Pain is feedback for what's going on in the body. But sometimes it can be deceptive, especially when it comes to chronic pain.
Working through an acceptable level of pain is not only encouraged in my books but necessary for a proper recovery. Let me explain.
There's a concern that persistent pain can lead to what's called Central Sensitization (CS), essentially an overly sensitive nervous system. (Reference here)
The implication is that when we're in pain for a while we might experience pain during activities that we normally don't, or we feel more pain in something that was only mildly uncomfortable before.
Because of this, it may seem obvious that we should avoid anything that causes pain to prevent this sensitization from happening.
Surprisingly, this is not always the case based on a number of different research areas. There are cases where exploring painful activities is not only acceptable but beneficial as well.
Let's analyze some reasons why.
1. Exercise is an analgesic
Movement and activity have the ability to decrease levels of pain. Think of the "runner's high" people get. This is a legitimate reaction to movement and exercise although it can be a short-term feeling. But in the long term exercise actually decreases our sensitivity to pain. (References here and here).
2. Just because something hurts, doesn't mean you're actually at risk
Sometimes pain is just a perception of a threat or an irritation signal. Other variables like stress and expectations can also affect our feelings of pain regardless of what is actually happening in our tissues. Chronic anxiety and fear of a movement can begin to cause pain but that doesn't mean there's an issue at the tissue level. (Reference here).
3. Even when there is tissue damage, it is safe to push into some level of pain
When you tear a hamstring or tear your ACL in your knee, for example, it is going to be impossible to work that tissue without feeling some level of discomfort. But rehabilitation programs are designed to make the tissues work in order to help them heal and make them stronger. You need to push into some level of pain to make this happen. (Reference here).
This doesn't mean you hammer away at the affected area relentlessly. Start with a relatively gentle entry point and build up tolerance from there.
4. We can habituate to painful activities
This means that we can do something that's painful, and slowly get used to it over time. Cooks get better over time at reaching into a hot oven. Rock climbers have adapted hands for holding on to sharp and jagged edges.
We simply get used to something as our bodies adapt to the demands. So even if something is painful at first, as we continue to do it our pain will decrease. (Reference here).
There are obvious situations where we need to simply back off and let things calm down, (think of stress fractures or immediately after full ACL tears). Avoidance in the very early stages is acceptable, but eventually, exposure is the way to go.
We always have to also take into account how a person feels about their pain. If they are constantly told that their pain is going to get worse and that if they feel any pain then they're causing damage, then it will make things worse the more you believe it.
Ultimately we should all be movement optimists! Trust your body's ability to adapt and you'll see the amazing healing capabilities for yourself.
To your good health,
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