Pain and the Brain part 2
Pain and performance
I can understand if you glossed over the other parts of this article, it did get a little nerdy and a little dense. However, you’ll want to perk up and take note as we explore how pain can impact performance and why we don’t want to wait to address the problem.
We all know from experience that when something is painful we tend to move differently. The way we walk, how we reach for something and even our posture is altered to avoid pain. These changes occur on a conscious and a subconscious level. Muscle inhibition refers to the idea that a muscles activity is decreased with the presence of pain. It is theorized that this occurs as a protective mechanism to reduce further trauma to an area. Several studies have looked at maximum voluntary contraction in painful muscles and found that output was significantly less then the non-painful muscles on the opposite limb. It has also been noted that when pain is present in a particular region there is an increase in activity of the functional antagonist, or muscle group(s) that produces the opposite action (think relationship of biceps to triceps). This can lead to changes in movement patterns and motor control and trigger a whole set of different issues. If the pain persists long enough muscle atrophy may occur, tolerance to fatigue is decreased and balance/coordination can diminish. The inability to lockout the clean and jerk may not be related to shoulder range of motion but the persistent shoulder pain that is experienced every time the arm is raised overhead, resulting in a weaker and uncoordinated system. How about a muscle-up that becomes significantly more difficult during the transition and dip phase because the triceps are weaker to one side due to elbow pain. Bottom line, pain can lead to poor performance both physically and mentally. Pain has the ability to impact our ability to concentrate, sleep, alter mood and decrease our appetite. All of which will further impact performance. Do you see the dangerous little cycle we can get into when we don’t address pain? A persistent, nagging, unaddressed issue often times wont fix itself and has the ability to quickly snowball into a much larger problem.
The question then becomes, what do we do if we have pain? The answer, it depends. A let down I know, but it is important to remember each experience is fairly unique and all variables need to be taken into consideration to determine the best possible treatment. However, there are several things that we can do to reduce pain and return to optimal performance as quick as possible.
Treatment or at least a consultation as soon as possible. In the acute stages of an injury there is a cascade of events taking place to help protect the injured site as well as assist in recovery. Things such as swelling, redness, bruising, weakness and of course pain are often associated with acute trauma. It is important that we accurately and quickly provide a clinical diagnosis that will start you on an early intervention protocol. Early treatment can make the difference between an ankle sprain that takes seven days or seven weeks to recover from. Connect with a qualified health care professional such as a physical therapist, chiropractor, athletic trainer or coach. If that person is not sure how to manage the condition, they likely have a great network of people that can get you on track and started as quickly as possible.
Consultation whenever possible. Even if you missed that acute phase and cruised through the subacute phase without talking to anyone, you should remember it is never too late to get good quality advice and treatment. Chronic, persistent pain states have a myriad of factors associated with it, but sometimes a few simple suggestions can make all the difference. On the flip side, a quality evaluation can provide you the level of detailed treatment and the self-management tools needed to get you on the road to recovery.
Avoid painful activities or movements. If reaching back into the backseat of your car brings on shoulder pain, don’t do it. Stairs make your knee throb, take the elevator for a little while. The more frequently we stimulate the area the more sensitized it can become. This can lead to elevated pain levels, pain lasting longer then it should and delayed recovery. If a particular lift produces pain modify the technique or find an alternative.
Staying active is true in most cases as long s you are adhering to the concept of avoiding painful activities. The body thrives on movement, so you can stay active and let the painful area of your body get some relative rest. There is no reason why you can’t continue to move and train as long as you are attentive to how it makes your body feel. Refer back to the hurt vs. harm concept. There will be times things won’t feel that great but it doesn’t mean you have done any long lasting trauma to your body.
When in pain, deal with it. Don’t put off taking care of that ache in your shoulder or knee for three or four months only for it to be getting progressively worse. Refer back to the section on chronic pain. Acute pain often is a much easier animal to deal with then a persistent six-month-old problem.
Remember, What you feel isn’t always what you get. Numerous clinicians have done an incredible job getting people to recognize some of the positional and movement issues we see in training. These concepts are also valuable for painful conditions. The fact that your shoulder hurts with overhead squat may have more to do with the poor mobility of your thoracic spine and your hips then with the shoulder itself. So, while you take time to actively rest your shoulder you should get with someone that can give you a good assessment of the mobility problems and strategies to help manage them as well. There is also the possibility that the discomfort you feel is being referred from another area on the body. Medial knee pain can emanate from the hip just the same as an elbow problem can be improved by treating the neck. The site of pain may be the noisy victim while the silent culprit continues to go unidentified.
If you ain’t sleep’n, you ain’t recover’n. This goes without saying but it is very important that you recognize the importance of proper sleep when it comes to recovery. If you are dealing with a particular issue that disrupts your sleep you may need to look at your sleeping position to avoid rolling or laying on that side. Pillows and blankets can be used to place your body into a position of comfort. Certain “soothing” techniques such as the shoulder pendulum or gentle repeated low back extensions might ease your symptoms as well, allowing for a more restful night sleep.
Nutrition and hydration is the cornerstone to anything physical. Regardless of the type of nutritional intake you subscribe to our bodies need to be fed and hydrated to recover. High quality fats, antioxidants, proteins and amino acids are vital for tissue healing. Maintaining proper hydration levels can allow for proper tissue hydration levels and fluid transportation. There are also foods that tend to be considered “inflammatory foods.” Dairy, alcohol, sugar and refined grains can contribute to the inflammatory process and elevated levels of discomfort. Foods such as sweet potatoes, blueberries, kale, cabbage and wild fish fat can help reduce inflammation. For more details regarding dietary recommendations I would suggest you talk with a registered dietician or naturopath that can help direct you on your individual needs.
Pain is not selective to just athletes or someone who sits at a desk. It does however have the power to quickly control our lives. The old adage “No pain, no gain” doesn’t fly anymore and not listening to what our bodies are telling us can only get us into trouble later. Above all else make sure you are taking an active approach to dealing with your condition and working collaboratively with a skilled clinician to help address your individual needs.