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Healing By “The Rules”
By Scott Kelly
ATC, LMT, CHEK III, HLC III, CSCS
What happens when that nagging hip, back or knee pain strikes again when you’re are out on a ride, hike or skiing on a fantastic powder day? Or when chronic neck and upper back pain re-visits you like a bad house guest. For most, the solution is to take a few ibuprofen and continue the day. Unfortunately, this temporary pain relief method often leads to further injury to the joint and soft tissue as well as harms to the stomach, liver and kidneys from overuse of pain medications.
If you want to heal, you must heal by “The Rules”. I would like to offer you just a few guidelines to get rid of the chronic pain you may experience and help you to become stronger and healthier than ever.
Here are “The Rules:"
- Listen to your body it will never lie to you. Extensive studies have shown that pain is not a nutritional deficiency of ibuprofen.
- Have a proper comprehensive assessment done of your whole health including your injury.
- Remove “trigger points” and hyper-constrictions of the soft tissue (muscle, tendons, ligaments, organs)
- Re-establish proper range of motion, movement patterns and biomechanics
- Rebuild the strength with properly programmed exercise
- Build endurance.
Following the rules of healing is essential in preventing injuries, ending chronic pain patterns and the endless search for someone who can help you. Let’s take a look at each rule so that you can feel better than ever.
- Listen to your body- Your body is a brilliant system of systems always doing it’s very best to stay in balance. This is very important to remember as many people walk around believing that their body has it out for them. Your body is busier than the largest and most complex computers in the world. When you experience pain, it is a message from your body to you that something is out of balance and it needs your assistance. Ignoring the message from your body generally leads to further injury to the body, and the development of other aches and pains. Here is a common exchange in my office:
Scott: How can I help you?
Client: My back and knees bother me, and now I can feel a little discomfort in my hips.
Scott: How did this begin?
Client: About a year or so ago I began to feel knee pain but as long as I didn’t over do it running and if I took pain medications it did not bother me too much. Now my knee hurts all the time and feels like it is spreading to my back and hips.
In this case, the body sent the message a year ago. In the meantime this client ignored the conversation that the body wanted to have and through compensation has developed imbalances in other parts of the body. Remember, the body is no different than us as far as pain goes. It will do all that it can to avoid pain. It does this through compensation and developing new motor patterns to avoid and alleviate the pain. The problem is that these new motor programs, when not corrected, will develop imbalances and pain in other parts of the body. To summarize rule # 1, your body is brilliant and is always working hard and doing the very best it can to create and maintain balance with the tools that it has. When its messages are ignored, it will eventually give you a forced rest period.
- Have a proper assessment done- If you have any plans to be the healthiest version of you, don’t break this rule. As you saw in rule #1 that the body is always working to balance our complex system of systems, it is important to have those systems checked for health. A proper assessment should include:
A. Postural measurements
B. Biomechanical, movement and range of motion measurements.
C. Assessment of your soft tissues
D. Assessment of your life and lifestyle stressors
E. Current nutrition habits- Your body uses the food you eat to create and maintain healthy tissue. Poor or unbalanced eating habits are often a component of pain and injury.
A comprehensive assessment as outlined above can go a long way in detecting imbalances that don’t, on the surface, seem related to your pain. For example, digestive problems can often times influence your ability to use your core muscles effectively and can leave you susceptible to back injuries. Undetected food allergies and sensitivities can create inflammation in your body and around your joints and can create pain. Being able to balance on swiss balls and perform high level exercises does not mean you have quality core strength. The complexities of the body are beyond the scope of this article and will be discussed in future articles. Having a proper assessment performed is the foundation to building the most effective healing plan. I always say, if you’re not assessing, you’re guessing.
- Remove and “trigger points” and hyper constrictions from the soft tissue (muscle, tendons, ligaments, organs)- There are many wonderful forms of massage and soft tissue work available to activate rule #3. Once you have had a proper assessment, your healing plan may indicate the need to release hyper constricted tissues that are no longer working in concert with other tissues. We often refer to these as trigger points. Trigger points and hyper constrictions are areas of tissue that are no longer getting proper blood and nutrient flow in or out of the tissue as well as having disrupted neurological activity. The result is tender tissue that limits the working function of that tissue, as well, as surrounding tissues leading to postural distortion, biomechanical dysfunction and faulty movement patterns. The removal of trigger points should be done in a specific manner as it relates to your initial assessment. Ignoring this rule and moving on to rule #4 may compromise your healing potential.
- Re-establish proper range of motion, movement patterns and biomechanics- Most people I know don’t take the time to stretch, and when they do, they break out the stretches that they learned in high school physical education class. In most cases they stretch equally from side to side not realizing that they are just maintaining their body imbalances. Activating this rule in the proper sequence is important in re-establishing proper movement patterns and breaking old destructive ones. Here, we focus on stretching the short tight muscles while training balanced movement patterns. For example, if in your assessment you discover a postural imbalance that indicates a tight left hamstring, stretching both hamstrings equally will only perpetuate the same imbalance. To activate and follow this rule properly, it must be based on your initial assessment. Re-establishing proper mechanics, flexibility, stability and posture is vitally important in eliminating chronic pain and avoiding future injuries. Jumping to the next rule, #5, too soon will most likely leave you where you began.
- Rebuild the strength of the injured tissue with properly programmed exercise- Now we get to the rule that is often times activated too early in the healing process. Engaging in exercises that are not properly programmed feeds into compensation and faulty movement patterns which prolongs healing. Your exercise program should be developed around your assessment and be focused on building strength on a balanced body with movement patterns specific to your needs. As you progress through your program, your exercises should become more sport or activity specific. I often tell my clients who want to ski after an injury. “If your exercises don’t look like skiing, you are not ready to ski”. This applies to all sports and activities. When you jump the gun on this rule, you may break yourself.
- Re-Build endurance- You can’t build endurance if you don’t have strength to endure. Cyclists, runners, swimmers and other endurance type athletes whose sports are very repetitive in nature dislike the fact that this rule is #6 of 6. Famous physical therapist Vladimir Janda stated that it takes about 500 repetitions to create a motor (movement) pattern and 5000 to unwind one. The nature of sports such as running and cycling are cyclical and repetitive in nature. For this reason jumping back into your endurance sports or activities that require high repetition and endurance, without following the rules above may leave you in the “chronic pain sufferers club.”
Paul Chek, holistic health practitioner, outlines this concept beautifully with the following progression: Flexibility, Stability, Strength, and Power. If you find you are engaging in strength and power type exercises without establishing flexibility and stability, you may be receiving a personal message from your body anytime now.
As you can see, the process of healing is multifaceted. If you have been dealing with an injury or pain that won’t go away, re-visit the rules to see if you have broken any of them as discussed above. Don’t be afraid to look at your nutrition habits or lifestyle stressors as possible contributors to your pain or injury. Take a look at your training and exercise programs. Do they follow the rules above? Be sure to interview your health care provider to see what their assessment will include and how you will be progressed in your health plan. If they violate the above rules you may be unsatisfied with your result. When you focus on one dimension of health, you get one dimensional results. When we begin to look at our bodies as a whole system of systems we quickly realize just how brilliant it really is and that the messages it sends are always friendly, helping us to realize our own health potential.
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