… I didn’t even really DO anything!?
I hear these types of things every day, and I have a theory about our pain.
I tell my patients, and anyone else who will listen, that I think of our bodies as buckets. We are born ’empty’ buckets and every time we fall out of a tree, trip off a curb, get in a fender bender, walk into a closed door (come on… I’m not the only one!!)… every time these things happen we get drops in our bucket. By the time we hit 30, maybe younger if we happen to be daredevils or particularly clumsy, our bucket is getting pretty full.
You know that little meniscus you see over a glass… that’s our pain. That’s 30.
We can lose weight, start stretching, go to physio and we can get ourselves below the lip of the bucket and feeling pretty close to ‘normal’. The very next time we do something, no matter how small… it could be vacuuming or raking leaves, or lifting a box, and it can refill the bucket if we move slightly incorrectly.
I had a patient once who was so frustrated, and I don’t blame him, but he could hardly stand or walk when he got to my office. The culprit manoever… bending over to throw away a tissue. It doesn’t need to be anything magnificent for us to start feeling pain again.
I think this is why we all feel invincible when we are young, too! The top of that bucket is so far away when you are 17 – nothing can hurt you!!
…but WHY does pain and restricted movement get worse?!
Inflammation (as a result of soft tissue injury*)
When soft tissue injury occurs, white bloods cells called Neutrophils are the first to arrive and they summon other immune cells by widening blood vessels to allow the area to be flooded with extracellular fluid. The fluid contains Monocytes, which mature into Macrophages (big eaters) that remove the damaged cells and metabolites from the area. While this is going on we see the ‘cardinal signs of inflammation’:
- heat (calor)
- redness (rubor)
- swelling (tumor)
- pain (dolor) – when the area is inflamed there is pressure on surrounding tissues, including pain receptors – nociceptors.
*there are other instances of inflammatory processes that can go on in our bodies that don’t originate with injury. Some examples include:
- Colitis and Crohn’s Disease
This is really a result of your body trying to protect you from further injury. Let’s take the fellow who was tossing away his tissue as an example. He bent over and felt a ‘tweak’ in his back. It was severe enough for him to discontinue activity. He tried to take things easy for a few days but things seemed to get progressively worse! Things seemed to be getting tighter! He couldn’t sit comfortably, or even tie his shoes!
When the injury occurred the body recognized that an area was in danger – a muscle tear was about to occur, or a facet joint was about to ‘go out’ – sensing this, the surrounding muscles contracted/tightened up to prevent further injury (a protective muscle spasm). The constant state of contraction causes decreased blood flow to the area – ischemia. The lack of circulation and tight muscle, over a period of time, causes the retention of metabolites, an increase in toxins, the muscle to shorten and to restrict movement even more.
A reactive spasm ‘should’ resolve on it’s own, when the threat to the area is removed, but that doesn’t always occur.
Stress, Pain and Cold can propagate this process and create a pain spasm cycle. Any of these can cause reactive tightening/protection and consequently, further reduction in blood flow and a chronic pain situation.
It doesn’t mean you are destined to live a life of pain. There ARE things we can do that bring us below the lip of the bucket again, the key is to do them regularly, and to look at the things in our life that we may do to aggravate our bodies… and modify them.
The good new is that massage, when provided by a Registered Massage Therapist, is an evidence based treatment that has proven effective in breaking the pain spasm cycle. The utilization of appropriate techniques will result in increasing blood flow, decreasing muscle tightness and aiding in the elimination of inflammatory cellular waste – metabolites/toxins. All of this brings about normal muscle function, range of motion and strength.
As we age, it becomes more and more important to be proactive in our health. We need to arrange our environments to be less aggravating and be consistent in doing things that keep your pain level low. Keep the aggravating factors at bay.
If you need specific advice, I’m here to help!