The Definition of Insanity and your "Old Injury"
"The Definition of insanity is doing the same thing over and over again while expecting different results"
Except - That's not the definition of insanity.
I'm sure you've heard that as many times as I have (which is a lot), but it's not true. That is actually a paraphrasing of the definition of perseveration. That being said, this saying and it's sibling "If you always do what you've always done, you will always get what you've always gotten" have a lot of truth to them in some instances. They are particularly true in practice when working with clients who come in and have an "old injury" that never really heals, or that hasn't seemed to change regardless of previous treatment.
Is it possible that there is something sinister going on inside your body? Maybe - but it's a lot more likely that you never actually addressed the problem that was causing your injury in the first place.
Habits, Repetitions, and Rabbit Holes
A lot of the problems I see in practice have to do with either A) someone's daily habits that they haven't (or can't) modify, B) someone's repetitions of an exercise plan, or C) an improper (or incomplete) previous diagnosis. All of these have a common thread - they aren't addressing the root of your pain or problem. You may have a short term fix, a "band-aid" that helps for a little while (orthotics for plantar fasciitis, for example) but eventually you end up with "another round of that same old injury". Let's dig a little deeper.
A) Someone's daily habits. There are a lot of issues that can arise inadvertently from what people do every day without realizing that it may be causing them problems. One example I have seen recently was a female who had knee pain that had been present for months, had gotten an MRI and had no answers to the cause of her pain. One of the culprits we discovered was her footwear choice at work - wearing heels for extended periods of time after switching to a new job caused her to lose a lot of ankle mobility without her realizing it. No more ankle mobility meant awkward stress on the knee (along with some weakness in the hips and poor movement patterns to begin with). Here's the point - this was an easy fix to change her footwear choices and immediately get feedback from her body that this nagging knee pain was due to something that was happening every day without her realizing it.
B) Someone's repetitions of an exercise plan. I'll put it simply and bluntly. Just because someone programmed a workout, does not make it a good workout or good programming. Compounding that, if an individual isn't currently physically capable of the demands of a movement or workout, it is only detrimental for them to continue to attempt that exercise without modifying it. Repetitive stresses on muscles and joints should be moderated and controlled intelligently. When this aspect of the programming of your workouts is out of whack, whether due to the exercise choices/volume of repetitions/lack of rest cycles, it increases your chances of having problems. This is especially true if you already have a history of issues with a body part or exercise, then pile the reps on top of that.
C) Improper (or incomplete) previous diagnosis. This is perhaps the least common of the three, but sometimes the most frustrating. Healthcare professionals are people just like their patients and clients - sometimes they miss something, or get stuck in a rut, etc. Unfortunately, that means that sometimes they don't see the whole picture of what is going on with a person. This can be even more frustrating when multiple providers have treated a person, but none of them have communicated about the case. I see clients who have "an old issue" that is actually still the same issue from 10 years ago that was never fully diagnosed and addressed - even after multiple treatments.
It's time the cycle of "old injuries" stopped. If your having pain that has been present for an extended period of time, or keeps coming back - don't give up. Seek out a healthcare professional who will help you get to the root of the problem instead of continuing to just bandage it up.
Dr. Paul Harris holds a Doctor of Chiropractic degree from Texas Chiropractic College and a Master’s of Exercise and Health Sciences from University of Houston Clear Lake. He is the owner of Delta V Chiropractic and Sports Medicine and an avid human movement specialist.