Last week’s blog delved into the commonly accepted guidelines in rehab that pain should be avoided at all costs. And while excruciating pain shouldn’t be pushed through, there is a way we can work with our pain, rather than always feeling like the pain is constantly working against us.
Pain is the biggest reason we see people here at Made 2 Move. So what is the Made 2 Move approach in addressing this pain to help get you back to the things you want to do?
How Do We Tackle Pain?
First, your PT will do a thorough exam to make sure nothing major is going on. Once that is cleared, we’ll take a look at these THREE things to determine what pain is OKAY and even helpful for clients to keep working through (vs. what pain is probably making things worse).
Pain during exercise, rehab, (and life) needs to be...
1. TOLERABLE
2. TEMPORARY
3. RECOVERABLE *ppl miss this one all the time
This framework can be applied to those with overuse injuries (ie- I’ve had this back pain has been off and on for years), or after an acute injury or surgery (ACL tear). Using this approach helps you and your PT determine how to appropriately dose + load throughout rehab.
Let’s break down this 3-pronged approach:
TOLERABLE
If you're experiencing pain during a workout, on a run, or with a certain movement, it's generally okay if your symptoms are:
Less than 3-4/10 (10 being extreme pain)
More like a sensation, awareness, discomfort (vs. sharp threatening scary pain)
Doesn't make you worried or distracted
If it's NOT tolerable, then we'll modify the movement to get it in the green light range - whatever allows us to keep the original intended stimulus.
2. TEMPORARY
We DON’T want the pain to increase beyond tolerable during the movement, AND we want the pain to decrease back to baseline, or pretty close to it, once the movement stops (temporary).
If symptoms are getting worse during a movement or they are super flared up afterwards, then we’ll modify it.
3. RECOVERABLE **this is the heavy hitter for most people and is super important to us
In the 2-3 days after a session:
If symptoms have increased BEYOND tolerable, or symptoms take longer than 2-3 days to decrease, then that means the stress/stimulus we placed on ourselves was probably too much (too many eggs in the banana bread - must adjust recipe next time) .
For example, let's say I'm doing an overhead press, and it's like a 2-3/10 discomfort. I decide it's tolerable and temporary, so I keep adding weight or doing more reps. If in the next couple of days - I am experiencing MORE symptoms or more shoulder pain than usual, I can conclude that what I did (the shoulder press) was a little too much stress for my body right now.
Does this mean the shoulder press is bad, damaging your shoulder, or something to avoid forever? NO! It simply means, we need to find a way to MODIFY it. This could look like doing a landmine press, which modifies the muscles recruited, angles moved through, and the overall load going through the shoulder. Pro tip - we usually opt for going more conservative the first time, bc you can always cut off more hair, but once you shave your head, you have to wait for it to grow back).
Here’s What This Means For You: (or too long, didn’t read 😜)
Pain isn't always something we need to completely ignore OR push through - finding somewhere in the middle helps us desensitize and retrain our tissues and nervous system to improve overall capacity.
Remember- the goal of densitization isn’t to somehow magically make this pain pleasant. Rather, it is exposure to the stimulus in an attempt to decrease your body’s interpretation and reaction to this pain. If you're wondering if pain is ok to work through, remember it's gotta be TOLERABLE, TEMPORARY, and RECOVERABLE 🚀
The tolerable / temporary / recoverable pain framework helps us keep our clients moving, decrease their pain long term, and make the most progress towards their goals - while giving them the tools and knowledge necessary to keep working out through the pain/injury rehab process. If you’re interested in working with a PT at Made 2 Move, reach out to frontdesk@made2movept.com today to set up an initial evaluation!