What is Pain?
How, Why, What is Pain All About?
Let us say that you have suffered whiplash due to a car accident. Whiplash is hyper-flexion and hyperextension of your cervical muscles, tendons and sometimes ligaments. It is a severe straining and spraining of your neck muscles and soft tissue causing them to tighten-up. It hurts because those affected muscles have spasm, become hypertonic (short and tight), which therefore entraps nerves and causes pain. There is damage to those affected tissues, including microscopic tears which cause “Trigger Points”. Trigger Points if not treated appropriately will cause adhesions and muscle gluing. Therefore once injured, your body does not want you to move those painful, affected, damaged muscles and soft tissue. So the body, being the intelligent wonderful creation that it is, says to you through pain, “Please do not move - I am injured!” If you do move, I will just continue speaking my message to you through pain. Pain can be a good thing, for without pain an injured individual would not know damage has occurred, and further damage would ensue. Think of pain as being the red light on your dashboard, warning you that there is system failure. Asking you to “check the engine”, (so to speak). You just do not want to live with pain, as the message would be the same “there is something wrong.” with continuing tightening and damage occurring.
You must eliminate the pain to prevent not only the discomfort of pain itself, but to correct the problem so the damage is halted and repair can take place. Therefore when you have tendonitis, bursitis or strained muscles, you should not exercise right away. First, you need to reduce inflammation, then LOOSEN those short, tight muscles and soft tissue, along with eliminating trigger points, adhesions and muscle gluing. That is the beginning of wellness, and your road to recovery. . Until soft tissue is loosened and treated appropriately, strengthening exercises can actually contribute to the problem and make the condition worse. Hot packs do not loosen; hot packs just relax the muscles, and should never be used when first injured (Acute phase). Cold packs and or Ice are most appropriate and effective
I repeat: First you must loosen your muscles before you attempt to strengthen your muscles. I ask you, “does it makes sense to strengthen muscles that are injured, hypertonic (short and tight), has trigger points, etc., or does it make more sense to loosen “before” you strengthen? And just as importantly, the therapist or medical practitioner has to know how to treat the fascia, trigger points, soft tissue etc., along with the appropriate stretching and strengthening. As previously stated, a trigger point is a hypersensitive area of muscle tissue that has been created by microscopic tears in the muscle fibers (those are the knots you might feel in your neck or back) these trigger points are tender when compressed and may give rise to referred pain and discomfort. You should also note that there are many ways to stretch incorrectly. Stretching for 10, 20, or 30 seconds etc. is incorrect and counter productive.
In muscle tissue, there are proprioceptor sensory organs such as the muscle spindle and a golgi tendon organ. These structures detect the intensity, force and duration of the stretch and or contraction. Notably, there is little duration in the stretch with a whiplash. Duration means the time taken to hold the stretch. In other words, if a therapist, tech or aide holds a patient’s muscle in a stretch for 20 seconds, that is the duration and it is overstretching.
When a stretch is performed and if held for too long, can create weakness in the muscle fibers and structures. This can then set up a scenario for a strain, tear, or injury to tendons, ligaments and soft tissue happening in the future. Accordingly these sensory organs will sense if the duration of the stretch if held too long, will signal to the brain and ask it to contract, shorten or even spasm that muscle to protect itself from damage during the stretch itself.
During a strong, intense contraction or stretch, again these proprioceptors take charge and are facilitated. (IE: whiplash, slipping and falling, intense work outs, etc.), and will then signal the brain to tighten/contract those muscle fibers from tearing and causing further damage to soft tissue, tendons and ligaments. (In essence, in the case of whiplash this fail safe system prevents your head from flying down the road). Likewise, the same protective response will happen to any other part of your body that is strained, sprained, or injured, (Shoulder, back, hip, leg, etc).
The short story is when muscles strained, they become short and tight. Nerve fibers and endings then become entrapped causing you pain. Loosen those structures appropriately, attain full range of motion coupled with timely strengthening and you will be back to your good ole self.
We treat patients in Clearwater, Palm Harbor, Safety Harbor and other surrounding areas in Pinellas County, Tampa Area.
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