The idea for this thread is born from my recent search for a suitable sport/workout routine. I have multiple issues I have to work around when exercising:
- I have cubital tunnel syndrome, which is entrapment of the ulnar nerve around the elbow, in both arms and carpal tunnel syndrome in my dominant hand. This makes a variety of exercises such as pull-ups, push-ups, and lifting very painful and harmful in my case.
- I have mild scoliosis, so there are some stretching exercises and yoga poses I need to avoid as well.
- This one is the most recent issue I found out about: since I have high foot arches, running and specific leg/foot workouts are also medically unadvisable for me. I had severe tendinitis when I was in the army because I ran and did leg workouts before realizing my high foot arches were an issue.
What about you? Have you found a suitable workout routine that avoids straining your health issues while still being helpful?
In recent years pain science has made great strides. A basic understanding of what pain does and does not mean can help everyone live fuller lives with less chronic pain. So here's the nickle tour:
1 - We don't have "pain" receptors in our bodies. Instead, we have various mechanoreceptors that respond to touch, pressure, temperature, stretching and so on.
2 - When mechanoreceptors experience stimuli, they send messages to the brain.
3 - The brain uses the context of the moment, plus its understanding of the world, plus input from mechanoreceptors to determine whether to issue pain signals to the tissue or not.
4 - We also have a brain/body proprioceptive map (or just "map"). This map helps us know where we are in relationship to external objects, but it also keeps our bodies in communication with our brains. When all is well with a body part, there is a steady, high quality communication of data between the brain and that body part.
Interlude: One of the brain's most important jobs is to keep the body safe. The brain is extremely conservative in this regard. It takes a
"better safe than sorry" approach to protect the body.
5 - When we experience a traumatic event to our tissue, the mechanoreceptors send the news to the brain. Usually, the brain sends pain signals back to the troubled tissue. The pain tends to make us immobilize that part of our body which helps it heal.
6 - Tissue is really good at healing itself, but it takes time, sometimes weeks or months.
7 - During the healing process, the map between the brain and the healing tissue loses quality. The brain gets sporadic or misleading or reduced data. The brain decides it cannot really trust the data it's getting from that tissue, and as a defense mechanism it continues to send immobilizing pain signals to that tissue. Again, better safe than sorry!
8 - It is frequently the case that tissue fully heals from a traumatic event, but the tissue is still painful. It will remain painful indefinitely until the map is restored.
==
"Imperfect" tissue
Well first it's really important to know that whatever state your tissue is in, there are thousands and thousands of people with "worse" tissue, who are pain free. It's becoming increasingly clear that the top doctors in the world, when looking at X-rays and scans and such cannot accurately predict who's in pain and who isn't. Spines that look like total wrecks belong to people who are pain free, and spines that look perfect are owned by people with chronic, debilitating pain.
There is a low correlation between pain and tissue damage !!! (Let that rattle around in your brain for a while.)
So when you hear "bone on bone" or "compressed disks" or "scoliosis", it doesn't necessarily mean you're doomed to living in pain or that you'll have to restrict your lifestyle!! There are no guarantees of course, but often you can have "imperfect" tissue and live a full, active, pain free life.
What to do?
Once the tissue has had a chance to heal, job one is to restore the map to that tissue.
Novel adjacent: Bodies are complex, interconnected systems. PTs often say "it ain't where you think it is". If you have pain in your wrist, it could well be because of restricted mobility in your shoulder, and so on.
The first thing to do is try movements using your painful tissue, up to, but not into the pain. E.g., maybe you can move your wrist a little to the left before you experience pain. Try raising your elbow and seeing if that impacts how much you can do pain-free wrist movements. Try rotating your forearm and see how that affects your painfree range of motion. And so on.
The idea is to give your brain as much painfree data as possible adjacent to the painful tissue. You are restoring the map to that area. In many cases, when the map is restored, the brain will decide that the tissue is good to go, and it will stop issuing defensive pain signals.
Next, work on your overall body mobility. There is an important distinction between flexibility and mobility. For example, a lot of people are flexible enough to do the yoda pose "downward dog". They can get into a perfect 90 degree bent posture. But gravity is helping, they are not using their own muscles to achieve that posture. Many people who can do downward dogs, cannot lie flat on their backs and raise both legs straight up in the air to achieve that same bend. It's mobility that allows that.
So flexibility is good, but we really want mobility. Mobility is flexibility under our own power.
So we all need to do mobility exercises to keep our tissue strong and our maps strong. Exercises like squatting and hanging from bars, and doing pushups and so on can often eliminate pain in seemingly unrelated parts of the body.
Okay, that's a lot for one post
