Posts Tagged ‘Pain’

Least I seem like a simple pied piper for exercise, oblivious to any potential harm or risk, this blog should help lessen that perception.  Exercise has wonderful therapeutic qualities to help manage pain and increase your brain functioning.  It’s not without a price.  That price comes in the form of pain – some of it is soreness as shared previously.  There is pain that can not be ignored,  It varies by type of exercise.  I’ll share a bit of the “soreness” versus “pain to get checked”.

Running – the #1 culprit in aerobic exercise pain. So simple to do.  So simple to get injured from.  The amount of force that hits the ground with each little pitter patter is profound.  Each foot strike can be a bit like a right jab from Mike Tyson in his prime x 20.  Not pretty.  There are some technique flaws that contribute to potential running injury – the top is, ironically, the way modern running shoes force the foot into a heel to toe strike.   While good for walking it’s biomechanically inefficient and awkward for running.  Related to this is the more spent on a running shoe the lesser the benefit – if the human foot is coddled it becomes miserable and aggressively shares its misery with the knee and lower back.  See the article below from Wired for more.

Pain not to ignore in running – chronic pain indicator:

  • Plantar Fasciitis – more than just a mild sore arch, plantar fasciitis is a slight to major tear or fracture of the tendon and connecting tissue in your foot.  It’s truly a runner’s plague.  Rehab can take months.  Best prevention is to ensure a strong arch (alas where most running shoes coddle too much and weaken) and cold soaks of the foot before the pain starts. I had a nasty bout of this in 1996 and went from a semi-curved last shoe to a straight shoe (new balance, mizuno and saucony are good brands for the straight last).  It did linger for five months.
  • Knee – all sorts of knee pain can be aggravated by running.  Some is transitional soreness.  Others in terms of ligament or knee cap stress should not be ignored.  Efficient running can help avoid this.  Another preventive measure is avoiding 100% of running on concrete surfaces (mix in trails, asphalt and cinder).  You can run on weak knees and see improvement in those knees.  A good friend of mine, after reconstructive knee surgery in one knee and a cocktail of treatments in another, has been able to regroup and resume his cycling / running combination as well as his pursuit of a marathon in every state.

Pain that is typically transitional soreness

  • Shin splints.  When I first began running, post high school running in 1992, one of my pain companions was a good old shin splint.  Shin splints occur as muscle and joints are stressed and strengthen along the calf / shin.  These typically grow and heal as consistent running occurs.  A simple way to strengthen your shin is to take can old paint bucket (empty), place a small brick in it (about 2-3 lbs max) and then place over your foot.  Lift your foot up and ease down slowly 12 to 15 times.
  • Sprained ankles, oh my.  Sprains travel in pairs.  Sprain one ankle and another one follows.  There are some good stretching exercises – a primary one is to simply flex your ankle in every possible direction.  Strength training for ankles (and other aliments) is important as well.  Check this article out for some good tips http://www.pponline.co.uk/encyc/tendon-strength-training-7
  • Sore shoulders, quads, buns, etc.  Soreness in those areas is just that – soreness.  Typically chronic pain will not ensue.  It’s just your body’s way of saying “hey, was pretty comfy all of these years, why are you changing now?”

To Run Better, Start by Ditching Your Nikes | Wired Science | Wired.com

Strong evidence shows that thickly cushioned running shoes have done nothing to prevent injury in the 30-odd years since Nike founder Bill Bowerman invented them, researchers say. Some smaller, earlier studies suggest that running in shoes may increase the risk of ankle sprains, plantar fasciitis and other injuries. Runners who wear cheap running shoes have fewer injuries than those wearing expensive trainers. Meanwhile, injuries plague 20 to 80 percent of regular runners every year.But the jury’s still out on whether going barefoot is actually an improvement.

“The running shoe right now is doing nothing for preventing injuries,” said Reed Ferber, director of the Running Injury Clinic at the University of Calgary’s Faculty of Kinesiology. But, he adds, going barefoot has downsides too, and the research so far is still inconclusive. “It’s a total tradeoff.”

Chris McDougall, author of the recent book Born to Run, goes further. “If this were a drug, it would be yanked off the market,” he said of running shoes. McDougall says his own persistent problems with plantar fasciitis cleared up after he started running in Vibram FiveFingers.

On a scale of 1 to 5 with 5 being the highest I’m probably a 5 on institutional running pain knowledge.  For two other aerobic exercises, swimming and cycling, my pain savvy is lower (4 for swimming and 2 for cycling).  I do want to share some about each in terms of chronic pain and touch on strength training.  Avid cyclists please add your insights as well.

