Excellent assessment and passion for both physiotherapy and cycling. Definitely goes the extra mile to help.
James, High Wycombe

Don’t let an ache become an injury!

Should we wait for pain to stop us exercising before we seek treatment? Or with better education can we be taught to recognise the early onset of an injury?

What is normal?  A frequently asked question from my patients. When probing into exercise and injury history, on many occasions the low grade but chronic aches are omitted from conversation. When asked about them, the response is generally “that’s normal, I have had it/them for a long time”.

Let’s explore what these low grade aches are.  When we are physically in tip top condition our body moves well, has good flexibility and above all feels good and free (in an ideal world). We can play with our children across many different activities with little or no inhibited movement or pain. We can exercise and play sport unhindered and we can sit at a desk with no neck, shoulder, back or leg pain.

Unfortunately this is not common place and we are steadily accepting these altered functions and chronic low grade aches as normal. Wouldn’t it be great if however, we could roll on the ground, squat down, wake up and exercise with little consequence to how we feel.

The body is made up of many joints, has many muscles and is connected by a big web of connected tissue call ‘Fascia’.  Inter-twined through all of this is the nervous, arterial, veinous and  lymphatic systems (see image).

Screen Shot 2017-02-24 at 10.31.25

All of these systems sit over, in and around this fascial and muscular web to create a very sophisticated but delicate environment, where each system is in communication with the others.

Let’s now break the body into joints for example, the shoulder, hip, knee or ankle.  Each joint has a range of movement profile, which may include one or all of the list below:

  • Flexion/Extension
  • Abduction/Adduction
  • Rotation Internal/External
  • Lateral Flexion/Extension

Good range of movement around a joint means that all ranges can work optimally.  If for some reason it can’t then the environment of the joint is compromised and the function will be changed. Look at the model below, where the ‘neural system’ is the nerve supply, the ’passive system’ is the fascia and non contractile tissue and the ‘active system’ are the muscles.  If one of these systems are not performing optimally then it directly  effects the other two.  This is the premise for any ache or pain that we get.

Screen Shot 2017-02-24 at 10.31.58

No matter how small the episode of dysfunction, eventually the accumulative effect then creates an ache, the ache gets bigger and becomes a small pain and then when the pain is at enough of a threshold, we start to pay attention.  The question to ask at this point is “have I left it too late?”

Look at the sketch below, it is not until the blue line reaches the horizontal red line that we ‘perceive‘ that we have created an injury, when infact the subclinical episodes started occurring several weeks, months, years before this moment.

Screen Shot 2017-02-24 at 10.32.11

So the moral of the article is really, take some time to listen to the body.  If it is playing the wrong tune, not giving out the performance that you expect, not responding to training, or providing discomfort during times of activity or inactivity then perhaps you could benefit from doing something about it. Think perhaps of a biomechanical appraisal which would address all 3 of the systems that we have just discussed.

Don’t let an ache become an injury – take charge of your body.

Categories: /