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In this episode, I talk about why the phrase root cause bothers me, why there isn't always one simple explanation for pain or injury, and why constantly searching for one can sometimes keep you from actually moving forward.
00:00:15.759 --> 00:00:18.640
Hello and welcome to Candid Conversations with Dr.
00:00:18.719 --> 00:00:19.359
Kelsey.
00:00:19.519 --> 00:00:20.480
I'm your host, Dr.
00:00:20.640 --> 00:00:32.000
Kelsey, and this is the space where I share my honest thoughts, real experiences, and the no BS conversations I wish more people were having about movement, training, injury recovery, and life as an active human.
00:00:32.240 --> 00:00:41.679
The goal of this podcast is to help you better understand your body, think more critically about rehab and fitness, and feel more confident making decisions so you can stay active long term.
00:00:41.920 --> 00:00:43.840
Before we start, a quick reminder.
00:00:44.079 --> 00:00:47.679
I am a physical therapist, but I am not your physical therapist.
00:00:47.840 --> 00:00:49.520
Nothing here is medical advice.
00:00:49.679 --> 00:00:55.359
So if you're dealing with something specific, please reach out to your PT or schedule a session to work with me.
00:00:55.600 --> 00:00:58.479
Alright, now let's get into today's conversation.
00:01:04.400 --> 00:01:10.159
So in theory, finding the root cause of a problem instead of only treating symptoms is a great idea.
00:01:10.959 --> 00:01:21.359
For example, in the physical therapy world, let's say someone is having knee pain and they're using like ibuprofen or other pain medications and ice to treat their knee pain.
00:01:21.519 --> 00:01:33.519
Well, we know that all they're doing is treating the symptom of pain and they're not, by using those two things, they're not actually addressing the underlying problem or the root cause of their knee issue.
00:01:33.760 --> 00:01:40.079
However, the problem is that when most people think of root cause, they're expecting a simple and singular answer.
00:01:40.239 --> 00:01:46.480
But the reality is that our bodies are complex and there is rarely just a singular root cause.
00:01:47.599 --> 00:01:53.040
Like in practice, a root cause can be multiple underlying factors contributing to a problem.
00:01:53.200 --> 00:02:06.239
So in the knee pain example, someone might expect their root cause to be like some sort of tear or something, something that you know you can easily identify and say, like that one thing is what is causing my issue.
00:02:06.640 --> 00:02:20.159
But in reality, maybe their root cause is actually a combination of extra stress at work on top of poor sleep, on top of an increase in running mileage or squat weight percentages during training.
00:02:20.479 --> 00:02:32.000
Like all those things combined is what contributed to their knee pain instead of you know something more simple or you know easily identifiable as a sort of tear.
00:02:32.319 --> 00:02:39.520
Or sometimes root cause factors aren't known yet, and so treating the symptoms is actually how we treat the problem.
00:02:39.759 --> 00:02:53.520
So an example of this is non-specific low back pain, where there might not be a specific injury, might not be any changes to your normal routine, and there might not be any imaging findings that can easily explain why you're having the back pain.
00:02:53.680 --> 00:02:57.919
It's just something that kind of just started and now you're having back pain.
00:02:58.240 --> 00:03:12.639
But even though we can't identify the root cause to make changes to, to fix, so to speak, we can still treat the things you're having difficulty with because of the back pain, so that you don't have to continue to deal with this back pain.
00:03:12.879 --> 00:03:22.719
And lastly, sometimes we know the root cause, but knowing why something happened doesn't necessarily tell us everything we need to do to treat the problem.
00:03:22.960 --> 00:03:29.439
An example of this is apophysitis, which some people might know as Osgood Schlauders if it happens in the knee.
00:03:29.599 --> 00:03:46.080
Um so basically apophysitis is um the inflammation of the bone where the tendon meets, like if it meets near a growth plate, um, that area is typically not gonna be, it's gonna be like softer, so to speak.
00:03:46.240 --> 00:03:49.439
That's like the best word I can think of, than like normal bone.
00:03:49.520 --> 00:03:56.800
And so um like the constant pulling on that area is what causes the inflammation and the pain and all that.
00:03:56.960 --> 00:04:14.560
So this to um when I say growth plates, you're probably thinking of like kids, and it is typically something that affects youth athletes going through a growth spurt who are also doing high volume, a high volume of activities, um, mostly running and jumping.
