Practical tips to reduce pain
Now understanding what pain is and how it protects us is useful, but now I would like to use this information to give some practical tips to reduce pain.
In Part 1 of this blog series we learnt that we need pain to survive, to avoid danger and protect us from injury. However in Part 2 we learnt that the protective response from an injury, such as muscle tightness and weakness can persist long after our tissue has healed. This can lead to pain being present for much longer than needed.
So if your pain has persisted for longer than the usual tissue healing time (around 3-6 months), then it might be useful to read below:
Tips to reduce pain:
Find movements that you feel comfortable with and progress slowly.
We know that pain is the result of our brain feeling as though we’ve pushed our tissue tolerance above a certain threshold (Butler & Moseley, 2013). So it’s firstly important to know where that threshold is at and gradually challenge this over time. For example, if your back gets sore after 10 minutes of continuous walking, start with less. Then you gradually build this up minute by minute until you get to an amount you’re happy with.
Now please understand, you will experience flare ups from time to time. However, it’s important not to worry about this. Unless there has been another injury/trauma (you will generally feel this at the time), these flare ups in pain are just a way of your brain telling you that you need to pull it back a bit. Go back to what was previously comfortable and then progress slowly once more.
Train your brain before you train your body
At times movement may be too much. You may know what types of movement give you pain. Quite often these movements are very similar to the movement that may have created your injury in the first place. So why not start with imagining the movement?
Motor skills studies show that just by imagining movements you can improve them. One in particular showed that basketballers who imagined free throws improved just as much as those that physically performed the task (Richardson, 1967).
Now when it comes to pain it’s important to imagine the movement pain free and in a relaxed state. Sometimes just thinking about an aggravating movement can make you feel anxious. It may bring up emotions that you need to recognise to move on. In this case you may need to relax yourself once more before you return to imagining the movement.
Distraction can be a great way to reduce pain
Our levels of pain are amplified in the brain when we focus on them. It makes sense that when we add other stimuli it gives your brain more to process therefore it decreases the pain stimuli (Schreiber et al, 2014).
Distraction is a great way to do this. Some things to consider while you exercise are listening to music, changing your visual input (closing your eyes or using mirrors), performing cognitive tasks (like crosswords/sudoku), adding balance (standing on one leg or moving on an unstable surface), and changing your environment (try outdoors, indoors or in water).
Find an aerobic exercise that suits you and perform it regularly
Now I understand that sometimes when you’re in pain it’s hard to find an aerobic form of exercise that is tolerable. However, research shows that if you can tolerate it (even if it produces a 6/10 pain level), doing it regularly will reduce your pain. This is because aerobic exercise has been shown to reduce your central immune response via the glial cells (Cobianchi, et al, 2017). People with chronic pain can quite often have a hypersensitive central immune system. When this system is always on it creates an inflammatory response, even when it’s not needed. So when you exercise is down regulates this response, leading to less inflammation and in turn reduces pain.
Choose fun, enjoyable activities with people you love!
Finally, one of my favourite pieces of advice is to find activities and movements you love! Not only will this help you reduce pain, we know that people who have hobbies and activities they enjoy typically live longer (and happier) than those who don’t (Fushiki et al, 2012).
In our brainstem we have certain areas that pick up pleasure and displeasure. Interestingly the area of displeasure is closely associated with areas of the brain that detect and produce pain. The pleasure centre does not have this relationship but is closely related to movement and attraction. So let’s use this to our advantage and find activities you actually want to do. It may even help you stay motivated to doing things that aren’t as pleasurable (such as the homework exercises your exercise physiologist gives you), so long as you can relate it to the activity you love (for me this activity is trail running!).
So there you go. Hopefully I’ve given you some practical ideas to reduce your pain and help you get back to doing the things you love doing. Obviously if you need any help with any of the tips above, we are alway here to help you with your journey free of pain.
