Movement, or more specifically, novel movements can be quite useful for pain relief. They are an opportunity to create a new impression in your nervous system.
There is no guarantee that this new impression will be a favorable one; if you’re not careful the impression may cause an output of pain from your brain. If you’re careful, the impression may help to “convince” your brain and nervous system that movement should not be interpreted as dangerous and therefore, offer some pain relief.
If the impression causes yet another output of pain, there will most likely be some protection, and therefore limited or limiting movement. In order to change things for the better and create a pain-free impression you need to nudge your painless range of motion in the right direction. One way to stack the deck in your favor is to pair the new or novel movements with something that already has produced a favorable impression by your brain and nervous system.
This is creating context to obtain pain-free movement. Context is important when talking about pain and can be used in your favor.
Do you need to perform specific movements or movement patterns for this to occur? People often worry that imperfect movements create patterns of strain that can cause pain at any moment. In fact there are those in the functional movement camps that insist this will happen (I know, I used to be one of those people). Is this based on fact? Will “improper” movement cause us to break down, will this result in pain?
Consider these questions and points:
- Why don’t people with cerebral palsy hurt constantly at every joint even though movement is often difficult to control and where movement and postural asymmetry are very common.?
- How do you explain why so many people display these imperfect and asymmetrical movement patterns but have no pain?
- Why are so many of us walking around with herniated discs, meniscus tears, rotator cuff tears, and/or arthritis without knowing it? There is actual tissue damage in these people and yet they don’t hurt. The research documenting all of these findings exists….. in large quantities.
- How can we explain phantom limb pain; even in individuals who were born without a limb?
What about the countless stories of how people (maybe you) have had pain relief by changing movement patterns and/or posture?
Body mechanics and movement are important and useful to consider clinically, but my argument is that I would not be helping my patients by convincing them that their body mechanics and movement patterns are going to lead to them falling apart, injuring themselves and/or leading to degeneration or arthritis. Not only would this be harmful to my patients, but this is clearly not the case in any way.
Now this is flies in the face of what many in my profession as well as the physical therapy, athletic training and personal training profession, as gospel. Am I denouncing my own profession as well as many others? Well, in this case….. yes!
Body mechanics clearly play a role in the treatment of my patients and I use movement every day to help people with pain. When pain is present, movement and body mechanics can change drastically, but movement patterns and body mechanics are not useful as a pain predictor even though they can be a useful in pain relief.
Regardless of how you move you will all hurt at times during your life and pain may correspond to certain movements.
Neuroscientist, V.S. Ramachandran said that “pain is an opinion.” Painful movement means that our body is acting on the opinion that we are under threat and should therefore be protected. So, how can we change this “opinion”?
Movement patterns and postures should be thought of as tendencies or movement habits. They develop over time and therefore can give me a glimpse at your movement history. If you do something new, something outside of your normal movement regiment (I will call this novel movement), you give your nervous system something to form a new opinion about. If you perform this novel movement in a non-threatening context, a context of safety, a context of expansion, your nervous system is not likely to come to an opinion hat this is threatening and therefor not output pain.
Pain relief that occurs with postural changes, specific exercises or prescribed movements likely helps to reduce pain because they are all novel movements and is another example of the power of novelty. It likely has nothing to do with attaining perfect posture or perfect movements patterns or reducing musculoskeletal strain reduction, but has everything to do with non-threatening movement variability.Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
Living pain free is not impossible for most; unfortunately, their journey to live without pain leads them to receive treatment that is often less than scientific. The problem is not that these treatments don’t work 100% of the time, it’s that they are often expensive and do not empower you.
A common question is, “If a technique helps my pain, it must work right?”
Well, not necessarily. There are many, simple ways that you can live pain free; ways that are not expensive and ways that will empower you and give you back the control you need in your life.
It’s not about disproving these techniques outright. Science is more about what is most likely and what is less/least likely. I cant say with 100% certainty that any technique is not helping your pain. I do not require a machine or special equipment to state that there is doubt surrounding the explanations behind many of the hands-on techniques that one may receive to help reduce pain. Science is about minimizing the number of assumptions we make in our efforts to explain the world around us.