00:04:14.800 --> 00:04:26.399
Um so with apophysitis, like the thing that caused it, or you know, the quote unquote root cause was you know them going through a growth spurt.
00:04:26.720 --> 00:04:33.199
And while they were training, basically, like doing high volume of running, high volume jumping.
00:04:33.360 --> 00:04:39.120
I guess it doesn't have to always be training, maybe they're just playing, but like doing a lot of playing.
00:04:39.680 --> 00:04:44.800
Um, but we can't like go back in time and prevent this overuse from happening.
00:04:44.959 --> 00:04:48.639
Like it's we can't reverse the apophysitis.
00:04:48.800 --> 00:04:56.879
Um, obviously, we can still address their training load right now, so we can be like, okay, well, this high training load is causing you pain.
00:04:57.120 --> 00:05:05.839
We can decrease that training load, but it's that's not the only thing that's going to help them like moving forward.
00:05:06.160 --> 00:05:22.800
We at this like the apophysitis has already happened, so now besides addressing the training volume, we need to also maintain their strength and potentially improve their flexibility until that painful area, the area of the apophysitis, um, calms down.
00:05:22.879 --> 00:05:26.800
And then once it does, then we will rebuild their tolerance to their sport.
00:05:27.199 --> 00:05:29.759
So basically, we know the root cause.
00:05:29.920 --> 00:05:34.959
The root cause was like the overuse while they were going through a growth spurt, but we can't reverse that.
00:05:35.120 --> 00:05:40.399
And so, like addressing the root cause isn't going to be the thing that helps them.
00:05:40.639 --> 00:05:49.120
The thing that helps them is going to be, you know, continuing to maintain their strength so that they have less cashing up to do once that area calms down.
00:05:49.439 --> 00:06:00.399
And so I think the biggest issue I have with the phrase root cause is that it can cause people to endlessly search for the one thing that will solve their problem or solve all their problems.
00:06:00.480 --> 00:06:02.000
It's sometimes it seems like.
00:06:02.240 --> 00:06:12.399
And in doing so, they get stuck constantly looking backward at past events instead of using the information that we do have to figure out how to move forward.
00:06:12.560 --> 00:06:24.079
You know, because sometimes maybe there isn't just one simple root cause, and maybe there's only like this unsatisfactory answer of like going back to the knee pain example.
00:06:24.399 --> 00:06:38.240
Like, you know, oh, you had all of a sudden you had an extra project or deadline at work, and then you weren't sleeping very well, and then all that combined with an increase in training kind of caused your joints to be a little bit more cranky.
00:06:38.319 --> 00:06:44.160
You know, that's that's an unsatisfying answer compared to, oh yeah, you tore something in your knee.
00:06:44.319 --> 00:06:45.920
Like that's that's something simple.
00:06:46.000 --> 00:06:52.319
That's like, oh, that's something you can blame, like one simple thing you can blame versus all of these other things.
00:06:52.560 --> 00:07:02.720
Um and don't get me wrong, like understanding how or why your pain or injury happened, you know, can be helpful for guiding treatment and preventing it from reoccurring in the future.
00:07:02.959 --> 00:07:12.959
But again, spending too much time like focusing on it and thinking about it and trying to figure it out can take away from actually treating the problem.
00:07:13.120 --> 00:07:28.160
Like you're constantly looking backward and like fixated on square zero, basically, like the injury before you started trying to fix it, instead of like taking the steps necessary to address, actually address the issue.
00:07:28.319 --> 00:07:42.480
Um, and so in practice, when I think for myself, when I think of finding the root cause as a physical therapist, I'm more interested in asking um what factors are contributing to this right now.
00:07:42.800 --> 00:07:47.040
Um which of those factors can we actually change?
00:07:47.279 --> 00:07:50.959
And what do we need to do to get you back to what you want to do?
00:07:51.279 --> 00:07:58.240
Because at the end of the day, what you really want is to be able to return to doing what you love without compromise, right?
00:07:58.399 --> 00:08:00.160
And so that's all I have for today.
00:08:00.319 --> 00:08:02.319
A little bit of a shorter one.
00:08:02.560 --> 00:08:09.360
Um, but either way, thank you so much for listening, and I will see you in the next conversation.
