Will I need to do exercises?  

Yes. Home exercise and self help pain relief strategies  are an essential part of recovery from pain or injury. A practitioner should help develop an effective self help  program and  work out strategies to  incorporate  exercises into  daily   routines.  

How often do I need to exercise? 

This depends on the problem. Most  need to start  little and often to get things moving again and ease inflammation. For example: if a joint is very swollen and stiff or a muscle is very achy, then small, hourly movements will  help. Once pain settles  and movement frees up,  exercises can be gradually cut back to once a day. 

How to get my child/teenager to exercise? 

Understanding the  cause of the problem helps a little. It is important to  find ways to incorporate simple  exercises and stretches  into day to day  routines, make them engaging (for example work with coaches to incorporate their program into a training drill, and link regimes CLEARLY to the goal. And, if possible get the sports coach or trainer on board with neruomuslcar exercies that wil help the whole team/class

Will I have to give up my work/sport/hobbies? 

Recovering from pain is unlike  recovering from a dental filling. It  is not a case of curing the problem.  It takes time to recover from the effects of pain and /or stiffness and/muscle weakness on muscles.  If pain has been present several months it can take three months to fully recover (the  same as after surgery). 

To reduce pain most need to undertake   a  home exercise program and  adjust their lifestyles or modify training or sports program.   It depends entirely on the circumstances and the  individual.This can range from playing alternative quarters/a month  out of sport/decreasing time spent standing/sitting  watching sport/music .   As pain decreases and  strength is recovered,   most  activities will be gradually reintroduced. Go too hard too soon and  pain will return.

What if I am already exercising?

The exercises  needed to recover from pain or injury are highly tuned, so may be  different to a  normal fitness program.  If exercise/sport  is causing pain,    training  will need to be modified  to a  pain free level.

It is important to incrementally progress exercises  after pain or injury.  Rehabilitation should  be carefully paced to regain full fitness strength and flexibility without causing too much pain. Exercises are usually changed each  week.   This process of cutting back, calibrating then introducing  the  next level of exercise  until full strength and flexibility and capacity  is attained, is individually prescribed every time pain occurs. Generic exercises from a friend or the internet seldom help.

What about no pain no gain?

There are some circumstances when  pain should be pushed through, but for the most part it needs to be respected and minimized. We will help you understand what type of  pain is safe to push  through and when pain  is harmful. It is not always intuitive. 

Will I  have to change what I am already doing?

Probably. In most circumstances pain is a warning that an action or task or posture is being overdone or that the body lacks the strength or flexibility or agility or endurance to do what is desired.  If these warning are ignored, the  body becomes sensitized, (the pain warning ramps up) causing  pain to  either  spread or become intense in one spot, sometimes freezing or stiffening or weakening a joint. This spread and/ or intensification   becomes increasingly difficult  to resolve.  Sessions  will help establish what is currently triggering pain and find ways to either modify activities  so they do  not  cause pain, or build up strength  and endurance needed to undertake  the task/activity without pain. Sessions will help you  understand how to match your body's capacity to your demands. The mismatch between what is  (often unrealistically) expected of  bodies  and  their  ability to deliver  can be   central  to  most persistent pain issues. 

 How many sessions will I need? 

Usually  4-6  sessions with a professional shoudl be adequate to help regain  movement  and  establish a self help program.  More sessions may be required if  pain is complex/ long standing/ intense or if  it is challenging  to modify lifestyle/work or undertake a comprehensive home program. It  can be hard to maintain the  motivation (and finances) needed for lengthy rehabilitation. Self help strategies are critical.  

How long until pain eases?

 If due to a recent flare up or a new problem, pain should settle  within a week or two. However, it can take months to change widespread or lingering or intense pain. 

Studies show that the most crucial factors are not the degree of damage seen on x-rays nor how severe an early injury / fracture was but, instead, the duration and intensity of pain felt. Other important factors include how many other sites of pain are also active in the  body(yes: an achy  knee ultimately  does  affect that stiff shoulder), and the past history of pain. The stronger and longer pain has been present and  the more sites are affected by pain, the longer  it can take  to ease. It is usually one step forward half back until all elements of rehabilitation come together (pain relief/inflammation control/self management /learning to live within capacity /preventing pain recurring and, where feasible, building capacity).

It’s not insurmountable.

Can I be  cured of pain?

 Some pain  is essential. How else would anyone  know when  their body is being pushed beyond its capacity? Learning to listen to the body and understanding when to push through pain and when to ease back  is an essential part of the rehabilitative process. 

Even once  resolved,  pain, stiffness and/or swelling can return if , once again, your body is pushed past its capacity.  Understanding  how pain works to protect the body and  how to respond  to early warnings  will  minimize the  chances of it recurring.  Offering a complete cure is unrealistic. This can be a hard lesson to learn.

 

What other techniques are used? 

All practices should use a multi-modal individualised approach which includes 1. soothing 'hands on' techniques for pain relief, 2.exercise prescription and 3. MANY self help strategies. The evidence suggests that simple cost effective  pain relieving treatments such as heat packs, massage rolls and  taping are  effective if combined with individually prescribed and  progressed exercises and activity modification. 

What about laser/ultrasound/TENS and other electrical modalities? 

Any modality that delivers pain relief (from massage to manipulation to laser to heat packs)  is helpful but all effects are short lived.Pain relief must be combined with an self help home program and pain prevention.  There is no conclusive evidence that expensive   electrical treatments are  more helpful than simple strategies such as heat packs/massage gadgets.  

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