Pain is something that no one enjoys living with, but it can be even worse when we start to feel better and a few weeks later we have a set back again, leaving us hopeless and wanting to just give up our favorite activities because of it.
Even with low grade aches and pains, utilizing a graded exposure strategy can help dampen the pain response and allow us to desensitize our hesitation towards certain movements.
This strategy allows us to slowly reintegrate patterns by progressively advancing the intensity and using a gauge of how we feel as the main feedback mechanism.
Let’s use the example of low back pain from bending over.
The act of bending over will become a hesitant movement going forward after the injury as your body will perceive that as a threatening movement and cause tension and restriction before even perfuming the activity.
By changing the environment and the perception of the task we can start to reintegrate the movement and change the notion of “threatening” to “safe”.
One starting option would be to squat up and down to a chair. If that feels fine, do it, while looking in a mirror to create a brain association that some spine flexion is safe.
As that gets better, the squat would progress to a lower depth under the same principles, furthering the need for some degree of spinal flexion.
Following this, bending forward in a chair, such as tying your shoes would be a great way to reintroduce the act of bending over, and you can repeat that in the mirror again.
After these moves, try bending over again in front of the mirror so that you can see the safety in the move. You’ve seen the spine bend in the chair prior, so this should not be as bad.
(Another option for bending would be in a pool if you had the accessibility to one, but this is not always a viable option).
These things are all case by case and the amount of time before progressing really goes based on how comfortable you are doing something, but you should also push the envelope slightly in order to progress.
For example squat pain with 225lbs may provide some discomfort after 5 reps.
If you were to complete 3 sets of 2 reps, you can get 6 reps in, but stay under the pain threshold. Then you can progress the weight to 235 with the same rep scheme.
Following the increase in weight, you can progress the reps, and if same sensation under more weight occurs after rep 5, it shows you are handling more with no increase in danger detected. This is the definition of progress is slowly reintegrating more work in with less chance of setbacks.
Are you still struggling with reintegrating movements into your programs or just struggling with doing daily tasks?
Don’t sweat it.
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Dr. Peter Dionisopoulos is the owner and founder of Dynamic Performance & Rehab. He has a Doctorate in Physical Therapy and enjoys to help active adults maintain their lifestyle and provide natural solutions to their pain.