For this week’s blog, I’m going to walk through a hypothetical scenario that might shed some light on how recovery from many painful injuries can occur. Keep in mind this is hypothetical and doesn’t hold true for all conditions and is not official advice for your specific condition. It’s simply a concept that may compel you to think a little differently about your injury. Please seek out the help of a professional if you’re struggling with an injury.
The following is a hypothetical graph outlining the course of a painful condition that eventually recovers. The area below the hashed line is normal life with no pain. Above the hashed line is when pain is present.
- This is the day to day tasks and demands of life. Laundry, vacuuming, cutting the grass or even going to the gym and lifting weights can fit in this part of the graph. Obviously, there will be some tasks that ‘irritate’ some tissues in some people. Let’s use lower back pain as an example here. Perhaps this person has had some previous episodes of back pain, and they have found that it ‘flares up’ on occasion. In this instance, over the span of a few weeks, the patient has managed to agitate it. Perhaps they have tried a few new exercises at the gym, and now pain is present. As you can see, sometimes there isn’t one real event that causes a painful condition. Sometimes it’s just an accumulation of nagging incidents that a person wasn’t quite ready for. Over time it has made the lower back rather painful. The line in the graph has now crossed the hashed line, and we’re heading toward section B. Perhaps it is worth noting that you don’t even need to have tissue damage to get this line in the painful area of the graph. Sometimes it’s just a sensitization of the nerves in the area and a pain signal is being perpetuated despite the lack of significant damage (but this is probably a larger topic for another blog post).
- In the case of section B on the graph, the patient is now in a frustrating situation in which the pain hasn’t diminished. No matter what they have tried (stretches/exercises/treatment) they are still in pain. In fact, the same day to day easy tasks that they’ve always done with no pain, seemingly ‘flares’ the pain a little and perpetuates the symptoms.
- At this point in the graph, the patient has recognized those individual factors that are perpetuating the injury. Sometimes we compare this to ‘poking a bruise’. Perhaps they are doing some movements, some stretches or even some treatment that is keeping the area sensitized in section B. With section C, the patient has recognized these aggravating variables and has stopped doing those movements or has modified them in a way that doesn’t ‘poke the bruise’. The patient has sufficiently unloaded the tissue, and the symptoms are now co-operating. Keep in mind, that in many cases (not all) there is no change in the structural tissue between area A and C.
- Area D is the area of the graph that some people ignore. This is after the injury, after the pain is gone. How do I increase my capacity so that I may be able to withstand more exercises, movements and day to day tasks in the future and prevent painful aggravations? This is where a professional can really help. A good healthcare professional will help you identify the factors necessary for section C and then offer suggestions and exercises that will help you increase your movement and tissue capacity (as in section D).
As mentioned above, this is just a theoretical concept and may not hold true for every condition. Perhaps it will compel you to re-think your pain and the strategy you have for recovery. Perhaps if your condition has been painful for a very long time, beyond what we would normally expect for the involved structures, then maybe you’re unknowingly perpetuating the pain signal through activities that are aggravating. Sometimes I temporarily recommend to patients to stop stretching, foam rolling or ‘working on their injury’ since it may be the aggravating factor that is perpetuating the pain! Perhaps it’s time to look for some guidance and unload the tissue. Are you struggling with a painful injury? Contact us at Burlington Sports Therapy today at 905-220-7858