So which side of the argument is correct? Well, as a physiotherapist, I can tell you that it is neither.
Although pain may seem like a linear, passive sequence from A to B — I slapped your hand and felt pain — it is actually a much more dynamic, active process. My clap on your hand creates an input that enters the nervous system and is then filtered by the brain based on various factors, such as past experiences, current mood, attention and more.
An interdisciplinary review from 2013 on Cognitive science The magazine described pain as “a personal, subjective experience influenced by cultural learning, the meaning of the situation, attention and other psychological variables.”
This kind of complexity makes pain an unreliable indicator of what is happening in the body. Chronic pain often occurs when there are no observable structural or mechanical changes. That is why the application of a simplistic model “without pain, no profit” or “if you feel pain, stop” does not apply. There is an important gray, and to deal with gray, we need a more differentiated approach.
“We try to train [athletes] about what pain is compared to what pain is — the idea of whether an exercise causes discomfort only while doing so in relation to whether the area is still causing pain after you do it, ”says Gerry DeFilippo, a power and athletics coach who owns Challenger Strength in Wayne, NJ. “If a baseball player has general pain in the forearm that is bothersome during the day and not directly during the throw, it indicates another factor and not the flight itself being the main issue.”
Tom Goom, a physiotherapist and running specialist at Body Rehab Studios and creator of running-physio.com, goes even further in this process. “I would often say that mild pain during activity (up to three in 10) is okay if it calms down within 24 hours and the patient improves over time,” he says. “Of course there are times when this message will change, for example if I suspect a stress injury to the bones or when there are other signs and symptoms, such as swelling or regression.”
Goom uses a lantern representation to help its patients understand this range of discomfort: If the excessive pain is six or more in 10, a red light comes on and signals that you need to stop. Four or five is acceptable and gets yellow light, while three or less gets green light to continue the activity.
“The reality is that, like everything else in medicine, the answer to the question of what to do when you are in pain or discomfort is: It depends,” says Shounuck Patel, DO, FAAPMR, a non-surgical physician at The Patel Center. for Functional Renaissance in Arcadia, California. “If patients harden their normal activities despite the pain, they can continue the actions that initially injured them. “On the other hand, if patients are afraid of movements that may cause pain, they may begin to develop abnormal movement patterns and, soon, even normal movement may become painful.”
In other words, the fear of movement can lead to compensatory pain and injury, to the extent that even movement that was not painful before now hurts, reinforcing a vicious circle.
With the advice of these three experts in mind, along with my own experiences as a physiotherapist, and in conjunction with the fundamentals of pain and movement science, I created a checklist of four questions to help navigate and understand pain. when it is safe to keep moving and when you may want to back off.
1. Is the pain five out of 10 or greater?
The optical analog scale used by health professionals proves to be a reliable and valid tool for measuring acute (new) pain: On a scale from zero to 10, a patient scores their pain level, with zero being without pain, five to be moderate. and 10 is the worst pain. I think of five as a level of pain that obviously changes your mood.
2. Is it the type of radiation pain and / or electrical nature? Are there constant severe pains?
Radiating pain is when the pain or discomfort feels like it travels from one area of the body to another, almost as if it were ejected into a different area. The electrical pain resembles a stabbing and burning sensation and is quite limited, almost as if you could trace it with a pencil if asked.
If any of these sounds familiar or if they are persistent and acute, the pain may indicate something more serious that should be treated immediately by a doctor.
3. Did the pain last more than 36 hours?
If the residual pain or discomfort from your activity has lasted for more than about a day and a half, it is very likely that you have done too much and the body needs more time to recover before returning to intense activities. Even if you are only 24 hours after the activity and you have pain, give her another 12 hours and see what happens. Intense activity can sometimes stay beyond this one day sign.
If you have pain that came out of nowhere (meaning it was not caused by a specific activity) and lasts for 36 hours or more, this is an important red mark that should be treated immediately.
4. Does the pain increase over time?
Watch the trend line carefully: Does the pain slowly increase from two to three to four, decrease or worsen? If it increases steadily over time, this is a key sign of persistent overuse and overload without adequate recovery.
What can your answers mean?
Answering “no” to all four questions means that you are on the right track with your level of activity. Keep going, but keep paying attention to these questions.
However, if the answer to Any of these questions is a “yes”, then your coaching load needs to be adjusted. I would recommend that you drop your activity levels and see how this changes your answers to the questions. If you have these severe pains or aches / pains with radiation / electricity, or if accelerating the activity does not lead to change, then it is time to see a doctor.
Remember, pain is a signal, but it is not binary. Know the signs and listen to them.
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