Science does not lead us to a point of absolute certainty. I can not say with certainty. Several studies have cast massive doubts over the reasonableness of some commonly practiced and widely/blindly accepted techniques. Consider the following:
- Myofascial trigger points, their existence, and the therapies that claim to treat them are not based on 100% fact. Their is some doubt in the scientific literature that we can reliably palpate and treat them.
- Various fascial therapies and those who use them are are convinced they can palpate and effect fascia and that fascia is a direct source of pain. This is unlikely, given what we know about pain.
- The Myofascial release crowd are convinced they can palpate and release emotions/memories buried in fascia and muscles. Science is pretty clear on this; emotions are not stored in your fascia or muscles. The definition of “muscle memory” has been corrupted.
- Many chiropractors and physical therapists are convinced they can palpate and effect specific joints and that bones can become “out of place”. This is an idea that needs to be put to rest. Bones do not “go out of place” regularly. Joints may need to be convinced to move better and more freely, but not because a bone is “out of place”
- Those that perform craniosacral therapy are convinced they can palpate and effect cerebrospinal fluid flow/pulses and cranial sutures position and that doing so helps all kinds of ailments. Why does it work? Likely because of light touch and it’s affects on subtle movements in your body. I turn, these novel movements help to decrease pain.
- The core stability crowd are convinced that your aches and pains are caused by muscle imbalances. Well, it’s probably the other way around, situations that cause an output of pain by your brain will likely change also cause a change in muscular control. It is very unlikely that this any perceived muscle imbalance causes pain. In addition, it’s fairly unlikely that we can reliably detect these muscle imbalances.
Probably the best evidence I can present is more of an observation. All of these techniques and more, can help to decrease pain in certain situations. That must mean that there is a common thread to all of them. Well, there is, the common thread is your nervous system.
- Your brain outputs pain as a result of many inputs
- All hands on therapies affect your nervous system through direct contact with your skin and your superficial nerves
- All movement therapies introduce novel movements and novel signals for your brain to interpret. All of this can help to decrease pain and improve function.
Do you have shin splints? Do you run AND take a creatine supplementation? Well, here’s a link to an article that found a relationship to anterior compartment problems (like shin splints), running and creatine.
Don’t get me wrong, this is not an anti-creatine blog entry. I recommend creatine to quite a few of my patients to help them build muscle and anaerobic endurance. If you want to know more, contact me.Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
Hello everyone, here’s another video update in which I talk about hypnosis and some of the exciting hypnotherapy programs in my Portland, Oregon chiropractic, nutrition, hypnosis and functional medicine clinic, Optimum Function.
Enjoy! Feel free to leave comments
Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
I have posted a couple of blogs about the seemingly fraudulent advertisements that tout certain unhealthy food as “health food”.
Here’s another article about the topic; you’ll be surprised to read about a certain yogurt company settling a suit for claims that their product “helps to keep you regular”. Health Food … or Health Fraud?Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
Here are some simple rules to follow when weight training to protect your shoulders. Remember, you can make all of the changes in the world, but if you continue to lift beyond your capacity or lift incorrectly, it won’t be a matter of “if you get hurt”, you WILL hurt yourself. Technique is everything. Do it right or don’t do it at all.
The “Dont’s” of Weight Training: Protect Your Shoulders
- No bench pressing with a straight bar
- No lat pulls behind the neck
- No overhead pressing
- No upright rows
- No “empty can” exercises (modified empty can is fine)
No Straight Bar
- Use dumbbells to replace straight bar on flat and incline bench.
- Dumbbells strengthen the “weak link”, rotator cuff, stress proprioception.
- Straight bar weakens and damages the shoulder.
- Even better….use kettlebells. I can teach you how to properly use them and even teach you one exercise that can replace almost all of your other exercises! Contact me for more info.
No Lat Pulls Behind the Neck
- Replace with front pull (bring chest to the bar) or reverse grips.
- Lat pulls behind the neck cause shoulder instability and neck pain.
No Upright Rows
- They cause shoulder impingement
- They cause abduction and internal rotation which can damage your subscapularis muscle
- Normal shoulder motion is to externally rotate and abduct (the opposite of the above harmful movement); this optimally loads the shoulder
No Overhead Presses
- At-risk position; for anterior shoulder instability;
- Causes shoulder impingement, especially internal impingement.
