RESEARCH YOUR PAIN
We've all experienced pain or injury at some point in our lives but for most, the way it was handled, likely left imprinted thoughts and behaviors that aren't conducive to healing or growth. In this post I’d like to discuss a unique approach that can help shift some of these previously gathered notions into a model of working with pain and injury inside of a movement practice and point to how it can actually be a positive force in upgrading the system.
*A note before moving onward. This is a very reductionistic look at pain from a more mechanical approach related to the physical body, and cannot be accurately parsed out from mental emotional, biochemical, or other aspects that could be contributing to a physical issue of pain. While there are many tools and doorways to work with pain, we are choosing to start with the more obvious and gross layer of the body.
First, a few definitions that may be helpful. We’ll keep this light on anatomical terms and stick with commonly used vocabulary for ease of use.
Injury - the instances of being injured.
Pain - physical suffering caused by illness or injury.
It’s worth noting we can often have pain without being aware of or showing signs for physical injury, but it’s rare to have a known physical injury without pain.
WHAT CAUSES PAIN?
The cause is often not clear. There have been many attempts to understand it and frequent explanations to a blanket cause but there are many factors related to pain that are very much an enigma. The body is a working system of systems, and like all systems, our best bet for improving understanding revolves around patterns, not single inputs.
From a perspective of diagnosing our pain or injury we have to start here, using principles that can help us circle the area and better understand what the possible solutions might be to direct our approach systematically.
From a general sense, pain is related to movement, or a lack of movement, which means in order to remedy, requires a movement solution. This means YOUR nervous system is in charge in bringing about the necessary change to improve the condition. Movement in this case, is the medicine we need for healing to take place.
Regarding a movement practice, and life in general, there are a few truths we DO know about pain and injury.
They are generally pattern specific.
They are unavoidable. We can prepare or be ready for injury all day, but on a long enough timeline both pain and injury are a part of life. We must go into practice understanding this so that our mind is open when something does pop up.
We can’t be completely sure of mechanisms, as this is often the wrong lens. Mechanisms involve single inputs which is too small a frame work to view the vastness and complexity of the body. The treatment of pain and injury are mostly an educated guess based on patterning.
It's generally not from the site of actual pain. Unless you have a trauma to that area, the actual cause of the pain likely stems from somewhere else, which happens to show up in the now painful spot. The most common pathways are above and below the painful areas.
It’s not the “thing or movement” that is bad or that caused the pain. Injury or pain often point to an underlying issue being exposed by the movement. It’s not the movement itself that is the problem.
One persons pain is not another’s. Pain is a relative scale based on many factors that aren’t often universal.
RESEARCH YOUR PAIN
The best tool you can use for your own learning which ultimately provides everything you need to fix yourself is to research your pain issue. By research I don’t just mean a book study of the painful area, but having a deep curiosity around understanding what is at the root cause of the pain, and instead of avoidance, going at it using the tools we’ll discuss below. This may involve an upgrade of anatomical terminology, movement re-patterning, and basic physiological understanding to help you better come at a starting point for healing. Remember, no one thing, movement, or person caused your pain therefore it is your responsibility to figure it out how to prevent and fix it in the future. This learning, like all education, is a process.
Here are a few ways we can research our approach to pain and reorganize the patterns involved:
Start with a hypothesis and generate a few questions around the problem. Let’s look at a scenario related to a right knee issue. You wake up and notice the knee is slightly swollen and restricted upon bending or squatting. You don’t recall any specific acute injury taking place but you did play tennis the day before. You remember that while lunging to strike a forehand there was a small “something” in the right inside knee that felt off, but it didn’t stop you from continuing as there was no lingering pain. Is it possible this triggered an inflammatory process that is now showing up as pain on the inside of the knee?
To begin the process of exploration, it’s the asking of questions that can help troubleshoot the problem area. The best place to start is by asking which patterns feel limited, noting as much detail as you can. In the example of the knee, if the squat and lunge are limited, what degree of range of motion is missing? Take note of both pain on a 1-10 scale as well as your range of motion as this is your new baseline for progress
The next step is to start creating movement around the area affected as often as possible, ideally starting more peripherally and working closer to the actual spot. In the case of the knee, investigating the calf, inner and top of leg, ankles, feet, etc Shaking, soft tissue work, lacrosse ball work -- all bring blood nutrition to allow for the inflammatory response to do it’s magic.
An example of what the process could look like using these tools.
Start with soft tissue work around the area noting points of tenderness. In general you want to move the tissue vs providing direct pressure only in one spot. This will allow all the tissues around the affected area to not only receive increased blood flow but to also slide and move in turn decreasing tension to the painful spot. A general rule of thumb is about 2 minutes in each tender area, breathing into the pain, until you notice the tissue release or relax.
Begin to explore movement possibilities, light mobilization, noting changes in foot position (lifted, inverted, everted etc) and and changes in pain. If the tissue work helped to improve movement, make note of the location and go there often. Find movements that are just below threshold level of pain (see below) and, for the short term, adjust your practice to these accordingly.
Never move past a 4 on the pain scale (1-10). There's an old saying, nerves that fire together, wire together. Being that pain is mechanical --> neurological, the more we move into pain the more these nerves learn to fire together. This applies to our societal norm of no pain, no gain. There are various ways to interpret this, but moving through pain is a good recipe to always be in pain. (as a side note, it also applies to all levels of biology including psychology, nutritionally, etc).
Reduce all factors that promote inflammation that aren’t injury specific. This includes dietary, bio mechanical, general lifestyle. Poor sleep hygiene, overtraining, PUFA's (too many poor-quality fats), poor diet overall, overwork, Alcohol, anxiety, etc. These all perpetuate the inflammation response making healing much more challenging.
SUPPLEMENTAL HELP
There are a number of things that can help decrease the inflammatory response and bring some relief. None of these are panaceas but have some proven results.
Soft tissue work, if available, is crucial. IT WILL NOT FIX YOU. But it will help move things differently so that you can move things differently. ART, FR, MAT or general massage are helpful and even more powerful when combined with dry needle or acupuncture.
Turmeric | Black Pepper | Ginger - multiple studies show to be effective a reducing inflammation. Higher doses are generally recommending (2-5g daily) during the issue.
Topical application - Helichrysum, Wintergreen, Arnica, Black Pepper, CBD, applied topically throughout the day and applied with a hot towel wrap during the night, can be extremely beneficial to reducing swelling and inflammation. For more information on sources or products please send us an email.
Digestive Enzymes - can help reduce inflammation beyond the gut when taken on an empty stomach. This acts in a proteolytic way to dampen an overactive inflammation response.
Pain is a very very broad topic but these are the first layers toward understanding how and why it comes about. As always, we are here to help you with any issues you are having in your practice and to better direct the next steps for management.