• Home
  • About
  • Articles
  • Coaches
    • Jamie Johnston
    • Ben Cormack
    • Laura Allen
    • Walt Fritz
    • Todd Hargrove
    • Robert Libbey
    • Meaghan Mounce
    • Dr. Erson Religioso III
  • Courses
  • Contact
  • Search
  • Menu Menu
  • Facebook
  • Twitter
  • LinkedIn
  • Instagram
Become a Contributor

Are Painful Flare Ups To Exercise, Just Like A Sunburn (and why we might need analogy anyway)

May 28, 2018/in Massage, Massage Clinic, Massage Therapist, Massage Therapy, Pain, Therapeutic Exercise /by Ben Cormack

Whilst Exercise CAN be a wonderful tool to use during the rehab process we must remember it is not a stick on, we can’t just fire and forget or plug and play and for every success, there are also failures. There just is not such a thing as a magic bullet in rehab.

Sorry about dat!

Before we get to the analogy stuff we might want to first ask WHY we might want to help people understand what is happening to their bodies and how ANALOGY can help with that?

In some cases, it can be much more about HOW we do things rather than WHAT we actually do.

Why? 

For all the studies we have extolling the virtues of exercise, although make sure you consider the effects sizes, an important question to ask is how generalisable are they to the real world? If I was being all sciencey and shit we could term this the external validity of a study.

Why might these studies lack external validity? In the tightly controlled world of the scientific study participants probably tend to adhere a little bit more to the protocol laid out than they do on their own, otherwise, studies would never get finished. Researchers can also employ things like the “intention to treat” analysis (ITT) that are designed to scientifically smooth out things like dropouts and missing data.

Out in the real world when we throw in the complications of life, exercises, however evidence-based, in some cases can tend to fall by the wayside. This is a problem with human beings they don’t always just fit neatly into EBM boxes. In fact, they can render all the science a touch redundant through things like their beliefs, preferences and lifestyles.

“Differences in the definition of adherence used, measurement and estimative of how many patients do not comply with their prescribed exercises vary, but evidence converge on a figure of 50% or higher”  *HERE*

We can all agree that that is a pretty high percentage of shit that is not getting done! What we CAN say is exercise is likely to infer some benefits IF IT GETS DONE! SO how do we go about doing that? And that, of course, is the $1 million question!

Barriers

This is an awesome piece of research that looks at barriers to people adhering to therapeutic exercise programs *HERE* One of the major reasons that people don’t adhere, or a much better term to use, commit, to exercises or exercise programs when they have pain is the fear of INCREASING that pain.

Here is a slide from my recent presentation at the San Diego pain summit.

 

Now, this is completely understandable. Our fears drive our behaviours, so if I am scared of making the problem worse that may drive me to, well, simply not do it. It may then be key to help people make sense of what they feel and how they can manage that.

For a lot of people, the science of both pain and exercise are pretty alien subjects. What’s the difference between exercise-induced discomfort and actual pain? For someone who has never experienced the former then perhaps not a lot! I have been pretty sore from training before and found some activities really quite painful.

The likelihood of getting some DOMS from prescribed exercises for someone with no real history of exercise and a low ‘zone of homeostasis’ could be pretty high, so it is vital we can put these sensations into perspective, allay fears and help people to SELF-manage their rehab.

A useful phrase I picked up a long time ago is “go to the P in Pain not the Y in Agony” which is a really nice way to say go into some discomfort, which of course is normal, but try to avoid rip-roaring pain. We still don’t know if painful exercise is actually bad for outcomes but certainly, it may dissuade someone from carrying on with it.

Things can and will go wrong and setbacks are normal. These setbacks can be influenced by a whole bunch of factors including stress and lifestyle that can negatively affect recovery, and no rehab plan will ever follow a linear upwards trajectory, especially if we are attempting to push the envelope and ‘vaccinate’ against future reoccurrences.

*HERE* we see psychological stress actually impairs recovery from exercise so we must be mindful of this. It may not be the intensity of the sensation that some struggle with but how LONG it goes on for. Desired adaptations such as strength might also be affected by stress too. *HERE*

Pain is often accompanied by worry and stress and could be both a cause and an effect of the current state of the individual. This is why we must be aware that our rehab programs carry the possibility that they could cause an adverse reaction in times of stress.

Analogy

Equipping people with the knowledge to both understand AND address these factors is vital for self-efficacy, another key player in the COMMITMENT to a rehab program.

An analogy is a fantastic way of helping people understand subjects that they have very little background in and for many folks, both pain and exercise fall neatly into this bracket. One of my favourite analogies for exercise discomfort AND pain is SUNBURN. The reason for this is it (hopefully) places the pain or discomfort into perspective and allows it to be seen as a temporary thing and one that can be easily modified.

