I’m a physician trained in sports medicine, and a chronic back pain sufferer. I first injured my back in 2001 when lifting a heavy bag and trying to sling it onto my shoulder. The pain was so severe that I couldn’t get off the floor for three days. I eventually ended up in the ER with an “unremarkable” MRI. The cause of my pain was never explained — all I knew is that I hadn’t herniated any disks.
Years later my back pain still flares up occasionally, and I’ve never really understood how to prevent it or treat it effectively. This has been very embarrassing for me, since I’m supposed to be an expert in this field. But today I finally got some insight into the real cause of my pain — not from a physician or physical therapist, but from a yoga instructor.
Now I must admit that I probably have some negative personal bias against yoga instructors — mostly because the ones I’ve met in the past didn’t care much about science, anatomy, or modern medicine. They explained physical problems in terms of energy flow and mystical blockages. While I liked the stretching and physical exercise, it seemed to me that the philosophy behind the practice was distracting and old-fashioned. I longed for some straight talk about physical anatomy, and some insight into the mechanics behind why I was in pain.
Today I met a yoga instructor who was exquisitely sensitive to body mechanics. She herself had suffered from low back pain and had taken it upon herself to memorize the anatomy of the back and spine. She understood how each muscle moved, what activated them, and how they could be stretched and relaxed. I described my pain to her and she zeroed in on my offending deep back muscle within 20 seconds. She had made the diagnosis that I had missed for 10 years.
As we spent an hour together, stretching and struggling on mats and with foam back rollers, I realized that she had a much better understanding of body mechanics than I did. In fact, I knew that my limited musculoskeletal physical exam tests were inferior to her well-honed sense of muscle tone and tendon stretch abilities. After years of placing her hands on people, helping them to achieve more supple, balanced bodies, she could tell instantly when there was a flexibility deficit or compensatory tightness.
To be a good physician, especially one who prescribes exercise programs, I’m convinced that you have to lay your hands on people. We spend too much time memorizing range of motion angles, flat anatomy images, and muscle origins and insertions, without an equivalent amount of time working with patients in motion. So much can be gained from examining people functionally — experiencing their strengths and deficits as they move. I know that spending time with my yoga instructor will make me a better diagnostician, more sensitive to musculoskeletal problems, and more effective at recommending custom exercise regimens. And better yet, I may finally be able to heal myself!
P.S. Curious to know what was causing my back problem? It was a quadratus lumborum injury.