Lack of fat on the toes causes numbness? – The shit we say

This is most definitely and unequivocally a rant! It’s a rant about the shit we say and what possesses us to say it. Actually, I’m not sure I can answer the second part of that question.

I was listening to the radio the other day and an interview with a contestant from Dancing with the stars NZ. The contestant was talking about the solid amount of dancing he had to do in order to be ready for the show. There were days that he was practicing from 8.15am till 9.30pm at night. He explained that he put a lot of time in over the last couple of weeks. The contestant was happy that he had lost a lot of body weight because of the dancing and good on him! (At this point we have to make some assumptions that this individual is of good health) However he also started to develop numbness in his toes. What I heard next shocked me! The contestant explained that the physiotherapist told him the reason his toes were numb was because he lost so much body fat as a result of the dancing. Therefore he had no fat on his toes and this resulted in his feet becoming numb.

Where on earth does this type of thinking come from, and is there any evidence for this? As my good friend Mike Stewart (@knowpainmike) explains, we have to stop thinking categorically, less of the CHO and consider the PHO and the USE. Look and consider the bigger picture. If you have listened to Mike’s Physio Matters podcast you will get the gist of what I’m talking about.  If not, then you really need to have a listen! Here’s the link.

I don’t understand how an explanation like this is logical for us clinicians to use. If you consider what the contestant had been doing for the last couple of weeks, he was practicing and training hard. Standing and dancing all day (if this is something he is not used to) would be the more logical answer for his numbness. Unless of course I’ve missed that study about the toes being a source of fat accumulation??

Any number of people listening may now attribute numbness in the feet to weight loss because of loss of fat around the toes. Where is the logic? Why do we persist in using explanations that can feed negative beliefs? Especially ones that don’t make any sense?

My take on this would be that if you don’t know then just be honest, say you’re not sure, don’t make up some BS! Then use reflective practice to assist your reasoning the next time.

If we think it through, looking at the bigger picture we could reason that the numbness is more likely from standing, dancing and doing intense work all day, kind of like when you get a numb backside from sitting all day.

Considering the evidence that is surfacing on language use, it is more important that we are aware of what explanation we choose to use, and that we are critically thinking to give well reasoned and reassuring answers to the public. Adam Meakins has written a nice piece about critical thinking here and about just being an arse.

Your comments are always welcome

Thanks for having a read

TNP