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Why Swimmer's Slap their Arms before a Race

4/11/2022

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The explosive start of a swim race requires a 0 to 100% effort at the beep of a horn. From the starting blocks, the swimmer's legs essentially perform a maximal broad jump while the arms shoot overhead into a streamline position. Power, reaction speed, mobility, and aerodynamics are several of the necessities to a strong start, and a strong start is essential to a successful race. The physical and mental preparation before a race is highly important.  

​For many swimmer's, part of this race preparation involves swinging their arms in circles and slapping their arms around their body. These large warm-up movements are so common that even Michael Phelps has a video promoting his impressive #MPbackslap.  
So why do swimmers perform these pre-race motions? 

Priming the Tissues

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Athletes from all sports have their signature warm-up movements. These movements are specific to the sport, but general in their functional intention. For swimmers, the specific purpose of the backslap is to activate the shoulder and core muscles in a quick, explosive, and springy nature. Generally, the functional intention is to prime the tissues in a similar fashion to how they need to work during the race.

​Slapping the arms around the body wakes up all the muscles from the powerful Latissimus dorsi muscle down to the tips of the fingers. The vibration of the slap jump starts the nervous system and sends blood flow and oxygen to the arms. Additionally, the backslap is a plyometric movement for the upper body. The quick stretch and release primes the upper body's connective tissues, such as the tendons. Similar to how a track and field sprinter jumps in place before a 100-yard dash, a swimmer performs the backslap to mobilize their tissues and find their tempo before hopping off the block.

Take Home Advice

It is well-established that the best way to warm-up is to perform the same motions required during the training session, but at a lesser intensity. This allows the nervous system, endocrine system, and other vital organ systems to initiate all the proper mechanisms without getting injured.

For example, during a warm-up the sympathetic nervous system turns on, blood vessels dilate to bring oxygen to the body, and specific hormones are released to prepare the body for more vigorous activity. The backslap and a few other full range of motion dynamic stretches accomplish all the necessary components to prepare the body for maximal effort! 
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Listen to Your Body

Many factors play into a successful warm-up, but the most important is listening to how your body feels.
  • If you feel sore during a warm-up, you likely need a few extra minutes to help ramp up your system for exercise.
  • If specific movements feel restricted, spend extra time opening up those movements so your range of motion and strength is available.
  • Lastly, try to enjoy the warm-up! Most people do not leave enough time to warm-up; and therefore, it becomes burdensome. If you consciously make time and enjoy the warm-up, your mind and body will be much more prepared for the task at hand! 
-Jim Heafner PT, DPT, OCS
Owner, Heafner Health Physical Therapy
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Exercise and Pain: Safety Considerations

10/2/2019

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Learn how to determine when it’s safe to continue a workout and when to stop exercising if pain arises.

Until recently pain has been thought to be an indicator of the amount of tissue injury present in the body. The belief is that a high amount of pain equates to a serious injury, and a small amount of pain equates to a minor injury. However, through extensive research, we now know that pain has surprisingly little correlation to the amount of tissue damage present. For example, it’s estimated that 40% of people without any low back pain have at least one “bulging” disc on a lumbar spine MRI. Instead of pain acting as a barometer for tissue damage, it should rather be thought of as an alarm system, warning you about actual or potential threats to continuing a workout.
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When is it Safe to Continue Exercising?

Since pain does not equate to tissue damage, does that mean you can exercise past the point of pain without any consequences? No pain, no gain…right? Not quite! As mentioned above, pain is an alarm system meant to alert you to potential danger. In the case of exercising, the danger may be caused by a specific movement or a specific weight machine. However, just as alarms can misfire, your internal protective mechanism can do the same. Factors such as fear, stress, anxiety, lack of sleep, overactivity, poor nutrition, and many others can influence your alarm system’s perception of danger. When exercising, do not underestimate the importance of these factors.
 
In my clinical practice, I always tell patients, “respect the pain and evaluate the symptoms you are feeling!” If the pain persists, stop exercising. If the pain decreases by modifying the exercise, warming-up the muscle, or simply desensitizing the movement with a few repetitions, it’s likely okay to continue exercising!

What are the Signs to Stop Exercising?

As you learn to calibrate your internal pain-alarm system, there are a few general rules to follow when exercising. My top three warning signs to stop exercising include: sharp pain, nerve-related numbness or tingling, and/or increasing pain. ​
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Sharp Pains 
Sharp pains may indicate that a muscle, ligament, or joint is actively getting injured or overstressed. These pains quickly catch our attention because they travel along fast-moving nerve cells to warn us something is not in balance. 
 
Nerve-related Numbness or Tingling 
Numbness, tingling, or sudden muscle weakness may indicate that a nerve is getting angry because the normal amount of oxygen around the nerve has been altered. In my book, Making Sense of Pain, I discuss how the nervous system is highly sensitive to changes in oxygen levels. The nervous system weighs only two percent of our total body weight yet requires 20 percent of our total oxygen supply. When a nerve becomes tensioned or compressed, its oxygen flow is altered, often resulting in perceived numbness, tingling, burning or aching.
 
