Have you woken up in the morning with a cricked neck? Do you have a niggling pain somewhere in your body? Does a certain body part keep becoming injured? While you’re doing a specific activity does your insert anything start hurting?
This is a self-help guide to help empower you to look after yourself in times of niggling pain and minor injury. Apply the following self-help steps after using common sense. If you think you may have broken something, torn tissue badly or if you are in any doubt you should seek professional intervention. These steps are for minor, niggling injuries.
If your pain is the result of an accident or a single incident during an activity, read part B: acute injuries. If your pain mysteriously started either suddenly, gradually, or only during a specific activity, read part A: chronic injuries.
Part A: Chronic Injuries
Receiving requests for remote help from family, friends and complete strangers is a common occurrence. Some recent examples:
“I tore my ACL a few weeks ago but I don’t trust the physical therapists rehab strategy. Got any good rehab drills?”
“I have a niggling pain in my hip flexor. Have you got any good hip flexor stretches?”
“My sternocleidomastoid hurts when I run. How can I release it?”
“My lower back hurts when I row but I have to keep rowing. Got any tips?”
Problem solving pain and injury was my passion as a sports and remedial massage therapist. Had any of these cases come to see me in person in the clinic, the first step would have been a brief gait analysis as they approached me. Then I would watch their movement as they sat on the couch in front of me and explained how they became injured.
Next, a thorough interview involving a detailed look into their lifestyle, diet habits, hydration levels, occupational posture, activity levels, training habits, injury history, medical history, stress levels and, if rapport allowed, their emotional or relationship state. All of which play a significant part on piecing together the pain puzzle. During the interview, I would have also been observing breathing patterns and postural tendencies.
For most cases by this point I would have a good idea about why they actually became injured, but the next step would be a standing postural analysis, then a movement assessment, to confirm. Only then would I make my assessment and decide on an appropriate course of treatment and aftercare or referral if I deemed the case beyond my paygrade.
So, going back the cases above, reading them usually comes with an endearing deep sigh. Suggesting an appropriate course of action with such little information to go on is near impossible (and sometimes irresponsible). Especially when people ask the wrong questions. Instead of asking questions like, “How should I stretch it?”, the question almost always should be, “What isn’t doing its job for pain to be felt here?”. Now we’re talking!
I’ve assessed and treated hundreds of conditions and injuries ranging from MS to gout, and prolapsed lumbar vertebrae to torn ACLs and shoulder impingements. All cases are vastly different. However, there are general patterns, rules of thumb, best practices and common denominators that I would like to share because they’ll help with most of the niggling pains mentioned above.
1. Activate self-healing mode. Yes, your brilliant body wants to heal itself. You just have to put it in the right environment to do so. This one point deserves an entire blog to itself and generally fixes most things, but in short:
A) Hydrate – Most people I’ve ever treated live in a perpetual state of dehydration. Do not underestimate the incredible healing power of water. Almost all chronic joint pain, including gout and the pain that is sometimes misdiagnosed as degenerative disc pain is either caused by or significantly accelerated by dehydration.
B) Locomote – we are hardwired for walking. It’s a major force against stress and stress is a major player in filling your pain bucket. The absolute bare minimum for the weakest of able-bodied humans of any age is 5000 steps per day. 10000 steps should be standard. Obviously, don’t walk through pain – never do anything that hurts.
C) Gut health – cut down on or eliminate inflammatory foods. Eat more anti-inflammatory and gut repairing foods. (see appendix)
D) Lube up – Your body thrives on movement. If you can make it a daily habit to bring every joint to its end range of motion every day, you’ll not only heal yourself, but you’ll significantly decelerate the aging process.
E) Breathe – If you can make focused diaphragmatic breathing for 3-5 minutes a daily habit you’ll not only wake up your all-important diaphragm, but you’ll reduce stress levels and help reduce pain.
F) Rest – Some people are rubbish at this. You’ve only got one life. During rest is when you repair and grow. Have the courage to take a step back and do so. Addressing A) through E) helps with sleep.
All the following points come secondary to addressing these vital factors. If any rehabilitation is ever prescribed without these factors being address I would advise you to find another therapist – one that treats the whole body and all of the subsystems as a single unit.
2. In almost all injury cases there is a dysfunctional diaphragm present. All peripheral injuries (elbow tendinitis, shin splints, etc.) exist in the presence of a dysfunctional diaphragm. According to some well-respected sources the sleepy diaphragm is the root cause of the injury. In all cases of lower back pain there’s an underactive diaphragm. In every case of rehabbing every single injury, activating the diaphragm should be a priority because in most cases it was the root cause. Do so with regular, frequent focused diaphragmatic breathing. Most people are chest-breathers and their diaphragms lay dormant due to chair abuse and emotional or physical trauma. It is entirely possible to breathe your way out of pain.
