- Movement and stress to the body is necessary to promote healing.
- Pain is best understood as an alarm signal, and does its best to tell you BEFORE there is any tissue damage, like any good fire alarm tells you before your kitchen is burning.
- “Relief Valley” is the period of time after you start moving again that the pain stays steady at a lower level, and ends when the pain begins to steadily increase. THIS IS WHERE YOU SHOULD BE DOING MOST OF YOUR ACTIVITY! If the valley widens over a day or over a few days, you know you are on the right track and continue to hang out there! One question I get frequently as someone is recovering from an injury is “Should I be moving around if it hurts?” The answer is YES! ABSOLUTELY!
Movement and stress to tissue helps create a blueprint for your body to heal itself. The only way your muscles know to increase in size is through telling them through exercise. The only way for bones to get stronger is to tell them through impact activities. This means that MOVEMENT IS NECESSARY FOR HEALING!
So then the question becomes “How much should I be doing?” The vast majority of patients will experience something I like to call “Relief Valley” when they do activity. For simplicity sake, I will use back pain and walking as an example.
You wake up in the morning and your back is sore and stiff. If someone offered a million dollar prize to touch your toes you wouldn’t even attempt it. As you move around more it seems to loosen up, movement becomes easier and your range of motion seems better. You get the kids ready and get into your car for the twenty-minute drive to school.
Then, when you get out of the car, there is that pain again. Almost like right after you woke up. You have a much harder time now herding the kids into the school than getting them into the car, but as you walk around it seems to loosen up again. That is, until you drive another 30 minutes in traffic to work, then you are right back to square one, only to repeat this indefinitely each time you get up to go to the bathroom, for lunch, or to go to meetings. You have developed a grunt each time you start moving in anticipation of pain.
Does this sound familiar? If so, know that everything is going as it should! Pain is best understood as an alarm signal (rather than a signal of tissue damage). Like any good alarm, it ideally tells you BEFORE any damage has been done. Would anybody buy a fire alarm that only told you after your kitchen was ablaze?
As you start moving again, think of the increased pain as your body reminding you that it feels vulnerable and to take it slow. Sometimes a few steps are enough for it to calm down, sometimes it takes a walk around the block. At some point your pain is likely to drop a few points due to the body feeling less vulnerable, and because warmer tissue tends to glide better and cause less aggravation (think about how you feel after doing a warmup compared to before the warmup).
“Relief Valley” is the period of time after you start moving again that the pain stays steady at a lower level, and ends when the pain begins to steadily increase.
THIS IS WHERE YOU SHOULD BE DOING MOST OF YOUR ACTIVITY!
Feel free to continue moving around when it feels better, but if each rep/step/lap hurts worse than the last, it’s time to give it a rest. This can be for 5 seconds, five minutes, or five hours, and it will change. It depends on how your body is feeling. And once it feels ready, know that there will be more pain before it subsides again, but remember that this is exactly how you would want an alarm to function (although experiencing the alarm can be frustrating…) The key is to give your body frequent doses of non-aggravating activity to help promote healing. Three 20 minute walks is better than one hour walk if you feel worse after the hour. Do more as you feel like you can, knowing that the size and shape of Relief Valley changes constantly, and how you feel will guide you!