How Can I Tell the Difference Between Good Pain and Bad Pain?

Good Pain vs. Bad Pain, How Can You Tell the Difference?

knee pain

It’s very important to listen to your body, especially when venturing to new activities/exercise. Your body is always trying to communicate with you, and it’s important you pay attention otherwise you could get injured. However, being able to decipher the different types of pain may take some getting used to. My patients often ask me if what they are feeling is normal? Below I have a few questions you can ask yourself to try to determine if what you are feeling is just muscle soreness or more significant of injury pain.

1.) Where is the pain? How would you describe it?

Is the pain in your muscle? Does it feel achy and stiff,? Is it tender to the touch? If the answer is yes, sounds more like muscle soreness.

 

Is the pain in your joint, muscle, tendon, or bone? Does it feel sharp? Is there swelling? Bruising? If yes, this could be an injury

pain image

2.) How long have you had the pain?

Does the pain come on 24-72 hrs. after the activity/exercise, but then slowly get better?

This could be delayed onset muscle soreness or DOMS. Muscle soreness is normal when working different muscles.  While working your muscles, they may start to burn –that is a good thing and it means you are pushing your limit to fatigue the muscle, and therefore make them stronger. When your muscles get sore, there are microscopic tears that happen in the muscle. When your body repairs these tears, it puts down more collagen fiber to rebuild, and thus your muscles get bigger and stronger.

 

Does the pain go on for 7 days or longer? Does it tend to linger?

 

When starting a new exercise it is important to increase the stress on the tissue gradually, especially when it comes to your tendons, bones, and cartilage. If you increase the load too fast, too soon, this could lead to injury. It is important to determine your individual activity threshold. That is the sweet spot between working your muscles to get stronger and over-working them. When doing a new exercise that point is when you are not able to do another rep with correct form. If you are sacrificing form to get in that last rep, it’s better not to do that last rep. Only do as many as you can perform with proper form!

 

3.) What makes the pain feel better?

Does stretching help or moving around make it feel less painful? If it’s just muscle soreness, stretching and doing some gentle cardio should make it feel much better.

stretching

Does only rest and ice make it feel better? Could be injury pain 🙁

 

4.) What makes the pain worse?

Does sitting still for a period of time make the stiffness/soreness worse?

Does movement make it feel worse? If moving the painful area makes the pain worse, this could signify something more than muscle soreness.

Let me know if you have any questions!

Why Is My Injury Not Getting Better?

Why Is My Injury Not Getting Better?

Nothing is worse than having an injury that seems to be taking a long time to heal, especially if you feel like you are doing everything right! Have an open conversation with your physical therapist about your prognosis and brainstorm together reasons why your healing time may be delayed. Below I have outlined just a few questions to ask yourself if you feel like your injury is taking a really long time to heal.

  1. Are you doing your homework? Are you doing your exercises? You knew this one was coming– I’m a PT after all.  A lot of people don’t want to put in the work to make themselves better, and this can lead to nagging injuries. If you take your rehab seriously off the bat and follow your physical therapist’s instructions, this can help tremendously. It’s really the most important part of any treatment plan, but the one people most often take for granted. That ultrasound you get in PT isn’t healing you–but the exercises given to you definitely will. Exercise is probably one of the only forms of treatment that is scientifically backed by research time and time again, and there is a reason for that it works! So do your homework!

exercise 2

(Side note: Sometimes when people start feeling better, they stop doing their exercises all together. But it’s important to remember these exercises and incorporate them as part of your maintenance routine.)

2. Do you smoke? If so, better drop that habit. Along with a slew of other reasons smoking is bad for you, it can also delay healing an injury. If your blood is not able to travel oxygen to your injury effectively, this can delay healing.

no smoking

3. Are you getting enough sleep? Back to the sleep conundrum. Your body does a lot of healing while you sleep, so if you are not logging in 7 or 8 hours a night, you could be doing your body a huge injustice.

baby sleeping

4. Are you stressed? Having a lot of psychological stress can definitely impact your body’s ability to perform a plethora of functions, one of which is healing. Plus stress can make your pain feel worse than it is. Those feelings of being stressed and depressed over a nagging injury can also play a role on healing. Set yourself up for success and try to focus on your mental health and your physical health could improve as well.

stressed

5. Are you nourishing your body with the proper foods? Are you eating processed refined foods or whole foods with good quality nutrients? Eating protein helps your body repair its muscles, tendons, and bones. Bone broth is one great example of a nutrient dense food that can help support healing. For an easy bone broth recipe, see below.

soup 2

http://balancedbites.com/content/easy-recipe-mineral-rich-bone-broth/

When trying to heal your body, make sure to remember that your body works as a whole, but it is made up of many parts. This incorporates everything from your heart, brain, mind, lungs, and GI tract. Your body is a complex machine and with so many moving parts, everything has to work together. This is why I think it is so important to address full body healing and wellness. If one thing is off, there could be a chain reaction. Help your body out and set yourself up for proper healing!

Let me know if you have any questions? 🙂

How to Help Your Neck Pain

Are you a slave to your i-device?

neck pain

http://cbsminnesota.files.wordpress.com/2014/11/spine-study.pdf

Are you constantly looking down at your smart phone, tablet, laptop during the day? Do you have neck pain? Ever get headaches? Any numbness/tingling down your arms? If so, these tips could help you.

