The Yass Method
The existing system is failing you and here’s why
The existing method of diagnosing pain is primarily dependent on the use of diagnostic tests such as MRIs and x-rays. The problem with these tests is that positive findings such as herniated discs, stenosis, pinched nerves, meniscal tears, arthritis and rotator cuff tears can be found in almost as many people with no pain as with pain. This suggests that these types of structural abnormalities are simply the result of wear and tear and generally do not emit pain. Conversely, these types of tests are not capable of identifying all possible causes of pain. Certainly, most people would agree that pain can be elicited from a nerve, a bone or a muscle. Diagnostic tests are not capable of identifying muscles in spasm, muscle strains, muscle imbalances or other muscular deficits which can lead muscles to emit pain.
In 2007, the American College of Physicians, recommended MRIs no longer be used to identify the cause of lower back pain because in 85% of cases the cause could not be attributed to a spinal abnormality such as a herniated disc or stenosis or a disease entity. In 2005, Aaron Filler created the MRN (magnetic resonance neurography), a high powered MRI which proved that in 93% of cases of sciatica the cause was the piriformis muscle in the gluteal region (buttocks) impinging on the sciatica nerve; not from any structural abnormality in the lumbar spine.
Most people would agree that when going to a specialist such as an orthopedist, neurologist, rheumatologist or physiatrist that these medical professionals have very isolated understandings of specific systems of the body. Therefore, they are not in a position to identify all potential causes of pain. At best they can try to identify something that they are familiar with and alter their understanding of the symptoms to match this familiar cause. The fact that no medical professional is trained to identify all potential causes of pain should be very concerning to anybody searching for the cause of their pain.
Understanding the Yass Method
1. Symptoms represent causes
It was based on all of this overwhelming evidence that I felt it was impossible for me to treat patients based on existing model of diagnosing the cause of pain. It was for this reason that I felt compelled to create a new method. The Yass method is based on the premise that the body emits symptoms with the intent of trying to help identify the cause of those symptoms. Pain is an indication of a tissue in distress. The goal of diagnostics is to identify which tissue is emitting the pain and resolve the distress of the tissue. Once resolved, there is no reason for a pain signal to be emitted and it simply ceases. It is funny that there is a generally acceptance of this idea when you look at symptoms of systemic disease. If somebody is having pain at the chest and left arm it is immediately perceived to represent the cause of a heart attack. Nobody dismisses these symptoms and says they will wait till their yearly check up to get an EKG. The same can be sad for the symptoms of loss of ability to speak and weakness on one side of the body. These are clear indications of a stroke and again the symptoms are perceived to represent a specific cause. This should present the back drop for how the body works when it comes to pain or other symptoms at the neck, back or extremities.
Each tissue, bone, nerve or muscle present with certain symptoms which when examined allows the person to know which tissue is emitting the symptoms. No diagnostic tests are needed because the symptoms are presenting exactly what is happening in the body. Presentation of where the pain is, what may have brought on the pain, what makes the pain worse or better are all key signals that can help determine which tissue is emitting the pain. Certain types of tests that can be performed by the individual such as range of motion of a joint, muscle testing, flexibility testing, functional testing and palpation (feeling tissues to see which one is emitting the pain) are all components that help provide an understanding of which tissue is emitting the pain. Once determined, the proper course of treatment can be implemented. If the cause is found to be muscular, then the appropriate strength training exercises can be implemented and the muscular cause resolved. If the cause is found to be structural, then surgery can be performed confidently knowing that upon completion of the surgery the pain will be ended.
2. The cause of most pain is lack of strength to perform daily activities
Beyond the understanding of the mechanism of the body which states that the symptoms provided are an attempt by the body to help identify which tissue is emitting the symptoms so the distress of that tissue can be resolved, there must be an understanding of why most people suffer from pain in the first place. This understanding relates to pain that is unrelated to systemic disease such as cancer, kidney stones and alike. This theory relates to symptoms at the neck, back and extremities. This is a theory that I have created to provide an understanding of the mechanism behind why people have pain. Without this understanding then pain seems to be arbitrary and without reason. There is no way to prevent and only a limited ability to address it when it appears. The reason that most people have pain is because we are all trying to perform functional activities during our daily lives. This requires strength in all the appropriate muscles. If the strength is not in all the appropriate muscles then a breakdown will occur and a muscle will strain and emit pain. It could be the initial weakened muscle or the weakened muscle could cause another muscle to breakdown and emit pain. A weakened muscle or imbalance muscle could create a misalignment of the joint surfaces of the joints they pass and support which could lead to pain at a joint. Weakened muscles could lead to breakdowns such as tendinitis, bursitis and swelling in extremities. Muscles can strain and impinge on nerves creating neurological symptoms. The key is that regardless of the symptoms being experienced the cause is still the same; a lack of strength of all the muscles required to perform daily tasks.
