When in Doubt, Get it Diagnosed.

When you are working out (or even just making your way through life), you’ll have tweaks here, aches there, and the typical reaction is to ignore it and hope it goes away. There’s nothing wrong with that as long is it’s not debilitating. Often, a little Ice, Compression, Elevation, and Rest (ICER) will take care of the little stuff. But, what if that discomfort lingers or starts to worsen? This is when you need to have it checked out by a medical professional. Don’t wait too long to do this, either.

diagnosis

While you may not like going to the doctor, going will get you the answers that you need to move forward. Here are four common outcomes from getting it diagnosed:

  1. It’s nothing serious and you can get back to working out or your life activities using discomfort as your guide as to how much is too much.
  2. It could be something that you can work around by using modified positions or ranges of motion.
  3. You could find out that challenging it is doing further damage and that you should avoid using it at all until it is healed.
  4. Resting won’t help and surgery is necessary.

Now, you may not like the sound of #3 or #4, but, if you could do more damage, you need to listen and fix it before you can return to activity.

On the flip side, there’s also a peace of mind if you find out that you aren’t doing more damage and you can continue with activity.

In example, I have arthritis in my thumbs. Exercising the joint is uncomfortable. Should I stop? Well, when I wasn’t sure what was going on, I didn’t know the answer to that. If it was carpal tunnel syndrome, continuing activity would likely make it worse. With the diagnosis of carpal-metacarpal arthritis, I knew that exercising within my discomfort (okay, pain) tolerance, would be my best chance of avoiding surgery. Getting the diagnosis allowed me to make an informed decision about how to move forward.

Aches and pains are a part of life (and getting older), but, if something is either very painful or lingers, get it diagnosed! One way or the other, you will be better off knowing what is really going on.

Will Working Out Fix My Back? (Shoulder? Hip?) 

I know a lot of personal trainers that will claim that they can fix your problem(s). Can they? Well, it depends on the personal trainer, your individual issue(s), and what is meant by “fixing” it.

pain

Let me start this discussion with a confession. Most people wouldn’t know this, but, I’m in physical pain, every day, and have been for years. It’s not overwhelming, but it is annoying. I have spinal stenosis that creates a radiating nerve pain down my right leg. I have a torn meniscus in my left knee. I have arthritis in both of my thumbs which make gripping things painful. I had a complete shoulder replacement about five years ago (Although, this is no longer a source of pain. My shoulder feels great these days.). And then there are the day to day aches and pains that we all deal with as we get older. Yet, in spite of all this, I teach group fitness, lift weights, and do pretty much anything I want. My, “issues” do not limit my activity. This is because I work out regularly and consistently challenge myself. Am I “fixed”? No, but I am soooo much better than I would be if I wasn’t working out.

That’s my story, but could it fix other issues? Well, it’s not going to get rid of arthritis (but, it can increase your ability to do what you want and it can diminish the sense of pain.) It’s not going to reattach torn ligaments (but, it can strengthen the muscles surrounding the area and may allow you to continue activity without surgery [always check with your doctor]). That said, if you are having back pain because of weak core muscles and poor posture, yes, the right workout with a qualified personal trainer can correct this condition. If you are having pain that is determined to stem from improper gait or movement patterns, yes, these can be corrected and alleviate the pain.

So, yes, working out can “fix” some problems and can make the best of others. The key is to check with your doctor and with his/her approval, find the right personal trainer to work with and you can be on the road to a better quality of life.

What a Pain!