Nowadays, we are constantly plugged in and looking at electronic devices during the day –one of the consequences of this could be a tight painful neck. If ignored, it could lead to nerve impingement, herniated discs, and migraines. So what to do? I’ve listed out a couple of tips that could help alleviate some of the problem and also described some activity modification that will be necessary if you want to prevent the pain from coming back!

1.)    Lifestyle modifications –I’ve listed this as number 1.) for a reason. It’s because if you make no modifications to overuse activities that bring on this pain, you can stretch til you’re blue in the face, but don’t expect lasting results. If your job includes long hours in front of your computer make sure you bring your screen up! Whether it be a smart-phone, tablet, or looking down at your computer screen, all these activities encourage you to look down. Instead of looking down constantly, try to bring the device up to eye level so your neck isn’t in a hyper-flexed position for a prolonged period of time. This tip is important in order to prevent the reoccurrence of neck pain. Look at your own activities and try to identify what movement patterns are causing this pain. This is where physical therapy can really help. They can help you modify and work on muscle/movement imbalances that may relate specifically to you. (see below for a few general exercises)

 

2.)    Mind the position of your neck when you sleep. Do you use multiple pillows at night under your neck? You could be perpetuating this forward head posture, pushing your head up while you sleep. Use just 1 medium-sized pillow to cradle the back of your neck, or a small towel roll under the crook of your neck to support it. Personally, I’m not a big fan of contoured pillows because if you don’t fall asleep in the same position every night, or you move around a lot while you sleep those pillows don’t move with you. Your neck could end up in a worse position before morning, and then you wake up with a terribly stiff neck! Therefore, don’t waste your money. The best positions to sleep in for your neck is either on your back or side with pillows for support. Sorry stomach sleepers, this is the worst position for your neck because you are forcing your neck to be rotated to one side the entire night. Ideally, you want your neck in a neutral position. See example below.

sleep position 2

 

3.)    Postural exercises! Yay! Over time, if you keep your head in a forward head posture you could actually change the length of your neck muscles. Usually with forward head posture comes rounded shoulders as well. This is perpetuated by tight pect. muscles. The muscles along the suboccipitals (back of the neck, where your skull meets your cervical spine) become stretched out and lengthen so it’s hard for you to contract them and therefore bring your neck back. Therefore, we need to strengthen them –here comes the chin tucks! See some postural strengthening exercises below.

Rows – with theraband, strengthen in between your shoulder blades to help you keep your shoulders back.  3 sets of 10 with squeezing shoulder blades together.

exercise rows pic

Chin tuck – 10x with 10 sec. hold (or work your way up to holding for 10 sec.)

chintuck 1   Step 1.) normal head posture -note forward head

chin tuck 2  Step 2.) think of making a double chin (glamorous I know 😉

4.) Neck Stretches – Your strengthening exercises mean nothing if tight muscles keep pulling your neck back to the position it was in. Below are 3 stretches that will help.

Upper trap stretch  – 3x for 30 sec. hold (each side) -Ear to shoulder on each side, with slight over-pressure with your hand. Make sure you are keeping the opposite shoulder down.

UT stretch

Levator scap. stretch, – 3x for 30 sec. hold (each side) – Nose to armpit with slight over-pressure with your hand on the top of your head.

LS stretch

Pect. stretch  -3x for 30 sec. hold – the one shown below is on a foam roller in what I call a ‘touch-down’ position. This is just one way to do a pect. stretch. You can also perform a stretch in a door-way. See below.

foam roller stretch

 

5.)    Modalities to help with pain/stiffness

  • Moist heat as mentioned in an earlier post, helps relax muscles and promotes blood flow to the area. Apply to neck and upper back for 15 -20 min.

hot pack

  • Biofreeze (Biofreeze) – pretty good topical analgesic used to help you with pain in your muscles. You’ll only need a dime sized amount and rub in until it’s absorbed. A little goes a long way. Also, be sure to wash your hands after use!

biofreeze

  •  Kinesiology Tape (Rocktape Kinesiology Tape) – everyone has their own opinion on this kind of tape, but in my experience it helps patients feel better. The thought is that is helps the fascia crinkle and move blood blow to the area. Kinesiology tape is taping for movement, NOT to stabilize or prevent you from moving. It’s supposed to help you move easier. It pretty much feels like a hand is on the back of your neck. See picture below for one type of taping technique for posterior neck pain. Keep tape on for 2-3 days, but not much longer because it can eventually irritate your skin. Make sure skin is clean when you put it on. Careful when taking it off, ideally after you shower, or with the use of baby oil to protect your skin.

neck tape

Rocktape Kinesiology Tape (click to purchase)

– Thera Cane Massager – Self torture device. A way for you to work out some of the adhesions/knots in your upper shoulder and back. You can use this for many areas of your body to work out the ‘kinks.’

theracane pic
t-cane exercise

Thera Cane Massager (click to purchase)

  • Manual therapy – whether that be a massage or if you are going to a physical therapist this can definitely aid in decreasing your pain and improving your ROM in the neck and shoulders. Research is varied on various manual techniques, but from personal experience I can tell you it helps.

massage pic

Word of note: none of these listed above modalities will do a lick of good if you aren’t making activity/lifestyle modifications because the tightness and pain will just come back!

DISCLAIMER – Although I am a physical therapist I am not your physical therapist. Always consult with your PT or health care provider for specifics about exercises and modalities that may be best suited for you. Also, if you have neck pain with any kind of numbness/tingling down your arms, I would suggest a visit to your doctor to rule out nerve related pathology.