The great part of this explanation is that it also provides an understanding of why there are so many people with degenerative aspects to their joints or spine and yet have no pain. This lack of strength of muscles required to perform daily activities can lead to lack of maximal support capacity of joints to take the loads that pass through them during activity. If there is lack of strength or a muscle imbalance between the muscles that support a joint then the joint surfaces can become misaligned. This means that instead of having 100% of the joint surfaces available to take the load, there is less. Since 100% of the load is being taken by less than 100% of the joint surface of a joint, the force is more than the surface can take. This leads to a break down in the cartilage that sits at the ends of the joint surfaces which is specifically designed to take the load that passes through the joint. Eventually there is a breakdown of the joint surface which can lead to arthritic changes and deterioration of the meniscus or cartilage between the bones that make up the joint. In the case of the spine, this lack of full congruency of the joint surfaces can lead to repositioning of the intervertebral discs which can present as bulging or herniated discs, stenosis or pinched nerves. The key to understand is that these variations in structure take years to occur. The progression is so slow that the body doesn’t even recognize it and doesn’t emit pain to identify that the process is occurring. This is why you can find about 70 to 80% of people with absolutely no pain getting MRI findings when performing studies and find them presenting with all forms of these types of structural variations. This is why you should never simply accept an MRI as the indication of the cause of your pain.
In a small number of cases, the symptoms that the body presents will show that the cause of the pain is due to a structural variation. It is in these cases that I completely endorse the use of surgery to resolve the cause of the pain. But recognize it is the symptoms that the body presents which provides the proper understanding of this cause, not an MRI finding.
3. Muscular causes can only be resolved through targeted strength training
Since I have found that in roughly 90% of cases of pain being experienced is muscular based, the next obvious question is what to do about it. The only answer I can provide is to use targeted strength training to resolve the muscular deficit. Since pain is the result of muscle weakness or imbalance, once the weakened muscles have been determined, the only way to change the circumstance is to used targeted strength training to achieve full strength and balance of all muscles responsible for functional activities.
The reason for the phrase “targeted” is because I am pointing out that the goal of the evaluation is to determine which specific muscles are leading to the inability to perform the functional tasks and create the symptoms. It is only these muscles that would need to be strengthened to resolve the symptoms. The idea of general strengthening to resolve symptoms is completely flawed. Once the symptoms have been resolved and full function achieved then certainly a general conditioning routine can be employed to enhance functional capacity to a higher level. My problem with any medical profession what promotes an understanding of how to use strength training to address symptoms doesn’t seem to understand the idea of targeted strength training. I have been told by innumerable patients who saw me after going to other medical practitioners that they were given the same exercises as they saw everybody else doing. They would tell me that if they were doing shoulder exercises they would perform internal and external rotation, they would perform biceps and triceps exercises, they would do quadriceps and hamstring exercises for the legs. This can’t possibly be right. There was also the problem that little to no resistance was utilized. Muscles only get stronger when they are asked to work against progressively increasing resistances. My understanding of how to strengthen muscles is self taught and I have used this understanding for thousands of patients to resolve their pain.
4. You can resolve your own pain
The best part of the Yass Method is that it is simply a blue print for understanding how to interpret the body’s presentation of symptoms. The use of the method can be implemented by anybody. An individual who presents with symptoms simply needs to understand what the symptoms represent. The Yass Method gives you the ability to interpret the symptoms to connect the symptoms to a specific cause. I have provided an understanding of how to use standardized testing procedures to differentiate bone, muscle or nerve as the cause of your symptoms. Right now, the medical establishment does not look at symptoms to help determine the cause of pain and other symptoms. This is why they are failing so miserably. Symptoms are clearly the body’s attempt to help identify a tissue in distress. You can identify the true cause of your pain when you understand how to interpret the symptoms your body presents. You don’t need me, you just need the method.