3. Chair-shaped humans break easily. If you spend more than 3-5 hours per day in any kind of chair, to avoid ending up looking like a human cashew nut and minimize the risk of future injury I strongly recommend some time spent every day bringing every joint to its end range of motion. Almost all common sporting, exercise or activity related injuries for everyday people occur, not due to the activity but due to chair abuse. Addressing your workstation could very well be a life-changer.
4. Neck pain? It doesn’t matter what you were doing at the time of the neck pain. Almost all neck pain exists in the presence of a dormant diaphragm. Almost all neck pain also exists in the presence of a restricted, immobile thoracic spine. Ergo, spend 5 minutes per day on focused diaphragmatic breathing. Spend 10 minutes per day on thoracic spine mobility drills. Sit in chairs less. Work regular movement snacks into your day.
5. Shoulder pain? Almost all shoulder pain exists in the presence of a restricted, immobile thoracic spine and immobile scapulae. This is often the cause. What causes stiff thoracic spines? Chairs and a lack of healthy movement. Spend at least 5 minutes per day doing scapulae circles with your arms in various positions (but nothing that causes pain). Spend at least 10 minutes per day doing thoracic spine mobility drills.
6. Knee pain? The knee is essentially just a hinge joint. The joints above and below the knee are supposed to be highly mobile. Almost all knee injuries exist in the presence of immobile ankles and/or immobile hips. You can do all the conventional rehab you like to fix your injured knee but if you don’t re-establish better movement above and below the joint, it’ll always be primed for re-injury. Although there are certain specific movements that are great for rehabilitating specific knee injuries (subject to a full assessment), working on ankle and hip mobility and foot stability does most of the work.
7. Foot pain? Stop locking your feet up in prisons and let them be feet. Move and spread your toes, like fingers. Pull them apart with a spikey ball. Make fists with your toes and scrunch up a towel. Work ankle and big toe flexibility – they’re probably restricted. Spend 5-10 minutes per day on focused diaphragmatic breathing – it’s likely there’s a sleepy diaphragm present. Go barefoot as much as possible. Balance on one foot every time you brush your teeth.
8. Be courageous and stop doing what hurts. Look at the five-year plan. Visualize yourself at 80 years old and ask yourself, “is hitting this short-term performance goal really that important?”. There are literally hundreds of activities, exercises and/or training goals that are still available that will give you as much if not more fulfillment than the one that’s causing pain. You may not have thought of it yet.
Part B: Acute Injuries
Step One: Is your injury acute? Did it just happen while you were performing an activity within the past 24 hours? If not, skip to step two. If it did, you should conduct the following drill with the aim of minimizing inflammation (inflammation = pain): Rest, compression, elevation (RCE). Do this as much as you can for the next 48 hours to minimize the risk of this becoming a chronic injury. Following 48 hours of RCE, carry out the post-acute drill in step two. Oh, and by the way, “rest” means rest – don’t move it, don’t use it, rest it.
This used to be known as RICE (Rest, ice, compression, elevation). Dr Gabe Mirkin coined the term in 1978. However, in the early 2000’s he took back his words, because the application of ice was actually found to delay the healing process. Ice feels good on a new injury but that’s just because it numbs the pain somewhat. The cooling down of the tissue restricts blood flow and obstructs healing.
Step Two: Is your injury post-acute? Did it happen a few days ago but you’ve just been ignoring it? If so, you’re in the post-acute phase of an injury. It’s been a few days since the incident, so the initial inflammation should have subsided. (If it hasn’t and you’re still in acute pain, just as it was at the time of the injury, seek professional intervention.)
Your main aim now is to create micro-circulation and movement which promotes healing, without annoying the site of injury. Do this by gently massaging the area around the site of pain several times per day and by moving you’re your body as much as you can, but only through pain-free ranges of motion. Repeatedly move your joints to the point of pain – never through it. As the next few days pass you should notice that your pain-free range of motion gradually increases as the injury heals. If it doesn’t, seek professional intervention.
Step Three: Avoid re-occurrence by addressing the factors listed in part A, above. The single event or activity you were doing at the time of the injury was definitely not the root cause. It was just the tipping point. The site of pain is never where the problem is.
I hope this helps!
Appendix: Inflammatory Foods
*All of these foods do not cause inflammation in all people but most of us are intolerant to at least two. To find out for sure, have some bloodwork done (Cyrex or Vibrant Wellness). Cutting all of these out and making a diet out of the anti-inflammatory foods will almost guarantee radical body composition changes, improved gut health, improved immune system, higher energy levels and reduced inflammation (pain).