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.”

Pronation

It is important to understand pronation and the way your foot moves when you run. Some people pronate more or less when they run. Learn about normal pronation, overpronation and underpronation, and how you can prevent injuries in this article published on Runnersworld.com. For more questions, call or visit our studio at 619-756-7500!

 

 

Pronation

Pronation is the inward movement of the foot as it rolls to distribute the force of impact of the ground as you run. The foot “rolls” inward about fifteen percent, comes in complete contact with the ground, and can support your body weight without any problem. Pronation is critical to proper shock absorption, and it helps you push off evenly from the front of the foot.

Although pronation is a natural movement of the foot, the size of the runner’s arch can affect its ability to roll, causing either supination (underpronation) or overpronation. If you have a normal arch, you’re likely a normal pronator, meaning you’ll do best in a stability shoe that offers moderate pronation control. Runners with flat feet normally overpronate, so they do well in a motion-control shoe that controls pronation. High-arched runners typically underpronate, so they do best in a neutral-cushioned shoe that encourages a more natural foot motion.

 

Normal Pronation

IThe outside part of the heel makes initial contact with the ground. The foot “rolls” inward about fifteen percent, comes in complete contact with the ground, and can support your body weight without any problem. The rolling in of the foot optimally distributes the forces of impact. This movement is called “pronation,” and it’s critical to proper shock absorption. At the end of the gait cycle, you push off evenly from the front of the foot.

Runner’s World Video: Normal Pronation

Normal Pronation: What is it?

We show you, in slow motion detail, how to determine if you have this gait pattern.

 

Overpronation

As with the “normal pronation” sequence, the outside of the heel makes the initial ground contact. However, the foot rolls inward more than the ideal fifteen percent, which is called “overpronation.” This means the foot and ankle have problems stabilizing the body, and shock isn’t absorbed as efficiently. At the end of the gait cycle, the front of the foot pushes off the ground using mainly the big toe and second toe, which then must do all the work.
Preventing Overpronation Injuries 
Overpronation causes extra stress and tightness to the muscles, so do a little extra stretching. Too much motion of the foot can cause calluses, bunions, runner’s knee, plantar fasciitis, and Achilles tendinitis.
If you’re an overpronator, here are a few tips to help you find the right shoes for your feet.
  • Wear shoes with straight or semi-curved lasts
  • Look for motion-control or stability shoes with firm, multidensity midsoles and external control features that limit pronation
  • Use over-the-counter orthotics or arch supports

 

Runner’s World Video: Overpronation

Overpronation: What is it?

We show you, in slow motion detail, how to tell if you have this gait pattern.

 

Underpronation (Supination)

Underpronation (or supination) is the insufficient inward roll of the foot after landing. Again, the outside of the heel makes initial contact with the ground. But the inward movement of the foot occurs at less than fifteen percent (i.e., there is less rolling in than for those with normal or flat feet). Consequently, forces of impact are concentrated on a smaller area of the foot (the outside part), and are not distributed as efficiently. In the push-off phase, most of the work is done by the smaller toes on the outside of the foot.
This places extra stress on the foot, which can lead to iliotibial band syndrome, Achilles tendinitis, and plantar fasciitis. Underpronating will cause the outer edge of running shoes to wear sooner. To see if your shoes are unevenly worn, place them on a flat surface. If they tilt outward, supination is the culprit. Runners with high arches and tight Achilles tendons tend to be supinators.
Preventing Underpronation Injuries 
Supinators should do extra stretching for the calves, hamstrings, quads, and iliotibial band. Wearing the right type of running shoes and replacing worn shoes will also help avoid injuries.
If you’re an underpronator, here are a few tips to help you find the right shoes for your feet.
  • Wear shoes with curved lasts to allow pronation
  • Look for lightweight trainers as they allow more foot motion
  • Check for flexibility on the medial (inner) side of the shoe

Reducing Workplace Stress

Times can be tough and stressful, especially during the holiday season. Things pile up, but don’t fret! Here are some ways to manage your stress at work from ACE Fitness.

Do you have a demanding boss or difficult co-workers? Stacks of work to get done and not enough time? Everyone encounters job stress sooner or later — but that doesn’t make it easier. There are many aspects of your work environment that you have no control over — but you can take action to manage stress so that work doesn’t take a toll on your well-being.

