Blog #3 What to do when it hurts.
So something hurts. What now? Who do I go to, where do I go, do I go anywhere at all or do I try to fix it myself, do I take anything for it, do I stretch or strengthen or rest? How will I work, how will I play, what will become of me?
There are as many answers to these questions as people with pain to ask them. But perhaps the best place to start is to ask whether you need medical help. I would say that you need to ask:
1.How severe is the injury/pain
2. How long have you had it?
3. Have you had it before and how long did it last?
4. Is there anything you can do or take to alleviate the pain?
Unusual, recurring pain/injury, chronic pain, severe intensity, significant lack of function, all these suggest that you need medical help. At the least, you need to determine whether or not you have a broken bone, a sprain or serious strain or any other structural problem that might require attention and treatment. X-Rays, MRI's, hands on diagnosis, all are important tools for determining if you need more than a functional approach to treating/training/managing an injury or pain.
If you come to me with a broken leg, I can't fix it. That's structure. The best I can do is refer you to an MD or Physical Therapist.
If you've already been to a doctor(s) and the pain is still there, then it may be at least partially a functional issue. Then I can design workout routines that are designed to restore balance to your muscles (so one hamstring is equal in strength/flexibility to the other, for instance), open up cramped and immobile joints, increase the responsiveness and decrease the reaction time of specific movements, and find an easier sense of balance while moving.
All of that will help increase functionality and decrease pain, even if there are structural problems. A bad ankle sprain, for instance, can leave you with foot pain long after the ligaments have healed. This may stem from movement compensations (like limping) that have left the foot/ankle muscles weak and tight from musclular atrophy. And the compensations may move up the chain of muscles to the hip (leaving you with lower back pain, sciatica pain, etc), and from there to the upper body and neck.
These compensations do not take long to take hold. A few weeks of limping is likely to create permanent changes in your muscle recruitment patterns - those patterns are the marching orders from the nervous system to the muscles (myo-) and connective tissue (-fascia). It takes very specific and detailed workout plans to address these new patterns and to re-educate the myofascia sothat the body moves in a more biomechanically correct fashion. This in turn will decrease the wear and tear on the other tissues.
All of this re-education and conditioning is best started before the injury, as prevention. But after the injury, you still need to address these issues. If you don't, the ankle sprain or the low back injury, the whiplash or fall on the ice will stay with you in one form or another for a very long time and may morph into any of a long list of chronic pains or reinjuries.
So to sum it all up:
1. Start with prevention. strengthening, stretching, movement skills.
2. In case of injury, see your doctor to rule out structural damage
3. Arrange for PT or some sort of MD-approved rehab if structurally injured.
4. After rehab, do post-rehab - continue to re-educate the myofascia to address thoise compensatory changes. Strengthen and stretch to hasten the full recovery of the whole body. The ankles aren't the only affected regions in an ankle sprain. The lower back pain after a fall is not the only part of your body injured. Your body is a whole and cannot be treated as if it's a collection of isolated pieces in a jigsaw puzzle.
The tools of the pain trade include Pilates equipment, other exercise equipment like dumbells, medicine balls and other traditional gym fitness equipment, plus bodywork modalities like FST and MAT (see the main website for definitions here). It's up to you to go online or make some calls to find a personal trainer with the certifications and training to bring this strategy to life. The field is growing all the time and the fitness trainers are out there. I highly recommend you get the help you need to re-educate and re-condition your own personal compensations.
My next blog will address the issue of how to find help and what is the proper training and background for your fitness trainer.
Good luck in your search!