I have been unable to work in the field of Nursing for several years due to my health. But to my friends I will always be known as “Nurse Ashley.” And that’s OK with me. I spent years studying and training for my profession, only to have it cut short by chronic illness. If I can put my knowledge to good use by serving people, then I will still feel like it was all worth it.
One of the most common concerns I am asked about are soft tissue issues: muscle, tendon, ligament. People have injured an appendage or strained their neck, and have been suffering for days or even weeks. They know that I have many tools to manage the pain and get out of the cycle. What baffles me is the advice that most of these people have gotten by doctors or nurses before they come to me: everything from using heat to steroid injections to referrals for orthopedic surgeons. What confuses my friends is when I tell them that I would almost never go to doctor for such a problem. “Unless you think you broke a bone or severely tore something to the point that you can’t bear weight on it, a doctor is not the person to manage this problem.”
Before you accuse me of medical malpractice (and you can’t, I’m not licensed), realize that the medical system works most effectively when we triage problems and when practitioners work in their specialty. Meaning, we can’t be clogging up overworked doctor’s offices for problems that are not in their scope of practice. Our medical system is now made up of specialists who see your body in parts, and the practitioners who are supposed to see your body as a whole, your General Practitioner or Internist, barely have enough time to cover all of your needs during your office visit. If you have an “–itis”, or an inflammation of a ligament, tendon or muscle and you see an orthopedist (a bone specialist), you are not going to the right practitioner. The best they can do is tell you whether or not your bone is broken, and give you a short-term “band aid” solution like a steroid injection to make you comfortable and reduce the inflammation. That is probably not fixing your underlying problem. And steroids have all kinds of side effects, not the least of which is depressing your immune system. Just say no.
What I do, and what I tell people to do, is use Physical Therapists, Chiropractors*, and Sports Massage Therapists who use a combination of Myofascial Release Therapy, Dry Needling, massage, gentle bone re-alignment, and exercise to strengthen weak muscles that will help the soft tissues recover from the trauma or injury and prevent future injury. This has been the key to my success, as well as my children’s success, in our journey with Ehlers-Danlos Syndrome. (*For the purpose of this post, the term Chiropractor will be used separate from doctor, which refers to an allopathic MD.)
Here is a perfect example of how a problem was misinterpreted by my doctors and very successfully treated by my “Dream Team” of therapists. For years, I couldn’t breathe well. I thought I had asthma: no wheezing. I thought I had bronchitis: no coughing. I thought I had allergies: no post nasal drip and no sinus infection. Pneumonia? Nope. But when I went to doctors about my problem, they gave me inhalers and sent me on my way. My heart raced from the adrenaline…and I still felt like I had a truck sitting on my chest. Over the years, I adapted. The problem came and went. Fast forward to four years ago: I went to a “gentle chiropractor” and as a part of my new patient evaluation he checked my rib alignment. Click! Click! Click! He used a small “activator” to click my ribs.
“OW! That HURTS!”
“I’ll bet it does…you have subluxed ten ribs – they are out of place. And from the look of it, they’ve been like that for a while.” CLICK!
When he punched the last one into place, I took an involuntary gasp inward, and it was like I was breathing for the first time. In the coming months, there were a few more times when I felt that chest pressure, but once the Chiropractor clicked the offending rib back, it cleared up instantly. Now, in four years of Nursing school, I never heard “rib subluxation” discussed as a potential Orthopedic issue, and I am quite certain it’s not currently being taught in medical school either. (If you are an allopathic doctor, and you have learned this as a part of your curriculum, please correct me! And then hug your professor!) Note: when my ribs were put back, do you know what also improved? My chronic fatigue. When you can’t breathe, i.e. get enough oxygen in, your body feels very, very tired. So sharp rib pain plus fatigue, absent fever, coughing, wheezing or any nasal drainage are good signs that this is a rib issue.
I soon developed a relationship with my amazing Physical Therapist, and she explained that hypermobile people often pop ribs out of place when they twist their torso, or even after excessive coughing fits when we are sick. This especially happens to collagen-normal people when they have deep coughing fits during illness, and then they think their respiratory issues haven’t resolved, when the infection has long cleared up. I thought about all of the upper body twists I had done in Yoga class (I don’t do Yoga anymore, only Pilates) or reaching back to hand my kids things from the front seat of the car, or deeply twisting in my chair to crack my back because it felt good on my tight, sore tendons. I shuddered, and vowed to stop. My PT taught me that I could realign my own ribs and strengthen my core muscles by lying on a foam roller. The stronger my core got, and the less I twisted, the less I subluxed my ribs. It rarely happens now! I became so passionate about using the foam roller, my Physical Therapist and I made a video. Click here to watch it!
There are websites out there that will try to define “costochondritis,” the medical term for the rib pain I was experiencing, and in my professional opinion, this is bullshit. It is a flimsy attempt at a medical diagnosis that says: “your rib muscle is inflamed, and it hurts.” Well, duh! When a bone has shifted out of place, the muscle becomes traumatized. Traumatized muscles become inflamed. Inflamed muscles hurt. Back to my original argument: don’t go to a doctor for something that is not in their scope of practice. Muscle trauma is for a muscle expert. There are no “muscle doctor specialists.”
I am not trashing doctors: most of them are wonderful people, and they wouldn’t turn you away when you are in pain. They are going to use the tools they have to try to help you. The problem is, they don’t have the right skills for this problem. Sadly, the details of other therapies, like the kind I am recommending to you, are often not taught in medical school. Many doctors have not had the time to develop an understanding of the benefits of these other methods of practice. If they did, they might be more inclined to refer their patients to chiropractors, massage therapists, and physical therapists for these soft tissue injuries instead of shooting patients up with corticosteroids. But for us hypermobile people, subluxations are a chronic problem, and things like steroid injections or pain medications are not a feasible long-term solution: a chronic problem requires a safe and effective chronic solution. However, considering that patients in pain become rather addicted to these shots, and that becomes big money for these medical practices, is it any wonder that some practitioners don’t refer them out? Just saying…
So, when do you see a doctor? If you’re worried that you need emergency care or even surgery for a serious injury, play it safe, and get checked out by a doctor. If you think that you are in need of lab work, radiology, etc., an MD can provide you with those things, but so can a chiropractor – chiropractors are actually doctors with the power to write referrals for tests. Any good chiropractor or therapist should know when your injury or trauma is out of their scope of practice, and requires a specialist (and that goes for allopathic doctors as well. They should know…) so if you trust yours, they are always a good place to start. When enlisting the help of a professional in maintaining your health, first and foremost make sure that you are seeing a reputable one. (Meaning, don’t go get a massage at the mall, and think that you are seeing a massage therapist. Professional massage therapists are very different.) The answer is, you probably need to do both: seek the opinion of a doctor to rule out a serious problem, but see a therapist or chiropractor for rehab to fix the problem long-term. (Just remember, if you are hypermobile, “bone cracking” Chiropractors can cause you more harm than good! Make sure they are only using gentle methods and focusing on your soft tissue.)
I know there are many people with chronic issues who are frustrated beyond belief, and have gone to doctor after doctor, with little to show for it but medical bills and a lot of anger. But I found when I started to hire the right people for the job, I finally started to get the right results. And you will too.
(Please note, I am not a medical professional. I do not diagnose or treat problems. If you have any serious medical concerns, seek the attention of a professional.)