When you’re in pain, your natural instinct is to search out and identify what’s going on. More than anything, patients want to know WHY they are in pain so they can do something about it. Makes total sense! You might ask your neighbor who also has back pain, read some WebMD articles, or schedule an appointment with an ortho doc to get an MRI. Not knowing what’s going on leads to anxiety, anxiety leads to ruminating, ruminating leads to…the dark side. Kidding, of course, but in all seriousness, knowing your pain is the first step towards taking control of it. It’s also the first step in the 3 step process we use here at Pack PT to help active adults overcome pain without stopping the activities they love.
Pain is a normal part of being human. If you want to push yourself physically and do hard things, expect to accumulate some nicks and dings along the way. We all have those areas of our body that tend to be “problem areas”. For me, it’s my lower back. For you, it might be your knee, your shoulder, or your hip. The pain you feel is really just information. Information that your body is asking for a change in some way. Interpreting that information is how we use pain education at Pack PT to help you understand how to take care of yourself long term.
In our current medical system, we look to things like MRI and XRay for the understanding of our pain. However, as I address in my article Fighting the Image, the picture rarely tells your full story. Pain is multifactorial and influenced not only by mechanical dysfunction in your muscles, tendons, and joints, but also by how you slept last night, your stress levels at work, training volume and workload, your beliefs and expectations, previous injury history…so many things! Check my article The I3 Model of Pain where we go in depth on how all these seemingly small factors add up to influence your pain experience. We cannot hope to unpack all of those things in a single session, BUT over the course of your treatment at Pack PT, we will help you identify these additional contributing factors and systematically address them, either directly in our work together or by connecting you with the right people outside our office.
I want to share a patient story to highlight the importance of this first step in our process at Pack. I have a patient with chronic back pain who felt “tight” in her hamstrings for years. But if you asked her to bend forward and reach for the floor, she could put her palms down to the ground. Certainly not “tight” by objective standards, but she felt a sensation she interpreted as “tight”. So what did she do for years? Stretch her hamstrings. However, her back pain never improved, she continued to be scared of deadlifts, and almost considered giving up her fitness routine because she didn’t understand what kept flaring her back up.
When she first came to see me, a major part of our evaluation and subsequent treatment plan involved helping her understand what the sensations she was feeling ACTUALLY MEANT for her body. We found that the tightness she felt behind her leg was actually a nerve tension, not true hamstring stiffness. The more she stretched, the more she was irritating her nervous system. We also found that her body didn’t understand how to bend backwards and her spinal extensors and posterior chain were pretty weak. So instead of having her stretch more, our focus was on developing better body awareness and control in extension, more efficient bracing strategies, improving her hip hinging technique, and progressive strengthening of a deadlift. No stretching necessary!
As her pain improved throughout her treatment, I taught her strategies to smartly manage symptoms at home based on HER specific needs. Now she understands that to take care of her body, she needs to extend not flex, bend backwards not forwards, and practice stability and strength on a regular basis instead of more stretching. She finally feels in control of her pain and even though there might be the occasional flare up along the way, she is no longer scared of the pain, she understands what she needs to do in order to calm it down quickly and get back to moving with little to no interruption to her routine.
During your first visit, after we’ve listened to your story and gone through our movement evaluation, we'll walk you through exactly what we found. You’ll leave with a clear picture of what is aggravating your pain and why, what you need to do to take care of yourself, along with a prognosis for how long we expect recovery to take. You’ll know exactly what you need to do at home and how to modify your training in order to set yourself up for long term success.
Our first step in Understanding is what helps us create the proper plan for our second step, Restore. In our next article, we’ll explore what the Restore process is and how we use it to reduce pain, improve the movement based limitations that have led to your pain in the first place, and get you on track to returning to your sport, training, or physical activities with full confidence.
If you’re ready to Understand your pain and develop a plan to get back to the activities you love, we’d love to help you. Schedule a FREE 15 minute phone call with Dr. Matt to get started today!
Questions? Text us at 860-266-6287 or email dr.matt@packperformancept.com.
Matthew Szymanski
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