Stress Matters

Workplace stress has been linked to serious health problems — including heart attack. Your body releases greater amounts of the hormone cortisol in response to stress — stimulating an increased appetite for high-fat, high-sugar foods, and increasing fat storage in the abdomen. A study of workers coping with corporate restructuring and layoffs revealed that chronic job stress led to weight gain. Not surprisingly, consumption of high-fat, high-calorie vending machine snacks went way up during the most stressful periods. Research also shows that intense job stress is an independent risk factor for high blood pressure at work, home, and even while sleeping.

Work Mindfully

Mindfulness is a way of zeroing in on the here and now instead of ruminating over the past, mulling over the future, or doing several things at once. Give your full attention to the task at hand, whether it’s a call, a meeting, or a project. Scrolling through your messages while on a phone conference may feel productive — but in the long run, multitasking will only add to your stress and drain your energy.

Be Nice

Get to know your co-workers by asking about their weekends, inviting their opinions, and eating lunch together. Collegial co-worker relationships make the workplace more pleasant for everyone —and studies even show that a positive outlook is contagious. Offer genuine compliments. Smile frequently — it’ll boost your mood and encourage those around you to lighten up.

Communicate Well

Miscommunication is the root of many workplace conflicts. Clarify details and expectations for every job task. Check for understanding if you’re the one dishing out assignments.

Annoying co-workers are best dealt with immediately and directly — or the behavior may get worse. If your co-worker distracts you with loud, lengthy personal calls, talk with her privately instead of just getting frustrated. If it continues, speak with your manager.

Shake It Off

You can let yourself get wound up and upset about things that happen at work — or you can respond differently. Instead of stewing about a project that was dumped on you, could you view it as an opportunity to showcase your skills, talent, and teamwork — or speak with your supervisor? Instead of letting one grumpy customer get you down, can you focus on the 50 grateful customers you helped today? Take a few full, deep breaths to clear your mind and proceed down a more positive path.

Practice Smart Self-Care

Regular exercise and good nutrition — along with time for fun and relaxation —boosts your ability to cope with stress. And when you’re well-rested, stressors are more manageable. Consider taking a walk at break time, or meeting a friend for lunch. Learn relaxation breathing and stretching exercises to do at your desk. Choose high-energy, nutritious foods for meals and snacks. Cultivate a healthy sense of humor; look for the laughable moments in everyday life at work.

Get Help

If your best efforts don’t reduce your stress and talking with your manager doesn’t help, seek advice from your human resources department or employee relations representative. Some employers offer employee assistance programs (EAP) that provide confidential, 24/7 phone consultation with professional counselors for personal matters and workplace issues. If your employer offers this benefit, don’t hesitate to use it.

Make a Change

Life is too short to spend it in a toxic workplace — and living with chronic stress isn’t a long-term solution. No job is stress-free, but if your current job isn’t a good match for your interests, talents, and goals, create a plan to move on. Paint a realistic picture of your dream job by talking with others in your desired line of work before you make the leap.

Additional Resources

The American Institute of Stress Job Stress Self-Test

UCLA Mindful Awareness Research Center Mindful Meditations

University of Pittsburgh Medical Center -Stress Coping: Relaxation Techniques

References:

Clays, Els Leynen, Francoise De Bacquer, Dirk Kornitzer, Marcel Kittel, France Karasek, Robert PhD; De Backer, Guy, High job strain and ambulatory blood pressure in middle-aged men and women from the Belgian job stress study, JOEM April 2007, Vol. 49, Issue 4, pp.360-367. Abstract.http://journals.lww.com/joem/Abstract/2007/04000/High_Job_Strain_and_Ambulatory_Blood_Pressure_in.5.aspx

Fowler J, Christaki, J, Dynamic spread of happiness in al arge social network, BMJ 2008; 337(2338), posted 12/16/2008, retrieved May 18, 2008 from: http://www.medscape.com/viewarticle/584834

Maglione-Garves, C, Kravitz, L, Schneider, S, Cortisol connection: tips on managing stress and weight, retrieved May 18, 2010 from: http://www.unm.edu/~lkravitz/Article%20folder/stresscortisol.html

Nauert, R, Workplace stress linked to obesity, retrieved on May 18, 2010 from: http://psychcentral.com/news/2010/03/25/workplace-stress-linked-to-obesity/12382.html

Fernandez, I, Su, H, Winter, P, Liang, H, Association of workplace chronic and acute stressors with employee weight status: data from worksites in turmoil, JOEM, Jan 2010, v.52, Issue 1S, pp. S34-S41.Abstract. http://journals.lww.com/joem/Abstract/2010/01001/Association_of_Workplace_Chronic_and_Acute.7.aspx