A New Perspective on Pain

I am re-posting one of my favorite articles I wrote from CrossFit Southbay….with some edits/updates because it was a 2-part-er. Enjoy!
photo-27My goal here is to help you gain a new perspective on athletic potential, movement, pain and injury. I avoided putting injury and pain in the title (and wish I could create nicer names to replace them during the rest of the posts) because I know that causes a lot of you to stop reading. But this is not meant just for those with injuries and pain. So please keep reading! I’m going to create different athlete scenarios based on the many athletes that I’ve worked with, in hopes that you can relate to one (or more) of them and improve your health and fitness……because that’s why we all workout right?!I’d like you to keep in mind CrossFit’s definition of health and fitness:”Health can now be concisely and precisely defined as increased work capacity across broad time, modal, and age domains. Work capacity is the ability to perform real physical work as measured by force x distance / time (which is average power). Fitness is this ability in as many domains as possible. And the ability to sustain that fitness throughout your life is a defining measure of health.” – Greg Glassman

Part 1: I Don’t Have Pain

This is usually a good sign, but can also be challenging when trying to convince an athlete that they are doing something wrong. It can be frustrating for the athlete to be told they are doing something wrong and they don’t want to modify anything or lower the weight because they can’t feel that something is wrong. They have no pain. And they continue to increase their weights with movements (which makes them feel they are improving and getting stronger), so why should they lower the weight and waste all this time on correcting form. They hear the coach saying “you may injure yourself” but this usually goes in one ear and out the other until injury actually occurs. So they continue to strengthen the poor movement pattern.

This isn’t the case with all athletes that don’t have pain because a lot of athletes do have good movement patterns. But the other percent with dysfunctional movement are going to be in for some trouble sooner or later. This saying sums it up quite nicely:

“Functional movement is not always pain free, and dysfunctional movement in not always painful.”

Since you don’t always get that pain warning  when you’re moving poorly, some athletes continue moving that way. Whether they are being stubborn or not aware that there is an issue, something is going wrong with their training and they will not be able to sustain this poor movement long enough to reach CrossFit’s definition of health and fitness. Because they will be injured in weeks, months or sometimes it takes years to finally give out. The human body’s pain system is remarkable, but sometimes the pain signal comes too late and injury has already occurred. Especially when you add in the endorphins that are released during the workouts (I’ll explain this more in the next few weeks).

9304719166_fff07e0e92_b

Take home message from part 1

Dysfunctional movement in not always painful, so don’t just use pain as your guide. Listen to your coaches and work on your areas of weakness and poor mobility. Remember those mobility issues are stronger than you. And trying to force through them only creates more poor movement that may not seem to affect your workouts now, but will later on. And we want all of you to be with us FOREVER……or as long as you want to be:)

photo-29

CrossFit Games 2013 Women’s masters 40-45

Part 2: It only hurts after the WODs or when I lay down to sleep at night

“Pain is a lagging indicator” – Dr. Kelly Starrett

Well said. When you feel pain it’s usually too late because injury has already occurred. The tissue has reached it’s threshold and is now yelling at you. And when I talk about pain it’s easy to confuse “pain” with “muscle soreness.” It can be hard to separate the 2, but for the purpose of this post and to make my point “pain” is that throbbing/aching/sharp/stabbing thing you feel that you know is not normal. It just doesn’t feel like muscle soreness. Now that we’ve defined the kind of pain I’m talking about I want to stress that pain is an excellent response that our body has to keep us safe. Without it, we would be a wreck because we wouldn’t be able to perceive anything that’s hot/sharp/etc. so we would continue injuring our body. So pain is not really the problem……it’s how we respond to pain that creates the issue. A lot of time we ignore the pain or accept it, without fixing what’s causing the pain in the first place. Then we become accustomed to the pain and continue to injury ourselves.

photo-28

Here are some ways that people ignore their pain:

  1. “My _______ only hurts after the WODs, not during the workout.” This is still a problem. This means that during the workout there is something that you are doing to your body that it causing pain and it needs to be fixed. Why don’t you feel it during the workout? Because you are so excited and pumped that your pain receptors have been altered so you can keep doing what you’re doing (scientific explanation here). We’ve all heard stories of professional athletes continuing to play on major injuries because their pain has been suppressed, and then it all catches up to them later once their bodies have calmed down from the “competitive high.” Still a problem, so please fix what’s causing the original issue.
  2. “My _______ only hurts when I lay in bed at night.” Similar concept to above in that we can become so stressed and busy throughout the day that our pain is blocked so that we can continue our activities. Then we lie down to go to sleep and start to relax, only to find some obnoxious pain not letting us fall asleep. Yes, there is a possibility it’s the position you’re sleeping in but it’s most likely something that you did during the day.
  3. “My_______ only hurts in the morning.” There is a lot of healing that goes on in the body at night. Which means a lot of scar tissue is created while we are lying in one (or a few) position all night. This causes stiffness in the body which can lead to painful movements in the morning.
  4. “My ________ was hurting, so I rested for a week and now it feels fine so I’m gonna go PR.” The pain you felt may not have been a bad injury and rest may have been just what your body needed. But make sure you find out the original cause of the injury and get it fixed so you don’t compensate in other areas or re-injure something that forces your one week rest into 3 months rest.
photo-25
CrossFit Games 2013 Men’s masters 60 and up

24-hour rule: I’ve seen this in the sporting/physical therapy world and I really like it. If you’re coming back from an injury and trying to see if you’re ready for a workout, try one thing at a time that tests your injury (i.e. air squat after knee surgery). If you don’t have pain/swelling for 24 hours after the exercise you are free to progress and maybe add some weight. Or try another movement. But if you have pain/swelling within 24 hours of the exercise, your body is not ready (or something is going on with your form).

Icing after every WOD: I see a lot of athletes doing this. Most say it’s a preventative thing because they know ______ will hurt after the WOD and when they ice _______ never hurts. I don’t like this rule because you are never able to keep track of what workouts are causing you pain……therefor you can never fix the problem. If something is swollen, ice it. If you have a traumatic injury, ice it. If it truely does hurt, ice it. But don’t make it a habit of icing without fixing the pain.

Take home message:

Pain is a serious sign that something is going wrong in your body. So please take it seriously and fix it. Yes, professional athletes push through pain all the time because it’s their job and they pay for it later. Don’t be that athlete. Your body will thank you for it and you may be able to continue working out just like the superstar masters athletes in the pictures above! Also, I don’t always have all the answers, but I am a physical therapist who knows a lot about CrossFit and is available to help YOU. Don’t let these nagging pains linger long enough to become an injury that puts you out for months/years/forever. Please use me (drmissyalbrecht@gmail.com) or another knowledgeable person to help you get rid of your pain!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s