Rather than viewing an exercise as simply being WRONG, a comparison to sunburn allows it to be viewed more as an issue with the dosage applied and the bodies response. We generally don’t see the sun as a BAD thing, of course, some do but we could put that on the spectrum of fear avoidance! Most people will get sunburn at some point in their lives and just see it is a little bit too much of a GOOD thing!

So what do we do if we overdose on the sun? Generally just ALTER the dosage, simply get less sun the next day by sitting under the umbrella or covering up my burnt bits with a towel, we may have just tried to rush the natural adaptation.

The negative physical reaction is only temporary, often just like the pain triggered from overdosing on exercise, the angry red skin and spiky feeling when in the shower will, of course, go away if I just alter the dose and let nature run its course. What we do see if dosed correctly is a slow natural adaptation that leaves us positively glowing.

What do you usually do next after burning? Well just be more careful when re-exposing yourself. Spend less time in the sun or apply a higher factor. We don’t freak out, in fact often we berate ourselves for being stupid! We know this happens after all. We can do the same with our exercises, just take a little time off or reduce the amount we do before building up again.

Why might we overdose? Perhaps we have been previously been underdosed. Just like coming out of a long sunless winter, not having exercised for a while probably reduces the amount I can tolerate and hence potential adverse reactions. This may explain why just a few sets could leave me pretty sore.

If we have previously been good at a sport we tend to be able to play at a much higher intensity than perhaps we can CURRENTLY handle. In fact being good at something could actually be a risk factor for some! Our skill level may far outweigh our tolerance for the level of intensity we can play at. The same is true of tanning, we tend to remember the lazy long days at the END of a holiday applying Hawaiian tropic rather than the blotchy days in the beginning, piling on factor 30.

Some people can exercise till the cows come home and never feel a thing, a bit like those really annoying people who go an amazing shade of brown by just looking at the sun! We may be predisposed genetically to being LESS tolerant of physical activity. We see discussion of the role of genetics in sensitivity *HERE*

People with fair skin and red hair are often less tolerant of the sun by nature of their Celtic heritage and those of Mediterranean or African origin far better genetically equipped to handle a greater dosage of the sun.

Now, no analogy is free from a negative misinterpretation. Whilst the sun could be seen as having dangerous consequences such as skin cancer from extreme overdosing we also see problems with underdosing such as depression from reduced serotonin. Like all things, it has an OPTIMAL dosage, after all too much or little water or oxygen can also kill you too!

How can we alter the dosage?

  • Frequency – How often. More is not always better.
  • Intensity – How heavy or how fast.
  • Volume – How much. Sets, reps and rest.

Read more here about dosage *HERE*

Take Homes

  • People don’t just fit neatly into science
  • Increasing pain is a real worry with rehab exercises
  • Arm people with information about what to expect and what they are feeling
  • Be smart in the first place – Less can be more.
  • Self-management. Give them the tools to manage the dosage.
  • Give support. If it does go wrong to help people get back on track

Ben Cormack

Ben Cormack has a passion for getting people moving and using and understanding movement as an important tool to help others. Originally from a fitness background, Ben has gone on to study Sports therapy and widely in the fields of rehabilitation, pain science and movement over the last 15 years. Ben owns and runs Cor-Kinetic, an educational company who use modern research into pain, movement and neurosciences to provide a reasoning process and rehab skills to those who also place a priority on using movement and exercise as key competencies. Cor-kinetic has provided educational services for the NHS, Elite level sports clubs and universities as well as individual physio’s, Osteopaths, Chiropractors, sports therapists, rehab, and personal trainers.

Facebook Twitter 

  • Author
  • Recent Posts
Ben Cormack
Ben Cormack has a passion for getting people moving and using and understanding movement as an important tool to help others. Originally from a fitness background, Ben has gone on to study Sports therapy and widely in the fields of rehabilitation, pain science and movement over the last 15 years. Ben owns and runs Cor-Kinetic, an educational company who use modern research into pain, movement and neurosciences to provide a reasoning process and rehab skills to those who also place a priority on using movement and exercise as key competencies. Cor-kinetic has provided educational services for the NHS, Elite level sports clubs and universities as well as individual physio’s, Osteopaths, Chiropractors, sports therapists, rehab, and personal trainers.
Latest posts by Ben Cormack (see all)
  • Have We Ballsed Up The Biopsychosocial Model? - January 4, 2021
  • In Defence Of The Advice To Remain Active For Back Pain - November 2, 2020
  • A Simple Guide To Patient Centred Exercise - September 28, 2020
Tags: Massage, Massage Clinic, Massage Therapist, Massage Therapy, Pain Science, Therapeutic Exercise
https://themtdc.com/wp-content/uploads/Untitled-design-61.png 400 600 Ben Cormack https://themtdc.com/wp-content/uploads/logo.svg Ben Cormack2018-05-28 21:03:022020-08-20 12:21:19Are Painful Flare Ups To Exercise, Just Like A Sunburn (and why we might need analogy anyway)
You might also like
Can Massage Therapy Lengthen A Muscle?
https://flic.kr/p/6NWC1J How Massage Therapists Can Treat The Thorax Part 2
Tips For Writing Amazing Massage Therapy Blog Posts
Why YOU Should Blog For Your Massage Therapy Business
Articles Of The Week September 22, 2019
Models Of Pain And Movement
What Is Involved In Being A Massage Professional?
Articles Of The Week April 22, 2018

