What is Pain?

Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Have anyone ever told you, “Your pain is all in your head.”?  That can be a frustrating statement to hear, but is there any truth to it?  Turns out ALL pain is in your head; at least that’s where it originates. painpic5

You don’t necessarily have pain receptors in your body; they could more accurately be described as nerve alarm receptors.  These receptors let your brain know that there has been an insult or injury to your body and you need to pay attention.  Your brain then decides how much attention this injury deserves and issues a corresponding pain response.pain-is-like-an-alarm-clock2

Most of the time this built in mechanism works well, and allows us to stay safe and survive.   threat-and-anxiety1-300x131What happens when our brain or alarm system gets it wrong, and what should be no threat or a very small threat to our body is turned into a life threatening emergency by our trusted brain??

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It is ironic that the organ in charge of distributing effective pain sensations, can’t actually perceive pain itself.   What happens is that this: papercut

is perceived as feeling like this: handcut.

The fear of pain is worse than the pain itself.  And if your alarm or pain alert system is overly sensitive, this truth can be debilitating.  percieved-threat-300x256  It’s know as pain catastrophizing and it’s real!  If you’re someone whose pain alert system is in need of  a “reset” and you expect to feel pain more intensely (most likely due to past experience with an overly sensitive alarm system), you likely WILL feel that higher level of pain as compared to someone with a healthy alarm system.  This is why perceived pain level is a poor or at best unreliable indicator of an actual injury.  So what’s the take home? painpic4 Your brain doesn’t have to be removed in order to correct this system and restore factory settings!  It is possible to “Control / Alt / Delete” your way to a brain/nervous system reset, and even use your brain to significantly reduce your pain levels!  pain pic1  We’ll get into more depth on how that can be achieved in our next blog post, so be sure to stay tuned.  painpic2.png

The Unstretchables

  • There are some muscles you simply can’t stretch no matter how hard you try, just don’t tell that to elastigirl! Truth is we have 3 different “types” of muscles in our body, and not all of the types can be intentionally stretched. (Unless you have super powers)         Here’s a list of unstretchable muscles.
  • The heart
  • The diaphragm (a breathing muscle)
  • Detrusor muscle (contracts your bladder)
  • Arrector Pili (muscle that attaches to hair follicle to give you goosebumps)
  • Recti muscles (group of 4 muscles that move your eyeballs)
  • Irises (muscle that controls diameter of your pupil)
  • Here’s a big one…levator palpebrae superioris (muscle that raises your eyelid). You get the idea, not all muscles were meant to be stretched. However, for the muscles that were meant for stretching, let us give you a few do’s and don’t to help you achieve better flexibility. 
  • Don’t bounce. Stretch into a comfortable pull sensation and hold it for 30-90 seconds. Do this 2-4 times or until the pull sensation lessens.
  • Do breath. Oxygen is good for your muscles, do not hold your breath.
  • Don’t stretch past pain. Unless you are being directly guided to do so by a physical therapist don’t stretch your body into pain provoking positions, you can do damage. Stretching can be uncomfortable but shouldn’t be painful.
  • Do stretches daily. Flexibility can only be maintained through consistent completion of stretching.  So there you have it, muscles are a lot like people…some are simply more flexible than others. Which type would you rather be around? Flexibility is a good thing, on a lot of levels. Be happy, be healthy, be you. 

Stretching, the Good, the Bad and the Ugly – Part 2

In part one of our stretching blog adventure we uncovered some researched based (& somewhat shocking) truths about stretching. Now it’s time to get down to business…let’s talk about a couple of weird stretches! 

PANDICULATION is a non-traditional stretch. If you’ve ever awoken in the morning, yawned, and stretched your arms, you’ve experienced pandiculation. Use the noun pandiculation to describe the particular sleepy combination of yawning and stretching. … The Latin root is pandiculari, “to stretch oneself,” from pandere, “to stretch.”

PNF STRETCHING is another non traditional stretch. Proprioceptive Neuromuscular Facilitation (PNF) is a more advanced form of flexibility training that involves both the stretching and contraction of the muscle group being targeted. PNF stretching was originally developed as a form of rehabilitation, and to that effect it is very effective.

Remember…no matter the stretch, it shouldn’t hurt! Flexibility is important and gaining flexibility can be uncomfortable, but it should never bring tears. 

