When it comes to self-treatment, there is a plethora of information on the internet. How do you navigate it accordingly? Stretch this, activate that, feel here and not there – you can quickly be standing on your head feeling more lost then when you started. We have put together a “cheat sheet” on what we find are the most important CONCEPTS when trying to self-treat at home. By focusing your efforts on concepts or principles, it will help weed out 95% of unneeded information on the web.
Complexity of Pain
Pain is not simply: it hurts here, so there must be a problem here. Think of when you lose someone close to you; your heart hurts, but there is nothing physically wrong with your heart. There can be many sources of pain, making pain very complex. Pain can be due to: emotional distress, tight tissue, weak tissue, chemical inflammation, etc. These may all be influenced by various factors such as: home and work environment, sports, family, friends, social settings, and psychological distress. Because there are so many factors to pain, it is often described as being bio-psycho-social meaning it is multidimensional.
Before reading on, understand there are limitations with everything. Our list of concepts to focus on are geared toward pain most likely due to tissue damage, close to or near the source of pain.
Movement Pain vs Chemical Pain
When you have pain, think about describing it. If you feel a sharp or stabbing pain with movement or if the pain increases with movement, then most likely there is something going on in that area. Because there is a movement that increases the pain, there will also be a movement that relieves the pain. More on this below.
If the pain is dull, achy, and constant, then there is chemical inflammation in the area causing pain. This type of pain is when anti-inflammatories like Ibuprofen usually works best. Also, consider modifying your diet with anti-inflammatory foods and spices. In the early phases of healing there may be overlap between movement pain and chemical pain; which is okay. If there is an intense dull ache and all movements make it worse, then relax at home, find a comfortable position to rest in, and focus on decreasing the inflammation. Respect the Phases of Healing; focus on the steps listed below and do not rush the process.
Phases of Healing
The body must go through 3 phases of healing: inflammation, repair, remodel. Below is a chart that helps to track the phases of healing. Now stating this, there are different types of tissue (muscle, fascia, nerve, bone, cartilage, ligament, etc.) and each has its own respective healing time. For example, a damaged tendon can take up to 52 weeks post injury to regain its past strength (1). It is also understood if you have surgery these phases of healing will take longer. Moral of this story: pain takes time to go away when there is damaged tissue around the area of pain. Respect the healing process.
Phase of Healing Healing Time (Days)
If pain occurs or increases with a certain movement, then there is a preferred direction to heal, repair, and remodel that tissue. When considering which direction to move listen to your body; it is often smarter than you give it credit for. This does not mean, ‘it hurts so I cannot move it.’ If nothing is broken, do not be afraid to move it. Inactivity will only make the healing process take longer. When moving the injured area follow the 2 steps below.
Centralizing and Peripheralizing
Pain can move and how it moves tells a story. Two ways pain moves are through the concept of centralizing and peripheralizing.
Centralizing means the pain is becoming smaller or more pinpoint.
Example: I go to pick up my nephew and feel my back twinge. The next morning it hurts like the dickens and I feel symptoms down into my foot. If I find a preferred direction that hurts, then I move in the opposite direction. If I move in that direction enough I feel my symptoms lessen in my foot and become more pinpoint in the low back.
In this example, the pain is centralizing to a smaller area which is good! Smaller area means “less” damage and better outcomes; this is what we are wanting. Starting to make sense?
Peripheralizing means the pain is becoming broader or moving away from the site of damage.
Example: Take the same scenario as above. If I move my back in a direction repeatedly and I feel more symptoms in my foot this is bad! No beuno!
This is called peripheralizing and this is not what we are wanting. Hint: try moving or resting in another direction.
End-Range of Movement vs Mid-Range of Movement
In the early phases of healing stick to mid-rage motion (or just rest if bad enough). This helps the tissue heal. The old idea of bed rest is relatively dead; movement is king. If you can move it in mid-range without pain, then do it. If it hurts, then don’t; it’s not rocket science here. Phases of Healing help guide you to end-range movement or mid-range movement. If you are toward the end of inflammation and/or within repair phase, then stick with mid-range movement. But this is not a meathead approach; moving farther does not mean better. Once you notice the pain less or not at all during mid-range motion and are into the middle of the repair phase, then try a few sets moving more into end-range of movement.
My hopes involve you giving the above advice a chance. There is nothing wrong with giving it your best shot and things not working out. If you find that any of this is too complex, then seek help. This is why the healthcare profession has so many different types of providers - all help within their own respects. It simply depends on the pain source, and how many sources of pain. Sometimes there can more than one type of pain source (ie muscle pain and ligamentous pain) occurring at the same time and that is okay. Do not stress over it. Finding the right chiropractor, physcial therapist, or other healthcare provider will also help in finding answers.
Remember, the body is a complex thing. There is a reason why people go to the gym and do not see results immediately. The body takes time to adapt and if it does not go through the correct stages, or keeps flaring-up, then further help is needed.
1. Buchanan CI, Marsh RL. Effects of exercise on the biomechanical, biochemical and structural properties of tendons. Comp Biochem Physiol A mol Integr Physiol. 2002; 133:1101-1107.
2. Principles taught via McKenzie / MDT (Mechanical Diagnosis and Therapy).