3 Common Pain and Injury Myths
1. Experiencing Pain Means Something in Your Body is “Broken”
Pain is a lot more complex than we’d often like to admit. Pain is not a simple A. caused B. relationship. It involves a variety of variables some of which we still don’t understand all that well. So while yes, if you slam a car door on your hand rushing to get ready for work, you’re going to feel pain…it’s not always that simple. You can experience injury followed with pain (consider the above example), injury with no pain (you have a broken ankle but can’t feel it because you are currently being chased by a mountain lion), and even no injury with pain (many cases of non-specific low back pain involve individuals presenting with pain, but no physiological damage). While pain is often societally oversimplified to ALWAYS indicate injury, sometimes pain just means…pain.
Infuriating? Yes. But, this knowledge can help with individual confidence and self efficacy when it comes to dealing with pain in the gym. Knowing that you could be experiencing pain, but not necessarily be “broken” is just enough motivation to get someone to participate in basic physical activity. This physical activity being crucial to aiding recovery in the case of injury, and moderating pain levels when dealing with chronic pain.
“So if nothing is wrong with my body… is this all just in my head then?”
No, your pain is real, you aren’t “making things up”.
Naturally, when someone hears they can be in pain with no physical damage to their body, they assume whoever is telling them this is calling them crazy. You’re not. Acknowledging that pain can be experienced even without the presence of any mechanical damage to the body is simply acknowledging the complexity of pain as a whole. This is referred to as the biopsychosocial model of pain. This model takes into account biological causes of pain (things like your nervous system, immune system, and endocrine system), psychological causes (how your own thoughts and beliefs effect pain, think stress, depression, fear of movement, etc.) and social causes (how you’ve culturally been conditioned and how that may effect pain).
There does not necessarily need to be a mechanical “why” behind someone’s pain, and only addressing things on a physical level leaves out a lot of the bigger picture, and often times leads to misdiagnosis.
2. If You’re Injured, Exercising Will Only Make it Worse
Bedrest. Bedrest. Bedrest. If you’re injured just take it easy for awhile and your body will handle the rest.
Not quite. In fact, bedrest usually ends up being detrimental to injury recovery.
Basic movement, and retention of range of motion of injured body parts is the basis of most physical rehab for pain and injury and with good reason. Basic physical movement continues to trend well in helping decrease pain levels in those with chronic pain, movement can help increase blood flow to an injured area to help speed up recovery, and at the end of the day physical activity keeps our bodies running at peak performance.
The hard part is often getting past fear and convincing someone who is currently in pain that moving is in their best interest. In cases of severe low back pain movement can be absolutely crippling, so much so that the person will not want to move, despite the potential benefit. In these cases it’s all about finding entry level movement. This will be different in every situation but you’re looking for movement which an individual can perform with little to no symptoms of pain, and additionally result in either a decrease of symptom’s post exercise or at the very least no increase in symptoms.
An easy example of this is a lifter presenting with non-specific low back pain while deadlifting 400lbs. Could a load reduction down to 200lbs reduce their symptoms? No. What about a load reduction to 100lbs? No. What about an empty barbell? Yes. Okay, there’s your starting point.
If simple load reduction fails, that’s when you look to how you could modify the movement to decrease symptoms of pain. Deadlifts could be changed to a high block pull, potentially decreased ROM good mornings, whatever needs to happen to reach that point of decreased symptoms of pain.
Now…could exercise potentially lead to an increase of your pain symptoms? Of course. If you aren’t willing to make the necessary changes to training, continuing to hammer an already injured body part will make things worse. That’s no reason to demonize exercising in the case of injury as a whole. There is always a way to modify physical activity to help reduce symptoms of pain, and this physical activity is going to be beneficial in the long run.
3. You’re Bad Technique is Why You’re Injured
“That hurt’s just to look at”, “You’re going to break your back deadlifting like that”, “My knees hurt watching that squat”.
Fun fact…there is no inherently “correct” way to move…
Suggesting that the reason someone got hurt was SOLELY due to the form they used is at it’s best ignorant, and at it’s worst downright negligent.
This again ignores the sheer complexity of pain. What was the persons training like up to this point? Have they done this movement before? What training load were they using? What were their stress levels like? Were they in sleep deprivation? So many variables could be in play yet we still rush to “they got hurt because their back rounded”. Case closed.
We currently have no evidence to support the claim that any particular technique is going to inherently reduce your instance of pain and/or your chance of injury. Read that again. So yes, while hard to accept, lifting with a quote “neutral spine” (not actually possible btw) and lifting with “spinal flexion” are one in the same in terms of pain and injury risk.
The best way I like to explain this to individuals is imagine if I were to bend over to pick a pen up off the floor. No one would particularly care how I went to pick up the pen. I could round my back, lean over with one arm, and even support my weight on a single leg and no one would bat an eye. If I were to try that same motion with a barbell in front of me however…everyone would freak out. So in this case the problem is not actually the movement pattern itself but the load involved. If I were to train myself to pick up slightly heavier and heavier objects slowly over time from that “pen picking position” I could actually reach a point where I could pick up that barbell with no fear of injury. The movement itself was not dangerous. The fact that I had never trained to pick up a heavy load with that movement however would be.
Now this being said, it would also be negligent to say “technique doesn’t matter”, because it certainly does. Here are some solid reasons you would want to pay close attention to technique.
- Performance: Improvement in technique/ particular movement patterns will be superior for certain performance goals.
- Repeatability: Improving technique helps an athlete perform consistent “repeatable efforts” which is helpful from a training standpoint
- Specific Goals: Certain techniques can be employed in situations such as a hypertrophy goal to maximize muscle growth
- Tolerance: As discussed above technique modifications can be used to reduce symptoms of pain and build tolerance to movement (don’t mistake this as the techniques being “more safe”)
Long story short, the human body was made to twist, bend, and extend in all kinds of different directions, and attempting to move like a robot for the rest of your life is not going to make you any more safe than those that use their natural movement patterns.