Sports vs. My Body - Cost Benefit Analysis
November 29, 2016 9:10 PM   Subscribe

Recently took up a sport, which I LOVE, but which my body doesn't seem well suited for. It has been suggested to me to seek orthopedic treatment, but I think it's an anatomical problem. What should I do?

About 6 months ago I took up a Sport (not important which one and I don't want to complicate the discussion) which I really enjoy, has gotten me consistently exercising for the first time in 5+ years, and is very, very good for my mental health. In all ways but one (see below), I have taken quite easily to Sport and am naturally fairly good at it.

Except for a certain part of my body! Basically this sport requires me to move certain joints in ways I never would in normal life, or other sports I've done, and I have a lot of pain in this joint that isn't muscular in nature - it's like my joint just. doesn't. move. like. that. There is associated lack of range of motion.

So, I saw a physical therapist. He is flummoxed by the lack of progress we have made after many sessions of stretching, manual work on the joint, and strength-building exercises, and agreed with my suspicion that my anatomy is just weird in a way that is preventing this type of movement. This weird anatomy is not common, but not uncommon either... it's a known anatomical quirk that some people have. PT says the next step is to see an orthopedist for imaging to confirm this anatomical quirk.

But... why bother? If a PT can't fix it, it's probably not fixable, right? I definitely would under no circumstances have surgery to fix something that only bothers me when I do this Sport. So far, this issue only rarely appears in my every day life, and when it does it's more of a, "Oh, that kind of hurts... I'll just stop making that awkward unnecessary movement that makes it hurt." Like, a non-issue. Seeing an ortho and the associated imaging will cost me time, worry, and $$$$$$, and I really don't think this is a fixable issue.

But (again)... this issue seriously hinders my competitiveness in and enjoyment of Sport. The only sport I've ever liked! And which is REALLY GOOD for my mental and physical health.

I feel like this is a lose-lose: I can spend lots of time and money seeing a doctor and getting imaging, but even if the doctor says, "yep, your body is weird," what can they do about it?! But this issue is majorly hampering my ability and enjoyment of the sport, so I also want to try to fix it. It just seems silly to go to all the time and expense when I'm a late-20-something newcomer to the sport with a chronic issue, not a world class athlete with an injury.

Even this question feels silly to me, but I feel so torn between "why seek treatment for something that wasn't a problem before Sport; just quit doing Sport if it hurts!!" and "but I LOVE Sport!" and "my body is just like this and there's nothing I can do about it." Wondering what makes sense to an outsider looking in, or if anybody's ever been in a similar situation.


[Apologies for the vagueness, I just don't want to get caught up in specifics of what sport and what joint because that's not what my question is about. Imagine that Sport is swimming, and I have a weird anatomical shoulder thing where I can't do a full rotation of my shoulder like swimming requires. I could adapt my stroke and manage, but I would be slow and awkward and not enjoy it very much, and also it would still hurt sometimes.]
posted by raspberrE to Sports, Hobbies, & Recreation (17 answers total) 2 users marked this as a favorite
 
My spouse had hip pain that became a serious issue when he started doing a martial art. Physical therapy and attempts at stretching were unsuccessful. After multiple consultations with doctors, he learned that he had oddly formed bones; repeated attempts to kick higher were forcing his hip joint out of the socket and tearing the associated cartilage. Surgery was the best cure, though he may still need a hip replacement eventually.

The moral I draw is that you may want to confirm the quirk, just to make sure it really is what you think it is: you don't have to break world records in your sport, but you should make sure that continuing to participate won't exacerbate the underlying issue.
posted by yarntheory at 9:19 PM on November 29, 2016 [1 favorite]


You are important. You doing sport is important. You doing Sport is important.

I am a sport hawk: people should think of themselves as Athletes. You are an Athlete. You do sports. Right now you are a Sport Athlete. This is non-negotiable up until it interferes with life, limb, or relationships at addiction-level degrees. You should do everything possible to continue doing Sport, to continue improving performance at Sport, to continue improving your body and mind and capabilities in all ways with Sport as your guiding star. Sport is good for you. Sport is worth it.

Definitely, definitely, definitely try to fix this problem. I'm not necessarily yet advocating surgery, but try to fix it. Your body is improvable, changeable, fixable. Your body is not an unchanging thing. You are not stuck with a body that only gets worse.

