Most of the patients who visit our offices are due to the presence of some type of pain; from different parts of the body, acute or chronic, of greater or lesser intensity, and caused by different circumstances.
When I talk about the causes that led to the presence of pain or other symptoms, many are surprised to hear that most patients come for micro-trauma rather than trauma.
What is a trauma?
Empecemos por lo más fácil y conocido; un trauma es un golpe, caída o impacto de manera directa o indirecta que genera una lesión de distinta gravedad en la zona afectada. En la foto del levantador de pesas, es fácil reconocer el trauma en ese accidente, sufriendo un grave impacto en su columna cervical; y que lógicamente, no habrá sido la única parte de su cuerpo que sufrió ante ese accidente. Cuando ese deportista acudió a la consulta por su trauma, no cabe duda que habrá podido describir lo que sucedió y por qué presentaba dolor cervical, entre otras cosas. Aquel paciente que sufrió un trauma lo sabe, (salvo que haya perdido el conocimiento) y lo puede describir en la consulta. Tienen la suficiente intensidad como para que el paciente lo sienta en el mismo momento que se produce y que lo recuerde al llegar a la consulta.
What is a microtrauma?
On the other hand, those patients exposed to microtraumas, generally do not know it. Microtraumas are those inadequate positions, badly executed movements (they can be sports, work or daily life) or movements performed correctly and repeated an excessive amount of times. Then, in the example in the photo, it is very possible that that patient comes to the consultation for cervical pain or headaches, and that he does not know that it is due to the bad habit of talking on the phone holding it with his shoulder so that he can have both hands free and thus continue working while answering a call.
Micro-traumas are extremely aggressive to our body precisely because we do not identify them; and we do not identify them because they are not aggressive enough in terms of intensity to generate symptoms at the very moment they occur. They have a cumulative effect and will certainly produce symptoms at some point if they are repeated enough.
That is why in the first consultation I asked about what they do at work, how many hours they sit every day, what position they sit in at work, what position they sleep in, what sport or physical activity they do. All these activities have the possibility of being done incorrectly and of gradually generating postural alterations or injuries that in the day to day almost nobody perceives.
Personally I insist with my patients about adopting proper positions when working and performing repetitive movements. It would be useless to make treatments to solve symptoms without identifying and treating the cause that generated them, because that way the problem will reappear in a short time.
In other words, microtraumas are an invisible enemy (for most) that generate lesions little by little until symptoms appear, most commonly pain. To such an extent that they go unnoticed by many patients, that several times I have had to explain to a patient that his symptoms were due to inadequate sitting positions for so many hours a day (for months and years) and that they tell me: “it can’t be, I have always sat like this And that’s why it hurts now! It is a microtrauma, it will not generate symptoms immediately.
We have an advantage over micro-traumas
The advantage we have with microtraumas is that by knowing about them, we can prevent them from ending up with the appearance of symptoms. It is possible to improve positions in the workplace, make the necessary breaks to not end the working day in pain or correct the movements that are made improperly. With traumas, we often do not have the possibility of preventing them.
Mi recomendación es cuidarse en aquellas posiciones que se mantienen durante muchas horas todos los días y en las actividades que se repiten con mucha frecuencia. Ambas deben realizarse de manera correcta para evitar problemas futuros.