The “perfect” patient – a bodybuilder

In contrast to the morbidly obese child I talked about yesterday, I had the ultimate patient later in the day yesterday – perfect for discussion of a few points.

25-year-old guy with a shoulder problem, big-time weightlifter/bodybuilder, noticed that his one arm just couldn’t do as many reps of dumbbell military presses as his usually-weaker opposite arm.


First off (vital signs being “vital”, after all), his BMI was a terrible reflection of his body composition. He had a BMI of 32.  This is a perfect example of the limitations of measuring BMI, for this guy was nothing but muscle.  Since the BMI is blind to body composition, it appears on paper that he is “obese”, but nothing could be further from the truth. 

Secondly, even in the setting of an apparent injury, he is capable of far more physical strength than any other patient I have on their best days.  Only because he is so “in tune” to his body’s capabilities was he aware that there was indeed a problem.

Finally, he is motivated to fix this on his own; he simply needed advice as to what the problem was and how to go about fixing it.  He did indeed have a problem in the shoulder, something that would respond to either physical therapy/strengthening or possibly an injection.  Presented with the options, he much preferred fixing it by himself with progressive strengthening, so I spelled out a regimen for him to perform in the gym. 

In contrast, the majority of patients I see want the “quick fix”, citing all sorts of excuses as to why they can’t participate in physical therapy or even do the exercises at home on their own.  Athletes don’t want any setbacks in their regimen and are more than willing to accommodate an injury by altering their activity rather than avoiding activity or opting for a “quick fix” which has potential for significant adverse effects.  I knew he wouldn’t accept a recommendation to stop weightlifting until his shoulder felt better – that would be ludicrous to a guy like this who is in the gym every day.

This was certainly a refreshing patient encounter after wanting to beat my head against a wall about the “fat kid” with a neglectful guardian.  I don’t expect everyone to be like this, but I do believe that people need to be more proactive about their health by aiming to fix the underlying problem rather than asking for that “Band-Aid” solution to cover-up their pain. 


One Response to “The “perfect” patient – a bodybuilder”

  1. It is so nice to see people taking their health into their own hands. Instead of complaining about sprains and strains and fatness, a person can take life into their own hands, workout responsibly and then when some kind of injury happens workout around it and get medical help to fix the problem.

    I be with an attitude like this this guy will actually heal his shoulder instead of getting a chronic problem by pushing through the pain.

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