9 Things You Should Know About Pain

Most individuals experience and deal with physical pain differently. It helps to better understand the reason why we feel pain to know what it means or could be signaling. This article helps explain the reasons behind feeling pain written by Joseph Brence and published on MoveForwardPT.com. MoveFowardPT.com is an editorial board compromised of physical therapists members from the American Physical Therapy Association. For more questions call us at 619-756-7500!

 

1. Pain is output from the brain. While we used to believe that pain originated within the tissues of our body, we now understand that pain does not exist until the brain determines it does. The brain uses a virtual “road map” to direct an output of pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body, to serve as a defense against possible injury or disease.

2. The degree of injury does not always equal the degree of pain. Research has demonstrated that we all experience pain in individual ways. While some of us experience major injuries with little pain, others experience minor injuries with a lot of pain (think of a paper cut).

3. Despite what diagnostic imaging (MRIs, x-rays, CT scans) shows us, the finding may not be the cause of your pain. A study performed on individuals 60 years or older who had no symptoms of low back pain found that 36% had a herniated disc, 21% had spinal stenosis, and more than 90% had a degenerated or bulging disc, upon diagnostic imaging.

4. Psychological factors, such as depression and anxiety, can make your pain worse. Pain can be influenced by many different factors, such as psychological conditions. A recent study in the Journal of Pain showed that psychological variables that existed prior to a total knee replacement were related to a patient’s experience of long-term pain following the operation.

5. Your social environment may influence your perception of pain. Many patients state their pain increases when they are at work or in a stressful situation. Pain messages can be generated when an individual is in an environment or situation that the brain interprets as unsafe. It is a fundamental form of self-protection.

6. Understanding pain through education may reduce your need for care. A large study conducted with military personnel demonstrated that those who were given a 45-minute educational session about pain sought care for low back pain less than their counterparts.

7. Our brains can be tricked into developing pain in prosthetic limbs. Studies have shown that our brains can be tricked into developing a “referred” sensation in a limb that has been amputated, causing a feeling of pain that seems to come from the prosthetic limb – or from the “phantom” limb. The sensation is generated by the association of the brain’s perception of what the body is from birth (whole and complete) and what it currently is (post-amputation).

8. The ability to determine left from right may be altered when you experience pain. Networks within the brain that assist you in determining left from right can be affected when you experience severe pain. If you have been experiencing pain, and have noticed your sense of direction is a bit off, it may be because a “roadmap” within the brain that details a path to each part of the body may be a bit “smudged.” (This is a term we use to describe a part of the brain’s virtual roadmap that isn’t clear. Imagine spilling ink onto part of a roadmap and then trying to use that map to get to your destination.)

9. There is no way of knowing whether you have a high tolerance for pain or not. Science has yet to determine whether we all experience pain in the same way. While some people claim to have a “high tolerance” for pain, there is no accurate way to measure or compare pain tolerance among individuals. While some tools exist to measure how much force you can resist before experiencing pain, it can’t be determined what your pain “feels like.”

Myths and Misconceptions: Muscle Soreness

Is it good to be sore after workouts? Check out this ACE Fit article to see if you may be over-doing it. Then come see us at San Diego Sports Physical Therapy for some great rehabilitation exercises to get you back on track. 619-756-7500

There is a common misconception that muscle soreness through exercise is inevitable and necessary to see results. For many, soreness acts as an indicator of a great workout. But this is a shortsighted view of exercise benefits and can have detrimental effects in the long run.

To clarify, this is not about the minor muscle stiffness that can be felt the day after a workout. This is about excessive soreness—the kind of soreness that lasts for a few days, has you avoiding stairs and dreading everyday activities such as putting on pants, getting in and out of a car, and even sneezing. Some people actually strive to experience this. And while a little soreness is safe and may motivate even the most sensitive among us, when it crosses the line toward debilitating movement, your body is telling you that you went too far.

The Science
In short, all muscle soreness is a result of microscopic tears that take place through workouts, followed by swelling as part of the repair and rebuilding process. This may sound like a violent way to treat your body, but it is a necessary process to stimulate changes that improve strength and fitness. But how much is enough? To answer this accurately, lets look at the available research and remove any anecdotal biases from the equation.

