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On Pain, Injury, And Aging - How Do We Keep Going?

In December of ‘21 I injured my back doing one of my favorite lifts, the front squat. I pulled a muscle in my lower back, took a few days rest, and got back after it. And it happened again.

And again.

After the third strain, I felt a shooting pain down my leg into my foot. I couldn't sit without a lighting bolt through my left glute down into my foot. It sucked. Driving was near impossible, and I had to stand while typing.

From my formal education and experience treating clients, I assumed that I had developed some type of nerve pain.

“God damnit, not me!”, I thought. What was I doing wrong?

Well, I was probably a little dehydrated the first time I strained it. Was that enough to do it? Seriously?

An injury occurs when the forces acting upon the area exceed the capacity of that area to manage the forces associated with the event. Your arm breaks because your arm bone can’t handle the force from a fall, your achilles tears when your tendon can’t manage the force from your foot hitting the ground.

Sciatica, my formal diagnosis, is a little different. True sciatica is defined as an irritation of the sciatic nerve. In some cases, it seems to be related to disc injury. At the same time, MRI studies have shown disc degeneration to be normal in the aging process, usually symptom-free.

My back didn’t explode. I had an irritated nerve, and couldn’t figure out how to make it improve. I felt like an idiot.

I digress.

I was in pain, and I wanted to feel better. I wanted to get back to normal.

I visited my guys at Champion Physical Therapy in Waltham, and they showed me a few exercises that immediately reduced my pain. Nerve glides from supine and prone (looks like one of the sun salutations in yoga) got me back to sitting comfortably in a matter of weeks.*

**Trainers and PTs: Spare me the spiel about tissue damage and pain, correlation and causality. I’m familiar with the narrative and agree with it - don’t forget that there often IS tissue damage as a causal factor in pain. Just not always, and often not. I haven’t had any imaging done, I don’t plan to.

As someone who works with people in pain, this has been a profound experience. Logic and rationality flies out the window when you feel like you’re going to be hurting forever.

So how do you move forward when you’re struck with an ailment that doesn’t seem to make sense go away?

  1. Be kind to yourself. You aren’t in control of everything all of the time. Shit happens, and you can learn from it.

  2. Find someone you trust and do everything they say. Even if you’re an expert in a particular field, a second set of eyes can remove bias from the treatment process.

  3. Find a pain free activity, and hammer it. Since heavy deadlift wasn’t an option, I started running and doing heavy single leg exercises. This will keep you hopeful and mentally engaged. Exercise reduces pain - period.

  4. Injuries and pain pass. It might take awhile, but with the right treatment and outlook, there will come a time where you’ll likely be in the clear.

  5. Tissues heal, but sometimes pain remains. This is where an experienced practitioner comes in the clutch. Be careful of creating a narrative for yourself that becomes a self-fulfilling prophecy from an old injury.

Here’s a quick framework for pain rehab:

  1. Reduce the pain. Any type of treatment that does no harm and relieves symptoms is indicated. Massage, exercise, meditation, whatever works. When you feel great for a few minutes, it opens the window of possibility. You CAN and WILL feel better!

  2. Gradually strengthen the area affected. The effect is two-fold - resistance training both strengthens the actual tissue and builds confidence.

  3. Gradually re-expose the tissue to load. If deadlifts were hurting, at some point, you should be doing light deadlifts.

  4. Rinse and repeat. Be patient, and appreciate the things that you CAN do, instead of harping on the ones that you can't.

Don’t let pain drive you into depression. Ask for help if you need it!

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