Help Your Body Heal

Help Your Body Heal

Pain inhibition and how to stay in the game

Lisa Jurski, PT
Chicago, IL

Key Facts

  • The repetitive motions of single-sport athletes often lead to overuse injuries.
  • Aches and pains that are not properly addressed can lead to pain inhibition and a cycle of compensations and injury.
  • However, if treated properly, the small aches and pains that accompany rigorous activity do not have to sideline athletes from participation in their sport.
  • By reducing training intensity and immediately and even preemptively addressing pain, athletes can stay in the game.

For love of the game.

Athletes love their sports.  Whether you are a golfer, a runner, or a weekend hoops player, the adrenaline of the day’s athletic adventure starts with anticipation and lasts well after that last bead of sweat falls.  For some of us, there is nothing we would rather do than play our particular sport.  Unfortunately, that often means that we refuse to do any other athletic activity but the one sport we love.

The repetitive motions of single-sport athletes often lead to overuse injuries.  There are many reasons why overuse injuries occur including incorrect biomechanics, ramping up training too quickly, or the taxing nature of a long (or in some cases endless) season.  Although these injuries slowly creep up on us, often they seem to hit us out of the blue.  Everything feels more or less great and is going well until suddenly one day, it doesn’t.

An injury can start as a small little ache after a long run or a particularly hard workout.  Within a week or so, even easy days can bring on that now not-so-little ache.  Perhaps basic day-to-day activities (walking, sitting, stairs) now give pause.  What is the best thing to do?  With the amount of time and energy you have poured into your sport and the love you have for participating, you can’t fathom giving up your passion.  If you heed your body’s first warning, you may not have to.

Little aches: you’ve been warned.

Treated properly, the small aches and pains that accompany rigorous activity do not have to sideline athletes from participation in their sport.  The key is for athletes to acknowledge these minor pains and treat them proactively before they turn into more serious injuries.

The body is an amazing machine.  We don’t often give it credit for all it does.  Pain is a warning sign.  According to H. Merskey in “An Investigation of Pain in Psychological Illness,” it is “an unpleasant physical and emotional experience associated with actual or potential tissue damage.” Ignore that unpleasant signal and you could be in for trouble.  Why?  Small injuries that occur from overuse can result in a phenomenon called pain inhibition.  Pain inhibition is a body’s physiological response to painful stimuli.  When pain occurs anywhere in the body, an inhibitory reflex occurs that will decrease muscle function in or around the area of the pain or even at sites remote to the area of pain.  This muscle inhibition occurs in specific patterns and is related to the spinal nerves that feed both the motor (strength/movement) and sensory (pain/sensation) components of every muscle and joint in the body.

Pain inhibition: it’s time to sweat the small stuff.

A small pain in a runner’s knee that results from a steep increase in weekly mileage can lead to pain inhibition in the hip muscles on the same side.  This pain inhibition and the resulting hip weakness alters the mechanics of the runner’s stride.  A similar response can occur when, as a result of the little nagging knee pain, the runner begins to compensate and change his or her stride to take stress off of the painful joint.  This shift causes the hip to move in an unnatural position and consequently causes the runner to experience pain, now in the hip.  The runner’s stride then changes once again in response to the hip pain, and the process continues.

This is how rigorous training gets people into trouble.  Athletes are often unwilling to modify their training schedule and intensity, ignoring small aches and pains and thinking that the best way to achieve their goals is to muddle through.  Though these minor injuries could be quickly managed and healed with proper attention, athletes ignore the pain and, by compensating in other areas, find themselves suffering from much bigger injuries including stress fractures, tendonitis and back pain.

How to stay off the bench.

Small aches and injuries don’t have to snowball out of control.  By reducing training intensity and immediately and even preemptively addressing pain, athletes can stay in the game.

Though most athletes fear dialing back their training, through cross training and a reduced load of sport-specific activities athletes can not only give their bodies a chance to recover, but can also develop strength and stability to improve performance.  For those that are too addicted to their sport to fathom bringing it down a notch, think of it this way:  the less you do today while you heal, the more you can do in the future.

Pain relief comes in many forms but icing is the most natural and effective means to recovery. Icing can reduce the pain associated with minor soft tissue (muscle) damage that occurs during intensive training and thereby help prevent pain inhibition and compensations. And icing poses no risk of the dangerous side effects and sometimes detrimental effects that pain relievers can cause.  Using icing to recover from those small aches and pains will have a twofold effect physiologically:

  1. Icing will decrease the local inflammatory response which decreases the tissue damage involved and, therefore, the associated pain.
  2. Icing in and of itself is also a very potent pain reliever.

Tend pain, more gain.

Athletes generally recognize the little aches and pains that they experience as a result of their training but they often choose to ignore them.  What they don’t realize is that the pain inhibition and compensatory mechanisms that occur as a result can pose a bigger danger to their health and hinder their ability to continue training.  Unfortunately, the rigors of training require persistent participation and progressively tougher activities which means minimal rest/recovery.  That being said, there is one undeniable truth:

The pain is not going to just go away by itself.

Failure to attend to real or potential tissue damage during the course of a competition or training can impair healing, diminish athletic performance, and ultimately lead to chronic pain conditions.  Taking immediate and preventative action allows athletes to continue participating in their sport without pain, without compensations, and without missing a stride.  For those who love what they do, the ability to actively participate in their particular sport during recovery (even at a reduced intensity) without any deleterious effects is crucial.  The alternative is to wait patiently for recovery and the concomitant decrease in injury-related pain … not a likely scenario for most of the avid athletes we know.

Jill Lohmann is a Director of Operations for Accelerated Rehabilitation Centers and a certified physical therapist. Accelerated Rehabilitation Centers is a physical therapist owned and operated rehabilitation company with a network of 170 outpatient rehabilitation centers located throughout the Midwest, Arizona and Georgia.

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