Body Usage and Conditioning

How pain affects the way we move

Pain can make us avoid some actions and some activities like going out, joining friends for meals. If it hurts, we keep that area still and not move it; so it can be protected and recover. Acute injury, such as a sprained ankle, requires rest for a short time to allow the sprained ligaments to heal. However, too much rest and inactivity after the healing period can cause more harm than good.

Understanding our joints

Our joints are surrounded by muscles, ligaments, joint capsule and cartilage, called soft tissues. These soft tissues need movement to keep them healthy and working well. when we move, the muscles will contract and create a pumping action. This action helps to carry oxygen and nutrients to the joint, and carry away the waste products that had built up. Fluids produced by the joints during movement also allows smooth gliding between the bones.

Our joints are designed to move and this movement is important for joints to work well. If movements are avoided, the joints would start to stiffen, and muscles can become weak.

What happens to your body when there is pain?

In the presence of pain, your muscles may not work together in a timely fashion when you move. You may also start to move differently because of the pain, e.g. To reduce using the sprained, you start to limp when you walk. This gives you some pain relief in the short term and allows you to continue some activities.

However, in the long run, this change in movement can lead to abnormal joint movements, stiffer joints, and in turn put more strains on other joints and structures in the body. The stiff joints may cause more pain when we try to move them, so we move them lesser to avoid the pain. The muscles become weak as we move less. A cycle of pain, poor postures and inactivity, can worsen stiffness and weakness, making pain worse and harder to treat.

This cycle of pain can result in further avoidance of activities and/or more rests. More generalised weakness and poor fitness can occur as a result, a term called deconditioning.

Deconditioning

What happens when you are deconditioned?

You may have less energy to do things and more energy is used for the same activities compared to before.

You may get out of breath and be more tired quicker when you exercise or do things.

You may find your muscles weaker

You may have reduced flexibility.

You may have poorer balance.

What can you do to prevent deconditioning?

Many problems associated with deconditioning can be reversed with exercises and return to daily activities. Setting targets for returning to activities and planning breaks in long or painful activities (pacing) are 2 main keys.

You may start an exercise programme, as advised by your physiotherapist. Your therapist will guide you in the level and type of activities to participate in, so as to restore normal movements. Exercise regimes should be regular, and gradually increased in duration and intensity.

Make a plan for your daily activities. Make sure the activities that you find more difficult are spread out. If an activity is difficult to do, think about changing the way you usually do it. You can discuss with your therapist strategies to overcome these difficulties, and how to engage in these daily activities better.

Appropriate pacing, graded increases in daily activities and exercise will avert triggering sudden increases in pain that can lead to a reduction in activities.