Don’t get me wrong, your diagnosis is important. It enables us to find a pathway of where to start the journey towards a more comfortable and less painful endpoint. But this doesn’t pigeonhole us into one particular avenue of movement that we must adhere to or that we must avoid, for fear of damage and danger.
Take note that there are a large number of people out there with terrible looking scans indicating this and that; however very few of them may ever experience persistent pain. There are also people who have no diagnosed pathology present on their scans beyond ‘normal findings’ (terms like disc degeneration, mild disc bulges, etc), who can experience debilitating pain.
Our pathology can allow us to identify a starting point to work to that is comfortable, which we can gradually expand on over time, increasing the boundaries we work within. However, bear in mind that most injuries heal very quickly, usually within a few weeks or months, and that a large amount of chronic pain can persist even though the body has almost completely healed physically.
We can safely say therefore that sometimes our pain can be present as a result of other factors outside of an injury. As mentioned in part 1, our mood and expression can influence the amount of pain that is felt. In addition, some of the experiences, understanding and beliefs of our friends and family can influence our reaction to certain stimuli, resulting in changes to our pain sensation.
At the end of the day, pain is a complex and multi-faceted experience that is affected by multiple influences, far beyond the physical.
Returning to our diagnosis, pathology gives us that starting point. If there has been tissue damage, all we have to do is potentially alter the way in which we move in certain activities for a short period of time, but once our body allows, we can gradually reintroduce these movements quite rapidly. Imaging or getting a scan can sometimes throw out things that don’t actually have anything to do with the pain that we are experiencing. Sometimes the things that show up on scans, could be seen as ‘wrinkles on the inside’, rather than something that is dire and debilitating.
Listen to your body, because between it and us as health professionals, you will be able to tell when it is getting better, and when you can start to progress your movements. Some of these changes might include being able to do a certain movement more comfortably, being able to walk for longer distances without feeling like you have to limp, noticing a reduction in heat around the painful area, or a reduction in the muscle tension. These can all alert you to improvements and a reduction in your body’s sensitisation and previously painful experiences to movements.
Before we go, the most important thing to remember is that we are working through two main principles with exercise and movement for dealing with our persistent pain. These are:
1. Specific Adaptation to Imposed Demand
2. Progressive Overload
That means, what we impose on the body, the body HAS to adapt to; and if we don’t apply gradually increasing levels of effort over a period of time (‘by greasing the groove’), it can be more challenging to see improvements.
Think of a prescription of medication that your General Practitioner has put you onto. It might indicate twice daily application, for the next fourteen days. That is the amount of time that the stimulus of the medication is required to have, to be effective in clearing the particular malady that you were presenting with. Physical exertion is just the same. Too much of a good thing is still too much. However we need to appreciate that not enough of a good thing, cannot be expected to give us improvements.
Your prescription of exercise is specific to you, the response will be specific to the dosage, and as we gradually increase the dose, we should see positive improvements, without negative side effects. Take note, you are not your diagnosis. Even just a little bit of movement can make the difference, regardless of what you may have been told by some specialists, and regardless of what your scan says!