Getting to the root cause

I'm an engineer. I've been tinkering as long as I can remember. It's taught me to think differently. When something is broken, I trace things back to find the root cause. I remember traveling to a remote location for work to help troubleshoot a piece of equipment. I was waiting for some technicians to resolve a problem with a huge motor before I could do my part. The motor wasn't running the way it was supposed to run; it kept turning on and off abruptly. And as I'm sure you can imagine, you don't want a brand new $100k motor starting and stopping on its own every few seconds! They had checked everything and had all but given up. The plan was to replace the motor, but even worse than that, I would have to fly back home and schedule another trip because I couldn't finish the work.

I asked them to take a step back and look at things from a different perspective. Let's assume the brand new motor isn't the problem, but rather a symptom. We began to look at the motor starter and the control system that told the motor to start and stop. We looked at all the sensors that monitor and protect the motor, and started to trace the wires from each of them. Lo and behold, we found a loose wire leading to a $50 relay in a control panel in another room. The wire would sometimes make contact and sometimes not, causing the motor to get the signal to turn on and off. A little wire almost cost us hundreds of thousands of dollars and several months' delay.

I'm glad that engineers are taught to find the root cause of a problem rather than addressing the symptoms. It's a philosophy that isn't as prevalent in our medical industry. It sometimes seems that doctors are more apt to prescribe a pill or recommend surgery to address the symptoms before figuring out the real problem. (Don't believe me? Read Complications: A Surgeon's Notes on an Imperfect Science by Dr. Atul Gawande!)

A few years ago I was diagnosed with plantar fasciitis. If you don't know what it is, it's essentially an inflammation of the fascia (connective tissue) on the bottom of your feet. It was excruciating! You wake up in the morning and you don't want to put your feet on the ground because you know how badly it's going to hurt. My doctor told me I was going to have to get used to the condition and work to mitigate the pain. He recommended that I stretch my feet every morning before I get out of bed. If the pain got really bad, the next step would be a big cumbersome brace that I would have to wear while I sleep to keep my foot flexed. I would have to cut back on the fitness classes I was teaching because he thought the impact was causing the problem. I was facing a lifetime of pain and limited mobility.

Suffice it to say that I didn't like the assessment. My engineering brain couldn't wrap itself around the fact that the stretching and boot were dealing with the symptom; but what was causing the problem? I started doing research and realized that everyone in the medical industry says the same thing. You can find boots and sleeves and wraps and splints... There are books and creams and lotions... Everyone has something to sell you, but everyone will tell you up front: plantar fasciitis can't be cured.

A month or so later, I happened across The Trigger Point Therapy Workbook by Claire Davies. He believes that the overwhelming majority of musculoskeletal conditions are caused by myofascial trigger points (in its simplest form, it's a knot in the middle of a muscle where the muscle fibers have bound themselves up and will not release) and are mis-diagnosed. At the same time, I was speaking with a non-medical colleague who told me that the inflammation was just a symptom that was masking the root cause; in order to find the cause, I would have to slow the inflammation down for a little bit by taking some anti-inflammatories. When the inflammation dissipated, I paid close attention to my body and felt a dull but constant twinge in my calf. I started to perform self-myofascial release on my calf and within two days, the twinge was gone. With it, the excruciating pain disappeared...

That was almost exactly 4 years ago and I have never had a problem with plantar fasciitis since. I have continued to teach group fitness and continued to do all the physical things I love.

What does this have to do with Unsteady State? My takeaway from this was that it's easy to get caught up in the symptoms of a problem. Whether it's a mechanical system, a piece of software, or the human body, those symptoms can sometimes call a lot of attention to themselves. But more often than not, they're just hiding that little loose wire or that trigger point in your calf, and it's up to us to find the cause. It's a way of thinking that is not taught in this world of instantaneous gratification. We're always looking for the magic button and we immediately gravitate towards the big, flashy symptoms.

In case you were wondering, Claire Davies' book actually says that trigger points can cause "referred pain" in places in the body far away from where the actual trigger point lies. The body is an incredible system and everything is inter-related. And trigger points aren't really part of the typical med school curriculum, although they've been documented for about 150 years. That's why doctors commonly mis-diagnose musculoskeletal problems.

Ever had a similar experience? What do you think? Sound off. Join the conversation and let me know what's on your mind...