00:00:00.000 --> 00:00:12.000
In this episode, I talk about why the phrase root cause bothers me, why there isn't always one simple explanation for pain or injury, and why constantly searching for one can sometimes keep you from actually moving forward.
00:00:15.759 --> 00:00:18.640
Hello and welcome to Candid Conversations with Dr.
00:00:18.719 --> 00:00:19.359
Kelsey.
00:00:19.519 --> 00:00:20.480
I'm your host, Dr.
00:00:20.640 --> 00:00:32.000
Kelsey, and this is the space where I share my honest thoughts, real experiences, and the no BS conversations I wish more people were having about movement, training, injury recovery, and life as an active human.
00:00:32.240 --> 00:00:41.679
The goal of this podcast is to help you better understand your body, think more critically about rehab and fitness, and feel more confident making decisions so you can stay active long term.
00:00:41.920 --> 00:00:43.840
Before we start, a quick reminder.
00:00:44.079 --> 00:00:47.679
I am a physical therapist, but I am not your physical therapist.
00:00:47.840 --> 00:00:49.520
Nothing here is medical advice.
00:00:49.679 --> 00:00:55.359
So if you're dealing with something specific, please reach out to your PT or schedule a session to work with me.
00:00:55.600 --> 00:00:58.479
Alright, now let's get into today's conversation.
00:01:04.400 --> 00:01:10.159
So in theory, finding the root cause of a problem instead of only treating symptoms is a great idea.
00:01:10.959 --> 00:01:21.359
For example, in the physical therapy world, let's say someone is having knee pain and they're using like ibuprofen or other pain medications and ice to treat their knee pain.
00:01:21.519 --> 00:01:33.519
Well, we know that all they're doing is treating the symptom of pain and they're not, by using those two things, they're not actually addressing the underlying problem or the root cause of their knee issue.
00:01:33.760 --> 00:01:40.079
However, the problem is that when most people think of root cause, they're expecting a simple and singular answer.
00:01:40.239 --> 00:01:46.480
But the reality is that our bodies are complex and there is rarely just a singular root cause.
00:01:47.599 --> 00:01:53.040
Like in practice, a root cause can be multiple underlying factors contributing to a problem.
00:01:53.200 --> 00:02:06.239
So in the knee pain example, someone might expect their root cause to be like some sort of tear or something, something that you know you can easily identify and say, like that one thing is what is causing my issue.
00:02:06.640 --> 00:02:20.159
But in reality, maybe their root cause is actually a combination of extra stress at work on top of poor sleep, on top of an increase in running mileage or squat weight percentages during training.
00:02:20.479 --> 00:02:32.000
Like all those things combined is what contributed to their knee pain instead of you know something more simple or you know easily identifiable as a sort of tear.
00:02:32.319 --> 00:02:39.520
Or sometimes root cause factors aren't known yet, and so treating the symptoms is actually how we treat the problem.
00:02:39.759 --> 00:02:53.520
So an example of this is non-specific low back pain, where there might not be a specific injury, might not be any changes to your normal routine, and there might not be any imaging findings that can easily explain why you're having the back pain.
00:02:53.680 --> 00:02:57.919
It's just something that kind of just started and now you're having back pain.
00:02:58.240 --> 00:03:12.639
But even though we can't identify the root cause to make changes to, to fix, so to speak, we can still treat the things you're having difficulty with because of the back pain, so that you don't have to continue to deal with this back pain.
00:03:12.879 --> 00:03:22.719
And lastly, sometimes we know the root cause, but knowing why something happened doesn't necessarily tell us everything we need to do to treat the problem.
00:03:22.960 --> 00:03:29.439
An example of this is apophysitis, which some people might know as Osgood Schlauders if it happens in the knee.
00:03:29.599 --> 00:03:46.080
Um so basically apophysitis is um the inflammation of the bone where the tendon meets, like if it meets near a growth plate, um, that area is typically not gonna be, it's gonna be like softer, so to speak.
00:03:46.240 --> 00:03:49.439
That's like the best word I can think of, than like normal bone.
00:03:49.520 --> 00:03:56.800
And so um like the constant pulling on that area is what causes the inflammation and the pain and all that.
00:03:56.960 --> 00:04:14.560
So this to um when I say growth plates, you're probably thinking of like kids, and it is typically something that affects youth athletes going through a growth spurt who are also doing high volume, a high volume of activities, um, mostly running and jumping.