So, what to do? You've seen one PT. That's normal. You've worked hard at PT. Good job. Now step it up. Athletes don't accept one PT's opinion, and athletes don't accept a PT regimen that doesn't work. The athletes I know have gone to six, eight, ten different medical and body professionals to fix something that interferes with their sport, because interfering with sport is intolerable and most docs don't see sport as a legitimate goal. To hell with those defeatist docs.

I and my athlete friends have been in similar positions to yours. What worked was trying everything and rejecting everything that says to give up. See a masseuse. See another. Ask your Sport buddies for doc recommendations. Talk to every sports chiropractor in town. Do a month of yoga, then schedule a private lesson with the yoga instructor specifically for this joint thing. Get a second opinion from a PT specializing in athletes. Find people (in person, thru email, on message boards) who have had your problem and who fixed it for your sport and pump them for every drop of information. Go to another Sport gym in town and ask them if they have any ideas. Get the imaging done just to know, then take the results and get a second opinion on those from a doc who wouldn't be doing the surgery. Talk to a sports surgeon just to learn more about what recovery would be like and what the alternatives are. Do all the recovery tricks—hot baths, vitamin D, extra sleep, massage, eating more, stretching five times a day—in a month-long fix-yourself blitzkrieg. This list is not an exaggeration and it's not made up. They're all real examples.

As an Athlete hawk, my message is: do not accept your body's limitations; do not accept the idea that Sport is discardable; do not accept your PT's opinion; trust no one except those who have had your problem and fixed it for your sport; do not accept any single professional's opinion if it is equivalent to "I don't know" or "you're screwed". You're not looking for confirmation that you can't do Sport, you're looking for a professional who will work with you to so you can do Sport.
posted by daveliepmann at 11:21 PM on November 29, 2016 [9 favorites]


I would definitely see either a second PT or go straight to the ortho imaging. One PT can always be wrong.

Beyond that - if you want to go nuts with seven sessions of yoga a day or get surgery, do it, but don't do it just because people tell you ANYONE CAN OVERCOME EVERYTHING IF THEY JUST TRY. Frankly, sometimes you are just screwed, and that's tough luck but you'll survive. Some people would rather spend the rest of their lives trying to overcome, some wouldn't. You probably know which type you are.
posted by the agents of KAOS at 1:09 AM on November 30, 2016 [2 favorites]


what if the orthopedist say it's not your body, but something that is actually easy to fix in some way?

obviously it's a trade-off, because you're spending money. but getting a second opinion doesn't seem that crazy to me. in my experience as soon as you get outside a narrow range of common ailments doctors are pretty bad at aches and pains, and a lot comes down to finding that one doctor that really does understand.

(for example, i had knee issues with cycling for an entire year, including mris and gym work, before being given that one weird exercise that somehow fixes things)
posted by andrewcooke at 2:27 AM on November 30, 2016 [2 favorites]


Yeah, you are making a ton of assumptions on the basis of one physical therapist who may not have much experience with the sport, joint, or the range of treatment options. An appointment with a specialist is not that expensive, and if you explain the situation to them as you have explained it here, they may be able to help you make a more educated decision about whether expensive imaging or treatment would be helpful.
posted by Rock Steady at 5:33 AM on November 30, 2016 [2 favorites]


Do you have a coach for this sport? Can you find one?

I also do a sport that requires unusual movements that some people just aren't physiologically suited for. In my experience, PTs and orthopedists have been less helpful in situations like this than an experienced coach. A coach can help you either work through your problem (they may know better stretches or exercises that are more specific to the sport than general PT) or find a way to work around it (alternate ways to move your body to get a similar result).

Look for a experienced coach who regularly works with adults who participate in the sport at your level--coaches that work only with kids or serious athletes may not be able/willing to help. Bonus points if they have a background in sports medicine, physical therapy, or a similar field. Find a few coaches to talk to if possible and ask for a single session to talk about your problem and see what they say--my experience is that you can tell quickly in situations like this whether a coach is likely to help you with your specific problems.
posted by Swiss Meringue Buttercream at 5:59 AM on November 30, 2016 [4 favorites]


My brother had run cross country in high school, and many years later got into road races. He was great at half marathon distance, but when training for his first full developed hip and knee problems. He went to (orthopedist/PT/witch doctor) with experience in running, and was told one of his femurs was an inch longer or something, and he needed to do some strength work to get his muscles able to hold things together over the long haul. So he started doing the exercises as prescribed, the joint issues went away, and he finished his training program.

