It happens to us all at some point; we slip, trip, try a bit too hard, get enthusiastic and do too much too soon (see last month’s post on that one) or some combination of the above. The result: injury.
Around 70% of runners will nurse an injury this year. A third of people aged over 65 will fall over. Back pain is the leading cause of disability worldwide. These are just three of the many, many, many ways in which we can experience pain and disability. Winter is the season for slides on the ice too. Alongside keeping strong and making sure your balance is as good as yours can be, it’s worth knowing what best to do if you do wind up with an injury.
Pain sets our alarm bells ringing – and in a confusing chicken-egg way the alarm bells also set the pain ringing. Below is brief and hopefully reassuring summary of a very complicated experience:
Pain is a perfectly NATURAL, completely HEALTHY, very PERSONAL and always REAL response to our body experiencing something that it doesn’t like.
One person’s experience of pain is never the same as the next person’s.
How we experience our pain is often not related to the the actual, physical level of damage.
Our perception of how significant our injury is can drastically affect the type and level of pain that we experience.
A huge positive is that learning about our pain is therapy. It can improve how we experience pain and the likelihood of us doing what our body best needs in order to heal.
With an acute (only just happened) injury, pain is usually a signal to back off, ease off and give your injured body part a (bit of a) break. In the short term, find the things – movements, positions, activities – that ease and that you can do as comfortably as possible.
E.G. for something like back pain, this may be lying on your back on the floor, or perhaps leaning on a worktop and gently arching your back one way and then the other.
E.G. for shoulder pain, a supported arm position, where the weight of your arm can be taken by e.g. a pillow or a chair arm, may be better than letting your arm hang.
Don’t forget RICEM – Rest, Ice, Compression, Elevation, Medication. A support bandage on a sore ankle can make it feel much more comfortable. Elevating a wrenched knee up onto your sofa with a cushion behind it can be very relieving. For swelling then an icepack/bag of peas on the affected area for 10 minutes can ease pain and reduce inflammation.
Rest is important because it does permit healing to take place whilst little to no strain is being placed on the injured part. But movement will, in many ways, help repair most body parts as well.
My most used phrase for initial healthy movement is GENTLE AND FREQUENT.
Mixed in with rest periods and positions, move pretty often and in a way that doesn’t cause too much discomfort. You will probably need to slow down and reduce what you do compared to your normal but again this is OK; you’ve hurt yourself, give yourself a break, just not too much of one. Some pain is to be expected but again, this is OK and is natural. Lying flat on your back all day in order to fix something is pretty guaranteed to not work.
They’ll be specific to your problem but some points to consider are:
Around 3-4 out of 10 on a pain scale, where 0 is none at all and 10 is the worst ever (for you) is probably acceptable. Our language is peppered with phrases to sum up our experiences and ‘grin and bear it’ is appropriate here. Those painful spikes, the ones that make us inhale sharply or let out an involuntary pain sound, are often unavoidable. Providing that over time they’re not getting more painful or increasing in frequency the above ‘grin and bear it’ applies.
Don’t do anything that obviously aggravates and increases your pain to very painful levels. This applies to pain experienced during and/or after the activity. We tend to be very tuned into pain ‘in the moment’ but keep an eye on your discomfort over time. If the problem appears to be getting worse over hours/days then it’s likely that you’re overdoing something and need to cut down. Conversely, it may hurt right now but if your pain this Sunday is noticeably less than it was last Sunday, you’re probably getting it right overall 🙂
A knee example: your knee started hurting a couple of weeks ago and you’re now testing it out on a walk. It’s fine for the first 1/2 mile but then starts to niggle and after 2 miles your knee is painful. STOP. You’ve done enough for today. 1/2 a mile sounds like your limit for now so have a break and try again another day.
A back example: you’ve hurt your back and are now moving a few pots around the garden. Your back feels a bit niggly at the time. By the evening it’s aching but the following day it actually feels a bit better than it did the day before. This suggests that, though it’d be wise to not shift any larger pots around for now, your current pot moving activities are probably OK. You’d probably also benefit, both now and in the longer term, from doing some general strength and stretch exercises and some exercises specifically for your back.
Once you’ve found the easing positions AND the movements that you can do with none to not-too-much pain, you can gradually increase and challenge your activity levels as your injury heals. Remember to keep all of your uninjured parts fit, strong and well stretched. Throw in some quality sleep, decent food and a few distractions and you’ll hopefully feel yourself improving bit by bit. In my experience it always takes longer than we think – and longer than we want – for an injury to shift. So close your eyes, take a breath and be patient. Use the opportunity to do something different that doesn’t bother your current problem.