Making Rehab Fun

Pain isn't fun. For many people who aren't accustomed to sport or fitness, exercise might not immediately be a fun thing either.

I find that many individuals struggle to adhere to their recovery plans due to the fact that the rehab process is perceived to be grueling and unenjoyable. Perhaps, even to the same extent as the pain itself!

Maybe the exercise is causing a different type of discomfort that the client is adverse to. Perhaps the rewards aren't immediate enough. Maybe the exercises being provided are just "lame". A lot of factors can play into the reasons why a client doesn't enjoy exercise, regardless of knowing the benefit behind it.

The difference between pain and the mental blocks of rehab is this: clients are often accustomed to the pain! That being said, it's sometimes easiest to simply deal with the pain rather than persevere through the work, as coping mechanisms for the former have already been developed.

So let's make the recovery process fun! Many therapists think that the fun factor is only applicable to making young children adhere to their pains, but why is it so absurd to think that adults might like a bit more enjoyment as well? People of all ages benefit from using fun to motivate their health behaviours.

Disclaimer: If you hate fun, don't book with me.

I'm not suggesting that every rehab exercises needs to be turned into a game. Regimented exercise has its necessary place and making fun out of everything is unrealistic. However, tedious sets and reps have a limit to holding interest and attention.

But how about using the activities that the clients are trying to get back to? Whether it's a sport, going for hikes, or gardening, there's bound to be an active activity that those individuals would like to get back to. Using a soccer ball as a piece of rehab equipment, walking or trails, or even simply incorporating light activities in the yard into the plan is going to go a long way to keep clients motivated. They'll enjoy the work, it will apply to their desired lifestyles, and it will act as a constant reminder of progress.

Many clients will thrive off of strict exercise plans and regular routines, but, like fitness, some people will need other alternatives to enjoy the process. As a therapist, it's my job to recognize which methods are going to be the most effective for each individual. At the end of the day, whatever works to get you feeling better.

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3 Lifestyle Influencers Of Pain

Posture? Training error? Mechanical form? Many people think that physical, musculoskeletal factors are the only ones involved in the creation or persistence of pain. Let's take a look back on some past discussions, however, and remind ourselves of some of the lifestyle situations that may be exacerbating the way that we feel.

Smoking

Understandably, the research of nicotine's effect on pain is much less thorough than on its effect on other annoying health concerns such as LUNG CANCER. However, I digress...

Despite the number of people who use smoking as a coping mechanism for their body and head pain, lets remember that pain sensitivity is going to be increased by nicotine withdrawal in the first place. Even so, some individuals report increased pain tolerance in general, but this could actually be attributed to nicotine causing damage to the nerves themselves.

What's more, if you suffer from any kind of neurogenic pain or fibromyalgia, you pain may be made even worse without even the option of being dulled by a cigarette.

Sleep

In our busy world of one in three Canadians not getting adequate amounts of sleep, this is an important aspect of life to look at.

While sleep deprivation does definitely correlate strongly with increased perceptions and sensitivity to pain, the relationship is actually a little indirect. Rather, that sleep deprivation can increase depressive symptoms and anxiety which are mental factors that more-directly effect pain sensitivity themselves.

And you can also consider the fact that increased pain increases sleep disturbances as well, further affecting this spiral.

Stress

It's easy to understand that stress has a massive effect on the body's functions, from cognitive to immune and everything in between.

The stress hormone, cortisol, is released during periods of stress to assist the flight or fight response. When cortisol levels are heightened for a prolonged period of time, however, individuals will begin to experience a decreased pain threshold and increased pain sensitivity.

On the bright side, aside from physical rehab alone, this also opens the doorway for mental health treatments, even those as simple as meditation, to have positive impacts on helping individuals recover from pain.

As suggested when it comes to stress, pointing out these lifestyle influencers on pain isn't meant to show how hard it is to subvert it; rather, it opens avenues for us to address when physical treatment alone isn't enough. Support for quitting addictive behaviours, careful consideration of sleep, and proper management of stress are all extra tools that can be used in order to help win the battle against pain. All in all, this demonstrates the importance of looking at pain and other lifestyle health factors as a closely-related cascade rather than separate entities.

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Is There Anything Else You'd Like To Tell Me?

I came across another blog post last week: When You Talk to Patients, Do You Look at Them or at a Computer?

It was a bit of a sad outlook on the state of our medical system, and it's something you've likely experienced yourself. Whether visiting a Athletic Therapist, chiropractor, or even a family doctor, have you ever felt like you were asked only very closed questions rather than being able to tell the story that you were waiting to voice?

I'm unsure if this is a growing trend or just one that's more-commonly reported on, but there seems to be a lack of empathic communication between medical practitioners and their patients. Yes, we as healthcare workers have our framework of questions that remain fairly standard from client to client. However, if a photocopied questionnaire were all that was required, then medical history would not be necessary.

What...what?!

Patients and clients will often not outright voice everything that they'd like to say immediately, often relying on cues and invitations from the professional in front of them before elaborating on how they feel. This isn't being meek; it's human nature! That being said, it seems like too many practitioners ignore and glaze past the clues that clients give them, returning to their standardized framework much too quickly rather than allowing that individual to explain their situation.

"I'm at the end of my limit and need help!"
"Mmhmm, ok. Do you wear orthotics?"

To say the least, this trend does not promote a trusting and satisfied relationship between the client and clinician.

This being said, this is why I'll continue to ask this question to all of my clients; the question that I can't feel like I have a clear understanding of their background without:

Is there anything else you'd like to tell me?

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Do Active Individuals Normalize Pain?

I've discussed, before, the barrier of individuals who identify with their pain to the point where they struggle to find the motivation to attempt recovery. Usually, however, we think about this occurrence when it comes to people who have been suffering from a specific affliction for such a long period of time that they simply come to terms with it.

What we don't talk about, though, is the rate that many other individuals seem to accept new pain as a fact of life, causing them to disregard the steps they need to take to completely heal.

We've all seen it before in athletes, gym-goers, and labourers, for instance. Highly physical people who intentionally place large demands on their bodies experience episodes of pain and injury, but for one reason or another, tend to disregard their bodies' alarm bells and simply carry on through it.

Nah, my ankle is supposed to dangle like that.

On the surface, it seems like an easy explanation. Active individuals, especially those who are mid-competition or are relying on remaining active for a paycheque, keep themselves going despite the pain as a necessity. While they may have fairly typical pain thresholds for the average population, they certainly develop higher pain tolerance. But why does this prevent these same people to continue to neglect their health once they're off of the clock or out of the arena?

I'm good, boss. Just a bruise.

Recent research on the topic was hard for me to come by, with the most current studies coming from the 90s. These studies, however, speak on the psychological effects of injury on athletes regarding depression and affected self-worth, factors that can certainly affect the perception of the injury. In fact, to cope with these effects, the acceptance of injury follows the same stages of grieving, and it stands to reason that many active individuals get easily stonewalled at the denial stage.

On the surface, this "work through the pain" attitude seems to work just fine and allows these people to finish the job and been none the worse for it. After all, ignoring your body's alarm bells can't end badly, can it...?

Juuuuuuust dropped a nickel.

Should athletes be more willing to stop in the middle of a crucial game? Should construction workers miss a day of work at the first signs of an ache? Of course not. That's not the world that we live in. What needs to happen, however, is more education from practitioners on how to guide these individuals through those stages of grief and working their recovery around the necessities of their lives. It IS possible to take care of yourself without interfering with your work and activities, and you can do it WITHOUT letting that injury define you.

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