You have the body you live in. You love Sport. Figure out how to adapt your body for Sport. For swimming with a shoulder impingement, that might mean taping your shoulder before swimming, or not reaching as far with that side, or adding strength/stretching, or physical therapy/chiropractic to resolve the impingement. For non-ideal anatomy causing hip pain due to repeated high kicks, reduce the frequency of kicks, kick lower, maybe switch the mindset from "kick as attack" to "kick as tactic", strength/stretching. Check out Sport forums. You can't be the only person with your particular condition. How have other people handled it?
posted by disconnect at 6:06 AM on November 30, 2016 [2 favorites]


Hard to tell with so little details, but maybe there's a posture element that can/should be changed that will help. I recommend a peek at the Gokhale method (I very much believe in) to see if there's anything relevant to the specific joint.
posted by mirileh at 6:13 AM on November 30, 2016


You should definitely see an orthopedist, even just to confirm the PT diagnosis if you don't want to do corrective surgery (assuming PT is correct). I had pain in my knee doing sport and a PT diagnosed Runners Knee. I did exercises, stretches etc, whole shabang and it did not really get better. Turns out I had a benign tumor in my knee, eating away at the bone. I don't want to scare you, just get it checked out by a orthopedist to be sure. It might be what the PT says, might not.

Re your question. If there is corrective surgery, which is not too intrusive and you really like the sport, I would go for the surgery in your position, so you can then hopefully enjoy your hobby pain free. Or as mirileh said, maybe there is an alternative way to do the motion you have problems with, but hard to say without more info.
posted by Megustalations at 7:10 AM on November 30, 2016 [2 favorites]


I think you did this in the wrong order. Orthopedist/sports med doctor and then PT. Doctors who treat athletes assume that people will not give up the Sport they love until it kills them (for better or worse) and will take you more seriously and look more intently for the problem. Once you have a diagnoses, they refer you to PT to do exercises to treat that problem (not diagnose it).

Or you could find another sport. That is obviously an option, and if that is truly acceptable then perhaps it's wiser. But will you actually do that, or will you go back to being unfit and be perpetually unhappy? Or continue working through pain until it does kill you? If either of those are true, you might as well push to see a specialist.
posted by epanalepsis at 8:37 AM on November 30, 2016 [1 favorite]


I can't favorite daveliepmann's comment hard enough, especially "You're not looking for confirmation that you can't do Sport, you're looking for a professional who will work with you to so you can do Sport."

I'm also an athlete who plays a sport that my body is both 1-unsuited for, proportionally, and 2-so beat up from other sports in my youth, that my current sport is made whole orders of magnitude more difficult. But I LOVE my sport, so I keep at it, even though I'm probably never going to be good enough to be competitive with anyone but myself.

Definitely go and see an orthopedist to see what's up. In my case, I discovered I had bone spurs and osteoarthritis just about everywhere. Yeah, it was some money, but it was nice to know what the specific problem was, so I could tell my coach what was going on with me — because then we were able to work around it. My limb proportions aren't going to ever go away, so my coach and I had to modify some things I do to make it work. The first PT I saw wasn't bad, but the sport I play is one that not a lot of run-of-the-mill PTs are experienced in or even familiar with. So I saw a different PT that my orthopedist referred me to, who WAS experienced with treating injuries from my sport, and it made a world of difference.

Good luck.
posted by culfinglin at 12:18 PM on November 30, 2016 [1 favorite]


A lot of pain in a joint isn't a "just find another doctor" issue in my mind. I had a serious injury due to a body that just didn't accommodate my sport, but unlike you, I had no pain until the injury (but knew of my joint issues), and then I had major pain and eventually surgery with a long recovery period and the end of that sport almost entirely for me.

So, it's many years past that. I injured myself pretty badly, I had surgery, rehab, I got over it, but the sport is mostly lost to me. What isn't lost is the love of movement that I gained by doing the sport. I know it's hard to contemplate, but I do encourage you beyond all the other things to see if there's another closely-related Sport that maybe doesn't test the joint so badly. For me, I hate team sports, and I have moved into other things that are individual practice. Some leftover movements from my old world, modifications, and new things to occupy my time.

By all means, get another opinion, seek out another doctor, see if there are easier fixes. Look for coaches who might know something. My joint issue was so uncommon that you couldn't find many people who had it, and experienced coaches had no idea how to fix it. It wasn't fixable, and I trained anyway until it caused me the severe injury. Do your research. But if you don't find anyone who has actually solved this issue? It's not likely to be solvable. I read forum upon forum and the few places I came across the issue, no one actually solved it.