No Empty-Can Exercises
- Internal rotation with abduction causes impingement.
- Replace with “full-can” exercises…. or better yet, replace all you shoulder exercises once stability is gained with the Turkish Get-up; contact me for more info
- You can also replace empty can exercises with side-lying abduction AKA side-lying lateral raise AKA “full can”.
Other Errors That Can Cause Injuries To Other Areas of Your Body
- One-arm rows: Letting the weight traction the shoulder during this exercise.
- Knee extensions: Open-chain exercise causes shear in the tibia.
- Squats: Squat using body weight only first for conditioning.
- Back extensions: Don’t swing; elevate incrementally.
- Seated rows: Don’t flex the back; be sure to retract shoulder blades first, then pull with shoulders and elbows. Use ropes or chains when possible; this allows the shoulder blades to fully retract around the thorax.
Increasing Weight and Keeping the Shoulder Safe
- Pick a weight you can perform for 12 reps.
- Give three to four weeks for accommodation.
- After four weeks, add five pounds to dumbbell exercises and 10 pounds to two-arm exercises.
- Increase weight on one exercise per workout.
- When weight is increased, decrease reps to six.
- Every two weeks, increase by two repetitions until you reach 12 reps.
- Stay at 12 reps for two weeks, then increase weight and decrease reps as previously detailed.
- Decrease boredom and increase strength gains.
- Example: Flat dumbbell bench press
- Set #1 50lbs 12 reps
- Set #2 55lbs 10 reps
- Set #3 60lbs 8 reps
- Set #4 65lbs 6 reps
Changing Weight in the Pyramid
- Perform the pyramid one to two times per week. The other workouts for example, would be performed using 55 lbs, for two to four sets. When 12 reps can be performed with this weight for two weeks, the pyramid shifts so that 55 lbs is the new starting weight.
- Set #1 55lbs 12 reps
- Set #2 60lbs 10 reps
- Set #3 65lbs 8 reps
- Set #4 70lbs 6 reps
Maintaining Shoulder Flexibility
- Posterior capsule stretch (behind the back or across-body while pulling on your arm);
- Triceps stretch;
- Behind-the-back stretch;
- These exercises can be performed using a towel, bat, stick or golf club.
- Train the weak link. If you don’t know what your weak link is, I can help you figure it out with a functional movement screen.
- Realistic goals and expectations will reduce injuries to your shoulder.
- Adopt the “condition to train” philosophy; that is, you must first do some prep movements before training. Again, my functional movement screen can help you figure out which movements you should be doing to prep..
- Safe training keeps you doing what you love to do.
- If you have pain, it “won’t just go away” call me right away!
I just wrote an article about “super foods”. Many of you have heard about many of these foods; if you are a patient of mine or have attended one of my lectures on nutrition, you have no doubt herd of them. Here are the foods I have deemed “super” in this article:
- “Lean and Clean” Red Meat (93% lean, top round, or sirloin)
- Wild-caught Salmon
- Omega 3 Eggs
- Low-fat, plain, Greek yogurt
- Supplemental Protein
- Cruciferous vegetables (broccoli, cabbage, cauliflower)
- Mixed Berries
- Mixed Beans
- Quinoa (Ancient grains)
- Whole Oats (large flake)
- Mixed Nuts
- Olive oil
- Fish oil
- Flax seeds
- Green tea
I wanted to write something down and explain why I have considered them as such so I could use this as a handout in my Portland, Oregon nutrition, chiropractic, hypnosis and functional medicine clinic, Optimum Function. I will most likely ad to this list but here’s a link so you can download it and go to the grocery store right nowYours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
I read this article this morning and thought I’d share it. All too often, we think about our vision after it has been affected by improper nutrition and disease and we begin to experience problems with it. This article brings to light nutritional steps to maintain visual health; here’s the link: Nutrition and vision: the food you eat can save your eyesightYours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health
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Yours in Health,Tim Irving DC, MS, LMTOptimum Function: 819 SE Morrison St. ste. 215, Portland, OR, 97215Optimum Function = Optimum Health