Association (JAMA) in 2013 we spent 87.6 billion health care dollars on orthopedic issues like low back and neck pain. This is about 50% of the total money spent on heart attacks and diabetes combined! And despite spending more money on orthopedic issues every year, the rates on non impact orthopedic injuries seem to keep getting worse.

By 2020, they are expecting that the US health care system, on its own, will comprise the 4th largest economy in the world.

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So this is a very big deal because what's currently being done doesn't seem to be working for us physically or financially. 

prevention = Screening + managing risk factors

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In health care, early detection & prevention is all about screening for and managing risk factors. This is how we have been battling cardiovascular disease.

Risk factors for cardiovascular disease include high blood pressure, high cholesterol and high blood sugar levels. So your yearly medical physical exam includes screening for these risk factors.

If two or more of these risk factors are present, along with lifestyle habits such as physical inactivity and unhealthy diet, you're placed into a high risk category for heart disease. This doesn't mean you're definitely going to get a heart attack. It just means your chances for heart related problems are higher compared to those who don't have those risk factors. 

Once you're placed into this high risk category, your physician will help coach you through addressing and managing these risk factors. All of this routinely takes place now BEFORE you ever start to experience chest pain, dizziness or other heart related clinical symptoms. 

When we screen your blood pressure and find that its a little high or "borderline", we investigate further and ask questions about your lifestyle. Currently, when your shoulder starts getting a little stiff, we don't even know because we don't check it unless it hurts. Then we back track and use expensive "advanced medicine" to try to figure out why.

It doesn't have to be this way. We can do better than this!

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how we start screening our movement & joints

The good and exciting news is that the current science provides us with well established orthopedic risk factors allowing us to start screening and placing people into low and high risk categories for orthopedic problems. The Functional Movement Screen (FMS) & The Selective Functional Movement Assessment (SFMA) are scientifically validated tools that help us tackle this problem head on.

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This allows us to coach and educate those in the high risk category how to address and mange the risk factors (on their own or with our guidance) before they even start to experience pain & disability.

This should come as no surprise but some of the orthopedic risk factors include:

  1. Significant mobility imbalances comparing right & left side of the body,
  2. Significant motor control imbalance like our ability to balance on the right leg compared to the left. 
  3. Significant core endurance imbalance like being able to side plank a lot longer on the left compared to the right. 
  4. Physical inactivity
  5. A previous injury
  6. Pain with basic body weight movements

The movement screening & assessment tools that we have today allow us to compare your current movement, mobility, and balance to quantitative & qualitative normative values that are based on scientific evidence rather than just professional opinion. 

These screening & assessment tools allow us to raise the bar for Movement Wellness & Joint Health. 

a professional dilemma

This sounds exciting & great until you realize that this kind of service is not all that popular, which can be very overwhelming. 

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This is especially overwhelming when you've tried to help rehab someone that was just too injured for conservative therapy and needed to be referred out to more invasive medical procedures like injections & surgery.

I'm not talking about someone who had an actual injury from a fall or accident that caused trauma. I'm talking about someone who gradually just became more and more disabled with "non-specific" neck or low back pain. This went on for so long that by the time I would see them I just could not help.

Every time I couldn't help someone like this it really bothered me and forced me to ask this burning question: 

"Could this have been prevented?"

confronting the professional dilemma

Again my curiosity drove me to go out and do more research to figure out how others before me productively questioned the "status quo" while bringing value to the community. 

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My "Aha" moment was born when I started reading Warren Berger's work, "A More Beautiful Question". Warren was the inventor of the prosthetic leg that allowed amputees to compete in the Olympics.

According to Warren Berger:

"To question well & productively requires stepping back from habits, assumptions, & familiar thoughts. It requires listening to & closely observing the world around you; being unafraid to ask naive or fundamental questions; and being willing to stay with the questions as you endeavor to understand & ACT on them."

Warren proposes a 3 step process to ask a question that drives action: 
1) A "Why" question: "Why is this situation not working as well as it could?"
2) A "What if" question: "What if we were to change it in some way?"
3) A "How" question: "How might we begin to do that?"

So I applied this questioning to our current orthopedic model: 

1) "Why do we wait till you hurt before we screen & assess your movement & joints?" AND "Why is this problem getting worse despite spending more health care dollars on orthopedic problems every year?"

2) "What if we offered the community movement & orthopedic 'check-ups' to help people manage orthopedic risk factors before orthopedic pain syndromes arise?

3) "How might we begin to offer the community an early detection & prevention service to help people avoid the frustration of being hurt?"

These are the questions that inspired the birth of Neuropedics' Movement Wellness & Injury Prevention services.

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Lets admit it, movement dictates how we express ourselves on a daily basis.

Movement dictates our well being & confidence, because if it hurts to move or if it feels awkward we simply don't move as much.

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When we stop moving we miss out on the opportunity to age with grace.

Neuropedics' Movement Wellness service is here to allow you to be more proactive toward early detection & prevention for the health of your movement & joints. 

We truly believe that with a movement screening & consulting service we can really help you minimize unnecessary injuries by teaching you how to mindfully take control before problems arise.

 

Ramez Antoun