Stretching is good for you, so no matter what type of stretch you choose….traditional or non-traditional, just s-t-r-e-t-c-h! 

Stretching…The Good the Bad and the Ugly – Part 1

Stretching is a form of physical exercise in which a specific muscle or tendon (or muscle group) is deliberately flexed or stretched in order to improve the muscle’s felt elasticity and achieve comfortable muscle tone.[1]Weerapong, Pornratshanee; Hume, Patria A.; Kolt, Gregory S. (2004). “Stretching: Mechanisms and Benefits for Sports Performance and Injury Prevention”. Physical Therapy Reviews. 9 (4): 189–206. doi:10.1179/108331904225007078. 

The result is a feeling of increased muscle control, flexibility, and range of motion. Stretching is also used therapeutically to alleviate cramps. Stretching can be dangerous when performed incorrectly. There are many techniques for stretching in general, but depending on which muscle group is being stretched, some techniques may be ineffective or detrimental, even to the point of causing tears, hypermobility, instability, or permanent damage to the tendons, ligaments, and muscle fiber.  -Tsatsouline, Pavel (2001). Relax into stretch: instant flexibility through mastering muscle tension. Dragon Door Publications. ISBN 978-0-938045-28-1.

So does stretching actually reduce muscle soreness or the risk of injury? The surprising answer is NO. Most studies indicate that stretching alone won’t achieve these feats. (I’m as shocked as you but evidence is evidence people.)   Herbert RD, de Noronha M, Kamper SJ (2011). “Stretching to prevent or reduce muscle soreness after exercise”. Cochrane Database Syst Rev (Systematic review) (7): CD004577. doi:10.1002/14651858.CD004577.pub3. PMID 21735398.  Behm DG, Blazevich AJ, Kay AD, McHugh M (2016). “Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review”. Appl Physiol Nutr Metab (Systematic review). 41 (1): 1–11. doi:10.1139/apnm-2015-0235. PMID 26642915.

Sorry about all the citations folks, but I couldn’t claim truths like this without proof. You understand, right? The curious among you will check, for the rest…just scroll through them. 

So for the pro-stretch people like myself here is some good news. Stretching keeps the muscles flexible, strong, and healthy, and we need that flexibility to maintain a range of motion in the joints. Without it, the muscles shorten and become tight. … Injured muscles may not be strong enough to support the joints, which can lead to joint injury.  As physical therapists and assistants, we recommend stretching for range of motion. Range of motion at a joint allows the right muscles to contract at the right time and in the right way. It also promotes a posture in which you’ll maintain optimal boney alignment. That’s a big deal because it can reduce pain and help you move in the right way.  Stretching is an intrical part of a multi faceted injury prevention and performance enhancing routine. It’s a piece of the pie, not the whole pie. The key is to create stability in the right places if you’re increasing mobility with stretching.  Stay tuned for part 2 next week where we’ll talk about types of stretching and how to effectively execute the right stretching program for you! **special thanks to my Marine brother for having these great questions & inspiring this series. 

Stress Relief From Laughter

LOL….hahaha….😆, all jokes aside, laughter is great for your health!  Laughter decreases stress hormones and increases immune cells and infection-fighting antibodies, thus improving your resistance to disease. Laughter triggers the release of endorphins, the body’s natural feel-good chemicals. Endorphins promote an overall sense of well-being and can even temporarily relieve pain.

So what exactly is laughter? Laughter is the physiological response to humor. Laughter consists of two parts — a set of gestures and the production of a sound. When we laugh, the brain pressures us to conduct both those activities simultaneously. When we laugh heartily, changes occur in many parts of the body, even the arm, leg and trunk muscles.

Will a small chuckle do? If your sense of humor is as dry as the Sierra dessert then something is better than nothing.  Start small…a smile, giggle, chuckle, then work your way into a nice harty belly laugh.  A British study shows how just 15 minutes of harty laughter can increase pain tolerance by around 10 percent as a result of endorphins being released in the brain. These endorphins cause something akin to a natural “high”, leading to pleasant feelings of calm, as well as temporary pain-relief. ( Ejaz Khan, wonderlist.com)

Winter Time Fire Safety

Recently I completed an interview with the local fire safety prevention officer who offered some insightful advice on staying safe this winter.  Normally we focus on physical therapy related topics, however occasionally if the quality of information warrants a veer from the norm…then we are going to take it.  Two main ideas were conveyed in the interview, and they seem quite simple, be careful with space heaters and be aware of your exposure to carbon monoxide.  However, when you dig a little deeper you will find that you (and more than 50% of the rest of us) are guilty of violating these simple rules thus placing ourselves and our families in unnecessary danger.  Let’s get started with some information on space heaters, the leading cause of winter fire deaths.

