“I’m fine as long as I don’t move a specific way.”
This is a statement we hear often. However, it only gets more and more scary every time we hear it. We fully understand that pain can be terrifying and that finding a way to avoid it, can provide a sense of security and control over the situation. Here are some reasons why it scares us to hear that you are avoiding a specific movement:
Reflexes are going to use any and all body parts to keep you safe. What does that mean? If you slip on ice, or trip on something, the messages come from the spinal cord (NOT the brain!!) on HOW to save you. This means that the brain won’t have time to decide on a different course of action and how to avoid using that motion that hurts you. This surprise movement can cause more pain and then more fear in moving. It’s a vicious cycle.
When we don’t move in a specific direction, the muscles that are responsible for that movement lose strength and may “atrophy”. Which is fine in the short term, if you get back to strengthening and moving, however, the longer it takes to return to using those muscles, the higher chance there is that “fatty infiltration” will set in. This is when muscle fibers are replaced with fat cells. It is difficult to return from that. NOT impossible, just challenging.
Nerves get tight. Nerves are slippery and like to glide freely underneath muscles, tendons, ligaments, fascia, and around all the corners and bends of the body. When we move in all directions throughout the day, we are naturally “flossing” or “gliding” the nerves without thinking about it, keeping them happy and healthy. This also ensures that nerves continue to send signals smoothly and uninterrupted. When we don’t move in a specific direction, we are losing the opportunity to keep the nerves happy, which can eventually lead to the nerves getting squished underneath the stiffness in the area. A chronically squished nerve can initially sound the alarm in the form of “numbness and tingling”. If it is ignored for a long period of time, the ability to use and control the muscles can be affected.
In the case of low back pain, avoiding a specific movement is also intentionally decreasing the food that the discs receive. Because the flow of nutrients/food into the disc isn’t very good, they rely heavily on our movements to actively push the needed repair products and food into the area. Over time and with prolonged starvation, the discs can become brittle. This is why we hear these insane stories of people rolling over in bed and herniating a disc. It wasn’t the rolling over that did it, the discs were just starved and losing strength for probably many years, maybe even decades beforehand.
This list is in no way intended to scare you. It scares us, so we are trying to get the information out there to help you make an educated decision on how to address your pain. An individualized approach, after an in-person evaluation, is the recommendation. We’ve had great success treating chronic pain patients with various manual therapy techniques (massage, cupping, instrument-assisted soft-tissue mobilization), depending on the person, and then progressively and very slowly re-teaching the body how to feel safe in movements. The ultimate goal would be to address pain, improve strength and flexibility, and then provide you with a reasonable maintenance plan.
Questions or comments? Please drop them below, message through social media, or email drmimee@velonahealth.com. Looking forward to connecting with you!
If you don't live in the area and need help to pick out a local PT please let me know that too, or visit apta.org/findapt. Always happy to talk shop and geek out about the body.
Wishing you health and happiness.
Warmly,
Dr. CJ Mimee, PT, DPT, RYT