Health Blog

September, 09 2010

Treating Chronic and Acute Injuries

Coping with pain

Sooner or later, everyone deals with joint or muscle pain.  The pain or discomfort that people experience in their muscles or joints can be associated with a wide variety of problems:  trauma or post trauma, overuse, and muscle imbalances.

The pain or discomfort that people experience can be classified into two fundamental categories:  acute and chronic.  Acute injuries are typically caused by accidents, such as spraining your ankle, whip lash from a car accident, broken ribs or impinged inter-vertebral disc from severe impact, etc.  Chronic injuries are typically caused by muscle imbalances, which can be the cause and/or the effect of poor posture and muscle overuse, as well as residual effects from acute injuries (chronic low back pain from a car accident that transpired years ago).

Regardless of symptoms, prevention is always the best medicine.  To keep your body in optimal function, it would behoove you to maintain an adequate balance of muscle strength and flexibility surround each joint.  Muscles exert tension on joints – via muscle tone, which is the low level of electrical stimulation at rest.  Having excess tension on one side and deficient tension on the opposing side will deviate bones from their normal, anatomical position.  Practical example:  many people have forward displaced shoulders (excess scapular protraction) due to tight pectoralis major (chest) and weak rhomboids/middle trapezeus which is often associated with working at a desk for prolonged periods of time.  If left unchecked, the discrepancy will perpetuate; tight musculature will get tighter and the opposing musculature will get looser and weaker, further exacerbating posture deformations.  Frequently, poor posture/muscle imbalance can cause pain in effected or associated muscle groups (stabilizers, antagonists, etc.).

General Recommendations For Resolving Pain

If you are reading this and already dealing with joint or muscle pain, there is hope.  The process will not be easy, per se, but the corrective exercises and stretching required for relief is typically not strenuous – just very technical and articulate.

Step 1

Whatever movement pattern causes pain, try not perform it.  Instead, try to find a way to massage or stretch the same muscles/connective tissue that is negatively affected.  While stretching/massaging, you may feel slight discomfort, which may be ok and to a certain extent necessary.  It is essential that you learn to create a distinction between muscle contraction pain and muscle stretching sensation.  Pain associated with muscle contraction will usually feel like a compressive force while the sensations (maybe discomfort, but not the same level of pain) caused by stretch should feel like more like an elongation force.  A good sign that you have found a safe and effective stretch/massage for your specific problem will be that the area will feel ‘lighter’, ‘relieved’, and ‘alleviated’ after the stretch.  This may not come about immediately, as effective stretches/massage may create an immediate swelling sensation once finished, but the lightness and alleviation should be present in proximity to the stretch.  Example:  After I stretch my grastronemius (calve muscle), it may throb for a moment, and then feel less tense after wards.  Try to experiment with only 1 or 2 different stretching/massage techniques as a control to discern what is helping vs. hindering.

Step 2

Once you have found a couple stretches that affect the injured muscles/connective tissue, practice them frequently throughout the day; stretching/massing the tissue for 20-60 seconds at a time.  Be aware of positive or negative signs.  Positive signs include:  immediate relief, improved range of motion/functionality, less pain, decrease in inflammation (less knots and muscle congestion – which can be felt through touch).  Negative signs include:  prolonged throbbing sensation with the onset of pain that last an unusually long time, restricted range of motion/functionality, the same amount or greater pain sensations throughout the day, increased inflammation (more knots and muscle congestion).  If positive signs persist throughout the day and provide residual relief in the following day, you are on the right track.

Step 3

Assuming that your injury is feeling better as a result of the stretching/massage, start experimenting with very light intensity exercises that stimulate the affected muscles.  Note:  this process is usually a little more challenging, as the muscles that cause pain may need to be stretched, but other related or seemingly unrelated muscles may actually need to be strengthened.  In any case, be aware of positive and negative signs.  Positive signs include:  no pain or slight aggravation of pain with decreased pain sensations with continual repetition, subsequent increased range of motion/functionality, subsequent decrease in pain.  Negative signs include:  immediate and significant aggravation of pain, no pain or slight aggravation of pain yet increases pain sensation with continual repetition, subsequent decreased range of motion/functionality, subsequent increase in pain.  You should be able to perform 15-20 reps without any significant problems.  If by practicing specific exercises produces positive signs throughout the day and provides residual relief in the following day, keep it up!

Step 4

If you have discovered safe and effective stretching/massage and exercise techniques that are consistently producing positive signs (alleviation of pain, improved range of motion/function, etc.), then continue to perform them until the injury is resolved.  If functionality, range of motion, and pain is mediated, however, not fully restored and the benefits cease, then you may need to practice strengthening additional muscle groups.  The same methodology may be employed, but finding the key muscle groups that need to be strengthened is a complex process.

Lastly, if your are dealing with pain that is so significant that it substantially affects your movement patterns, try to get it resolved immediately, either by yourself or with a qualified professional.  The human body is very smart (or incredibly stupid, depending on how you look at it) – will automatically avoid pain by alternating recruitment patterns to avoid stimulating injured muscle groups.  Although this defense mechanism is an essential function, it is meant to deter people from moving so that the body can rest, recover, and heal.  If you keep aggravating it, the other muscles that are forced to take on the additional load can experience experience overuse and lead to more injuries.

The prevention of injuries is essential.  Not only can it improve the quality of your life by enabling full functionality – pain free!  But by keeping inflammation within the body down, you can improve oxidative metabolism, thus improving fat utilization.


54 Responses to “Treating Chronic and Acute Injuries”

  1. Donna says:

    my fitness coach and online trainer gave me your site link as a possible training company for me while im in CA. I hope to connect with you all sometime later this year. Good site!

  2. Jen Hurt says:

    So glad I found this…I get acute back pains and my husband gets chronic ones- this will help us both!

  3. We find that our clients respond best to having our locum doctor assess the injury and then refer to our in house physio. The next steps are to have a three way collaboration to get our client back on track fastest.

  4. Excellent site. A bunch of valuable info below. I’m sending it to a few friends ans in addition sharing in delectable. And of course, thanks for your initiative!

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