First and foremost cycling and swimming are considering healing aerobic exercises – they do not impose nearly the force on the body that running does.  There are some longer term, chronic pain issues.

Cycling – there should be minimal chronic pain, if done with proper technique (not grinding the pedal with your legs but smooth stroke cadence) and proper equipment (clip shoes, right bike for right road, right size and seat placement).  The potential for a crash at high speeds does ratchet up the pain potential (remember your helmet).  Beyond that, knees can be stressed by cycling – though as shared this is due more to improper technique or gear.  Buns also take awhile to adapt.

Swimming – even more than cycling, swimming is considered a healing exercise.  Your body endures no impact in terms of gravity.  You’re buoyant in water.  You learn to move well.  There are some chronic pain problems associated with adapting to water (swimmers eye or ear). The butterfly is the number stroke culprit in terms of strained shoulders.  Then again butterfly is not a staple for endurance swimming. Its a great change up stroke for simulating anaerobic debt for workouts.  I have yet to see someone crank out a 1,500 meter fly in the open water and doubt I will.  Also if piling up swim laps is on your agenda, give your body some rest (24 hours) between swimming and strength training – some strength training during a swim is a great idea!

Strength Training – truly no pain, no gain is NOT the right mindset.  The benefit of strength training is for longer term muscle and joint strength.  Keep weights light and reps high as your body adapts.  There’s no benefit from trying to slam down 8, 45lb plates on your squats or 4 plates on your bench to compete in the weight room.  Most serious weight lifters are very helpful in terms of explaining proper technique and weight.  I’m a bit beyond caring whether someone uses my bench press weight for their curls – the person that does can be a great resource.  Absent a physical trainer (recommend you do find a good physical trainer) you can pick up some solid advice.

An overall pain prevention technique is to blend and weave in multiple exercises – tie in the ones listed here with Aerobics, Spinning, Indoor machines (elliptical, stair step), Martial Arts, etc.  Ongoing repetition limits improvement and reinforces the “pain side” of the exercise force.

Next up on the Exercise – Brain Connection is Goal Setting.  Whether at our TAPU blog or via Facebook/Twitter/LinkedIn – please do share your experience and opinion with exercise and chronic pain.

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The following article from WebMD helps and encourages anyone beginning an exercise program or anyone who’s been in their program for years.  Sore muscles will occur – call it the acute pain of overcoming inertia.  I was thinking of this very topic during a 20 mile run today – which was relatively pain free.  There will be some pain from exercise.  That’s OK.  The key is to determine what is normal soreness and what may be an indicator of a more serious problem.  This blog concerns normal soreness.

Two Types of Soreness that are good

acute, immediate– this is the type of soreness that occurs during or very soon after you’re done exercising.  It can happen to newbees or experts.  There’s also some characteristics of soreness from different activities – here are some that bubble up high on the list

Running:  shins, quads, hamstrings, knee, feet and shoulders, oh my!  Each of those will be pushed.  Depending on current fitness level and body composition, your soreness in any one area will vary.  Here is one big hint. Learn to run on the balls of your feet (I’ll have an entire blog on fore foot running).  For now let me just say that our bodies are meant to run toe to toe or on the ball of the foot (walking is heel to toe).  The downside is most running shoes cater to heel to toe strike.  Test this yourself – run barefoot for 200 meters and see how your foot falls.  Its natural fall is on the balls of your foot right before your toes.

Cycling:  buns, quads, shoulders and back.  Lots of bending over on top of a bike.  Proper technique (smooth and fast rotation instead of straining or chopping your stroke) helps.  For the buns aka “saddle sore” a cycling or triathlon pair of shorts  is well worth the investment.

Swimming: a wonderful healing aerobic activity swimming can strain the shoulders and back depending on type of stroke and, more importantly, your efficiency with each stroke.  Other irritations include swimmer’s ear and even the dreaded google imprint on the nose.  Compared to running there’s far less soreness involved. 

Lifting: more related to DOMS and discussed below, the soreness from weight lifting is typically 30-48 hours after.  This is the old “bench pressed 205 yesterday and can’t lift my toothbrush today” syndrome.

Sore Muscles? Don’t Stop Exercising  http://www.webmd.com/fitness-exercise/guide/sore-muscles-keep-exercising?page=3
After participating in some kind of strenuous physical activity, particularly something new to your body, it is common to experience muscle soreness, say experts.

