Am I Feeling Better?

It's funny how often that my clients, when asked how they're feeling, answer that they feel roughly the same as the last treatment.

I then proceed to interrogate question them on their symptoms, and they suddenly realize what improvements that they've made!

Sometimes, the changes are simply just gradual, so the improvement isn't as apparent. Other times, a person's symptoms had become so day-in-the-life that the client noticed neither the symptom anymore nor the progress.

Here are a few questions to ask yourself when you're unsure if your rehab is working.

Is my pain less severe, less frequent, or both?

Many people, habitually, focus on only severity or frequency of their pain, but not always both. It sometimes is worth taking a moment to simply question both of those factors next to each other to remind you that things are getting better.

Is my pain the same but while I'm doing increased work/activities?

This one is humerous. A client will tell me that their pain is still a 7/10....however, they did an hour hike instead of a half hour walk. I think we can put the math together on this one.

Is the pain the same but require more activity to trigger it?

Similar to the last point, but a bit different. Sometimes, people have pain that isn't a gradual buildup, but rather a quick trigger for a flare up. But often, it's easy to miss that the trigger is getting harder to pull, with more work or activity being required before that flare up occurs.

Is my life being affected less by pain?

And finally, pain is sometimes directly affecting very specific aspects of our lives, such as sleep, energy, and even diet. It's good to evaluate all of these sorts of areas to see if there's any improvement and indication that pain is dictating your life even a little bit less.

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Shattering The Glass On Exercise Promotion

"It's easy to fit exercise into every single day."

"Just take 20 minutes to get up and move!"

"Time is only an excuse to not exercise."

How often do we see statements like this plastering our media? According to fitness and health professionals out there, exercise is the easiest, simplest thing to insert into your day or week, and no one has an excuse to skip it.

In theory, this makes sense. We all definitely spend 20 minutes or more doing unimportant work during our days. Replacing it with a 20 minute walk should be no problem.

The problem that I have with promotional messages such as this is that they ALL come from professionals who work and spend their entire days in health-promoting environments. Personal trainers who work at gyms, therapists who do exercise with clients all day, doctors who maintain health initiatives for their entire staff; the list goes on.

Let me make this clear. We professionals say that exercise is easy to work into a day because, for us, it IS easy! We work in settings that contain exercise equipment. We spend all day positively enforcing the idea of movement. Our job is to focus on health!

But for the individual who works an office job on the 20th floor of a building in the downtown core with little surrounding greenspace; the member of a staff that is, overall, not active or interested in health promotion; the person who works a second or third job on the side to support their kids, this message has little hold.

If you're not part of that environment, yourself, can you just imagine so for a second? Access to exercise is one thing - and one that many people still do not have to a great extent. Motivation is another. When you spend your days surrounded by people and work that do everything but promote exercise, what is the inclination to partake. (Aside from gorgeous Instagram trainers who make you feel guilty for skipping something soooo easy in your day.)

Now, I'm not saying that the public is a lost cause to convince to exercise, and I'm not guilt-free of trying to make broad, general statements on ways to incorporate exercise into the day. However, as a mindful practitioner, I realize that access and motivation for exercise is a highly-individualized thing, and generalized tips will not go far. It boils down working with each client, one-on-one, to develop methods and ways to increase a client's participation.

And don't feel bad because that guy on Facebook says it should be easy.

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Trust Your Body - The Bridge Between Recovery And Comfort

I had a client who I helped to rehab a dislocated shoulder. We got their shoulder strong again and returned its range of motion, and thereafter we went several months without seeing each other again.

Fast forward, and the client returned for a visit after reaggravating the old injury. Upon an update on the past few months, I found out that this client was still having a lot of hesitation, before that point, when it came to supporting weight through the shoulder with a hand on the floor.

To me, this highlighted the importance of making sure that rehab was carried forward beyond simply removing the pain and getting strength in each range of motion back.

Rehab is essentially relationship counselling between the brain and body.

This comes back to what I've talked about before regarding helping clients through avoidance habits. When the hesitation and lack of trust regarding certain movements is too great, it's easy to avoid anything resembling that movement to the point that we see a weakening in that joint's function again.

And with that lack of specific activity, the more likely it becomes to re-injure that joint as soon as you do anything resembling that activity again.

