My practice of medicine has much to do with trying to put pieces together of a puzzle. The puzzle being why an injury or pain syndrome occurred, or how to fashion a successful rehabilitation program for a patient. The image below can also stand for all the members of a team gathered to help a patient.
When a patient presents with pain, the Rule of 3 holds reign in establishing why something happened. The Rule of 3, and commonly 4 or 5, stand for the factors that had to exist for a problem to develop, a sort of perfect storm. One simple example is from a patient I saw yesterday. The patient has a tibial stress fracture from running. The injury occurred in clear overuse fashion (Cause #1). The injury, which is to a bone, occurred during a time of low Vitamin D (Cause #2). The runner is a overpronator who had recently prior to the injury switched from Stability shoes to barefoot technology shoes which proper transitioning period or running style changes (probably Causes #3, #4, and #5). By putting these pieces of the puzzle together, the patient was be successfully rehabbed, and the injury will not reoccur.
