When to Go to the Doctor

by Nina

Eleven years ago when we used to have a Friday Q&A, we received a question from a reader that I thought had very important implications for all yoga practitioners and teachers. I thought my answer to this specific question about a knee problem was worth republishing now because the basic message is one that I frequently continue to give to people in my everyday life who ask me what to do about this or that physical problem they’re having, saying things like “I think I have sciatica” or “maybe I tore my ACL.”

Q: Well, my right knee has bothered me for about three years, which is my fault as I really pushed too hard on the “perfect” lotus position. And now, about 6 months ago my right hip has really been hurting and stiff and I’m wondering is this arthritis?

I purchased the book you recommended by Sandy Blaine, Yoga for Healthy Knees. I figured I would give about 6 months try with the knee poses she recommends and if I’m still in trouble, go to a knee specialist. However, I do have a question about my knee. On page 21, she states, “ligaments once torn or stretched out of shape, do not heal.” That statement got my attention. I wondered if I had TORN a ligament in my knee? Perhaps I’m being foolish and need to have the doctor look at it and at least go from there. What would you say to this? I’m just afraid of these doctors as 1/2 the people my age seem to be having knee surgery. I often wonder if it is really that necessary?

A: This is the kind of question all of us here at Yoga for Healthy Aging get frequently from students, friends, colleagues, etc. And basically the answer we give is always the same: go to the doctor for a diagnosis! It is only when you have a proper diagnosis that we can help you with some yoga recommendations. Now, your doctor may make some recommendations based on the diagnosis that you don’t like or don’t agree with (such as surgery), but you don’t have to follow them. But only a trained professional (not a yoga teacher) can tell you whether your guesses about what is wrong with you are accurate. (For example, a friend of mine who was having back pain discovered after going to the doctor that she had gallstones!)

After discussing this with Baxter, I, Nina, decided to answer this question because my own experience is so relevant. For years I had ongoing problems with my right hip, but one day I woke up and my whole right hip kind of froze up! So I called my doctor and my doctor referred me to an orthopedist. The orthopedist asked me to get an X-ray before my visit, and when I walked into my appointment, he told me bluntly, “You have arthritis at the back of your hip joint. And you’re headed for a hip replacement. Could be months, could be years. Meanwhile, nothing you do could make it better, and nothing you do could make it worse.” Well, you can imagine my shock! As a yoga teacher, I knew from the X-ray and the tests he did on me that I did indeed have arthritis. But I also knew how wrong he was with his single recommendation (hip replacement). I understood that I could definitely make my hip worse by not exercising, and while I probably couldn’t make it better, I could possibly postpone the need for a replacement by keeping my joint as healthy and mobile as possible. And keeping my joint as healthy and mobile as possible became my new goal. (For further information on this, see Yoga for Osteoarthritis.)

Here’s what I did after my appointment (that is, after I nicely told my referring doctor how arrogant and uninformed I thought the orthopedist was, and that I never wanted to see him again, thank you very much): I went to see a physical therapist (who understands yoga), and he helped me unfreeze my hip and regain some mobility. Then, with his guidance, I adapted my regular yoga practice to include hip openers to keep the blood flowing to my hip joint. I later had some chiropractic adjustments as well because I wondered if my scoliosis wasn’t contributing to the problem. So using my doctor’s diagnosis of my condition, I was able to put together my own treatment plan. And guess what? Five years later, I have to say, I’m actually—and I wasn’t even hoping for this—seeing even more improvement in my mobility.

My wish for you is that you can find a nicer, more knowledgeable doctor than I did. But the point is, even if you don’t, the information you get from the diagnosis itself is invaluable. Only when you have a real diagnosis can you make an informed decision about the next step to take. And only when you have a real diagnosis can your yoga therapist or yoga teacher help you figure out how to use yoga to ameliorate your condition.

Am I ranting a bit? Well, yes. But that’s because I really want to get this message out there, not just to the person who asked this question, but also to everyone else who is listening!

Update: Since this original post was 11 years old, are you wondering what ever happened with my arthritic hip joint after what is now 16 years? Well, basically I do seem to have somewhat less mobility in my hip joint, but walking is still fine and I’m not in pain in my daily life. So, I still don’t need a hip replacement! I continue to get regular chiropractic adjustments because it turns out my hip problem IS due to my scoliosis, so having regular treatments keeps my body more symmetrical. And I also continue to do hip stretches in all directions (forward, backward, out to the side, across the body, internal rotation, and external rotation) to maintain my mobility and keep the joint nourished. My current chiropractor, who is a long-time yoga practitioner, says that I may never need a replacement because the arthritis is only partial (she looked at my X-rays!), but if I do, I’ve managed to delay that surgery through my practices. And that’s good because 1) hip replacement techniques continue to improve and 2) hip replacements do wear out and then you need another surgery so delaying surgery by many years can mean fewer surgeries!

 

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