“Muscles go through quite a bit of physical stress when we exercise,” says Rick Sharp, professor of exercise physiology at Iowa State University in Ames.
 
 “Mild soreness just a natural outcome of any kind of physical activity,” he says. “And they’re most prevalent in beginning stages of a program.
 
delayed onset soreness (DOMS)   Ah, the joy of the two days after a marathon, triathlon or 100 mile bike ride.  Walking around with a little hitch in your giddy up.  I’ve included a link to a fun video about the day after a marathon.  This type of soreness will lessen.  It’s a profound how our bodies are wired to deal with pain.  It’s associated with the muscle tear down and recovery cycle.  Read more about why DOMS happens in the WebMD article referenced above. 

To overcome DOMS the most powerful and frequently overlooked treatment is the cold soak – within 15 minutes of ending your session.  This runs counter intuitive to what our body tells us (a message of let’s soak in a hot tub and grab a massage is much more inviting than lets sit in a tub for 20 minutes with ice and shiver like a Titanic survivor).  But it’s the best way to reduce inflammation and quasi secret method for Olympic and professional athletes to treat DOMS.  Another good method is to stretch, warm up, cool down and stretch – call this more of a preventive technique.

In the next Exercise – Brain blog we will share a bit about what to do about chronic soreness or pain that indicates a deeper issue.  Additionally some ideas on how to manage that pain will be provided.

 

The day after the Marathon

“Delayed onset muscle soreness (DOMS) is a common result of physical activity that stresses the muscle tissue beyond what it is accustomed to,” says David O. Draper, professor and director of the graduate program in sports medicine/athletic training at Brigham Young University in Provo, Utah.To be more specific, says Draper, who’s also a member of the heat-responsive pain council, delayed onset muscle soreness occurs when the muscle is performing an eccentric or a lengthening contraction. Examples of this would be running downhill or the lengthening portion of a bicep curl.

So you thought exercise meant pain? 

While there’s some pain that results from exercise (either during or after – called delayed onset) the pain relief benefit from exercise greatly outweighs the pain creation.  This article provides a nice summary of what’s involved and I’ll shout and echo the sentiment that “Moving is what the human body is designed to do”…

http://www.nationalpainfoundation.org/articles/11/reaping-the-benefits-of-exercise?PHPSESSID=0e91394ee648b212802586b2a34ddd63

Mixing aerobic, strength (anaerobic) and flexibility are the key – one type alone will not accomplish it. 

  • Aerobic exercise from running or cycling or aerobics classes help fuel that authentic wonder working tonic called endorphins.  From Medicine.net “Endorphins are manufactured in the brain, spinal cord, and many other parts of the body. They are released in response to neurotransmitters and bind to certain neuron receptors (the same ones that bind opiate medicines). Endorphins act as analgesics (diminishing the perception of pain) and as sedatives”
  • Flexibility helps your body correct itself from a generally sedentary lifestyle we have.  If you think about it, sitting at a computer or standing all day on your feet are the most punishing things you can do to your body.  So stretching, yoga and Pilate’s help increase your range of motion
  • Strength training does not mean “you’ll get pumped up” in the “governator” sense.  It does mean you’ll build muscles first and then over time (3-6 months later) your joint strength.Consider strength training your body’s natural ibuprofen. 

I’ve seen the benefits of exercise increase as I age or struggle with some minor chronic pain issues.  I have a flaky almost non existent thyroid that presented itself in 2001.  A 2 mile run felt like I was at mile 20.  It didn’t add up.  After a diagnosis and proper meds – Levoxyl rocks – I was back on my way.  However by focusing too much on running I would find myself fatiguing.  As I’ve mixed in a heavy triathlon dose and kept my strength training year round, I’ve noticed a much greater improvement in pain management.  Again, my pain management is very minor and I empathize with those who have arthritis or fybromyalgia or Lyme disease.  I’ve also seen that blending in healing aerobic activity of swimming and cycling helps with the body pounding nature of running (in a future blog I’ll share some secrets on how to make it less body pounding beginning with “get off your heals and onto the balls of your feet”).  My next step is improving my flexibility. 

Now further testifying to the benefit of exercise, I’ve felt the old body aches more if I’m away from some serious workouts for 4-5 days (lets say traveling).  The lower back creaks, feet hurt, etc. 

Please do share what you’ve found – whether you’ve exercised all your life, its been a few months or you’re just beginning.

Next up – overcoming the Pain from Exercise.