"Do you think that is air your breathing now?" -Morpheus
My clients are very familiar with this interaction at REFIT
“I am tight in my right knee”
“ Interesting, I reply what did you do?”
“ I have no idea it just hurts.”
“ You know I am going to need more words.”
“ My knee is feeling pain here and it it feels very tight”
“Ok hop up on the table and we will take a look” as I begin to palpate the left hip and right glute.
“You know it is my knee rig…..ohhhhh what the actuall!@$#@ is that ?”
“Most likely the bigger cause of your issue.. i reply Now hop up and walk around”
Clients often come to me with “tightness”. They also know I ask another 30 probative questions about the tissue and immediately palpate the area in both directions.
According to a new study at the University of Alberta’s Faculty of Rehabilitation Medicine I have good cause to do so
“A conscious experience of feeling stiff does not reflect true biomechanical back stiffness,” explained Greg Kawchuk, professor and back and spine expert in the Department of Physical Therapy. “When we use the same word, stiffness, to describe a feeling and how we measure actual stiffness, we assume these words are describing the same thing. But that is not always the case.”
The study asked participants to describe their sensation and then actually measured the range of movement to determine the level of “stiffness” through movement. “There was no relation between biomechanical stiffness and the reported feeling of stiffness,” he said. “What people describe as stiffness is something different than the measurement of stiffness.”
Tasha Stanton, lead author and senior research fellow of pain neuroscience at the University of South Australia, said that “the feeling of stiffness may be a protective construct that is created by our nervous system.”
“It’s our body’s way of protecting ourselves, possibly from strain, further injury or more pain.”
While in this study focus has remained on the back in general we know that stiffness through the body is pretty universal of a sensation. Clients often come to me with issues in the hips, knees, shoulders, legs all using the same terms to describe often very different issues and even more often from a source other than where they are feeling it.
“Words are important. The words patients use to describe a problem in the clinic may not be the same thing we as clinicians measure in the clinic,” said Kawchuk. “We need to find out what it means exactly when someone says they have a stiff back. We now know it might not mean that their back is mechanically stiff.”
What I chuckle at is what “THEY now know” my clients have been experiencing for over 10 years.
I Like Big Phones and I cannot Lie....
A client came to me the other day and mentioned that they were experiencing pain in their hand. Specifically the pain was in the most distal joint ( fingertip ) of their index finger. They pointed out a small protrusion that had appeared that they had not noticed before. They had been to their physician and the Dr. had prescribed the usual rest and ice and a follow up visit for a few weeks after if the symptoms did not subside and they would be sent to a specialist.
It had been more than a few weeks and their symptoms had lessened but the pain was still there. I suggested that they pull out their cellphone and send a text.
“Send a text? they asked .. to whom? “
“Anyone you like .. I don’t care .. text me for that matter.”
They grumbled a bit and then took out their phone and started to text.
“Now stop, don't move” I said.
They looked up from their phone “Text don’t text what do you want from me?”
“Take a look at your phone and your hand.”
Sure enough their phone was nestled in their palm and their index finger was wrapped around it at a crazy angle. The same angle and in the same place as their mysterious finger pain. You could see the skin actually white knuckled around the joint.
The response was as I have heard before ..
“Omg!” and then “What do I do about it? “
There is no easy response to that question. It can be as simple as shifting your grip to a new one for a while, or as complicated as surgery. I won’t bore you with the long details of the muscles of the Hand and Forearm. But the common advice of stretching, rest and more often than not ice is not practical for everyday use of the hand. SImply stretching can relieve some tension but not address the root cause. The advice of not using your mobile device this day in age is pretty impossible by all accounts so rest is out; and more often than not hand pain can be traced up the arm into the shoulder and neck. As for Ice the jury is still out on if Ice does anything more than numb the pain. The fingers are merely the end point of a long chain of flexing, tension, and torque that the body can no longer support in such a concentrated area. Holding your phone for hours at a time not just in short increments (checking social media, and gaming for example) places an extra strain on the area that it is just not equipped to handle.
I included several hand exercises and techniques for self care into their program and after a few weeks my client was pain free and texting away again. (But holding their phone in a new way with assistance by one of those pop out holders from Target 14.99. I own one myself)
Helping you recognize these everyday issues is what REFIT is all about. Helping you work through them is our business. Give us a call and let us know how we can help you.