In today’s blog I want to get across the idea that, whilst "Pain" may be the reason you booked an appointment with your local pain professional, becoming “Pain Free” is not a good marker of successful management.
In fact, the reliance on "Pain Reduction" rather than "Tissue Health" is the very reason that people suffer recurring injury in the first place. So let’s dig into this a little further.
“Pain itself is generated in response to tissue damage.”
Whilst that statement seems true it is actually incorrect. You can have tissue damage and no pain and you can have pain without tissue damage. The following statement is a little better:
“Pain is generated in response to the context of tissue damage”.
It seems like I’m splitting hairs here but it is an important point. Context means that the brain took all the relevant information and decided whether or not to generate a protective sensation that we call pain. If there isn’t enough concerning information then it may choose not to generate a pain sensation. The classic example is when someone tells you that you’re bleeding but you had no idea (until you change the context and look at the blood. You now have a new level of concerning information and pain suddenly starts up!)
If you follow this process through you’ll realise that pain also goes away quicker than the tissues fully heal.
For example: You cut yourself and it hurts for a few hours yet the actual cut may take a week or more to fully heal up. So there is still tissue damage but the pain only lasted for the first few hours of the week long process of recovery.
Hopefully the answer is obvious from the last paragraph but I’ll clarify it for you anyway.
When a client, for example, comes into my clinic with a painful Achilles, we spend the first few sessions getting on top of the pain. We can expect Achilles “Pain” to resolve in around 5-6 weeks if managed well. However, full tendon healing itself usually takes 3-6 months.
It is in these following months of tissue strengthening that re-injury occurs. Particularly in the early days after pain has gone. The tissue is still very fragile at this point and sudden increases in activity can’t be tolerated yet, despite there being no pain. Therefore people can set themselves back weeks or find themselves in a cycle of "Recovery and Re-injury".
Hopefully you can see that “Pain Free” and “Healthy Tissue” are two separate conditions. But that doesn’t mean you should be concerned. Soft Tissue Professionals (the good ones at least) know that they can help you get on top of pain quickly to make life more comfortable but also support you in the following months with a progressive plan to strengthen those tissues. It is simply a case of challenging the tissues long enough, with enough load to restore full and complete health.
If you are stuck in the "Recovery and Re-injury Cycle" then let us help you get out of it with a tailored plan. With the right markers of success (first pain reduction and then tissue strength) you will be enjoying your activities to the highest level again. Book yourself a Free Assessment and we can help you understand your next steps.