00:04:14.800 --> 00:04:26.399
Um so with apophysitis, like the thing that caused it, or you know, the quote unquote root cause was you know them going through a growth spurt.
00:04:26.720 --> 00:04:33.199
And while they were training, basically, like doing high volume of running, high volume jumping.
00:04:33.360 --> 00:04:39.120
I guess it doesn't have to always be training, maybe they're just playing, but like doing a lot of playing.
00:04:39.680 --> 00:04:44.800
Um, but we can't like go back in time and prevent this overuse from happening.
00:04:44.959 --> 00:04:48.639
Like it's we can't reverse the apophysitis.
00:04:48.800 --> 00:04:56.879
Um, obviously, we can still address their training load right now, so we can be like, okay, well, this high training load is causing you pain.
00:04:57.120 --> 00:05:05.839
We can decrease that training load, but it's that's not the only thing that's going to help them like moving forward.
00:05:06.160 --> 00:05:22.800
We at this like the apophysitis has already happened, so now besides addressing the training volume, we need to also maintain their strength and potentially improve their flexibility until that painful area, the area of the apophysitis, um, calms down.
00:05:22.879 --> 00:05:26.800
And then once it does, then we will rebuild their tolerance to their sport.
00:05:27.199 --> 00:05:29.759
So basically, we know the root cause.
00:05:29.920 --> 00:05:34.959
The root cause was like the overuse while they were going through a growth spurt, but we can't reverse that.
00:05:35.120 --> 00:05:40.399
And so, like addressing the root cause isn't going to be the thing that helps them.
00:05:40.639 --> 00:05:49.120
The thing that helps them is going to be, you know, continuing to maintain their strength so that they have less cashing up to do once that area calms down.
00:05:49.439 --> 00:06:00.399
And so I think the biggest issue I have with the phrase root cause is that it can cause people to endlessly search for the one thing that will solve their problem or solve all their problems.
00:06:00.480 --> 00:06:02.000
It's sometimes it seems like.
00:06:02.240 --> 00:06:12.399
And in doing so, they get stuck constantly looking backward at past events instead of using the information that we do have to figure out how to move forward.
00:06:12.560 --> 00:06:24.079
You know, because sometimes maybe there isn't just one simple root cause, and maybe there's only like this unsatisfactory answer of like going back to the knee pain example.
00:06:24.399 --> 00:06:38.240
Like, you know, oh, you had all of a sudden you had an extra project or deadline at work, and then you weren't sleeping very well, and then all that combined with an increase in training kind of caused your joints to be a little bit more cranky.
00:06:38.319 --> 00:06:44.160
You know, that's that's an unsatisfying answer compared to, oh yeah, you tore something in your knee.
00:06:44.319 --> 00:06:45.920
Like that's that's something simple.
00:06:46.000 --> 00:06:52.319
That's like, oh, that's something you can blame, like one simple thing you can blame versus all of these other things.
00:06:52.560 --> 00:07:02.720
Um and don't get me wrong, like understanding how or why your pain or injury happened, you know, can be helpful for guiding treatment and preventing it from reoccurring in the future.
00:07:02.959 --> 00:07:12.959
But again, spending too much time like focusing on it and thinking about it and trying to figure it out can take away from actually treating the problem.
00:07:13.120 --> 00:07:28.160
Like you're constantly looking backward and like fixated on square zero, basically, like the injury before you started trying to fix it, instead of like taking the steps necessary to address, actually address the issue.
00:07:28.319 --> 00:07:42.480
Um, and so in practice, when I think for myself, when I think of finding the root cause as a physical therapist, I'm more interested in asking um what factors are contributing to this right now.
00:07:42.800 --> 00:07:47.040
Um which of those factors can we actually change?
00:07:47.279 --> 00:07:50.959
And what do we need to do to get you back to what you want to do?
00:07:51.279 --> 00:07:58.240
Because at the end of the day, what you really want is to be able to return to doing what you love without compromise, right?
00:07:58.399 --> 00:08:00.160
And so that's all I have for today.
00:08:00.319 --> 00:08:02.319
A little bit of a shorter one.
00:08:02.560 --> 00:08:09.360
Um, but either way, thank you so much for listening, and I will see you in the next conversation.
