Exercising with Nagging Pain

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Disclosure: I never work with anyone that is in acute, burning, stinging, sharp, etc. pain. The people that i work with and this post is intended for have either seen a medical professional or they have the dull, annoying, chronic pain. If you are unsure of the severity of your injury, get it checked out. I am not a physical therapist or MD and I will not pretend to be. If you have that nagging tightness or ache that doesn’t require medical intervention but still bothers you then this will help.

At Evolution Sports Performance I work with everyone ages 8 and up. As a result I see a wide variety of people.

With a wide variety of people comes a wide variety of bumps and bruises.

Adults and kids usually display different types of pain and they often are caused in different ways.

I am going to refer to anyone that competes in organized sports as athletes and anyone that works for a living as adults.

The athletes that I see are often in pain due to overuse. Knees, hips, and shoulders are all banged up because they are constantly playing their sport.

There is often a “motivational” quote that says There is no off-season.

That is only true if you would like to have no future success in the sport.

Playing for a school, a city team, and an AAU team is a good way to get athletes injured, not better.

Unfortunately the reality is that athletes are either good or they are not. If they want to get better they need to perfect their skills through training.

They will not get better if they are riding the pine on the most elite, select, team in the upper left quadrant of Plymouth county.

If they are not good, then playing the sport more (while still not being good) does not make sense.

Take the time to do the skill training and learn to play the sport.

This will get them better at the qualities of the sport and reduce overuse greatly. Do not worry about getting noticed, the scouts will find them if they are good enough.

These athletes are not recovering from all of the activity and they do not have the adequate strength to resist injury.

Strength is the most key aspect to sport preparation. You do not get stronger from playing a sport year round. They need to train.

Adults can go through a similar issue. The only difference is that they are not playing sports, they have overuse from everyday life.

Poor posture can beat the crap out of the body. In fact, most injuries can be attributed to poor posture and positioning.

This is evident at work, doing every day activities, and during leisure time.

Training to be stronger and get into proper positions can reduce the effects of pain caused in everyday life. If people are taught how to move correctly then they will move better all of the time.

When someone is having issues with chronic pain there are a few ways to address it with exercise.

1. Address the potential movement flaw

The actual injury is often irrelevant when it comes to dealing with chronic pain. We need to determine which movements are painful and why.

When we look at these movements, something is usually out of place. How we can start to address these things is through a test and retest model.

Do something that should help the situation and then retest it to see if it worked.

The first step would be to roll out the areas above and below the painful joint. This should reduce the tension that other structures are putting on the area.

Next we need to stabilize the painful area. This often includes building total body stiffness and activating the muscles associated with the area.

Once the muscles are activated and stability is achieved we can work on mobilizing the joints that should be mobile. If a back hurts then we can mobilize the T spine and the hips to take some of the pressure off of the back, for example.

trendelenburgs-sign

2. Omit before you add

If we have addressed soft tissue, mobility, and stability then it is time to continue exercises. Most people think that the next step is to start adding things to help.

Someone in back pain might try to start stretching, mobilizing like crazy, and adding in tons of core work. That is all well and good but if you are still deadlifting through pain, then all other efforts are for naught.

The same can be seen in all of the other joints. It is easy to Google rehab exercises for knee, elbow, shoulder, etc. but that does not mean they need to be added.

Take away the painful or potentially hazardous movements before you start adding in everything else.

3. Address technique on everything

See if there are any common denominators during exercise. A person could lack any and all core stability and therefore has no brace during lifts.

Once you teach someone how to brace then they will do it in everyday life and reduce the risk of re-injury.

This is also a good time to teach total body stability in all of the joints. Getting people to get in a stable starting position will lead to success in the lift.

If they start out in a bad spot, it is very unlikely that they will figure it out as they go.

4. Then strengthen the weak areas

fig04_03a

Once the other things are addressed you can now bring up the weaknesses. This is the time to start switching in the beneficial exercises. Do not add, but make the necessary changes.

The person should be able and ready to train once mobility, stability, technique, and exercise selection have been addressed. If the problem still exists, then the strategy did not work.

In summary if you are in pain during exercise you must mobilize the joints that need it, stabilize the rest of the joints, omit painful exercises, and improve technique.

Once these are taken care of the pain should be reduced or even gone and you can then start strengthening weak areas.

In the case of an overuse injury that is not getting any better, it may no longer be chronic pain. Get it looked at by the right person and follow their recovery strategy.