Fix Your Elbow Pain & Become a Better Problem Solver (The Upstream/Downstream Approach)

The AT

In October I camped in the backcountry along the Appalachian Trail.

My first time out in the woods since my son was born.

One of my companions is a physical therapist and the other an endocrinologist. As we wandered through the woods, so did our conversation.

As we commonly do, the conversation turned to fitness at one point.

I asked Spencer (the DPT) to help me trouble shoot some elbow pain I was getting when doing rope climbs. Spencer said that patients often find better results treating elbow pain by strengthening their scapula, rather than focusing solely on the elbow itself

This hit me like a ton of bricks. I’ve been preaching the gospel of “Becoming A Supple Leopard” by Kelly Starrett for years, and even wrote about “the upstream, down stream” mental model years ago but here I was doing curls to try to solve my elbow pain. Like a bozo. I should know this…but then again, that’s why I asked the professional.

Becoming a Supple Leopard teaches the reader that if they have pain in a certain area they should treat what is upstream & downstream of that pain. Using my elbow as an example, I can strengthen my scapula & wrist. To address knee pain, focus on strengthening the glutes and ankles

What I love about this mental model is how it transcends treating injuries.

Upstream/Downstream Examples:

  • Elbow pain? Treat wrist & shoulder.
  • Angry customer? What were the expectations set and what service was delivered?
  • Problem with the code your running? What are the inputs and lets revisit the outcomes we’re aiming for.
  • As Epictetus wrote: want to be an Olympian? You need to be willing to stay sober, work hard, and be OK with the opportunity cost down the road.
  • Trying to land a new job? What relationships & skills can you build now – how will your lifestyle have to change after?

This form of problem solving allows you to get to the root cause instead of treating the symptom.

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Walking on the AT