Whenever you move your body, you are creating movement habits. Every time you goes to pick something up off the ground, your body creates a way to bend down and pick it up. The body loves quantity over quality; it doesn’t care how it happens, but that pencil on the ground is going to get picked up no matter what. Over time, the body tends to find a default pattern. This happens whether the pattern actually is ideal or is a suboptimal pattern; importantly, this applies to the execution of exercises as well. The more a pattern is performed, the more it is reinforced. This actually happens all the way down at a cellular level. “Roads” are created, and the more times the road is taken, the more that pathway is strengthened. Other pathways grow weeds and aren’t used, even if they were better long term strategies.
If a pattern of movement causes pain yet you keep performing it, those habits become linked. Specific movement ignites the pain receptors, and it happens over and over paving the pathway. Your brain starts to map the pain pathway with the movement motor pathway and those become conjoined.
What can happen sometimes is that even though the tissues may be healed, there is still a hypersensitivity – the body still feels it needs to protect you from that hurtful pattern.. Remember that pain is our body’s way of telling us something is wrong. When we perform a pattern and experience that painful sensation, our body wants to warn us to not do that again. In simple terms, pain is essentially the resulting signal that gets sent to the spinal cord, and then to the brain. The brain then processes this and creates the pain response. It’s important to note here that the tissue itself in addition to the central nervous system that are both contributing to the pain perception.
The brain starts to remember the movement that created the pain and even if there is no further trauma, every time you move that particular way you still get the pain sensation. So, one of the ways that we’re able to help people get out of chronic pain is to give them a new motor program.
Kelly Starrett of MobilityWOD fame has this great idea that in order to decrease pain levels, you want to do a movement that is “extremely similar to the movement but just a bit different” (his words) to take people out of painful patterns. This difference, oftentimes which is one that is more optimal for ideal body mechanics, allows a new pattern that doesn’t light up the pain receptors. The good news is that all we have to do is consciously be aware of changing the pattern into a less, or non-painful response. As we build this new pattern and frequently practice it this new road starts to become the high speed pathway. The process here can be described in four steps:
- Step 1: Unconscious wrong pattern
- sub-optimal movement pattern performed with no awareness
- Step 2: Consciously wrong pattern
- sub-optimal pattern performed, however with recognition of deficit
- Step 3: Consciously correct pattern
- conscious awareness to creating a new motor program through practice
- Step 4: Unconsciously correct pattern
- newer, more effective motor program performed automatically
What takes time, patience and determination is moving from step two to four. In fact, in my experience I have seen the transition from step three to four sometimes takes months. However, the end of the path (see what I did there?) is worth it in the end if it means leaving chronic pain as the road less traveled (sorry, couldn’t resist!).
Remember that the number one risk factor of getting injured is…. Prior injury. What this implies is that even though healthcare providers such as physical therapists, athletic therapists and chiropractors do a magnificent job decreasing the pain level, injury still reoccurs. It is my belief that this stems from a failure somewhere in steps 2-4. Often times, this is not the fault of the healthcare provider at all – it’s because once pain levels either ceased or decreased, the patients stopped attending. There was no return to function after injury!
This is where a good kinesiologist or S&C coach is imperative to the return to activity. Never forget that treatment is necessary: the therapist plays the important role determine the pain trigger and select the optimal strategy to remove pain and re-strengthen the structure. Once pain is removed and no more clinical care is needed, the kinesiologist is the bridge from rehabilitation to exercise or activity. One of the guiding principles of exercise is that it should never cause you pain. Don’t let it; If you have pain, see a provider. If you don’t have pain with activity, or you have just rehabilitated any painful issues, get a movement screen today to determine the best way to restore function and capacity.
Check back soon for our next article, which will break down the role a kinesiologist or strength & conditioning coach can play to assist an athlete return to play after an injury!