by Craig Faeth, PT, ATC, CSCS, FAFS(FMR), 3D MAPS, FGS
When you suffer with pain, it is common to want to find the source of pain and how it got started. Finding the source is usually not too difficult at first. You can probably point to it, press on it, and confirm, “Yep, that’s the spot!” Determining how it got started is another matter.
For some, this will be easy. If you fell from a horse, felt pain in your back while lifting something heavy, tweaked your shoulder helping a friend move, started noticing pain in the middle of the night while rocking your newborn, felt your knee pop when you got tackled during a high school football game, got pushed off the swing by that jerk at school, or any number of other ways in which you can injure yourself, you have a well-defined action, or set of actions, to work from.
For others, determining how, or when, your pain may have gotten started is much more challenging. For some, you didn’t really think of it as pain at first, just an irritating soreness. In fact, it wasn’t even that consistent. It happened most when you did yard work, or after playing with your grandkids, or entertaining for family gatherings. For others, it was most noticeable at the end of your workday. Then it got better.
During those times when you had no signs of the soreness or discomfort, you assumed it was “gone.”
In both cases of a well-defined injury incident and relatively vague soreness onset, the pain and dysfunction increase over time. You manage it the best you can with rest, gentle exercise to lose weight or get stronger, perhaps with medication, all with reasonable success. However, none of those efforts seem to really take care of the problem. It continues to exist on some level.
Finally, you decide to seek medical advice on what to do. In the case of joint pain, you will often be sent for an x-ray. You may also be given some recommendations for anti-inflammatories or be prescribed pain medication. You are encouraged to eat well and “get some exercise.”
The results come back from your tests. Arthritis. “Wait a minute. How did I go from just having a little pain now and then to having arthritis? Wouldn’t I have had more of a warning that something like that was the problem, like more pain? I mean, just the week before I was feeling pretty good. Then I got the pain, and it hasn’t gone away. I don’t understand how it can be arthritis.”
There is a cascade of changes that happens around areas of your body that do not possess good mechanical efficiency. These areas are often missing movement in one or more of the cardinal planes of motion.
What may be most perplexing about this is that you may have no knowledge of your inability to move in those planes. It won’t be painful. If you are aware of your motion limitation at all, or lack of flexibility, you have probably ignored it for the most part. Maybe your mom or dad had the same limitations, and you just write it off to heredity.
So you go through life with your functional limitations guiding how your motor system is going to decide the best way to utilize your body to achieve your goals. This is your unique m movement signature…your secret code. This simple idea is at the root of degeneration on the tissue level, the level of the joint surfaces. The subtle restriction in one or more planes of motion results in abnormal, asymmetrical compression of the joint surfaces.
The cartilage over the bone is incredibly tough and able to withstand a high level of compression. This resilience is somewhat dependent on the uniform compression of the joint design. In other words, one part of the joint surface may be more resilient than another part, consistent with the amount of force with which the different surfaces of the joint are compressed. If you throw off the symmetry of the compressive force a bit with subtle restrictions in one or two of the planes of human motion, you create an environment where the surface is more susceptible to developing fissures…the beginning of arthritis.
Over time, this area may be more painful or achy after some physical activity. It may be more painful or achy depending on the barometric pressure outside, which can affect joint lubrication. The pain response itself can foster degeneration in other places in your body, or to another aspect of the same joint.
When the force is not adequately distributed, it tends to be diverted to areas in your body that are less able to withstand the force. To your brain’s motor system, these are areas of less resistance, and therefore, ideal places to direct the force for absorption.
Absorbing this force in places that are less equipped to withstand it comes at a cost. Certain areas of your body are troublemakers (i.e., foot, ankle, hip, and mid back or thoracic spine) because they put up a fight when they are asked to absorb force that is distributed to them unnaturally, or asymmetrically.
The victims often become the knee, the low back or lumbar spine, the neck and shoulders. These areas depend on the good mechanical functioning of the troublemakers to such a high degree because they cannot withstand the force outside of their proportion. If just a little extra force absorption is asked of them, they take it with no questions asked. Their voice is small…until they start breaking down.
When the troublemakers accept the force passed along to them in a smooth functioning neuromuscular system, they store this energy elastically in the muscles and connective tissue surrounding them. They are then primed to release it to be successful in the next phase of the physical task to be completed. They harness the momentum more effectively to reuse the elastic energy created.
When your knee, or your back, accept the force passed along to them in a smooth functioning neuromuscular system, they will have this same success in proportion to their design. If the system isn’t functioning smoothly, however, they will simply absorb the force into the tissues (i.e., osteochondral cartilage, connective tissues, and muscular tissues). This absorption isn’t elastic. It is transferred into the tissue to be dissipated in the tissue. Each time this happens, there is just a little more wear and tear of the tissues.
The system is incredible! The most sophisticated design ever created. Most of its functioning is well below the level of your conscious mind. When we are talking about how you move around this earth, doing whatever it is you are doing, the vast majority of the planning of how to do this takes place subconsciously for you. Amazing!
There is one downside, however. The motor system has a healthy interest in responding to any pain response in your body. As quickly as possible it would like to have a resolution to the pain, so that the pain signal, traveling on the nerves close to the area of tissue pain, will be stopped. Most often this is accomplished by increasing the amount of tone in the surrounding tissue, sort of like a mild spasm. It functions as a tissue guarding of this area, a type of internal splint.
Unless this internal splint, this mechanism of muscle and connective tissue guarding, is shown a more effective way to reduce the pain signal response, you will begin to adopt a way of functioning with this tissue guarding.
In some cases, because the pain signal has been reduced, you will be led to think you have healed, and maybe even gotten stronger. In reality, you have become just a little more dysfunctional. You have borrowed resources from the surrounding joints and tissue of your body to accommodate this painful or sore area.
When you layer this on top of the dysfunctional joint compression mechanics illustrated in the development of arthritis, it is like adding fuel to the fire of the degenerative process. Multiple areas become affected, and in turn affect each other. If you add in the extreme loads that come from heavy manual labor, the operation of heavy equipment, full travel schedules across multiple time zones, and yes…intense physical exercise, the degenerative process becomes exponential.
It is this last point, high levels and high amounts of physical exercise accelerating the degenerative process, that finally motivated me to write a book. I have seen too many clients who have done their very best to take care of themselves, unable to escape the suffocating influence of their own physical degeneration.
When I look at their efforts to get enough sleep every night, eat clean and targeted diets for their physiology, engage in exercise every day, and maintain a healthy life-work balance, their efforts are far superior to mine. I am convicted every time, and this is my professional avocation.
So why is an understanding of this so important? To be blunt and to the point, you can’t trust your body sometimes. The absence of pain, soreness, or stiffness does not always suggest good movement health or efficiency. This concept is the hardest for most clients to understand and accept.
The old exercise mantra of “no pain, no gain” is a double-edged sword. Tissue change and adaptation from its current state, even for positive and productive gain, will come along with a bit of soreness. How we manage that soreness makes all the difference in becoming better or finding ways to compensate around the pain. Knowing how to manage it starts with knowing your movement signature, your secret code for functional mobility. Get the book Move Better, Feel Better, Live Better: Your Secret Code to Effortless Movement, Enhanced Performance, and Aging With Ease, and start your journey to your best health.
