Pain!!!!
David Fleming
In his latest revolutionary article, Mr Fleming tries to explain to us that pain is not just weakness leaving the body, but is in fact a signal from our body that something isn't right. Apparently, 'run it off' isn't always the best advice! Take home message, if something hurts, hunt the cause, find a correction and don't ignore it or just treat the symptom.
Bring The Pain!
Pain, it’s part of life and has many guises. From broken hearts to broken arms, all of us at some point will have experienced various levels of pain. This article will attempt to give the reader an overview of pain with relation to the joints and soft tissues of the body. With better understanding comes more informed decisions and therefore less time spent in agony. The more you understand about your own body, the more empowered you become to stay healthy and on track towards your physique, performance and fitness goals.
Ouch!
Pain hurts. For the vast majority of us, sadomasochists excluded, pain is a thoroughly unpleasant experience. What you may find interesting is that there are no ‘pain’ receptors in the body. Instead we have an extremely sensitive and integrated alarm system that informs the brain when our tissues are in danger or under some kind of threat. Following a series of actions at the level of the tissues and then the spinal chord, the brain if the input is loud enough takes notice of this information and decides up on an appropriate response. If the danger level is considered high enough we may get a sensation of pain to some degree. Equally if the brain decides there is a more pressing issue that supersedes your injury, like survival, the incident you think should have hurt like crazy doesn’t give you any immediate pain but may hurt later on.
The great thing about this amazing protective system is that it will often alert us, especially in the gym and sports environments before any serious tissue damage occurs. Pain is a great motivator and it will often be severe enough to get you to stop or change whatever it is that you’re doing that is putting your tissues at risk. This is a key point. While the sensation of pain is unpleasant it is merely an informative signal. The control centre in its wisdom is alerting you to a potential problem, making you take notice. Remember, your back doesn't hurt, your sensitive, danger detection system is activated.
Painful Points
The following points are taken from the excellent book 'Explain Pain' by David Butler and Lorimer Moseley. I would urge anyone who suffers from chronic pain of any kind to read this text as a greater understanding of how what is happening in the brain when you experience pain, can have profound effects on the management of that experience.
1) 'All pain experiences are a normal response to what your brain thinks is a threat'.
2) 'The amount of pain you experience doesn't necessarily relate to the amount of tissue damage sustained'.
Extreme examples of this range from limb amputation procedures that occurred without anaesthetic and no reports of pain during war situations to a paper cut that hurts like hell. As I mentioned earlier there is a lot going on in the body besides the actual damage to the tissues that do or do not produce pain.
Here are two quotes from the book 'Painful Yarns, Metaphors & Stories to Help Understand the Biology of Pain' by G. Lorimer Moseley: "Pain, like vision, is a conscious experience that is based on many complex processes, not just sensory information coming from your body (or, for vision, your eyes).”
"The evaluation of how much danger the tissues are actually in happens really quickly and outside of your awareness and control. Pain then, depends on the unconscious evaluation of threat to body tissue" In the example of a paper cut, there are several points to consider.
The hands hold extremely high numbers of nociceptors (danger/threat receptors) that hog a lot of space in the somatosensory cortex of the brain. More nociceptors, more potential to experience pain. Also, paper cuts tend to be quite shallow and on a microscopic level make quite a rough cut. With the wound being so shallow, it re-opens easily exposing the nerve endings to the environment. While this is interesting, it isn't a definite explanation, apparently the big brains in science just don't know.
3) 'The danger/threat messages are processed throughout the brain and if the brain concludes that you are in danger and need to take action, you will experience pain. The brain activates several systems that work together to get you out of danger'. The sympathetic nervous system, motor, endocrine, pain production, immune and parasympathetic nervous systems all work in concert to get you to do whatever is required.
4) 'When pain persists, the danger alarm system becomes more sensitive'. The rate at which tissues heal is largely down to blood supply. The better the blood supply, the faster the rate of healing. While some structures take longer to heal, all tissues can heal. This is a key point for chronic pain sufferers. Often pain can persist long after the tissues have healed. Essentially, an old injury may leave behind certain triggers that can activate the old pain program very easily. The more this occurs, the more readily the brain responds to the faulty signals it receives. Just because something still hurts after a long period of time or begins to hurt again doesn't necessarily mean there's anything wrong with the body part in question. Essentially the response system becomes more involved and starts to contribute to the problem.
5) Continued from point 4 - 'The brain adapts to become better at producing the neurotag for pain'. Still don't believe me that pain is literally in your brain? Consider this:
The Phantom Limb
Either through injury or disease people can lose limbs. If an arm were to be amputated you would think that any aches, pains, injuries, movement quirks or any sensations at all associated with that limb would be lost for good. This isn't the case. As the brain holds 'body maps' for all parts of the body, a 'virtual limb' exists in the brain. Even if the actual limb is removed with all nerves feeding the limb and the brain severed, the brain still holds a representation of that part. The 'virtual limb' will still hold neurotags of all the experiences that limb encountered including any injuries or pain. The amputee can be tortured by an itch they just can’t scratch.
This proves above all other evidence the concept that pain resides in brain. Thankfully, incredibly brilliant neuroscientists have come up with strategies to trick the plastic brain to deal with these frustrating problems.
Take Home Points
When your brain is trying to tell you something, listen! 'Run it off' may be the worst bit of advice ever uttered with regards to dealing with pain.
No pain, no gain is also pretty misguided. Pain is inhibitory. That means if the alarm bells are set off and your brain responds by providing the sensation of pain your range of motion, strength and over all performance is compromised.
Hopefully you can see how ignoring pain, especially when exercise is involved is a bad idea, so what should you do?
Seek Help
This may seem obvious but so many people ignore their bodies to the point that pain becomes chronic. This is a far more frustrating problem to have. If we can accept that everything is a skill and the body will get progressively better at whatever you ask it to, why should being in pain be any different? It isn't. The longer you leave problems untreated the more you are reinforcing the pain response in your brain. Even if the tissues are no longer in danger, the 'brain map' of the pain response can become so sensitized that the slightest deviation in movement or worry or thought process towards that painful experience can flare the sensation up again.
You need to choose your healthcare providers carefully. Get a recommendation from someone and ask questions. Make sure the Osteopath, Chiropractor, Physio, Doctor or Personal Trainer isn't just going to treat your symptoms but is equipped to assess your overall movement and mobility to find out why the alarm bells started ringing in the first place.
Improve your technique, work on your weaknesses and listen to every signal your body throws at you. Pain is a warning, act on it to take control of your body, health and wellbeing.
References:
Explain pain; David Butler & Lorimer Mosley. Painful Yarns, metaphors & stories to help understand the biology of pain; Lorimer Moseley. Z-Health. Essentials Of Elite Performance course manual; Dr. Eric Cobb
About the Author
David Fleming is one of London’s top personal trainers. He is obsessed with helping people get stronger and helping people to get More-Athletic. He has studied and learned from the best strength coaches in the world. He is happily married and can lift heavy weights. His mother is very proud of him and he writes a good article.It took him until the age of 30 to pass his driving test, but other than that he is a solid chap.
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