#632 Is your doctor pushing you out of your comfort zone? - DOC

#632 Is your doctor pushing you out of your comfort zone?

Is your doctor pushing you out of your comfort zone? Well, that’s what we’re talking about today on the Doc On The Run Podcast.



Growth happens outside of your comfort zone and this is something you’ve probably heard, you might have seen it posted on some site related to athletic training. We know that like for example, when you lift weights, what do you do? Well, you lift reps and Arnold Schwarzenegger kind of famously explained it one time is saying that most athletes, bodybuilders even, are afraid to actually go beyond where the pain is when they’re exercising. But he says, when you have pain when you’re doing exercises like lifting weights, that at the end of your set of reps when you start to have pain is where you start to cause the damage and the muscles that actually leads to the growth that you really want to achieve.

This is true in all things. This is true in physical fitness. This is true in training for running injuries. It is true for emotional growth. A lot of times we don’t want to have difficult discussions with our friends or with our partners or our kids because why? They’re uncomfortable. But that’s where the growth happens.

I came up with this idea, I was sitting in a conference and I was thinking about how it is that we as physicians want to keep patients comfortable and sometimes doctors have to push us out of our comfort zone, and sometimes you have to do this yourself, but there are very few patients really and truly who call me for, let’s say a second opinion with a stress fracture. When they need help, they’re not getting better. They’re very few of them. They’re not actually really upset. Many of them are upset for a variety of reasons, but they all feel that they’ve wasted months of time in treatment. Nobody calls me really and truly right when their problem starts. People call me when they cannot get better, when they’ve seen lots of doctors and they still don’t have an answer.

I did a call this week with a physician. She’s seen lots of doctors and she’s a doctor herself, but she called me because she wasn’t getting the answers that she needed and she was getting frustrated because she was just drifting off into nowhere land without a clear direction and a path to get her where she wanted to be.

So the thing is is that there are really two things that have happened with all these runners that’s really a problem. Number one, either the treatments they’ve done have not helped or the lack of direction has actually made them worse and in the consequence what happens, you can lose all your physical fitness, which is something that all runners know as soon as the doctor tells them not to do stuff, you start to feel lethargic and then you start to get kind of cranky. You start to get irritable and you become frustrated because maybe you go to the doctor and he says, “Well, you’ve got a stress fracture but there’s not a crack on your x-ray.” and you say, “Well I think, a crack is a fracture, right?” But the doctor says it’s a fracture even though there is no fracture, and it leaves you a little confused.

All of these runners seem to express the same concern. What that really is is that all of these runners are really trying to express the same concern and what that really comes down to is that the correct path for them with their unique circumstances is just as mysterious as this non-existent crack on the x-ray that isn’t there that’s being called a crack and a fracture that keeps you from running. So I do understand why runners get so frustrated with this, but you have to really know what your comfort zone is and how to get out of it.

The way that I really think about it in terms of what I was trying to present in this episode is that your activities and behaviors fit into a routine that minimizes stress and risk. That’s what your comfort zone really is. It’s doing things that keep you comfortable because you don’t want to have stress and you don’t want to have risk. Now, that’s true for the doctor too. If you go in to see a doctor and you say, “I saw this guy, he told me I had a stress fracture but I have a marathon this weekend. Can I run it?” Most of the time they’re going to go, “Are you crazy? That’s way too stressful and way too risky for me to think about telling you to do that because if you do, you’re going to blame me.”

So doctors will sometimes do this to protect themselves. They say, “Look, you need a cast because I don’t trust you to wear a fracture walking boot. I think you’re going to take the fracture walking boot off.” Actually, they don’t ever tell you that, but they just put you in a cast without telling you that they don’t really trust you or they say “you can’t run” because they don’t trust you to run in a way that’s actually reasonable and low enough stress that the stress fracture could still heal.

There is a good way and a bad way to think about your comfort zone when it comes to physicians. In a good way, removing just enough stress and strain on the bone that has a stress fracture that allows you to exercise and maintain your running fitness is obviously a good way to push your comfort zone. It’s going to make you a little uncomfortable. It’s going to make the doctor a little uncomfortable, but it minimizes the stress and the risk regarding your ability to run forever. Because the bad way to think about your comfort zone is to try to stay so far within those activities that limit your stress and risk that you get zero exercise, your fitness starts to drop off, you get weaker, you get stiffer, you lose your neuromuscular connections, you actually get plastic changes at the levels of spinal cord in terms of your reflexes that actually make you less stable and more prone to running injuries later if you just stop all exercise altogether.

But you don’t have to do that. You have to think about ways that you can push your comfort zone in terms of what can I do that is going to actually strengthen everything that’s not injured to support that one part that has this stress related injury. The one bone that has the stress fracture. That’s what you got to think about and you have to encourage your doctor to think about it too. Frankly, the doctors are in a hurry most of the time. They don’t want to sit there and explain all these details to you. They just want you to get the thing healed. But getting the thing healed is crucial in the short term. Getting it healed while you maintain your running fitness is critical in the long term. So you have to think about your comfort zone and you have to think about your doctor’s comfort zone when they’re giving you limitations that you don’t like.

Granted, both ends of the spectrum are true. If a doctor says, “Do no activity at all for the next six months and your stress for actual heal,” that is definitely going to keep you out of your comfort zone because your comfort zone is running, your comfort zone is being fit and your comfort zone is moving. So no movement is definitely going to put you out of your comfort zone. At the same time, if the doctor just says, “Don’t worry about it, it’s just a stress fracture, it’s no big deal, we can fix it if you break it.” Well, then you’re going to be out of your comfort zone because you have uncertainty. You don’t know whether or not it’s actually safe for you to run the distances you’re running, the way that you’re running without making it worse. The goal is to stay somewhere in between to make sure that you’re maintaining activity, make sure that you’re maintaining your fitness, make sure that you’re strengthening the bone fast enough so it can continue to heal while you maintain your running fitness. That’s really the key.

Now listen, if you want to know more about stress fractures, I’m going to be doing a live master class. If you’re listening to this soon enough after it came out, you’ll be able to adjoin. Don’t send me emails saying, “I’m not going to join, but I want you to record it and send it to me” because I’m not going to do that. It’s called Running With a Suspected Stress Fracture: dos and don’ts and what I’m going to do is I’m going to teach you all the principles that I teach to doctors at medical conferences when I lecture to them on stress fractures and runners. I’m also going to share with you all the ideas that every runner needs to know in order to really understand how to fast track the recovery process with a stress fracture.

I’m also going to talk about the approaches that I always use with athletes when I meet with them in person during a house call or on a webcam call. And in terms of what exactly you should do given specific circumstances that are really, really common that I encounter all the time with these athletes.

As a bonus, if you have questions, you’ll be able to send them to me and I’ll answer all those questions live during this masterclass. Now, you can join for free, doesn’t cost anything, you have to go to docontherun.com/stressfracturelive and you can join it there. So go sign up and I’ll see you in the training.