MRIs vs. Movement
As many of you know, earlier this week, I spent three days at a huge sports medicine conference organized by Mass General Hospital in conjunction with the Harvard University Medical School. It was a great event geared toward sports orthopedists, radiologists, physical therapists, and athletic trainers; I was very humbled to have been invited to present alongside some of the brightest minds in the sports medicine world. The discussions on surgical technique, physical examinations, etiology of injuries, biomechanics, rehabilitation, and return-to-play guidelines were absolutely fantastic. The stuff that caught my attention the most, though, actually came in the discussion of imaging – MRIs, MRAs, and x-rays – by some of the best radiologists in the world.
Several of these brilliant radiologists made specific points of commenting on how not every abnormality you see on diagnostic imaging constitutes a symptom-causing issues. A perfect example would be a SLAP 1 (superior labrum fraying) in a baseball pitcher, which is completely normal for 79% of major league pitchers. Just because the labrum is fraying doesn’t mean that the pitcher is going to be in pain; it’s a passive stabilizer, and the active restraints (rotator cuff, scapular stabilizers) can get stronger to pick up the slack. Likewise, just because a player is having shoulder pain and he has a SLAP 1 lesion on imaging doesn’t mean that the frayed labrum is the cause. It could be coming from the biceps tendon or rotator cuff, for instance, and the labral issue is just “there.”
So what does that mean for strength and conditioning professionals? Well, as I wrote in Inefficiency vs. Pathology, there isn’t a whole lot we can do to effect favorable changes in what diagnostic imaging looks like, but we can go out of our way to ensure that clients and athletes move efficiently and have adequate muscular strength, stability, and tissue quality.
This is actually my exact topic on the Perform Better tour (next stop is Long Beach at the end of July). If you can’t make it to Long Beach, I’d highly encourage you to check out these previous writings of mine:
Inefficiency vs. Pathology (noted above)
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