Butler, D.S., & Moseley, G.L. (2013). Explain Pain (2nd Ed). Adelaide: Noigroup Publications
Cobianchi, S., Arbat-Plana, A., López-Álvarez, V. M., & Navarro, X. (2017). Neuroprotective Effects of Exercise Treatments After Injury: The Dual Role of Neurotrophic Factors. Current Neuropharmacology, 15(4), 495–518. http://doi.org/10.2174/1570159X14666160330105132
Fushiki, Y., Ohnishi, H., Sakauchi, F., Oura, A., & Mori, M. (2012). Relationship of Hobby Activities With Mortality and Frailty Among Community-Dwelling Elderly Adults: Results of a Follow-up Study in Japan. Journal of Epidemiology, 22(4), 340–347. http://doi.org/10.2188/jea.JE20110057
Richardson, A.. (1967) Mental Practice: A Review & Discussion Parts 1 & 2, Research Quarterly. American Association for Health, Physical Education and Recreation. Volume 38, Issue 1.
Schreiber, K.L., Campbell, C., Martel, M.O., Greenbaum, S., Wasan, A.D., Borsook, D., Jamison, R.N., & Edwards, R.R. (2014) Distraction Analgesia in Chronic Pain Patients: The Impact of Catastrophizing. Anesthesiology;121(6):1292-1301. doi: 10.1097/ALN.0000000000000465.
Golf is one of the most popular pastimes in Australia, and we see a large number of recreational golfers as clients at iNform. One of the greatest things about this sport is that it allows for a broad range of participants from the very young to the very senior, and from active to not so active.
Despite it’s reputation for being an activity of relatively benign physical demand, Golf can place significant amounts of stress on the body, and injury rates can be high among even ‘casual’ of players. This article is the first of a series discussing the most common golfing injuries, and strategies on how to prevent them.
In this piece, we will take a quick look at low back pain in the golfing community.
In a number of clinical studies, low back pain has been reported to be the most common injury amongst golfers (as high as 25% of all injuries in the sport). The news is not all grim however; as there are simple strategies you can employ today to assist in avoiding golf related back pain and they may very well improve your game!
The swing is an explosive movement that takes the spine through a large range of motion, so it is imperative that all golfers ensure they are well prepared for such movements each time they play a round if they aim to prevent back pain.
The first strategy you should take heed of is to ensure you are using an efficient swing technique. Make the valuable investment of taking a couple lessons from your club pro to iron out any biomechanical problems with your swing. This will enable your body to cope with the forces involved in the swing.
The second strategy is to ALWAYS warm-up prior to playing a round. Most golfers get straight out of their car and head to tee-off without employing any measures to prepare their body for movement. A few simple mobility exercises will go a long way here. Speak with your PT or Exercise Physiologist for some ideas.
I’ve included one example (pictured) that our golfing clients at iNform have found very helpful in preparing them on the course, and for keeping their spinal mobility in great shape. Try the Thoracic Rotation exercise below before your next round and see how you feel!
For further advice on improving your Golfing performance and reducing your injury potential contact iNform Health & Fitness on (08) 8431 2111 or at firstname.lastname@example.org
Concepts such as the ‘core’ and ‘core training’ to many people, are like algebra to me. I know of it but have no idea about any of the specifics or what the hell it does in the real world. I hope this article can elucidate what the core is, but I know I may also cloudy the water a little further, which is typically my way.
So what is the core?
The core is basically a ‘team’ of muscles and connective tissue located around the pelvis, lower back and abdominals. The primary functions of this team are:
- To provide stability and protection for the lower back, and the all important spinal cord which is housed inside the spine.
- Connect the lower body to the upper body to allow us to move in the complex, coordinated fashion that we do.
Who are the big players in this team? (more…)
One of my previous blogs, ‘Pain? It’s all in your head’ certainly caused quite a stir. I attribute this mostly to the tabloid-style title I gave it, which may have paled the complexity of our experience of pain. So I thought a little clarification was in order to help broaden our understanding of the physiology of pain, and also how our perception can influence our experience of pain, here goes.
(advertising) only feeds our society’s often skewed perspective on pain. This does nothing to empower us to change, in fact it intentionally intends to disempower us. (more…)
After discussing our last post on spring related aches and pains on radio last week (ABC 891 ‘Drive’ with Grant Cameron – wednesdays at 5.45pm) we’ve been told by a lot of people that they felt challenged to get out and get more active, which is fantastic!
