Life Doesn't Mirror Gym Movements (And Doesn't Have To)

No, I'm not telling you that the gym is bad and that you should stop going. There are many fantastic reasons why the gym is awesome.

However, there's a certain phenomenon among many of my clients that I'm noticing. Fear of movement.

The best example is the rounded-spine position. On one hand, many individuals who experience back pain are told by doctors, therapists, and more to absolutely avoid bending down and rounding their backs; that doing so will result in more pain. Having this fear of that movement instilled, however, does little to remove their pain, as these positions are, to say the least, inevitable. As a result, the nervous system, essentially, becomes primed and ready to guard against those movements, causing pain in those ranges and positions when pain wouldn't normally be a necessary response in that case. 

We call this kinesiophobia, the fear of movement due to pain which actually works to prolong pain and disability.

Here's the surprising thing. Active and healthy individuals experience this too! I've also seen this in very disciplined gym-goers who, for all intents and purposes, have nothing mechanical going on to suggest that they should be in pain. However, due to the immense emphasis on "good form" that active and athletic individuals may be bombarded with, I've been witness to the exact same avoidance-triggered pain. These are clients who are under the impression that it's necessary to square-up and keep a neutral spine curve every time that they so much as bend down to tie their shoes. And again, this belief that any other type of position is harmful is so strong that, just the same, they experience guarding and pain. Even so-called functional training isn't devoid of instilling these messages.

The takeaway from this is that the body has very natural movement patterns that it likes to use that don't necessarily reflect the strict and controlled form of the gym. Absolutely, if you're at the squat rack, moving in a single-plane only, and are loaded up with multiple plates per side, then you should definitely be observing "proper form". However, whether you're an active or inactive individual with or without formal training, the body is built for free and fluid movement. Don't let anyone, including Instagram personalities, magazines, or even doctors to tell you that dropping form as you live your life is a dangerous thing.

Credit: Greg Lehman

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!
Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!
Click Here!

Is Running Bad For Your Joints?

You'll be hearing me celebrate the return of running season for the next little while. Running is a fantastic exercise and sport, and I'm more than happy when I see both experienced and brand new runners partaking. However, is running a healthy activity?

It has generally been the common consensus that running is bad for your joints, whether it be for your knees, your hips, or back. Thus, it's often the reason (or excuse) for many people to not partake in any running. It makes sense; too much impact on the joints could totally cause some arthritic development or degeneration in the spine. As we understand it, this is basically the definition of how osteoarthritis onsets, right?

The research journal search was actually extremely easy here. As I was able to find out, between both old and new studies, long-term studies, and cross-analyses, running was almost always found to be unrelated to any development of osteoarthritis in the knee, hip, and spine. At the worst, some studies suggested it to be merely inconclusive.

In fact, one brand new piece of research even found that, as far as intervertebral discs go, running actually promoted more strength and better disc health as opposed to contributing to degeneration!

So what's going on? What actually causes arthritis? Well, recent skeletal examinations are now suggesting that osteoarthritis development has more to do with a lack of physical activity rather than too much of any particular type. This was strengthened by the fact that degenerative joints correlate highly with the morbid obesity seen in many modern-day skeletons.

Furthermore, there may even be mechanisms that actually protect runners from degenerative changes from their spot. While the overall impact and force going through the joints is higher during a running gait, there may be some evidence suggesting that the decreased contact time with the ground actually works to counteract any damaging effects.

All this being said, no, running is not the joint-destroying, pain-inducing activity that many out there believe it is, and there's even the possibility of being a runner if you already do have arthritis. Keep in mind, running, like ANY other activity, can cause injury, whether it be from an accident, poor conditioning, or training error, so don't forget the importance of proper training.

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!
Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!
Click Here!

Get Out Of Pain - 3 Steps For Maintaining Motivation

I tend to harp on New Year's resolutions a lot, mostly because of how well-documented it is that they don't work.

That's not to say that it's not possible to make changes at this time of year. However, "because it's January" is a reason for change with a rather abysmal success rate. I see many clients at this time of year who have looked at the calendar, groaned, and decided that it's time to deal with their back pain, and it often becomes my challenge to make sure that they take advantage of that temporary drive and turn it into a permanent one. Here are a few things to think about when you're considering taking the first step.

1) Determine Your Reasons Why

A lot of people will walk into a therapist's office saying that they want to get out of pain, but without much more reason in mind other than "knowing they should" or "have to". Especially in chronic pain cases, this attitude is very detrimental to the recovery process, as it reflects a kind of "going through the motions" approach.

If you've had severe back pain for years, it's easy to default to this attitude, but if you want to make an earnest attempt at progress, then you need earnest reasons for it. Try to find intrinsic, rewarding factors to motivate you such as family, quality of life, return to activity, or longevity to keep you adherent to the healing process.

