Two Specialists, Two Opinions

Should you see a second opinion, or fine-tune the first?

Last November, I sustained a mild rotator cuff injury that worsened before I realized what it was. It was diagnosed by a physical therapist that had treated me earlier for a knee issue, with great success. The results were so good that when I injured my shoulder, I went back to the clinic and requested the same PT. Long story short, after a month-long layoff from all exercise but rotator cuff work, I made no progress. I had taken all the necessary steps, but hadn't gotten anywhere.
Last weekend at the Tactical Strength Challenge in Grand Junction, Colorado, the man (another highly regarded PT) who hosted the event took a look at me and asked what my PT had advised me to do. He then advised that I cease doing everything the other had prescribed, and gave me a bunch of different exercises and stretches to work on.

On the one hand, I was thrilled to have new options to try, since tried-and-true wasn't working. On the other hand, I was confused and a little worried that two professionals could have such different opinions. People disagree: it isn't news. They disagree across all disciplines about every subject under the sun. If determined enough, they will continue to disagree no matter how much evidence to the contrary is presented. In fairness, most doctors do recommend "getting a second opinion". But what if the second opinion turns into a third, and so on? How do we without those fancy diplomas know who to depend on, and when to quit listening?

I've made a lot of progress after following the recommendations of the second PT. What does this mean? If the first PT was wrong, why was he wrong? If the second PT also proves to be wrong, what then? I'm afraid that if I ask you what your experiences have been, you'll have similar stories, but I'm going to ask.

If you are injured or sick, hopefully you seek medical advice when appropriate. Doctors are the experts and should be the first ones to advise you, if not the only ones. They have the knowledge, the tools, and the prescription pads. Specialists have paid their dues and you should be able to go to them with confidence, expecting that they know what they're talking about. You don't ask a baker to shoe your horses and you don't ask a blacksmith to do the etching on your fine china. Specialists have specialties. We go to them because they don't have to guess the way we do...right?

Specialist 1: "In my professional opinion, that arm will be just fine."

Specialist 2: "In my professional opinion, we're going to have to
cut that arm off...with a rusty AXE!

Who would you rather see?

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When I was experiencing the "glory" years of Tourette's Syndrome, I came into contact with so many specialists that I was soon begging for mercy. I saw geneticists, neurologists, psychologists and psychiatrists, reflexologists, nutritionists, and a guy named Dr Hansen who told me that if I could envision myself in a special circle for "17 perfect seconds", I'd be cured. It didn't work, but he ensured me that I'd only completed "14 perfect seconds", so I suppose he can't take all the blame.

Maybe this is that "magic circle". Photo by thegarethwiscombe.
He also ate a Cup O' Noodles during my examination and saw nothing strange about it at all. But it's not for me to judge him. He was judged soon enough. Dr. Hansen later went to prison for giving people a "magic bath" that cured cancer.

Later I had high hopes when visiting an eminent geneticist. After a handshake, he asked, in all seriousness: "Josh, are you now, or have you ever at any time, been afraid of using contractions in your words?" "No, I haven't" I said, proving him wrong. And still, he looked at me out of the corner of his eye as if he knew that turning "have not" into "haven't" just then had unhinged me a little bit.

I really hope that genetics study told them something useful, but it didn't amount to much in the way of results. When you're desperate, you're desperate, so you're willing to try anything. If an injury has ever interrupted your training, you know how badly you want to believe your specialists, even the Dr. Hansens. And if he would have told me to stop using contractions, I would've.

My Doctors did a lot of guessing with me, because Tourette's specialists are playing a different sport than most other medical professionals. They are specialists in a field where ongoing research doesn't turn up much of anything new--and since cases vary wildly, what works for Twitchy Guy A. might not work for Twitchy Guy B. So it can be unrealistic to expect the results you want. I did, however, want them to admit they were guessing, which they never did.

Addressing something like a mild rotator cuff problem does not (in my opinion) have the same sort of mystique or margin of error. When I go to a specialist (or two) for help with my shoulder joint, I believe that expectations of answers and relief are realistic, assuming I'm willing to put in the work and do what they say.

For anyone who's ever been diagnosed with an illness or injury, here are two questions I would love to hear your answers to:

  1. At what point do you get a second opinion?
  2. If the second opinion does not help you, will you be less trusting of the third opinion?

Best of luck in all your training goals.

Josh Hanagarne

Josh Hanagarne has an undeniable obsession passion for grip training. When not re-adjusting his bun and telling people to shush, you'll find him over at World's Strongest Librarian. And, of course, on Facebook, Twitter and Google+.

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