Tuesday, June 7, 2011

Some answers for pain

In my experience, I have noticed that a big deterrent for people in working out is pain. If it's the pain they experience post workout, or more concerning, less easy to explain pains that occur during the workout.
I found this very helpful article on one of my favorite web sites, Precision Nutrition. I stole a few key points from that article to share with you.

If this is all too much for you, a basic sum up would say that (pain free) movement is key to health as well as to healing. To work through the pay keep moving, in your pain free zones. 

*Silencing pain signals

In the gym or on the field, if we experience a twinge, we often ignore it until it becomes a scream. The best response to an immediate pain, however, as soon as it happens is:
  1. Stop what we’re doing – whether it’s a muscle cramp or just a twinge.
  2. Reduce speed – recheck.
  3. If there’s still pain, reduce load – recheck.
  4. If there’s still pain, reduce range of motion.
  5. If there’s still pain, do some other movement that incurs no pain.
In each of these tests, the advice is not to stop moving our body but where possible to keep moving the affected body part without pain.  Find a pain-free way to move.

*The importance of movement

Movement is a key signal to our bodies about how well we’re doing. We are designed as “use it or lose it” systems, constantly adapting to what we do (see discussions of Woolf’s Law for bone formation and Davis’ Law for tissue; also see Lederman reference below for reducing scar tissue formation).
Our bodies adapt to the demands — or lack of them — they experience. If we don’t move something for a while, our bodies begin to adapt to support that lack of movement. Unused bone disappears. Unused muscles atrophy.
Our bodies compensate in other ways too, to make up for the lack of mobility. We often get new pain as a result of those compensations. For instance, our joints may swell, or muscles may complain when asked to do work for which they were not designed.
For instance, let’s say you have pain in your right hip. You start favouring your left leg to compensate. While this makes your right hip feel better (sort of), you eventually get pain in your left leg and hip, because you’re suddenly doing much more unbalanced work on the left hand side. Then, maybe your right shoulder starts to hurt, or your neck, because you’re walking around lopsided like a boat with one oar, and it’s pulling on your spine.
Here’s another common example. Your back hurts. So you go to bed. After a few days of lying around, you feel worse. Now your shoulders and neck hurt too. Your hips hurt from the pressure of lying down. Not a great solution!
Thus, immobilizing oneself can create a vicious cycle. Compensating for one painful movement induces other restricted movements.
By staying as mobile as possible, at every joint, without pain, we signal two things.
First, movement says we are still using this part of our body and thus this body part needs resources for healing and growth.
Second, the movement signals themselves can overwhelm a pain signal to say there’s more right than wrong going on in the area: there are more nerves that tell the body how we’re moving than nerves that say there’s something wrong.
Movement nerves (mechanoreceptors) are also easier to turn on than nerves that trip in the presence of noxious stimuli. This receptor ratio is used to great effect when we drop a weight on our thumb and then shake and rub the area and find the pain is reduced, as per the Oh Canada section in All About Dynamic Joint Mobility.

*Moving forward, pain free

  • Pain takes place in the brain. It is an outcome of the cognitive interpretation of multiple signals, from social to physical to neural.
  • Pain is a response to actual or perceived threat to the body’s homeostasis. The same action may be interpreted differently under different circumstances, depending on whether the body thinks it’s a threat.
  • The site of pain does not equal the source of pain.
  • Pain is individual. Our experience of pain can change, depending on who we are, what we’re doing, and the context in which we experience it.
  • Pain is a signal to change; it is not a prescription of what to do or where to go.
  • Pain often directly affects quality of movement. However, one of the worst things we can do in response to pain is either ignore it and keep going (the tough it out, “no pain no gain” response) or respond to it by shutting down movement (the chronic pain vicious circle).
  • Movement that does not cause pain is often an effective path to better function. It both reduces the duration of acute pain and helps to address the intensity or frequency of chronic pain.
  • A movement assessment – especially one that considers somatosensory responses from the integrated visual, vestibular, and proprioceptive systems — can provide insight about movement strategies to help address a particular pain and improve performance.

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