Dr. Lyons – It All Comes Down To Habits

In the end, it all comes down to something you’re doing. You just haven’t figured it out yet.
I have to have the conversation with patients all the time. They’ve come in for treatment for something that hurts….their neck….shoulders…wrists. You name it. We’ll do a course of treatment and they’ll improve and feel better. I’ll teach them exercises and stretches. Discuss good and bad ergonomic habits for them. You know the drill.

If I could wrap them up in bubble wrap and put them on the shelf, they’d be good to go. Of course…we all know that can’t happen. We have to go back to life. Back to work. Back to home making dinner and taking care of the kids. So for many of us, the problems come back. When his happens patients often return for treatment and we’ll take care of the problem again. Then it happens a third time. That’s when we usually have this conversation.

It all comes down to your habits. You’re most likely doing something that causes the problem. Sometimes the source of a your pain is obvious. You sit down to work on your computer and your wrist immediately starts to throb and go numb after just five minutes of using your mouse. Very few people miss these. They’re obvious, both to the patient and to the clinician. And it’s why every HR department has pamphlets touting good workspace ergonomics. Many companies even have ergonomic specialists or even departments to take care of these issues.
What I’m referring to are the more insidious versions. One’s that no one, not even yourself, will often think about. Things that aren’t on the questionnaires or in the pamphlets from HR. Sometimes its even something your body has started to do FOR you….without you making any conscious decision.

So I’ll discuss this topic within my next two blog entries by telling you about two separate times in MY life where I’ve been doing something that seems harmless that was directly causing me months and months of pain.

Episode 1: The Case of the Unrelenting Toe Pain
This actually happened to me while I was in Chiropractic College. Chiropractic students put in a lot of time learning to be Doctors of Chiropractic. Typically 35+ hours per week of actual class and lab time with usually 20-30 additional hours studying per week. I’m telling you this because you have to realize something that Chiropractic students DON’T have a lot of time for…..laundry. So it will often be that students will wear the same pair of jeans and hoodie the entire week. Well….I was such a student once. And I can tell you….I fit this description. So this will accurately set the table for my toe pain.

Sometime within the first year of being a Chiropractic Student I started to develop pain in the Big Toe on my Right Foot. It started out as kind of a mild aching or discomfort. Over the course of the year, this pain got progressively worse and worse, going from mild to moderate, and eventually to severe pain. I could no longer flex or extend my big toe comfortably. It was stiff and swollen at all times. And it seriously started to impact my ability to work out, play sports, and eventually even walk.

Of course right about this time we starting to learn about Inflammatory Arthritis. And I learned all about Gout. Unrelenting pain in the Big Toe with stiffness and swelling. And mind you VIRTUALLY EVERY Chiropractic/Medical/Nursing student is convinced no less than five times during his or her schooling that they have various diseases and medical conditions they’ve just learned about.

So here I am….terrified I have Gout. Not wanting to get it actually checked out because….well that would be just awful. I employed what I call the “Ostrich Technique”…..burying my head in the ground and not facing the problem. What can I say….I was young and on a student’s budget (read….no healthcare coverage). I spent over a year with this pain, thinking I must have Gout.

Then something happened. During one of our breaks in between school quarters I went on a vacation. And on that vacation I didn’t take my ABSOLUTE FAVORITE pair of sandals. A black pair of Oakley sandals. Comfortable…Sleek and Stylish….. I loved them. And as you probably guessed by now after my story about Chiropractic Students wearing the same thing all the time…..I wore them EVERY DAY OF MY LIFE.

But I didn’t take them on my vacation. I didn’t want to lose them. So I never got a chance to wear them. And my Toe Pain vanished. BUT….I wasn’t smart enough to draw the connection YET. I didn’t realize the pain was gone. I was just having a nice vacation.

It was when I got BACK from my trip….And wore those sandals for just a few hours. THAT’S when I suddenly realized (a) my toe hadn’t been hurting me all week and (b) it is suddenly NOW hurting me. I thought of the shoes….but they were my favorite and I didn’t think it could be them. But I decided to test it out just in case. Sure enough…if I wore those Oakley sandals my toe would hurt. If I left them off for a couple of days, I had zero pain.

And that’s when I finally realized what was going on. These sandals were not the traditional flip-flop sandals that have the “Y” shaped toe spacer between your first two toes. And they didn’t have anything across the back of your heel to hold them in place. There was just a thick band that would go across the tops of your toes and forefoot. Women will know them as “Slides” and men will likely call them “Sandals without the Y thingy or strap across the heel”. I digress. Without anything to hold these sandals in place, I realized they would translate or shift forward and backward a bit with each stop. Not far….just a few millimeters. But it would happen with each step.

So what my body started doing…..Let me stop right there and emphasize this…what MY BODY STARTED DOING….without ANY DECISION on my own part….was to reflexively extend my Big Toe up to hit the roof of the strap and hold it in place. Thus stopping the shifting of the sandal. And it was THIS abnormal extension with pressure of the big toe that was creating my pain.

As soon as I realized this, I tried walking in these sandals without extending my toe. And the sandals would slip off my feet within 2-3 steps every single time. They were completely unusable. And that was the day I had to retire my Oakley sandals.

I still look back on them with fondness to this day. I held on to them for literally a decade. And I’d occasionally wear them in the garage to grab the laundry (which I’m glad to report is clean these days).

The takeaway lessons from this story are:
It all came down to a bad habit….the extending of my big toe with every step.
It came from an insidious, unexpected source…my favorite sandals .
I had made NO CONSCIOUS DECISION…..my body LITERALLY created an automatic or reflexive solution to the problem. (This is probably a great Blog topic on it’s own)

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