Why it's still painful despite multiple treatment?

Do you have a body ache or pain that doesn't go away despite going for treatment after treatment?

- Went to the doctor and got all the relevant checks done? Check!

- Took a muscle relaxant? Check!

- Got physio hands-on or machine treatment? Check!

- Had tuina done? Check!

- Tried acupuncture? Check!

- Got chiro adjustments? Check!


But none of those seem to provide lasting pain relief; why so? Is it because you have not gotten the "right" treatment for addressing your pain? There is no doubt each of these treatments is effective in its own right and has helped many people; but why do all those seem not to work for you? Is there much more to it?


You see, as much as passive treatments are powerful in helping to reduce/relieve pain, it has their limitations; it cannot help ensure muscles are strong enough to manage joint forces while preventing any overloading of structures/ soft tissue and cause pain. That is to say passive treatment doesn't build tolerance that will help us cope with the demands we put on our bodies. This ties into my story of how I got interested in rehab/ conditioning.


Back in junior college times, I was in canoeing as my cca. As some will know, training for canoeing is pretty intense with many lower and upper body training as well as runs to improve stamina; tough as they were, there was a general desire amongst the entire team in training hard together. When canoeing training season was in high gear, I got a knee injury from a basketball match I played outside of school. One of the opposing players decided to play dirty and kicked the top of my knee mid-air when we were tussling under the basket. Thereafter there was a huge bruise (nd huge pain) on the top of my knee and walking was hard; for a couple of weeks and I couldn't participate in any form of lower body training during canoeing training. I thought something was torn (back then I didn't understand anatomy well). It was frustrating, to say the least, as the younger me really want to be part of the team, training together and hustling together. So I went from GP to GP and TCM to TCM and to physio to try to get it "fixed". But none helped much as it felt weak and painful when I exerted with that knee. As recovery evaded me, I became increasingly fed up and was starting to feel as though I could never catch up with my teammates.


Just as I was not seeing the light at the end of the tunnel, I decided to disregard any well-meaning advice to not load it and went for a very slow jog along the canal behind the school. The knee felt weak and uncomfortable for sure but I persisted session after session, slowly increasing the pace from a snail crawl to slightly faster than that and progressively building up more speed as my knee started to tolerate jogging more. After a while of working at it, my knee recovered and it was no longer painful or felt as weak. I had unwittingly put my knee through a process of reconditioning, albeit a very haphazard one at that. It then struck me that perhaps passive treatment in itself isn't enough; more needs to be done to help recover functionality.


As with any injury or musculoskeletal issue one experiences, there will definitely be a certain amount of muscle wastage after a long duration of disuse. In the absence of structural or physiological issues, other than passive treatment, the next best thing you can do for yourself is rehab/ reconditioning. Not only are you strengthening the muscles to deal with joint forces better, you are also helping the mind and body register that it is okay to do certain things and load the area in a certain manner. It is not just a biomechanics and tissue tolerance thing, rehab/ reconditioning is a confidence-building process in itself. With both physical and mental state addressed, you will have successfully addressed the bio and psycho part of the bio-psycho-social component of the pain science model. In essence rehab/ reconditioning if done right can be a multi-prong approach to a singular functionality problem.


And that applies to not just traumatic injuries, it applies to various musculoskeletal issues too. At the end of the day, we need two hands to clap; while getting the necessary passive treatment is important, so is the rehab/ reconditioning that comes along with it. Combine both well and you'll be more or less back to where you started pre-injury.


Supporting your lifestyle always,

YB


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