Pain!
I hurt so I'm injured so I shouldn't move, right?
No!
This a common assumption. I'm hurting so I have a new injury, and I'm making it worse if I move. So, they go for bed rest for a week. Unfortunately, for many types of pain or injury, bed rest can make pain worse and increase the length of time it takes to heal.
**Don't Rely on Bed Rest**
By maintaining passive, overly lengthened muscles will remain weak, tight muscles will increase tension, ligaments will further slacken from disuse, all of which causes the joints to become more unstable and overall pain to increase. This is particularly true for back pain. Especially with back pain, the common instinct is to stop moving and lay down until it stops hurting. However, this will likely create more pain and spasming, adding to the cycle of pain followed by a lack of movement.
For specific aggravations and injuries, it can be beneficial to change the type of movement and reduce amount of load or frequency of training. Whenever there is a rupture, break, or fracture it does need time to rest.
**Sensation of pain does not always equal tissue damage**
When you feel pain, it does not mean you have a fracture or debilitating injury. This is one of the most revelatory statements for clients who deal with chronic pain. Simply because there is nociception does not mean you are continuing to damage the area of the body that has sensation. Quite often, muscular pain is actually reduced by moving, even if initially it appears to increase. And it's possible that there may be some sensation while moving.
When I'm working with a client to reduce pain, I try to give them a specific amount of sensation I want them to try to feel. This guidance is especially necessary when someone has had chronic pain for many years. For the chronic pain client, both the fear of pain and the inflammation at the tissues can be triggered by any sensation at all. The body and mind are both in an overstimulated response, ready to overreact to any stimulation. This will be different for each person, and can also be different for one person from day-to-day.
**Bump up to the pain, but don't push through it**
Work up to where you feel the pain, then gently back off. You can feel pain when you're moving, but don't try to muscle through it. I don't want the client to "just do it", or to think "no pain, no gain". This simply isn't beneficial. We need to work into the stimulation to desensitize the tissues. We have to work intelligently, and slowly, by listening to the body, not fear or assumptions.
You should generally be warier of sensations that include sharpness or tingling referring distally, or away from the spine. We prefer pain to slowly centralize as you move, where the pain sensation may stay the same or even increase a bit, but the sensation will slowly reduce in physical perimeter in the body. To centralize the pain it will become more centered into the midline of the body, moving more toward the spine (proximally) rather than away from it (distally).
As practitioners, we have to be aware of the client's pain, but sometimes the goal should simply be to get some movement, not only focusing on reducing the pain. Movement itself can be what reduces the pain, in time, with proper programming.
Sometimes just get moving.