Pain is a funny thing. For personal trainers, we have been taught that when a client feels pain it is a red flag. Stop what you are doing and send the client to a doctor. But pain is not redflag1always that simple. First, everyone perceives it differently. I’ve had clients that, after a few reps of an exercise, said that it hurts. ? OK, do I stop and send them to a doctor? Well, I do stop. But then we talk about what they are really experiencing. Where does it hurt? In the joint? In the muscle? OK, it’s in the muscle. What does that feel like? Is it sharp or stabbing? Is it dull or achey? Is it tension and fatigue? You’d be surprised how many people are unused to feeling muscle fatigue and report that as pain. I’ve also had clients that would tell me that their backs hurt when they did abdominal crunches (back when I used to have them do crunches). We’d discuss what they were sensing and determine that they were feeling a stretch tension in their lower back. This was neither harmful nor uncommon as one of the limiting factors in how high someone could crunch was the flexibility of the low back.

My point here is not to support the common declarations of “No pain, no gain.” or “Pain is weakness leaving the body.” Rather, I bring this up to make you aware that there are many sensations when you are working out that are often lumped into the pain category and to take a moment and analyze what you are really feeling.

“Pain”, like Baskin-Robbins ice cream, comes in many flavors and depending on the flavor and where it is located, can help you understand its severity. First, let me say that joint pain is always more concerning than a muscular pain. With muscles, you can feel a burning fatigue, stretch tension, acheyness, soreness, cramping, etc. All of which are really more discomfort and, while not pleasant, they are not that concerning. A tearing feeling or pop, on the other hand, you had better pay attention to (stop what you’re doing and see your doctor). Joint pain should rarely be ignored. If ysevere-knee-painou have diagnosed arthritis or are just stiff and achey, maybe you can keep on keeping on. However, if you feel a sharp, stabbing sensation, a radiating pain, or even a strong ache in a joint, it is cause to stop what you are doing and seek medical attention. Joint issues can be very serious and should be addressed before returning to activity.

Backtracking a little, if there is any chronic pain that you are experiencing, no matter what flavor,  you should see your doctor. It’s always better to know what you’re dealing with. The diagnosis will let you make an informed decision as to what you can safely do or not do.

So, while some discomfort is expected in a fitness program, being able to discern between what might be considered normal and what is potentially a real injury, is important in keeping your body healthy. Listen to your body and get to know your flavors.

 

Got Back Pain?

In all likelihood you have experienced back pain at some point in your life, especially if you are over 50. Here are a few quick facts about back pain:

  • Low back pain is the single leading cause of disability worldwide.
  • One-half of all working Americans admit to having back pain symptoms each year.
  • Back pain is one of the most common reasons for missed work.
  • 80% of the population will experience a back problem at some time in their lives.
  • Americans spend at least $50 billion each year on back pain

backpain

According to the Mayo Clinic, risk factors for back pain include:

  • Age. Back pain is more common as you get older.
  • Lack of exercise. Weak back and core muscles can lead to back pain.
  • Excess body weight puts extra stress on your back.
  • Diseases. Some types of arthritis and cancer can contribute to back pain.
  • Improper lifting techniques can lead to back pain.
  • Smoking can keep your body from delivering enough nutrients to the disks in your back.

So, where do we start to reduce back pain? See your doctor first! Get a diagnoses to establish if there is any risk to starting a core strengthening program. (Yes, the core is where your training should begin.)

The first exercise for most individuals (everyone’s case is different) is to learn and practice core bracing. This is where you draw in the waist as if you are trying to fasten pants that are a bit too tight. This girdling creates pressure inside the abdomen which, in turn, supports the low back. Because this exercise supports the back and doesn’t bend and/or rotate the spine, it can usually be done with no harm to the back. You need to practice this to both strengthen the core muscles and to be able to call on that strength when needed.

In my experience, one of the best ways to “find” this bracing is to sit on the edge of a chair and then, while keeping your face straight forward, push the top of your head toward the ceiling. I call these “sit-talls” because that’s what you’re trying to do, sit as tall as you can. In order to be tall, you need to lengthen your spine. To do that, you need to draw in your navel toward your spine and that is the core bracing.

Once you learn what bracing is and how to do it, other static (non-movement) exercises can be incorporated to get you started on the road to better back function with less discomfort.

Let me know if you have any questions.

Mark