For this reason, as a client, we always recommend perseverance in the rehab program beyond the point where there's simply no more pain. As we return the strength and range of a joint, we then turn the exercise plan into something practical and reflecting the demands of your life and any physical activities that you do.

What's more, the sooner we can start the rehab process, the fewer avoidance habits you'll develop and the more easily we can transition to your life-specific reconditioning.

Rehab is essentially relationship counselling between the brain and body. Being strong is great, but if you can't build trust that your body can perform again, the chances are that it will struggle to ever do so.

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3 Ways To Incorporate Your Rehab Into Your Day

We all live busy lives, which can sometimes make following a recovery plan difficult. With that said, it can be very frustrating to be handed a list of exercises by a therapist with orders to do them every day, unconditionally.

As we know, it's just not realistic for many people to simply create a block of time during the day. As well, motivation and energy, fairly enough, may not be in great supply first thing in the morning or at the end of the night.

Some kind of commitment and regularity is needed when it comes to exercise rehab, however, and simply planning to exercise in front of the TV just never seems to work.

So what are some ways that we can work our exercise routines into our daily life without having to feel like we're punishing ourselves or sacrificing other aspects of our day?

1) Pick A Consistently-Free Time

Maybe you find yourself with 15 minutes to relax between finishing breakfast and leaving for work. Maybe it's directly after getting home, before cooking dinner. Perhaps you have a second wind after dinner, and can set aside a moment before hitting the couch and catching up on Big Bang Theory.

It's a common fact that regularity with a time of day to exercise is the best method of making it a long-term habit. IF you have the time during your day or evening that you know you'll always (or nearly-enough) have available, then it becomes easier to make it a rule to yourself to do your exercises then.

2) Warm Up Before Activity

This is an easy one if you're someone who has a workout routine or sport that you stick to on a regular basis. However, it can apply to you if you have a dog that you take to the park, like to go for bike rides, or enjoy any other physical work and activity, such as gardening.

Using your rehab plan as a warm up before any other physical activity that you do, whether it's a traditional workout or simply a walk in the park, is not only a great way to make your exercise a habit. It's also excellent for getting your body accustomed to new ways of moving that the rehab plan is meant to achieve.

Now it's a treat for both of you!

3) Breaks

We all (hopefully) have breaks during our work days that allow us to decompress and take a moment to ourselves. If so, this provides one more opportunity to create an exercise habit.

It stands to reason that work tasks are a common cause of individuals' pain, and so taking routine breaks from those duties to relax and move around is both efficient and a great way to relieve some pain or discomfort while on shift. While not realistic for every single type of workplace, if there's a chance for you to take a corner, or even just stand up at your desk, to perform even part of your rehab plan, then take it.

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Don't Chase Your Pain

Wrist pain that has nothing to do with your wrist? Elbow pain that's doesn't stem from a structure of the elbow? Hand pain...well, you get the picture.

Many of our clients see our therapists for pain that just can't be traced to the area where the pain is perceived. Classic examples of this are symptoms in the elbow, wrist, and hand that we find rooted from the neck and shoulder.

It's not at all uncommon for nerves, as they travel from their origin to the spine, to cause pain at the furthest extremities. In the shoulder, for instance, the bundle of nerves leaves the neck and travels through a pathway in the shoulder before innervating the rest of the arm. 

At both of those locations do we often see a restriction of the nerves, whether it's from muscular tension, poor mobility between joints, or anatomical bone structure. That restriction can then result in pain, numbness, tingling, or other neurological symptoms.

However, nerve pain is interesting in that it follows trends, but not rules. Individuals often expect that they need all of the symptom criteria in order to identify the cause as a nerve. Radiating and electrical pain is a classic sign, as is the numbness or other sensory changes throughout the arm.

Neuropathies do not follow strict guidelines, though, and can easily present as localized sensations, resembling muscular soreness, tendinitis, or arthritic pain.

For this reason, we cannot simply point to the pain and assume that that's the spot that we need to rub and exercise. Our therapists will ensure to rule out the joints above and below the site of pain to narrow down, exactly, where those symptoms are originating from. (Fun fact, it could be MORE than one place. Fun.) With that being said, to the carpal tunnel or tennis elbow clients out there that seem to have found no relief, it may be time to seek an additional opinion to make certain that the right area is being addressed.

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