How do I stay active while dealing with pain?
In our busy society, we do not take time to care for ourselves as much as we should with things like relaxation, getting together with friends, and exercise. When we do get the opportunity to do something important for our well-being like exercise, we often expect our bodies to operate at full capacity and without complaints. This is quite unrealistic and can often lead to aches, pains, and possibly injury. Often when these things show up, we don’t take the time to properly care for them, rather we continue to exercise the way we normally do, and expect the aches and pains or injury to resolve on its own (and sometimes, it does.)
But what if it doesn’t?
This blog post will cover the different views of pain, highlight the contemporary view of pain, as well as discuss how to interpret your pain and work with it.
Training to improve performance is always a matter of balancing enough stress to create physical improvement, but not so much that we cause injury.
3 views of pain:
The Old View of Pain – In the old view, pain meant damage to a body part. It was thought that the body sent a pain signal to the brain informing it of damage. This can lead to a mentality of “always listening to the pain.” We now know that the body actually does not have any pain receptors, nor does have the ability to send pain signals to the brain. Instead we have receptors which tell us about potential harm (nociceptors), but these can’t tell the difference between potential and actual harm.
Sport & Performance View of Pain – This is the “No Pain, No Gain” attitude that is commonly found amongst athletes or die-hard exercisers, and is often accompanied by the belief that “pain should be ignored.” However, training to improve performance it is always a matter of balancing enough stress to create physical improvement, but not so much that we cause injury.
The Modern View of Pain – We now know that pain is an OUTPUT of the brain. It is a behavior modifier, meaning that your body and brain are trying to get your attention! As an OUTPUT of the brain, pain is influenced by all our senses, past experiences, and stress/emotional level, which all reside inherently in the brain. As an example, professional violin players will report pain in their pinky finger at a lower temperature and pressure than the rest of us, demonstrating greater sensitivity as their little finger is vitally important to playing the violin and to them as a whole person (Zamorano et al., 2015).
To put it simply – Pain is complicated! However, this modern view that has emerged from 'Pain Science' demonstrates that “pain should be respected, and can be worked with.”
Pain is good in that it serves a purpose. It is the messenger that gets your attention, BUT it is just the messenger and not the problem. Pain is your brain and body’s assessment of your own health, and it can be influenced by many things. Your pain should be respected, but it can and should be worked with to help you improve. This is the idea of training and being active intelligently!
How to work with pain:
1. Respect your pain
The first question that you need to ask when you are learning to deal with pain is how is it behaving? Is it always there (constant)? Is it only there sometimes (intermittent)?
Constant Pain – Here I mean truly constant, as in the pain never goes away even for a second. There are a few reasons for constant pain, but the one that we are most familiar with is after an acute injury. If you have an acute injury, you will know it. There will have been something you did that led to pain immediately and you will see signs of inflammation such as redness, heat/warmth, swelling, pain, and loss of function.
Intermittent Pain – This is great news! It means that there are some things that are perpetuating the pain and some things that are relieving the pain. This pain can be worked with!
2. Look for redness, heat/warmth, and swelling
If these are all there, this is likely an acute injury and it deserves to be cared for. This is when protection, rest, ice, compression, and elevation, or PRICE, is the thing to do. (link to POLICE post)
3. Determine which things cause your pain, and then minimize these for a short period.
4. Keep pain after activity down (i.e. irritability).
Here are some helpful guidelines to assess your pain with activity, think of it like a traffic light:
Green Light – the activity helps my pain; I should do more of this.
Yellow Light – I feel my pain while I perform the activity, but when I stop it goes back to normal in less than 5 minutes
Red Light – My pain is aggravated by this activity and stays aggravated for more than 30 minutes or I have notable pain the next morning.
Pain does not always mean damage and, while it should be respected, you can work with it if you know how. Hopefully now you know a little more of the “how.” Think of pain as the messenger that the brain and body uses to get your attention. This messenger is meant to change your behavior, so don’t ignore it, work with it!
If you continue to have difficulty or pain, reach out to your physiotherapist. We can help with some hands on treatment, exercise and education to help you get moving better and pain-free again.
By Sean Overin, Physiotherapist