The importance of n=1 for healing tissue degeneration injuries
Here’s your Word of the Week: agnosticism. It’s a fancy word that simply means the truth is unknowable. The term is generally used in a religious context — agnostics believe it is impossible to prove or disprove the existence of a higher power. However, in my experience, agnosticism also applies to health.
Look for example at studies about COVID vaccine effectiveness. A September 2022 study in the Journal of Pediatrics and Child Health said that, according to mathematical modeling, the vaccine prevented worldwide up to 19.8 million deaths. On the other hand, a September 2023 report that studied countries on four continents said that the vaccine failed to save even one life. Furthermore, the report said, surges in all-cause mortality “are synchronous with or immediately preceded by rapid COVID-19-vaccine-booster-dose rollouts.” This paper estimated that through September 2, 2023, 13.5 billion injections killed about 17 million people.
Conflicting studies are nothing new. Dr. John Ioannidis explained in his famous 2005 essay why published research findings are more likely wrong than right. He noted: “There is increasing concern that in modern research, false findings may be the majority or even the vast majority of published research claims.”
There are a variety of reasons why studies on the same topic can yield wildly different results:
- Distinct methodologies, sample sizes, and statistical approaches (i.e., mathematical modeling vs. observed data)
- Different time periods (one month vs. one year)
- Discrepancies in data collection, reporting, accuracy, and the reliability of sources
- Publication and peer review bias/financial interests
Then there’s plain fraud. A 2021 analysis by the British Medical Journal found that at least 20 percent of reported clinical trials never happened. In 2023, researchers used AI for the first time to screen 5,000 medical publications, and determined that between a quarter and a third of the papers were made up or plagiarized.
Given the sorry state of clinical research, I think health agnosticism is the right mindset. I’m also comfortable with not accepting any health doctrines beyond my own reality. In fact, personalized, n=1 care is not just the next frontier in medicine. It’s also the best framework for healing injuries.
When it comes to tissue degeneration due to overuse — dreadful injuries labeled tendinosis or fasciosis — I’m convinced that one breakthrough exercise lies between your -opathy and your relief. For example, for my golfer’s elbow, I spent a year fiddling with FlexBars and grip machines and wrist rotations. Then I landed on Farmer’s Carries, and my pain was gone in a month.
The same concept applies to plantar fasciitis. I’ve heard about people curing their problem with just one session of a Thai foot massage, or by wearing Crocs, or doing only a few days of the couch stretch. You’ll know instantly when something special is happening. For me, my 11-month ordeal with plantar fasciitis vanished after a week of performing the short foot exercise.
While it’s true you always find a misplaced item in the last place you look, that’s because you stop looking for it after you find it. The same rule applies to soft tissue injuries. Work your way down the list of rehab exercises for your pain until you discover the one that heals you.