For people who make fitness part of their lifestyle, pain can create an interesting dilemma.

You know your body. You have a routine. Training keeps you physically healthy, but it may also make you better at your job, improve your mood, and help you show up better at home. Then something starts hurting.

So you do what active people often do: work around it.

According to orthopedic sports medicine surgeon Dr. Justin Harrington of Hughston Clinic Orthopaedics, that isn’t necessarily the wrong decision. The problem is when a temporary modification quietly becomes months — or even years — of avoiding an issue.

“Sometimes you can train around or through something,” Harrington said. “And sometimes that is the right move.”

But if the problem continues getting worse instead of better, it may be time to stop accepting the idea that an activity is gone forever.

Harrington regularly encounters patients who have gradually eliminated movements from their lives because of pain. Eventually, “that exercise hurts” becomes “I can’t strength train anymore.”

The Fear of Hearing “Stop”

Another reason people wait to seek help is the fear that a physician won’t understand why an activity matters.

A runner with knee pain may worry they’ll be told to stop running. A lifter may expect to hear that they should stop lifting. And someone visiting a surgeon may assume surgery will automatically be the recommendation.

Harrington wants to challenge that perception.

Treat the Person, Not Just the MRI

Treatment, he says, should begin with the person rather than with the MRI alone.

The same diagnosis in two different people may require two completely different approaches based on age, lifestyle, symptoms, and each patient’s goals.

Before recommending an operation, Harrington asks himself a fundamental question: Does he truly believe this person will be better after surgery than they are now?

If the answer isn’t yes, there may be other paths worth exploring first.

“If I can get somebody better without surgery and I can get them better with surgery, I’m choosing without surgery,” he said.

That could mean physical therapy, modifying training, or incorporating other treatment modalities. Harrington also believes the orthopedic community has historically been too quick to dismiss things such as massage therapy, acupuncture, chiropractic care, and myofascial treatments.

If something is safely helping a patient feel and move better, that matters.

Don’t Let “Working Around It” Become the Plan

It’s a philosophy that fits particularly well with today’s fitness community. People aren’t simply exercising to burn calories. For many, movement is tied to identity, confidence, mental health, friendships, and quality of life.

Telling someone to stop doing what they love shouldn’t be the automatic answer.

Instead, Harrington wants patients to have conversations about what hurts, what they want to accomplish, and what options could realistically help them get there.

Sometimes that answer may ultimately be surgery.

Often, it isn’t.

The important part is addressing the problem before months of “working around it” turn into years of living with limitations.

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Author: NFM Staff

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