Eternal victim in the face of pain
Here you are, an innocent, virginal creature, minding your business, when, wham, you are saddled with an achy joint or spasmy muscle. This is a toxic viewpoint, one that keeps you in pain. I will explain how pain is caused by you, preventable by you and treatable by you.
*The following pertains to musculoskeletal pain. I will not be addressing pain as it relates to disease (cancer, etc), catastrophic injury (broken bones, etc) or emotions (lost love, etc).
Pain is a lagging indicator
If you have pain, you have been messing up for a while. Pain is your body's last ditch effort to get you to be in a better position or change your movement patterning. Our bodies are meant to go through millions of repetitions of movement and countless hours in positions throughout our lifespan. Our joints and muscles are supposed to last over 100 years before starting to deteriorate. We expedite this deterioration with negative lifestyle choices such as: sub-par nutrition, not enough sleep, lack of exercise, poor movement quality and being in crummy positions all day long.
Pain can be prevented by understanding its two main causes: repeatedly being in a position that encourages poor spinal organization, repeatedly performing a movement with lack of mobility or stability in a joint system.
The Core of the Matter
What is the core? No, it's not your abs, not your obliques, not your back (because the back is one muscle, right). The core is composed of every muscle that works to keep your spine in a braced and neutral position. Many people spend hours in an over-flexed (rounded) or over-extended (arched) spinal position. This becomes their default position of spinal stability.
The body will put up with this faulty position of stability for ages until one day, it doesn't. The final straw could be a bad deadlift in the gym or picking up a pencil incorrectly. It isn't the final straw activity that causes pain (a back spasm in this example), it's the thousands of bad lifestyle and activity repetitions that accumulated prior. Many people will associate their pain with the final straw activity, vowing never to pick up a pencil or barbell again.
This line of thinking is toxic viewpoint #2, it never address the underlying postural issue and therefore never addresses the root of the pain. If you learn how to brace your spine and be in a good spinal position, you can prevent back related injuries for life. In this video, David O' Connor explains Kelly Starrett's bracing sequence for the spine.
The knee bone's connected to the...
Each joint system (group of muscles and joints that work together) in our body provides us mobility (the ability to move through a range of motion) or stability (the ability to maintain a position). These qualities alternate with each system, looking like this:
Foot - Stability
Ankle - Mobility
Knee - Stability
Hip - Mobility
Lumbar Spine - Stability
Thoracic Spine - Mobility
Scapula - Stability
Glenohumeral Joint - Mobility
and so on...
When you lack mobility in a mobile joint system, the stable joint system(s) above or below it will become more mobile to compensate; the inverse happens if you lack stability at a stable joint system. Herein lies the foundation for toxic view point #3 on pain: Pain is often directly correlated to the body part that is hurting (i.e. knee pain equals crappy knees).
Pain is often referred. For example, a runner (Jane) thinks her knees hurt all of a sudden because she's getting old and has 'bad knees.' In actuality, Jane has been running improperly for years. Over time, her shins and calves shunt mobility from her ankles, her hamstrings and quads become stiff, limiting hip mobility. These compensations, lack of mobility and influx of gamy muscle begin to pull on Jane's knee and cause her pain.
Jane will go to doctors, therapists and surgeons trying to fix her knee. Jane's knee will not get better because her knee is not what is causing her pain. Jane's running form and maladjusted tissues are the culprits. If Jane works on improving her form and mobilizing her gummed up tissues, her knee pain will subside.
Roll out
To review, the top three ways to prevent pain: have a good default spinal position, do not sacrifice quality for quantity in terms of movement, have optimal mobility/stability in each joint system. Now, what to do if you already have pain? Let's say you have knee pain. You are going to have to look above and below your knee for poor tissue quality and trigger points. Your muscles should feel lithe and supple to the touch. If you come across an area on your quad, for example, that feels rigid or sensitive to the touch, you can try rolling (self massaging/releasing) this area out with a lacrosse ball or mobility tool of your choice. I recommend using Yoga Tune Up balls or Mobility WOD tools as an upgrade on the lacrosse ball. Kelly Starrett's YouTube has hundreds of videos on how to 'roll out'/mobilize your tissues, improve your ROM, resolve pain and immobility. A lot of information in this entry is derived from his book: Becoming a Supple Leopard. Learning how to perform self myofascial release (SMR) is extremely valuable. If you understand how to restore tissue quality and mobility in your body, you will be able to remedy pain and make movement feel good again.
Detective time
Before you run out and buy a lacrosse ball you must also figure out what is causing you pain. Riffle through your daily activities, ask yourself what you do a lot of and what movements might be causing you pain or what faulty positions you are in. Movements don't cause pain when done properly, you make them hurt by doing them wrong. The solution may be getting a standing desk if you can't seem to sit in a braced position, or getting a running coach if you never learned how to run correctly. You must address the underlying root of your pain in addition to restoring tissue quality to make it go away for good.
How you sleep is very low on the list of positions that cause pain. Pain is often felt most in the morning so it can be associated with sleep. Inflammation is highest at night, it is part of the healing process and can have some residual presence in the a.m. Also, pain is not sensed as well during movement, its nerve signals come in clear with the stillness of sleep.
Sometimes a lack of strength and stability is to blame for pain. If you can get into positions easily but cannot hold yourself in them or find it hard to get out of them, this may be the case. For example, if you can get into a squat easily but cannot stand up out of it you need to get stronger and more stable. 'Tight' muscles are not strong, they are overworked and doing the wrong job.
Healthcare
You are your best healthcare provider. It is your responsibility to care for your health and prevent disease in your muscles and joints. Take responsibility in the face of your pain, understand proper positioning and movement as it pertains to your lifestyle. Know how to restore tissue quality and range of motion in your body. Prioritize quality of movement over time, distance or weight. Go from being a victim to being a hero.
