VOL. 12 · JULY 25, 2026

Coffee first lads. And it's time to stop being afraid of the imaging you get.

THE RESEARCH — Your Scan Found Something. That Doesn't Mean It's the Problem.

Two things are guaranteed in this world:

1) The Cowboys will have an elite season and blow it in the playoffs (which is BEAUTIFUL to see). Go Pats.
2) Men will have back pain, get some kind of imaging, usually an X-ray or an MRI, and get a report stuffed with frightening words they can barely pronounce: degeneration, disc bulge, protrusion, spondylosis, facet arthropathy.

By the time they get to me, they're treating their spine like it's made of glass. They've stopped lifting. They avoid bending or twisting. They walk around genuinely believing they are fragile.

Here's the big problem.

Most of what they're seeing on those images is completely normal.

In 2015, the Mayo Clinic pooled 33 studies covering 3,110 people with no back pain at all — completely symptom-free. Among those pain-free people, disc degeneration showed up in 37% of 20-year-olds and 96% of 80-year-olds. Disc bulges: 30% at age 20, rising to 84% by 80. Protrusions and annular fissures were common too, and every one of those findings climbed steadily with age.

Think of most of those scary words like wrinkles. Nobody looks in the mirror at fifty, sees crow's feet, and concludes something is wrong with them. That's just a face that has been used, smiled, and aged. Same story on your spine. These findings are so widespread in people who feel completely fine that they're better understood as normal signs of a life lived in a body — not a diagnosis.

Now, I'm not being hyperbolic here and telling you imaging is useless. It isn't. It's genuinely helpful, and a companion analysis by the same group found these changes are somewhat more common in people who do have pain. Imaging is a companion to what's happening — it is not the whole thing, and it is not the thing at all times. So the findings aren't meaningless. They're just not the definition of who you are.

Both things are true at once: plenty of pain-free people have scary scans, and plenty of people in real pain have clean ones. The picture and the pain simply don't track as tightly as everyone assumes.

Why? Because pain isn't a direct readout of tissue damage. It's produced by your nervous system's assessment of threat — and a fearful label on a radiology report can crank that threat up all by itself, adding guarding, stiffness, and disability that the tissue never required.

(I devoted an entire chapter of The Heroic Man to understanding pain — how it actually works and why it isn't a damage meter. If this is hitting home, that's the place to go dig in.)

The takeaway: Your scan is a snapshot of your tissues' mileage. It is not a verdict on your capacity or your future. Most everyday back pain improves with movement, gradual loading, and time. Don't let a noun on a report convince you you're fragile.

(One honest exception: certain warning signs — pain with fever, unexplained weight loss, loss of bowel or bladder control, progressive weakness, trauma — are not in this conversation and need prompt medical evaluation. This is about ordinary mechanical pain, not red flags.)

Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811–816. PMID: 25430861.

WORTH REMEMBERING

This week I'm pulling from my own journal — an entry from July 21st that I re-read right before sitting down to write this Standard.

It still gets me how often I go looking for good words or a little wisdom and end up right back in my own notebooks. Not because I'm wise or special. But because when you honestly put your thoughts down on paper, something good almost always comes out of it.

TRY THIS WEEK

Start journaling every morning, before the day gets going.

It doesn't have to be much. Write something down that you're grateful for, and one thing that happened the day before.

That's it. Thirty seconds, maybe a minute. But do it every day and you start building the habit, and I'd put journaling near the top of the list of the most beneficial things you will ever do for yourself.

FROM THE BOOKSHELF

The Odyssey — Homer

Christopher Nolan's adaptation landed in theaters last week, and the takes are already polarized. Some of it is true to the book. Some of it certainly isn't. Plenty of people are going to complain about the changes, and plenty more are going to politicize the whole thing.

Here's what I'd rather see happen. This is a rare opportunity for a whole lot of people who have never touched the original to go read it. Whatever your position on the movie, if it pushes men to pick up the actual text, it will have done something genuinely good.

Because the book is one of the most incredible pieces of literature ever created — a man clawing his way home over ten years, losing nearly everything, refusing to stop. It has been one of my favorites for a long time. Go read it.

CLOSING THOUGHT

I've watched strong men get talked into fragility by a single piece of paper. Told their back was "degenerating," they started living smaller — lifting nothing, bending for nothing, slowly becoming the weak thing the report implied (or their doctor convinced them of).

That's how it actually works. Fear leads to avoidance, avoidance leads to catastrophizing, and before long a man has built a life around protecting himself from a word on a page. I've seen it wreck people's ability to simply exist — to play with their kids, to work, to go do the things they love.

So hear this: you are not your report. Your body is remarkably adaptable, and it responds to demand.

You are not fragile.

Is pain difficult? Absolutely. It's real, and it's part of being human — nobody gets out of here without it. But there's a world of difference between a man managing his pain and a man being managed by it. What matters most is that you're the one in control, rather than being controlled by what a little piece of paper says about you.

See you next Saturday — adios July.