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You're in pain, now what?

Being active and athletic (yes, you are) means that you have probably encountered pain somewhere in your body. Most commonly shoulders, backs and knees. Sometimes that pain may last 3 days, sometimes a week but what about when it lasts longer?


The most common question is, "what do I do now?" That question also runs a lot deeper.

"What can I do?"

"What should I not do?"

"Do I rest?"

"Ice or heat?"

"Do I have to stop x....?"

"How long is this going to take?"

"Do I need an x-ray or MRI?"


Pain is scary. Pain just sucks. There are so many unknowns about pain. Even a medical professional doesn't have all the answers. If they say they do, RUN. So I am going to try shed some light on what to do after you have encountered pain. What I am going to say is not the absolute truth. There is a balance to just about everything in life. You want the absolute truth...read the bible. :)


Step 1: Assess your pain.

How severe is it?

How long has it been going on?

Does it stop you from doing the things you love or life in general?



Step 2: Seek help

If your pain isn't severe (>3-5), hasn't been going on for over a week, and isn't really limiting you, then just give it time. Don't worry about it. YOUR BODY WILL HEAL.


However, if your pain is limiting you from doing something you love such as running or working out, then look to get some help. If you can continue the majority of your activities such as crossfit as a whole but you are avoiding certain activities due to pain like muscle-ups or box jumps, then get some help. If you are still pushing through all those things and doing it anyways but paying for it later with 7/10 pain, then get some help. In the majority of cases, pain is only temporary.


Step 3: Seek the right help

Every medical professional has their place. You aren't going to go to an eye doctor to look at that weird growth on your foot. You aren't going to a neurologist specialist for your knee pain. Your primary care physician knows a lot about everything but chances are they are not specialized in musculoskeletal injuries. Their job is to help you get acute relief and send you to the right person. That person could be an orthopedic doctor or a physical therapist. Physical therapists are trained to send you to the PCP or orthopedic doctor as well. So you can just as well start there. Of course, that's what I would recommend. I am biased- BUT the research supports lower costs and quicker recovery when you start with the person you are most likely going to end up with anyways (Go figure.)


Step 3a: Don't rush to get an MRI or X-ray.

While you may think imaging holds all the answers, it doesn't. It is a snapshot into what your body looks like, not how it feels or moves. Does't that smiling picture you posted on Facebook really show the aftermath of before or after trying to get your kids to smile? No because it is a single moment. Your MRI may show "nothing" but that doesn't mean you are not validated for having pain. Your MRI may be "really messed up" but if that is not matched with your symptoms in the clinic, then it can instill fear and an expectation of pain. It is more important to watch and see how you move, listen to what your symptoms are and touch those area that hurt. I am not saying MRI's and Xray's aren't useful or aren't needed. I am saying they are not needed for the majority of musculoskeletal injuries (muslces, nerves, bones) for a good physical therapist to treat. If your symptoms warrant any imaging, your PT will know and refer you back to the doctor.


Step 4: Rest, but not really

Rest can be important for a healing body. But sorry, I don't mean feet up on the couch all day. I mean modifying the activity you are doing but still keeping at it. Let's take running for example. How do you modify? Well, switch to elliptical, pool running or change your mileage. Or maybe, you started off running up hills so just changing your terrain can help. The modification should only be temporary to allow your pain to calm down while you build the strength you need or address the mobility issue that is the likely cause. Very rarely should you ever have to completely stop an activity for good. Modify! YOUR BODY CAN HEAL! If you have an activity that you love doing it, keep doing it! But if it hurts, get the right help so that you can modify and make the right adjustments until you are able return fully to doing what you love.


Step 5: Develop patience.

YOUR BODY CAN HEAL! (Have I mentioned that?) But healing takes time. If your injury has lasted more than a week, chances are your injury is more than just a "tweak" however even "tweaks" take time. Surgery actually takes longer to get through, though. Many people think surgery is a fast fix. The fix part might be quick but the recovery is much, much longer and then usually you still won't get to 100%. Take a look at the following healing times to help your expectation meet reality.


Does this mean you will be out that long? Not necessarily. Theses are just average times. There is not a correlation with pain. You may get back to 99% of your activities before these times. However, don't expect to be better in just days or weeks.


Rest won't get you there. The body heals under load. You must spend time under tension to improve your tissue quality, improve strength and improve mobility. It can be frustrating to know where to start. Find a good quality physical therapist who understands what you are doing and your love for it. Be patient and get better!

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