"DO I NEED AN MRI?" WHY PHYSICAL THERAPY SHOULD BE YOUR FIRST STEP

Updated: Aug 8


Scenario: You land from a box jump wrong and tweak your knee, enough to make you go see your doctor. Doctor decides to take an MRI. MRI shows osteoarthritis. So naturally that must be where your pain is coming from… right?

Not exactly.

X-Rays and MRI’s are awesome diagnostic tools to help get a view of what we can’t see from the outside, but there’s also a little danger in that. What you see on an MRI might not be what is actually causing your symptoms. In fact, if you took a knee MRI of everyone you know, I am willing to bet that most people would be “diagnosed” with something. Maybe arthritis, maybe a meniscus tear, or maybe even some ligament damage. So does it mean anything? The truth is, if you are not having any problems or symptoms then no, it really doesn't mean anything. I just saw this awesome quote- (and I apologize that I can’t remember where it came from)… “Arthritis is like a wrinkle on the inside.” Read that again! It’s SO normal to see wear and tear on the joints over time, especially the hips and knees. So no matter what that diagnostic image is telling you, we must look at the person as a whole rather than slapping a label on your pain and calling it a day. We must look at the symptoms, not the diagnosis. You CAN still function with arthritis, you don't always need surgery, and you most certainly can still be active, lift weights, and play basketball even if you have been diagnosed with a "degenerating joint." I really cannot stress enough that this is not an end of the world diagnosis.

If I haven't convinced you yet, let me back it up with some science. An article was recently published in the Journal Of Skeletal Radiology and heres what they found:

They took MRI’s of 115 adults with no symptoms of knee pain or injury. The results are crazy-- 97% of knees showed some abnormality. That’s 97% in people who had NO SYMPTOMS AT ALL! The MRI findings included things like meniscus tears, cartilage, tendon and ligament abnormalities.

Moral of the story-- if you get an MRI, take the findings with a grain of salt. It is only one peice of the puzzle, and if we treated every little thing we saw on an MRI you just might end up in PT forever. We always need to treat your symptoms, NOT just your MRI results.

My best advice to you if you hurt yourself? Come see me, or your local PT, first! We will assess your function and pain through a Physical Therapy assessment. Then, we can tell you if we think its necessary to go see your doctor and get additional imaging done. No sense in having to spend the extra time and money if we can solve it conservatively with PT instead!

Also, next time a doctor tells you that you have arthritis, just wink and show ‘em your deadlift ;-)

Here’s the link to the full article so you can read it yourself: https://link.springer.com/content/pdf/10.1007/s00256-020-03394-z.pdf

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