You can train until the joint or a related joint fails. I knowingly did that, and I don't entirely regret doing it. But you WILL fail, sooner or later, with a joint that isn't cut out for your sport. I wish I could be that cheerleader but I can't, the cost to your body for hurting it repeatedly is a real fucking cost that you can't just wish away and to pooh-pooh that as not Real Athlete is a dangerous fiction.
posted by ch1x0r at 8:50 PM on November 30, 2016 [2 favorites]


Thanks, everyone, for the input.

It seems like most of you agree that seeing an ortho isn't a silly waste of time or money. And I think you've convinced me.

The tricky thing from there will be whether to side with the "nothing can keep you down" crowd, or the "don't F up your body, no sport is worth it" crowd. I guess I'll cross that bridge when I come to it.

Also encouraged by how many of you have faced similar issues. Thank you for sharing your experience.
posted by raspberrE at 11:16 AM on December 1, 2016


(By the way, I bested answers from both sides/arguments.)
posted by raspberrE at 11:18 AM on December 1, 2016


Let me refine my earlier answer.

Nobody can overcome anything if they just try. We are all constrained by our genetics and current situation.

Nor am I saying that getting hurt is no big deal. I've quit sports because they're too much. Athletes do that. Athletes quitting a beloved sport due to age and injury brings us the adage "Athletes die twice".

Nor, on second thought, do I really take a position about your cost-benefit analysis, raspberrE. That's entirely up to you and your value system: how much you love Sport, if you could learn to love another sport, how you feel about being the costs of sedentarism.

I'm saying that (1) my values include "thinking of oneself as an Athlete is good", and (2) most injuries that sideline folks can be overcome using an athlete's approach as described above.

Though you can do with it what you wish, it seems to be a basic fact that the general public is unaware of the gulf between medical practitioners who try to get you back to sport and medical practitioners who try to get you back to a sedentary lifestyle. Finding a doc (or yoga teacher, or masseuse) who is actually a partner in the goal of restoring you to sport is a major unspoken part of doing sports and maintaining an active lifestyle. It's an aspect that makes me despair because it perpetuates the myth that sport is for the naturally talented and luckily uninjured. It's not. Sport is for everyone, including those of us who get massively injured or who doctors say will never walk unassisted again or who are 86 years old and already tried three doctors.

Anyway, I'm just saying that we should all take a growth mindset rather than a fixed mindset regarding our bodies. We should treat an injury as a surmountable obstacle until proven otherwise by multiple sports-oriented docs/PTs/masseuses/coaches/yoga instructors. And if an injury does stop us from one sport, that doesn't have to stop us from other sports.
posted by daveliepmann at 4:16 AM on December 2, 2016 [1 favorite]


If you do decide to see an orthopedist, PT, trainer, massage therapist, or other professional (and I hope you do, because there is an excellent chance that one of them can help you) keep in mind that each professional, even within the same field, is very different from the next.

Recently I've been recovering from a sports injury. I've now seen 4 different physical therapists. #1 and #2 both sucked despite being highly recommended. #3 and #4 were both amazing and useful in different, complementary ways. It was absolutely worth it to keep going and get their additional opinions. Not all PTs are the same.

Here's a really good guide for how to find a good PT. The key point:

If a PT is not helping you after the initial session, in my experience it is time to cut your losses and move on to someone else right away. If they don't give you some constructive advice from day one, I doubt it will ever happen. They either know how to treat people with your type of condition or they don't. If they don't, it is best not to be their guinea pig.

This absolutely holds true in my experience too. Don't wait 4-6 weeks to evaluate whether PT is working. You should be making some kind of progress from Day 1. If you really want to be sure, give it 2 weeks. It doesn't matter if the PT is a specialist in your injury, has been an athlete themselves, came highly recommended, etc. That's a good start, but it doesn't guarantee success. If you're not making progress after 2 weeks, move on to someone else.
posted by danceswithlight at 9:38 PM on December 4, 2016 [1 favorite]


An update to anybody reading this later -

Did end up getting imaging on this joint. Everything looks normal, and the ortho I saw said he couldn't really give an explanation for my pain. But on the upside - he said continuing Sport probably shouldn't cause any lasting damage, and better PT with a therapist that specializes in this joint may help. On the downside, he said if there is damage in the future, the only way to fix it would be major surgery that wouldn't be worth it, so I'd have to probably give up Sport :( But at least that's a hypothetical.

Thanks for encouraging me to at least see what there was to see.
posted by raspberrE at 1:19 PM on December 30, 2016 [2 favorites]


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