2) Start Small And Create Goals

Next, those reasons you've determined are important, but going all in with only that end-goal in mind often leads to failure as well. Long-term plans are tough to keep to when the going gets tough and the end barely seems any closer.

If your long-term goal is to run a marathon in two years, remember that you need something to keep your motivation during all 24 of those months. Have a one-week goal, a one-month; two, half-a-year, and so on. Those steps are vital in order to maintain a sense of realism and attainability with the entire process.

3) Expect Speed Bumps (And Prepare For Them)

Clients can often be dismayed by the fact that they've been doing incredibly well in their rehab and feeling fantastic, then hitting a hump and experiencing a relapse in pain. They can often feel like this is an indicator of the treatment not working or that their condition is, in truth, there to stay with no hope of permanent recovery.

This is wrong, however, and it's important that clients know that these are only speed humps, not complete road blocks. Even in drug addiction rehab, a relapse is not considered to be a failed recovery; rather, it's a delayed one with a lesson learned.

If a perfectly healthy person can't expect to never experience an injury, then recovering pain clients don't need to expect to never experience reirritation. Just know that it's coming, have tools to help cope with that temporary increase in pain, and then be prepared to hop right back on the train.

One step back, but always two steps forward.

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!
Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!
Click Here!

The Stressful Effect Of Stress On Pain

It's the New Year! I hope your holidays were fantastic. However, now's the time for all of us to buckle down and get back to work. Don't let the stress get to you!

Stress! GAHHHHH!

If you read even the occasional post from myself, then by this point you know that pain is not a response that's simply caused by a physical lesion alone; it's a complex phenomenon with massive psychosocial and neurochemical contributors as well.

And just like how poor sleep can (indirectly) cause an increased sensitivity to pain, perhaps mental disstress can as well.

We all know negative stress as causing potentially negative effects on the body. Many of you may also have heard of cortisol, the stress hormone. Or, to get technical, the hormone released by your body in response to stress to take part in the fight-or-flight response, regardless of how major or minor.

Well, cortisol also has this interesting effect on pain, with several demonstrations showing an decreased pain threshold and increased sensitivity while subjects were under mental strain.

This can have huge implications from a rehab perspective, especially in chronic pain cases. Even as tissue heals and rehab programs are followed, negative stress can certainly interfere in the regression of pain symptoms. This is largely why conditions such as fibromyalgia are commonly looked into, at least in part, as a stress disorder.

This could be particularly problematic with progressive pain and stress before intervention occurs. As we are finding, chronic pain clients typically have an elevated cortisol level even when looking at them in absence of stress-specific factors. This implies that the body may be pumping out even more stress hormones simply in response to pain (as seems reasonable), resulting in a potential cycle of pain and cortisol continually causing one another to spike. (Hmm, haven't we seen a cycle like this before?)

Fortunately, this opens up more avenues of treatment as well. Simply doing mental relaxation exercises and activities is showing positive effects on many chronic pain conditions. This goes to show the importance of stress management when it comes to long-term or complicated pain cases. We often overlook this mental side of physical pain, but disregarding it means overlooking a crucial avenue for recovery.

Relax man!

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!
Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!
Click Here!

The Nocebo Effect - Why Belief In A Treatment Is Vital

We all know what the placebo effect is. It's the very real-world phenomenon of the body responding positively to an otherwise ineffective treatment or stimulus caused by the belief that there will be a positive outcome. The placebo effect is, in reality, a large reason for many success stories in the therapeutic world, believe it or not. In fact, some modalities actually rely on a patient's belief that it will decrease their pain.

Source

BUT.. did you ever stop to consider the opposite effect being a possibility as well?

The "nocebo" effect is classified as when a negative expectation results in a negative outcome, whether it's to do with movement, nutrition, a clinical treatment, or virtually anything else. Truly, it's the other far-side of the spectrum from the placebo.

This ties directly in with my past topics about how language selection and expectations of pain can propagate and cause more pain. Like I've said before, mental state has a huge effect on driving the body's outputs, whether it be pain, inflammation, or more.

This being said, the nocebo has a massive influence on the effectiveness of a therapy treatment. If a client does not believe in a certain type of treatment or modality or they think that it will cause them harm, then it absolutely can interfere with the treatment outcome!

For this reason, I do my best to thoroughly educate my clients in exactly what kind of processes are occurring in their body before, during, and after any treatment I provide in order to help them understand the targeted effect and increase the probability of success.

If a client simply doesn't believe in a modality at all, then that's ok! Therapists work for the client, not the other way around, and the client does not HAVE to subscribe to every philosophy. However, in absence of that belief, gears need to be switched with either a new approach or a new therapist, otherwise we're charging that client continually for treatments with no outcome. And that's where responsibility on the clinician's side comes in.

The brain is a funny thing, but it's the boss. We gotta work with it.

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!
Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!
Click Here!