Why People Get Hurt and Don’t Always Get Better…
When I was a young child, I remember an incident in which a close family member, who worked in a bowling alley, slipped and actually got his ankle caught in the pin re-stacker. Ouch!! From then on he experienced ankle problems, and as I child I distinctly remember thinking that once you injure your ankle, it looks like it will always be a problem.
The Resilience of Childhood
The severity of the incident was never really taken into account during my initial inexperienced hypothesis. In my defense, from a child’s perspective, every time we get injured we always heal. Since I had never injured my ankle, I assumed that ankles didn’t heal the same as every other body part. Let’s face it, as a child you fall down and scrape your knee and a few days later, it’s like it never happened. Therefore, from a very young age we are taught that injuries heal, mostly on their own, and maybe with some help from Doctor Mom. We are innately trained to believe this. However, what happens when our bodies stop growing?
The Realities of the Adult Body
At a certain point when we are finished growing and become the adult person we are, our bodies and the way they heal do change. Injuries may not heal as quickly, and conditions, such as that ankle injury mentioned earlier, do have the tendency to become chronic. Many people start experiencing lower back pain as early as their twenties, after youthful years of activity become replaced with 8 hour work days seated at the computer.
As children we were encouraged to be active, schools require us to participate in gym classes, and for those of us who grew up prior to personal computers, children played outside and were active every day. As adults, those of us who understand the importance of activity spend one hour a day, three days a week at a gym trying to stay in-shape. This essentially adds up to less than 2% of our week. On the other hand, many of us understand the importance of activity and never participate in exercise at all. As a society and as individuals, we are becoming physically de-conditioned.
Deconditioning & Cumulative Damage
Webster defines deconditioning as “causing to lose physical fitness”. This loss of fitness can often be the result of chronic problems we experience with age, especially lower back pain. It is difficult to accurately summarize all of the causes of lower back pain. There are a broad range of causes, but many have in common the concept of deconditioning of the body.
We place an enormous amount of physical stress on our bodies every day. Long periods of sitting in one place are especially wearing on the spine. This wear and tear is cumulative and our bodies constantly work on repairing injured tissue.
When describing injured tissue, I am not referring to traumatic injury, but to micro-trauma that occurs from daily stresses on a microscopic level. Since this type of micro-trauma adds up over time, eventually our bodies can’t keep up with the healing. We either become more vulnerable to injury or experience new injury. This is why most of the patients that walk into my New York City chiropractic office have trouble identifying what caused their onset of pain.
Many times I hear from a patient, “I was just bending over to brush me teeth and as I got up, my back went out”. Well, I either treat a population of patients with the world’s heaviest toothbrushes or more likely, these particular injuries are caused by cumulative micro-trauma. The act of brushing their teeth was literally the ‘straw that broke the camel’s back’.
Help for Chronic Problems
Priority One: Restoring Function
So what can be done for these chronic back and joint injuries? The first priority goals revolve around restoring proper function. In order to heal properly, function must be restored to the affected area, and this can be much easier said than done. In most injury cases, the individual experiences pain when attempting to perform activity. This results in a natural avoidance behavior that ultimately leads to further deconditioning.
In order to restore function, the individual should seek out the help of a licensed professional such as a chiropractor, medical doctor and/or physical therapist. The practictioner will perform a thorough evaluation to determine the cause of the problem and should provide a custom plan for recovery.
Most treatment plans initially begin with the short-term goal of pain-reduction, and once significant pain is reduced functional activities are re-introduced based upon the individual’s tolerance. In my chiropractic practice, treatments such as Active Release Techniques®, Graston Technique® and Neuromuscular Re-education are included to help facilitate the healing process. Rehabilitative exercise both in the office setting and at home are prescribed in order to re-strengthen these areas of chronic injury.
It’s Not ‘All Better’ with Pain Relief
The biggest issue I notice with patients is that once they experience relief, they assume their problem has resolved. They try to return too quickly to full activity or when they feel better, they suddenly act like the problem never existed. Unfortunately, this too often leads to a re-occurrence and possible worsening of the original injury.
A Word to the Wise: Listen to your doctor or therapist, and follow the progression of treatment all the way through to discharge, not just until you are feeling ‘OK’. Do this and you should be able to restore your original function and keep it for the long run. With increased physical function, pain should decrease, and you can restore your ability to perform your normal activities of daily living, working, and playing.
The author, Dr. Paul M. Salinas, is a licensed Doctor of Chiropractic specializing in the treatment, rehabilitation, and prevention of neuro-muscular skeletal injuries. He is a certified Full Body Active Release Techniques® practictioner, and also practices Graston Technique®. His New York chiropractic practice is Park Avenue Spine, located in Manhattan. In addition to his practice, Dr. Salinas has been an adjunct professor of Anatomy and Physiology at Berkeley College, as well as a lecturer for corporate wellness programs. Contact Park Avenue Spine via the website or call 212.685.9123 for information or an appointment.