Simple Answers In A Complex System
A Guest Blog by Shaun Astorga
I am a doctor of physical therapy who tends to see a lot of “tough” cases. People who have been experiencing pain for months or years. People who have gone to every specialist, tried every medication, and even undergone expensive and elaborate procedures.
Yet they still have pain...
And they don’t have answers.
The truth is, outside of injury, pain is extremely complex. But that does not mean we need to rely on extremely complex solutions to find answers. In most cases...it’s quite the opposite.
When something isn’t working, we must look elsewhere for answers.
In 2017, I suffered a brain injury after 2 heavy boxes fell on my head. My recovery was typical for the first couple of weeks...I started to feel better every day. I was able to gradually increase my activity level, and I returned to working with patients and clients full time.
Then one day, with no rhyme or reason, I started to drastically regress.
All of my symptoms from the original injury came back full force. I had pain that shot down my arms and into my face any time I turned my head. I was dizzy to the point where I didn’t feel safe walking. And the pressure in my head was almost too much to manage.
As the months passed, my symptoms worsened. My health declined to the point where I couldn’t walk to the mailbox and back without having to sit down and rest.
And I had no answers. I was sent from specialist to specialist. I tried all of their recommendations. Every type of therapy. I even had testing done that I didn’t know existed.
And still...no answers.
I was told by a number of specialists that I would never fully recover and that I should plan for what my “new normal” was going to be. I was told I would never lift weights again. That I would never be a physical therapist again. That I would have to take medications to manage pain and some of the other issues I had as a result of the injury.
I couldn’t accept that this was going to be my new reality.
And like I tell all of my clients: When something isn’t working, we must look elsewhere for answers.
Evolutionary biology and why we are the way we are.
In order to understand how we have developed, we have to understand where we came from...and that is what evolutionary biology is the study of.
Evolutionary biology is a fancy term to describe the study of how humans have evolved throughout time. Think Darwin, natural selection, and survival of the fittest.
What evolutionary biology tells us is that our biology - the things that make us who we are - has been adapted over the course of time based on our need to survive in an ever-changing world.
And what evolutionary biology also tells us is that human beings are the most impressive species...ever. We have adapted to the changing world better than any other species. We can create, we can dream, and we have survived and progressed when other species did not.
We cannot ignore the basic fundamental needs that have gotten us as a species to this point.
Modern life is convenient for many of us.
We have heat in the winter. We have supermarkets so we don’t have to worry about where our next meal will come from. We have indoor gyms, boutique fitness facilities, and online trainers we pay to make sure we get in our physical activity.
While this convenience is great...no complaints from me!...it does make it easy to avoid some of the basic fundamental things that we need to thrive as human beings
We can go days without getting direct natural sunlight. We may never do anything that is physically challenging. And the only steps we might take are from our door to our cars and from our cars to our office.
This is becoming an issue in our current society as medical advancements continue to increase our lifespan - the amount of years spent on this planet, but our healthspan - the number of meaningful years doing the things we love on this planet - is declining.
The question becomes: how do we bridge this gap?
The stress bucket - making it bigger and keeping it full.
What we as a medical community know is that uncontrolled stressors overtime underlie many, if not all of the noncommunicable diseases (things that are not caused by infection - think cardiovascular disease, cancer, diabetes, chronic respiratory disease), that can affect us.
As such, it makes sense that in order to have sustainable health over the course of a lifespan, we as humans need to get very good at coping with the various stressors we encounter.
There are many representations of the stress bucket. I like the version adapted by Bill Hartman, PT, in his book All Gain, No Pain.
The stress bucket represents our ability to tolerate the things life throws at us. The bigger and more full the bucket, the more resources we have available to handle the physical, mental, and emotional struggles each of us faces in our own lives.
What I love about the concept of the stress bucket, is that everything that goes into making the bucket bigger and keeping the bucket full is within OUR power to control.
The very things that allowed our ancestors to thrive: social interaction, adequate nutrition, effective physical activity, walking, getting sunlight throughout the day, and sleep to name a few, are all things within our power that we can take into our control and positively impact our ability to add meaningful years to our lives.
Here are clips from a talk I gave on this subject at the start of the pandemic. It is a topic I am passionate about because it is something I lived through as a patient.
Bridging The Gap: Becoming An Antifragile Human
The concept of being antifragile comes from Nassim Taleb. It describes a situation where when a stress is applied to something, that something gets better. It grows. It gets stronger. It thrives.
Antifragile is one end of a spectrum...with the other end being fragile.
You know what fragile is. Fragile is a glass cup. You drop it on the floor and it breaks. Humans can be made fragile...and unfortunately this happens very often...especially with people who experience chronic pain.
Antifragility is what we need to strive for as humans if we want to increase the meaningful years we have on this planet. We need to make sure we set ourselves up for success...To thrive in times of chaos. To come out on the other end of struggle stronger than when we went in.
This comes from consistent effort over time. 1% better everyday. Think about your finances. Most people don’t become wealthy in one shot. They save a little bit over time. Think about weight training. You don’t lift a weight one time and get bigger muscles. You lift weight over time. Think about weight gain or weight loss. You don’t do either by eating one meal. You do it by eating too much or too little over time.
Becoming antifragile is the same process. It is not easy. And it is definitely not a quick fix...but in my opinion and experience as both a patient myself and as a medical professional who works with clients who can’t find answers, this process is how results are realized when nothing else “works”.
Conclusion:
There needs to be balance in healthcare. A symbiotic relationship between all of the medical technology we have and the very basic things that have allowed humans to evolve when many other species haven’t throughout the billions of years Earth has been a thing.
Life will always throw challenges at us...this is a universal truth. It is how we respond to these challenges that truly matters. We can be the glass cup that breaks when a little stress is applied, or we can strive to improve 1% every day so that when life inevitably throws something hard at us we can come out on the other side stronger than when we went in.
This article is titled: Simple Answers To A Complex System. Simple does not mean easy. I live what I preach...but I have days where I feel like eating pizza, drinking a beer, and playing video games all day. And that’s exactly what I do on those days. Eat pizza. Drink beer. Play video games. It is the consistent effort I put in on every other day that allows me to do those things and not suffer ill-effects in the long term.
And that’s what health is. Consistent effort over time. Not perfection. Not quick fixes. But rather doing enough of the right things so that we can thrive in chaos and come out stronger.
One last message - for those reading this who have been experiencing pain for a long period of time and are searching for answers, please know that there are medical professionals that can help you. When the current options you have been experiencing are not working and getting you the results you deserve, you need to look elsewhere. Try to stay positive and not become too discouraged...all it takes is finding the right person to help you get from where you are to where you want to go. It took me almost a year to find that person for myself, but once I did I got my life back. The same will happen for you.
Link to full video recording of “Structured Chaos - How To Regain Focus When Your World Turns Upside Down”: https://youtu.be/n1eewLaKzys
Bio:
Dr. Shaun Astorga is a board-certified doctor of physical therapy, strength and conditioning coach, and owner of AMP Performance Rehab in Morris County, NJ. AMP Performance Rehab helps fitness enthusiasts, strength athletes, and runners get past injuries when others told them it wasn’t possible by bridging the gap between rehab and performance. Shaun also works directly with clients who experience chronic pain and have not had success with other options. Click here to book a free pain/injury strategy call Free Pain Strategy Call or email Shaun directly at shaun@ampperformancerehab.com with any questions, comments, or concerns.
