This could be why you aren’t progressing... - KIME Physical Therapy

This could be why you aren’t progressing…

January 27, 2021 | Tony Mikla DPT

Pain is… well, a pain. It can debilitate you and get in the way of your progress towards healing. But why does it happen? What is inflammation and how does it work to help us heal? Let’s talk about inflammation in different phases of rehabilitation and what you can do to minimize it.

First, the definition of inflammation. Inflammation is the body’s innate response to injury, resulting in pain, swelling, redness, and heat coming from the area. This is an immune reaction in response to a surgery or an acute injury, or it could be relatively chronic. This could happen in the middle of rehabilitation as well, showing up as a return of old symptoms that you may have thought you eliminated.

So why is that happening?

 Why do we have this recurrence of symptoms when you’ve been progressing? You get a little confident in your functionality, you get a little better and then re-aggravate. It’s important to understand that inflammation is a result of many, many factors that influence your health. Your nutrition, sleep and stress contribute greatly to whether your body is able to heal and recover from injury. The higher the stresses on your body, the more sensitive you will be to progress. 

How long should this inflammatory process last? The science suggests strongly that the inflammatory process should be a very short window of time, usually about three to five days. This is a normal part of the healing process, and is usually not a concern. However, we often see it become more of a chronic issue, lasting more than five days and sometimes months or years. What contributes to this?

Lifestyle is an overlooked aspect in physical therapy. These lifestyle factors affect your healing and your progress, so it is important to learn the basics so you can make the most of your rehab. Before we get into it, let us tell you a quick story.

One of our patients that I have worked with showed up with terrible back pain that was seemingly out of the blue. He works as a lawyer, a runner, an active cyclist. He’s healthy, not overweight, and with no history of back pain. Initially, I looked for mechanical problems using one of our movement assessments, but the main consideration was that his nervous system was very guarded. This is surprisingly common in the legal community because they work so hard in such short windows of the time. We see these kinds of symptoms, like frozen shoulder and back pain, pop up relatively often. After noticing the patient’s neurological symptoms, I asked him, “Has anything changed in life that would cause this? Does anything come to mind that might trigger this?” Because there wasn’t any mechanical reason. He couldn’t think of anything at the time, but as we went through the session he mentioned that he had just got promoted about two weeks prior, and he is concerned about his new workload. I immediately knew that that was it. That was the trigger to why his back hurts and why his nervous system went sympathetic. When he first presented he couldn’t even stand up straight, his back was in so much pain. Within three or four weeks, we had him back to his prior level of function, he was doing well. So it was a pretty fast recovery. This speaks to this idea of the nervous system. At the end of the day, whether it be in the weight room, in the physical therapy field, or in many forms of coaching, we are always treating the nervous system first. And I think that’s something that we tend to look past often.

Moral of the story is: look at the nervous system first and see how that’s affecting you. If you’re in sympathetic mode, you can’t really learn very well, you’re not going to sleep very well, your stress level will be high, your nutrition may be poor. Science supports this. There are four areas we focus on: sleep, nutrition, stress, and movement. Let’s dive deeper on these areas so we can optimize healing. 

It’s really not much debate at this point that sleep is a crucial variable that’s really gonna impact healing rates and recovery. We’re looking for sleep in the adult population to be seven hours plus. It’s not really even debatable at this point as to whether that’s needed or not in science. If you have less than that, your likelihood of disease or other injury is significantly higher, which we know because we know that fatigue is one of the number one factors for producing injuries. So if you’re not sleeping enough, it will be an issue.

Nutrition has a little bit less clarity to it. We use a couple strong themes in nutrition that I think are really valuable and simple. Firstly, we say to eat the rainbow. Eat a variety of colors and a variety of options to give yourself a good balance of nutrients. Secondly, shop the perimeter of the grocery store. This is such a super simple tip, but really valuable. Staying on the perimeter is probably where all the good stuff is, right? This is where all your fresh fruits and vegetables are, fresh meats, even the dairy products that are appropriate for those folks. The second you go down a middle aisle, your chance of making a bad decision just went through the roof. Everything’s in a box or a bag and such. You have to be a little bit careful, because beer and wine is sometimes located on the perimeter of the store. The third tip is to avoid alcohol. Alcohol is one of the worst things you can do for your body. Short consumption can be okay, but at the end of the day it’s one of the biggest factors of disease in the future, so keep that in mind. Finally, consume high quality protein sources. We use an easy concept to say the less legs, the better. So less legs the better would be that fish is probably your best source of protein, chicken and turkey being the second on the list, and then your four legged animals being your next best option for protein sources. 

Stress management is a little bit tricky, but the first step is to be able to identify the stress. When we look at stresses, was it a physiological stress? Was it emotional stress? Was it a financial stress? Was it a workplace stress? Where does that stress come from? It is incredibly important to identify this stress because this will make an impact on your progress.

Lastly, movement is also key here. We know that different people are conditioned differently, but the goal is to move from 30 minutes to an hour a day. Incorporating movement into your life will help you tie each of these aspects together. Movement can help you release some stress and sleep through the night. Moving well and moving consistently is key to your progress.

Each of these aspects impacts your inflammation and how long it lasts. Remember, inflammation typically lasts 3-5 days, but only if these categories are intact. If you aren’t sleeping enough or eating well, your inflammation will likely last longer than normal and impede your progress. 

Keep up the hard work. 

-Your Team at KIME

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