Have you ever had pain somewhere, let’s say your shoulder, and you take a few weeks off of any exercises or movements that may irritate it (pull ups or snatches). But when you get back to those movements weeks later, you find that it is still painful? You are not alone.
Long gone are the days of R.I.C.E. (rest, ice, compression, elevation). For acute (new, traumatic) injuries there is still an indication for this but past the initial injury, this is not a solid plan.
Many of the active individuals that come through the door can see an improvement in their pain with movement coaching and graded exposure to the irritating movement.
Is your pain a lingering issue? Does it increase with certain activities? Contact a physio or movement specialist who understands your sport/training and its demands!
The initial area to focus when you have pain with movement is HOW you are moving. Find a provider that watches you perform the painful/sore movements. If your shoulder only hurts when you snatch, well let’s see it! I can’t tell you how many times runners will come through the door who have been going to PT or chiro for months because of pain with running and NO ONE watched them run.
Perhaps your movement could be cleaned up or you could be offered different strategies for completing the task. There is rarely one way to do something, but often we don’t realize this because we have our favorite way.
Unfortunately, you may have been told “if ____ hurts then stop doing it!” It would make sense for something like banging your head into the wall. But if running is your mental outlet, your social circle and your favorite hobby, should you stop doing it because your hip hurts? No.
Rather, we first address movement. Can we change how you move to decrease pain?
Then, how can we keep you running but decrease the load while addressing the pain you are feeling?
Graded exposure! That means we progressively introduce threatening or previously painful movements to increase tolerance and resilience in that position or movement.
In theory it seems so obvious but folks can struggle to put this into practice. This is the key to increasing your strength, comfort and resilience in a position. Perfect example: back pain and deadlifts.
Jack has back pain after heavy 2x3 deadlifts at the gym. He takes some time off from deadlifts then works his way back up to heavy lifts a few weeks later. When programming comes back to 2x3, he is anxious but tries the deadlifts. His back is sore again, he is bummed. “It’s probably the deadlifts” fault. Wait 3 months and repeat……
So common! Many people will repeat this cycle with deadlifts, box jumps, running, yoga, you name it.
More appropriate- How is Jack moving? Is Jack strong in a hinge position (deadlift)? Is Jack strong when his hinge position isn’t perfect?
In this case we should practice other hinging movements and not-so-perfect hinging movements to make him resilient when deadlifts get heavy. This leads to tissue adaptation so the body is used to higher loads. It also leads to nervous system adaptations to decrease the SOS signals sent to the brain when a deadlift gets heavy.
Summary- don’t just REST, makes some changes in your movement and training!
- RICE (rest, ice, compression, elevation) has little value after the first 24-48 hours of an injury.
- Resting or avoiding a specific motion because it causes you pain is not usually all it takes to feel better.
- Find a movement specialist (PT like me!), address how you are moving and work back with graded exposure.
- Have questions about how to address your nagging pain and get back to your favorite activity? Send an email to info@SpectrumPerformance.fit and let’s schedule some time to chat about your goals!
Thanks for reading!
Dr. Jackie, DPT