Wednesday 29 November 2017

More Pain, More...Pain?

A lot of you reading this may subscribe to - and possibly live by - the "more pain, more gain" rule. The harder you workout and the more sore you get, the more strength and size you gain. The harder you run through the burn, the faster you become. Transferring this train of thought to the rehab realm: the harder you dig in there, the better you'll recover.

Whether it's through traditional massage, Graston, cupping, active release, or some other form of modality, does a higher intensity of the treatment correspond to increased recovery? In other words, does a more painful session somehow equate to less pain once a client leaves? (Even if the client can "take it"?)

Well, let's consider the reasons why people may believe that "going harder" results in an increased benefit. For instance, when it comes to tight muscles, scar tissue, adhesions, and the like, the common believe is that these modalities are physically breaking down those restrictions. Unfortunately, as I've pointed out in the past, massage does not break down muscle or scar tissue. Rather, these treatments are providing a new sensation to the nervous system in order to allow the tissue to relax and release its tone in the region.

That being said, given that this effect is nervous system-driven, more or less pressure may sometimes be required. Pain tolerance, while not all in your head, can dictate how much of an effect you experience from treatment. With that in mind, however, it can mean that a highly-sensitive person can get the exact same result from a very light massage as a very highly pain-tolerant individual with a more aggressive session of active release.

With all of this being the case, I can't say that I'm very comfortable with trying to give anyone a "harder" session of soft-tissue work than they can take. Some discomfort is to be expected, of course, but if I'm causing excruciating pain, I don't see how that can result in the pain relief that I'm striving to achieve. In fact, the intensity of these treatments might actually work to increase pain-sensitivity, acting in the exact opposite direction of what the goal is!

Does this diminish the usefulness of therapists, however? Of course not. It's still my job to be able to gauge each individual's reaction to different sensations and deliver an effective treatment that remains within their tolerance. When it comes to modality application, just call me a Conservative.

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