Symptoms vs Dysfunction (Kinetic Control Part 3)

Posted on March 30, 2015

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This continues my notes on the book Kinetic Control: The Management of Uncontrolled MovementOther parts can be found here

This part continues with the philosophy behind the book’s approach. I gave this one quote, and my commentary, its own post.

“Reduction of dysfunction is a primary short-term goal of therapeutic intervention, although the patient is frequently symptom free before dysfunction is corrected. Treatment should not cease just because the symptoms have disappeared, but may need to continue until no more dysfunctions are measurable.”

“The timeframe for expected improvement in symptoms should be considered independently of the timeframes for recovery of dysfunction and disability when making prognostic judgments for recovery.”

The authors hit on this a few times, illustrating the importance they place on it, but I’m not sure they made this as clear as they could.

Let’s look at it like many other habits. Say smoking. Or addiction. You can go a week, two weeks, a month, even a year, without smoking / drinking / doing a drug, and you’ll likely notice a significant improvement in how you feel (symptoms). However, that doesn’t mean the habit is gone (dysfunction). Or something you don’t have to still be aware of. Some smokers will tell you decades later they still get cravings. Especially when say, having a drink. That habit of having a drink, then smoking a cigarette, is still there.

One of the ways I see this with clients, and you do see this often, is after roughly a month in, where a person has been steadily feeling better, they suddenly report back things are starting to not feel so great again.

Almost invariably, once you see that person move, you realize their old habit(s) have come back. Or rather, they didn’t really leave in the first place. They were dormant, sort of speak. While conscious movement had been getting better, unconscious movement had still not changed. The old issues become more and more prevalent again as unconscious movement begins to come back. In other words, a person slacks off to some degree.

I have people who a year later still fit in this category. Depending on the habit, it may be something the person has to work on for the rest of their life. There is a saying in the addiction world, no matter how long you’ve been sober, you’re always one day away from death. Old habits die hard indeed. “It’s like riding a bike” isn’t always a good thing.

-> Many of us have heard of those with drug addictions dying after being sober for a long time. Even though they haven’t done the drug in, it could be decades, the moment they do it again, they do it to the degree they used to. They don’t shoot a little bit of heroin, the shoot as much as they used to when they were not sober. But their body no longer has that tolerance, so they overdose.

There are loads of other examples of this. Sprain an ankle -> Feel better after a couple weeks -> Doesn’t mean your ankle is back to normal. If you’ve ever had a really bad sprain, you know it can take a year for that thing to feel right again, even though you may be off playing sports within a month.

Depending on how you think of it, this can actually go the other way. Dysfunction isn’t there; symptoms are. With that ankle, you’re playing sports again, tough to consider that dysfunctional, but it still bothers you time to time. You’re still symptomatic.

Blood pressure dysfunction -it can be high, versus blood pressure symptoms -there often aren’t any.

Or dieting. You’re eating less, you know you’re in a caloric deficit, but you’re not losing weight. You’re diet is “functional” but the “symptoms” aren’t.

Symptoms and dysfunction often don’t line up when you’re in the moment. Over time, they typically do. It’s good to know this as it keeps you sane when you’re say, eating less but not losing weight. Or exercising but not getting better. Eventually, all of a sudden you drop a bunch of weight in a few days. Or you do something around the house and go, “Oh wow. I used to not be able to do that.”

 

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