Pain is a standard issue in the world today!
Unfortunately, the prevalence of pain is high, and almost everyone will likely experience pain in their life. Pain is an enormous issue in the United States, in which an estimated 72 million surgeries are performed in a year, and many of the patients require pain management strategies (Robertson, 2002). In addition to the operations that may cause an acute pain response, another 34 to 50 million individuals suffer from chronic pain, which can lead to poor quality of life and reduction of workdays (Robertson, 2002). These statistics provide that nearly 37% of the United States population in a given year will experience pain from a medical procedure or other ramifications! This is an alarming statistic, and strategies need to be set in place to help reduce these numbers!
It's an Old Saying
When it comes to exercise, one should not experience pain while moving. There is an old saying, “No pain, no gain!” and I am here to stated that the motto is obsolete. Pain should be considered a signal due to a threat or danger (Meng, Li, Peng, Li, & Shen, 2020), not mixed with the nomenclature of fitness and wellness responses and adaptations. If training leads to pain, there might be a common fault that is causing the pain: incorrect technique or structural damage.
Many fitness professionals need to understand the boundaries when it comes to training individuals with pain. If the case can be revised with superior coaching and integration of biomechanical shifts, this fits a fitness professionals’ scope and can be programmed for position integrity. However, some cases may reach a point of referral. When a client keeps experiencing pain, and position alterations did not fix the problem, another healthcare professional needs to be assigned to help assess, diagnose, and potentially treat the issue. With that said, this doesn’t mean the fitness professionals need to halt the training sessions completely. It is known that when physical activity is completely stopped, muscular atrophy is possible. Atrophy decreases the mitochondria functions by reducing oxygen consumption and ATP production, thus reducing the metabolic and contractile functions (Ji & Yeo, 2019). Therefore, completely stopping training altogether may result in further impairments in the long haul.
Fitness professionals can still do their diligence! Dane Bartz
This is the time to make appropriate adjustments to training sessions that incorporate functionality. The use of functional training has been used for years by many leading fitness professionals to prioritize the reduction of body pain and increase vitality, balance, strength, power, and endurance (Cortell-Tormo et al., 2018). The client’s goals might shift a bit after the reactions from pain, but as the professional who was hired to manage their client's fitness and wellness engagements, make variations for the good. Keep them on track and appropriately modify the training to fit the new “needs” for the client.
Unfortunately, particular muscles can alter movement when pain or an injury is present. Baker, Souza, Rauh, Fredericson, and Rosenthal (2018) researched runners' knee pain from iliotibial band syndrome. The researchers were able to conclude some very interesting movement-based biomechanics with pain. It is important to know that each of these participants were recruited based on their previous history of pain and injuries (Baker et al., 2018). The three-dimensional motion capture devices were able to show that the injured runners had an increase (P = 0.002, injured runners = 3.74 degrees vs. non-injured runners = -1.48 degrees) knee adduction (valgus) when compared to non-injured runners (Baker et al., 2018). Additionally, the tensor fasciae latae muscle activation significantly increased compared to the non-injured runners (Baker et al., 2018). The results from this study provide important information on how the biomechanics can ultimately change because of an injury.
Our bodies will always try to get the job completed, but sometimes it doesn’t perform the right task. However, pain from movement shouldn’t trigger someone to keep fighting through it but rather, determine the appropriate course of action to help reduce the pain and eventually train pain-free.
The body will always go into defense mode and start reducing muscular activations in specific areas to protect itself from further pain or injury. Despite the reduced activation, current fitness professionals need to have a good understanding of movement and neuromuscular mechanics to boost the functionality of training. The human body is wired to defend ourselves from pain but some areas start to shut down to begin the healing process. When developing programs for training, it's necessary to study human movement through a deeper lens and reach out to fellow experts that recognize the current situation.
Again, just becomes a client is in pain doesn’t mean fitness professionals need to stop training their clients. Fitness professionals need to empower the situation and enhance their approach to training. Training might need to be regressed and modified to fit the new needs of the client but training shouldn't stop. At this time, professionals need to reach out to fellow professionals and collaborate upon the needs of the client.
Just remember, everyone should train pain-free!
Baker, R. L., Souza, R. B., Rauh, M. J., Fredericson, M., & Rosenthal, M. D. (2018). Differences in Knee and Hip Adduction and Hip Muscle Activation in Runners With and Without Iliotibial Band Syndrome. PM & R: the journal of injury, function, and rehabilitation, 10(10), 1032-1039.
Cortell-Tormo, J. M., Sanchez, P. T., Chulvi-Medrano, I., Tortosa-Martinez, J., Manchado-Lopez, C., Llana-Belloch, S., & Perez-Soriano, P. (2018). Effects of functional resistance training on fitness and quality of life in females with chronic nonspecific low-back pain. J Back Musculoskelet Rehabil, 31(1), 95-105.
Ji, L. L., & Yeo, D. (2019). Mitochondrial dysregulation and muscle disuse atrophy. F1000Research, 8, 1621.
Meng, J., Li, X., Peng, W., Li, Z., & Shen, L. (2020). The interaction between pain and attractiveness perception in others. Scientific reports, 10(1).
Robertson, S. A. (2002). What is pain? J Am Vet Med Assoc, 221(2), 202-205.