  1. All space heaters used in your home should be labeled with “tip over protection”, which means exactly what it sounds like it means, if the heater should be tipped over it will shut itself off.  Most heaters are equipped with “overheat protection” which means before they get hot enough to catch on fire they will shut off, but not all are equipped with tip over protection which is just as important.
  2. Any space heater should be plugged directly into a wall outlet and not into an extension cord or a power strip.
  3. Space heaters should not be used within 3 feet of ANYTHING…#3feetfromheatfema-fire-safetyThe second biggest danger most of us will face in the winter time is exposure to carbon monoxide.  CO is a poisonous gas that has no odor, it is a bi-product of incomplete combustion which is produced by any fuel burning device.  It kills you by not allowing your blood to carry oxygen to vital organs like your heart and brain.  Here are some examples of items that can generate this dangerous gas: generator, gas stove, gas furnace, gas water heaters, cars, and non-electric space heaters. carbon-monoxide-poisoning    Here are some things you can do to limit your exposure to this dangerous gas.  Don’t warm up your car in the garage, even if the garage door is open.  Don’t set up your generator outdoors near a furnace intake vent.  Don’t use cooking appliances to heat your home.  Don’t use a gas grill in an space attached to the house like a garage.  Do inspect your vents to ensure that nothing is blocking your ventilation to outside prior to firing up the furnace or wood burner for the winter.  Do open your fireplace damper completely and ensure chimney is clear prior to starting a fire.  Most importantly have CO detectors installed in your home, there are products available that are both smoke and CO detectors.
  4. co-levels

Home Exercises – The Good, the Bad, and the Ugly

Have you ever had the wonderful experience of outpatient physical therapy?  I can almost hear the silent chuckle…yes, it actually can be a wonderful experience.  A hard experience? Yes.  An unforgettable experience?  Definitely.  I’m going to share a secret that all therapists know, and only some patients end up realizing; the ones who do usually remember their experience in a much more positive way than those who never quite get it.  Who knows, if you take this advice to heart you may even one day describe your therapy experience as “wonderful”.  Drum roll please…you have to actually do the exercises that are assigned to you by your therapist.  Those 3 wonderful little letters, H-E-P stand for home exercise program and will make or break your therapy experience.  Yes, it may take up some time daily.  Yes, you may need to rearrange your routine to make sure you can get them in.  Yes, your therapist knows when you don’t do them regardless of what you tell them.  There are 168 hours in a  week (7 days), you will most likely spend 2-3 hours of that time in physical therapy doing specific exercises tailored to your deficits.  So why do you have to go home and do them more?  Do the math.  You are spending less than 2% of your entire week working on your recovery.  If you really want to improve your condition, it’s a no brainer; you HAVE to spend more than 2% of your week dedicated to making yourself well again.  So next time you’re thinking about skipping it all together, or  complaining about how long your “HEP” takes, think about it objectively.  How much is your recovery and your health worth to you?

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Pokémon Go Stretching

Feeling a little sore after scouring through the woods, or traveling several blocks to catch Pikachu or Squirtal? We have you covered with some great lower body stretches to reduce your muscle soreness and allow you to continue your Pokémon adventure! Each stretch should be held 20-40 seconds and completed 2-3 times on each side.
The calf stretch: this targets the back of your leg

The hamstring stretch: this stretches the back of your thigh…keep your knee somewhat straight, chest lifted leaning forward until a pull is felt.  Toes can point up, to the right slightly or to the left slightly. By changing toe position for each stretch you target all 3 of the hamstring muscles.

The quad stretch: this stretches the top of your thigh.

The IT band stretch: this stretches a large thick ligament that runs from the side of your hip to your knee.

Don’t forget neck stiffness from looking down at your phone.  Looking up 3 times for 5 seconds every 5 minutes of play will prevent “tech neck”. Safety first, never walk into a road, through a parking lot or over uneven ground while staring at your phone.  Happy Pokémon hunting!