Categories

  • Business
  • Cardiopulmonary Resuscitation
  • CPR
  • Emergencies
  • First Aid
  • First Responder
  • Massage
  • Massage Clinic
  • Massage Therapist
  • Massage Therapy
  • Mental Health
  • Myofascial Release
  • Nutrition
  • Pain
  • PTSD
  • Social Media
  • Sport Massage
  • Therapeutic Exercise
  • Uncategorized

Join and stay up-to-date!

Email Marketing by AWeber

Have a solution to a problem within our industry? We want to hear about it!

Learn More

© 2020  James Johnston RMT • All Rights Reserved
Website by Caorda Web Solutions

Ben Cormack

Ben Cormack has a passion for getting people moving and using and understanding movement as an important tool to help others. Originally from a fitness background, Ben has gone on to study Sports therapy and widely in the fields of rehabilitation, pain science and movement over the last 15 years. Ben owns and runs Cor-Kinetic, an educational company who use modern research into pain, movement and neurosciences to provide a reasoning process and rehab skills to those who also place a priority on using movement and exercise as key competencies. Cor-kinetic has provided educational services for the NHS, Elite level sports clubs and universities as well as individual physio’s, Osteopaths, Chiropractors, sports therapists, rehab, and personal trainers.

Facebook Twitter 

  • Author
  • Recent Posts
Ben Cormack
Ben Cormack has a passion for getting people moving and using and understanding movement as an important tool to help others. Originally from a fitness background, Ben has gone on to study Sports therapy and widely in the fields of rehabilitation, pain science and movement over the last 15 years. Ben owns and runs Cor-Kinetic, an educational company who use modern research into pain, movement and neurosciences to provide a reasoning process and rehab skills to those who also place a priority on using movement and exercise as key competencies. Cor-kinetic has provided educational services for the NHS, Elite level sports clubs and universities as well as individual physio’s, Osteopaths, Chiropractors, sports therapists, rehab, and personal trainers.
Latest posts by Ben Cormack (see all)
  • Have We Ballsed Up The Biopsychosocial Model? - January 4, 2021
  • In Defence Of The Advice To Remain Active For Back Pain - November 2, 2020
  • A Simple Guide To Patient Centred Exercise - September 28, 2020
Scroll to top

This site uses cookies. By continuing to browse the site, you are agreeing to our use of cookies.

OK

Cookie and Privacy Settings



How we use cookies

We may request cookies to be set on your device. We use cookies to let us know when you visit our websites, how you interact with us, to enrich your user experience, and to customize your relationship with our website.

Click on the different category headings to find out more. You can also change some of your preferences. Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer.

Essential Website Cookies

These cookies are strictly necessary to provide you with services available through our website and to use some of its features.

Because these cookies are strictly necessary to deliver the website, refuseing them will have impact how our site functions. You always can block or delete cookies by changing your browser settings and force blocking all cookies on this website. But this will always prompt you to accept/refuse cookies when revisiting our site.

We fully respect if you want to refuse cookies but to avoid asking you again and again kindly allow us to store a cookie for that. You are free to opt out any time or opt in for other cookies to get a better experience. If you refuse cookies we will remove all set cookies in our domain.

We provide you with a list of stored cookies on your computer in our domain so you can check what we stored. Due to security reasons we are not able to show or modify cookies from other domains. You can check these in your browser security settings.

Other external services

We also use different external services like Google Webfonts, Google Maps, and external Video providers. Since these providers may collect personal data like your IP address we allow you to block them here. Please be aware that this might heavily reduce the functionality and appearance of our site. Changes will take effect once you reload the page.

Google Webfont Settings:

Google Map Settings:

Google reCaptcha Settings:

Vimeo and Youtube video embeds:

Privacy Policy

You can read about our cookies and privacy settings in detail on our Privacy Policy Page.

Privacy Policy
Accept settingsHide notification only

Clinical Pain Science For The Low Back, Pelvis And Hips

This course will be presented over a zoom meeting.  Details will be sent after you register.

Clinical Pain Science For The Low Back, Pelvis And Hips Remote

  • Price: $ 500.00 CAD