Sorry I've been away for a bit, but I'm happy to be back after a great Christmas and New Years
with my wife, girls, and family. My youngest celebrated her first Christmas with her cousin also celebrating her first Christmas. So, anyway, the Active Tallahassee Blog is back and this week with the question of which exercise or movement is best for pain. This is a question that I'm often asked and like most other questions around pain and movement it starts with a big...It depends. And I'm going to let you in on a secret...just as there are many "wrong" answers, there are also many "right" answers.
So, how do you figure out which one is which?
Should you stretch it, strengthen it, stabilize it and what do any of those things mean?
First, let's refresh what it means when we're in pain, for the more detailed versions click here, here, and here. So...what is pain anyway? Pain happens when your body senses something dangerous is happening. It is your body's way of protecting you. Let's say you rolled your ankle, you'd want to know about it right? Your nerves send a message saying "something dangerous just happened on the outside of your ankle". This then travels up to your brain for its attention and decision on whether or not this is really dangerous. Then, get this, the brain decides whether or not you are in pain(which is NOT to say that pain is in your head...but more on that in a bit). Now we can all agree that when we roll our ankle it hurts, right? But what about if I roll it stepping off a curb into the street and there is a bus there...I can suddenly run on a rolled ankle because, remember the brain...that bus is now more dangerous than the ankle and it says run...it now no longer cares what the ankle is saying to it. It can deal with that later. And it is that "Later" that everybody who is in pain is dealing with.
Do I Stretch, Stabilize, or Strengthen?
Great question, here is how to think about this question after an injury. Let's take low back pain as an example. Does the pain go up and down(even just a little). Is it agony to get up from a chair but it eases if I walk a little bit(or the other way around...is it agony to walk but calms down when I sit)? Then hooray! There is something you can do about the pain and limitation. If I'm better after getting up and walking then my back may like being taken into a bit more of a back bend. For how to treat your back, you can find download your free guide here. This is more of the "Loading" or "Reset" your pain alarm strategy. This type of strategy works great mostly when you are missing motion(knee, shoulder, neck, headaches, and TMJ pain).
What about if it is your knee that hurts when you walk, run, or go to the gym? Now we might be
looking at the "Stabilize" category, like in the gallery to the left here for hip stabilization, because the knee is a joint that loves stability and gets angry
when it doesn't have it. The knee is at the mercy of the ankles and hip and it is to those that I look to stabilize when there is knee pain with activity, especially knee pain on the inside of the knee or around the kneecap.
Time to Strengthen?
Whether you have been in pain for years or have pain when you go above a certain activity level or weight lifted, the jury is in...Strength is one of the top things you can do to prevent injuries, improve life, and improve performance. After resetting and stabilizing, all my patients are encouraged to improve strength because that is what is going to serve them best in the long run. What strengthening? The more functional the better(and the fewer machines the better too). See the post later this week for my top 5 functional exercises.
Thanks for reading.
-Dr. Brandon