Cause and Effect
Many people argue in favor of soreness because they have experienced positive results and associate soreness with the results. But soreness does not necessarily equate with a cause and effect for the improvements. In fact, there is no scientific evidence that proves soreness gets better results. While there is a lack of research in this specific area, there is no shortage of research indicating that progressive challenges are responsible for improving fitness. The question then becomes, can we progress effectively without soreness? And the answer is a resounding YES.

Consider world-class athletes. No athlete, after falling short in competition, has ever said, “I should have trained to be more sore.” Yes, athletes do sometimes experience sore muscles from training. But it is neither the purpose nor the target of their training. In fact, workouts are often modified for athletes if they are experiencing excessive soreness. The measuring stick used to track success for an athlete has nothing to do with the level of soreness derived from day-to-day training and everything to do with the longer-term outcome of their training program and competition goals. In fact, too much soreness will negatively impact training and competition.

Overload
To improve fitness, it is true that an “overload” is required. This means you need to apply a challenge that is greater than what your body is accustomed to. However, this “overload” can be applied aggressively or it can be applied gradually. Many assume the more aggressively you overload, the faster you will see results. But the body is more complex than that and pain is its way of telling us to slow down with the overload.

Law of Diminishing Returns
Most improvements follow a basic premise of “the more you put in, the more you’ll get out.” However, there is a tipping point that suggests a certain level of extra work does not yield any additional benefits. In short, it means you are working overtime and not getting paid for it. This can be illustrated through the concept of exercise dosage. Much like medical prescriptions, too high of a dose does not provide additional benefits nor increase the speed of benefits. Additionally, repeated “overdosing” can invite negative consequences. Extreme soreness is often just that—an “overdose” to the body.

Why it is Important to Avoid Muscle Soreness?
The Hot Iron syndrome…
Most kids only need to touch a hot iron once. If you simply don’t like to feel pain, soreness is more likely to be a deterrent to exercise, not a motivator. In fact, it may be a subconscious reason it is so difficult to start up or get back to that first workout after a layoff.

Fitness should make everyday life easier, not harder…
Extreme soreness naturally alters choices for activity outside of workouts. If your weekly leg workout leaves you feeling sore for three days, and you choose escalators over stairs, it defeats the functional purpose of being more fit.

Tighten up those muscles…
This phrase, which is often used to describe a positive outcome, may literally mean “tighten” in this case. Consistent states of soreness can easily reduce range of motion and lead to permanent changes to your movement patterns.

Overtraining and overuse injuries…
Overtraining and overuse injuries take time to develop. Unfortunately, by the time they are noticed, you are too deep to reverse the process quickly. Aiming for and achieving soreness week in and week out is inviting either or both.

Distraction from more important goals of exercise…
Exercise and fitness success needs to have a far more sophisticated evaluation tool than the level of soreness. By aiming for soreness in the short term, we may be ignoring the true measurements of success for exercise, such as fitness, strength, functionality and longevity, among others.

How to Avoid Muscle Soreness and Still Achieve Great Results
Avoiding soreness is not the same as avoiding high intensities. High intensities and maximum effort can be reached through sensible and progressive overloading strategies. You just don’t want to start there. Gradual progressions are very effective and are a far more reasonable and comfortable way to improve fitness and reduce short- and long-term risks. This can be accomplished by understanding your current levels of fitness and strength, and applying small and frequent increases in intensities and volume according to where you are now—not the level you someday hope to reach.

Remember, fitness is built. It is not injected. Build it wisely…

By Christopher McGrath

Chris McGrath, M.S., is the founder of Movement First, a New York City-based, health and fitness education, consulting and training organization. With more than 20 years of fitness and coaching experience, McGrath specializes in a variety of training modalities including sports performance, injury prevention, post-rehabilitation and lifestyle/wellness coaching. McGrath is a Senior Fitness Consultant to the American Council on Exercise and has established himself as an international fitness expert.