However some of the approaches and concepts that people mentioned have needed a bit of guidance, so here are the top 5 typical fitness misconceptions that we often hear. Hopefully this will help you stay on a better, more informed path towards health and fitness!
- Spot fat reduction – we cannot target a specific body region for fat loss. eg. Situps to reduce abdominal fat. The body burns fat as a result of diatary modifications and/or exercise generally, and not from specific targeted areas. While some areas do lose fat quicker than others, this is hormonally and genetically predetermined. For more information on this check out an earlier post on doing sit ups to get a flat stomach
- Situps to strengthen the lower back – while abdominal strength is crucial for low back strength, the muscles that need to develop are those deep muscles of the abdominal region, typically known as the ‘core’. This does not include the rectus abdominis (RA) (or ‘six-pack muscle). The 6-pack is a superficial power muscle with little endurance and capacity for prolonged spine stability. In addition, the tuypical way of working it, crunches and sit ups, is a repetitive bending of the spine under load. Exactly the same movement that tends to hurt the back in the first place! stay tuned for a future post developing this argument further. In the mean time, if your abdominals need greater strength to protect your spine please see a quality exercise professional for guidance, as this is an area that if worked incorrectly, could hurt more than benefit form badly performed exercises.
- Weights bulk you up -of course doing resistance training (weights) correctly will increase muscle size strength and improve shape. However the progress is at best slow and requires significant effort. The most significant factors determining the speed and amount of muscle growth are the type of training you do, your nutrition, and hormonal levels. This last fact disadvantages females significantly due to their lower levels of testosterone and growth hormone. Interestingly we most often hear this concern from women! Body Buiders adhere to training routines similar to those of professional athletes (and many of them are just that), including 10+hrs in the gym weekly, very strict nutritional plans and hundreds of dollars on nutritional supplements and other ‘aids’. Unless you are willing to subject yourself to such a routine, you are in little danger of bulking up out of control!
- Pushing through pain & exercising when sick – have you ever exercised to ‘sweat out’ an illness/cold? firstly, pain beyond that normally experienced muscle soreness 24-36 hrs post exercise, is often a warning signal of a developing injury. training ‘through’ that will only increase the chances of you developing an injury. We recommend that you stop the activity that causes the pain and see a trusted health professional to rehab that weak ‘link’. We start all of our clients with what we call ‘foundation exercises’, which are designed to improve the function of postural and stabilising muscles and thus strengthen those ‘weak links’. In as far as ‘sweating out’ a cold: we know that long term, exercise improves immune function, but exercise has a short and acute supressing effect on the immune system. Exercise places a large energy demand on the body, which during a sickness, should be directed towards fighting that sickness. Exercise, then, while ill, palces a greater load on an already stressed immune system. the best thing would be to keep fluid intake high, eat a natural and colourful diet, and rest!
- All I have to do is exercise to lose weight – check out a previous post that goes into good depth about this argument/belief. To add to that information it is interesting to note how much exercise actually needs to be performed to ‘burn’ some common indulgences:
- 1 SLICE OF MUD CAKE IS 1200 kj & WILL TAKE YOU
55 MINS OF WALKING TO BURN OFF OR 27 MINS OF MODERATE CARDIO (JOGGING)
- 2 GLASSES OF WINE are 850 kj & WILL TAKE YOU
38.3 MINS OF WALKING TO BURN OFF OR 18.8 MINS OF MODERATE CARDIO (JOGGING)
- 1 GLASS OF BEER IS 570 kj & WILL TAKE YOU
25.9 MINS OF WALKING TO BURN OFF OR 12.7 MINS OF MODERATE CARDIO (JOGGING)
- 1x 55gm CHOC BAR IS 1200 kj & WILL TAKE YOU
54.5 MINS OF WALKING TO BURN OFF OR 26.7 MINS OF MODERATE CARDIO (JOGGING)
- 1 50gm PACKET OF CRISPS IS 1100 kj & WILL TAKE YOU
50 MINS OF WALKING TO BURN OFF OR 24.4 MINS OF MODERATE CARDIO (JOGGING)
hmmm, food for thought!