Increased Pain 
Finally, pain that continually increases is a good reason to stop a workout. Increasing pain may indicate that the aggravated tissue is repeatedly getting over-stressed. This can lead to an overuse injury, which could require you to stop exercising for several weeks.
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Key Takeaways

  • Pain is like an alarm system designed to keep you out of danger.
  • Numerous factors such as nutrition, sleep, stress, and fear turn up or turn down the sensitivity of your internal alarm system.
  • If you experience pain during a workout, stop and evaluate the symptoms to determine if further exercise is safe.
  • If the pain decreases by modifying the exercise or further warm-up, it’s likely okay to continue exercising!
  • Sharp pain, nerve-related numbness or tingling, and/or increasing pain are all reasons to temporarily stop exercising.
Written by: Dr. Jim Heafner PT, DPT, OCS
Originally written for the IDEA fitness blog with contributions from OPTP.
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Lower Back Pain? Try These Simple Strategies

2/13/2019

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If you have ever experienced lower back pain, there is a good chance you can recall some very specific details about the experience. For example, you may remember where you were, what you were doing, and how intense the pain was for 24-48 hours after the injury. People often remember this experience (and those similar to it) because the human brain prioritizes experiences that require a significant amount of attention. On the same list of significant experiences (even though the emotional response is different) would be watching the birth of your child, seeing a beautiful sunset, getting married, etc... Any experience that overwhelms the senses (sound, sound, touch, smell) is likely to be remembered because of the intense emotional association. 

If you are currently experiencing low back pain or worry about having low back in the future, this article will help you better understand pain and quickly manage any symptoms that may arise.

Understand Your Pain

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At this point,  you may be thinking, "Leave the emotions out of it...I strained my back muscle, not my brain!" While the low back muscle may be the injured tissue, it is necessary to look beyond the muscle to fully understand why the magnitude of your pain. Pain, by definition, is an unpleasant sensory and emotional experience, unique to every individual, associated with actual or potential tissue damage.  Therefore, it is impossible to seperate the pain from the emotional response. 

Regarding low back pain,  it is important to know that pain is rarely caused by a serious medical issue (such as a fracture or cancer), that would require urgent medical attention. The majority of lower back pain (>70%)  is due to tissue sprains and muscle strains, which respond well to rest, easy exercise, and education. For this reason, X-rays and MRIs are not indicated as they often do not correlate with pain. 

Learn the Back Facts

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  • Most people recover from a low back injury in 4-6 weeks (50% recover in ~2 weeks, 80% recover in ~6 weeks).
  • Intense pains should resolve within a few days. Moderate to mild symptoms may persist for a few weeks.
  • The severity of the injury, level of stress, fear of movement, and other factors will all impact recovery time.
  • The use of ice or heat has not been determined by the research. I often recommend ice for the first 24-48 hours, then heat after 48 hours. However, individual preference is most important. Ultimately, do what feels good!
  • NSAIDS and over the counter medications can be helpful, but should not be taken without physician consent.
  • Bed rest should be limited after a back injury. Gentle exercise and movement is indicated as soon as possible! 

Get Moving (Gradually and Easy): The Goldilocks Principle

The story of Goldilocks is about finding the right fit, and I can tell you that little blonde girl was onto something! The idea of not too much, not too little, but just the right amount applies to many facets of life. Gradually increasing activity to improve pain and gain strength is certainly no exception. The human body gets stronger and more resilient through a process of gradual, progressive exposure and strengthening. To get stronger, you slowly and steadily lift heavier weights over time. If you lift too much too soon, you’ll become sore, or worse, injured. However, if you don’t lift enough weight to challenge your body, you’ll never get any stronger. The exact equation of not too much, not too little, but just the right amount is unique to everyone and will change over time as your body matures. 

As you are recovering from a lower back injury, start moving slowly in small ranges of motion. As your fear decreases and ability to move increases, gradually increase the range of motion and demands of the movement. For example, in the progression below, I show how to gradually improve bending forward. 
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Low Back Self Treatment

Don't Neglect Other Areas of Your Health

If you are experiencing pain, it is easy to blame the pain solely on a physical or structural problem. With that being said, I am not discrediting the tissue injury that may have occurred. After a traumatic event, such as a car accident or lifting injury, inflammation and other chemical signals (redness, warmth, swelling) can be observed. However, since you just learned about the complex nature of pain, I urge you to think about other areas in your life that may impact your pain response. In these moments, I always tell my patients to 'respect the healing process.' This includes focusing on good sleep and rest, reducing or minimizing stress, eating a well balanced diet, and performing gentle movement (as discussed above). In the picture below, I outline many of the areas that impact your experience of pain.
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Remain Positive and Optimistic

Finally, mindset is key! Following an injury, our brains naturally revert to the worst case scenario. Fear, anxiety, worry, and other negative emotions flood your mind. While listening to these emotions is important in the moments of actual threat, the majority of these fears are not accurate. The reality is that you will most likely return to your normal life in a matter of days or weeks. In the midst of pain, having a mantra, such as "my back is strong and health," can help slow down the negative emotional response. By mindful repeating or thinking optimistic thoughts, you will strengthen the brain connections geared toward optimism and happiness.
Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
​Boulder, CO

If you are looking for low back self treatment strategies, click here!

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Muscle Memory: What Is It and How Does It Change after an Injury

9/27/2018

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Your muscles are a very important organ system in the body, as they play the role of the workhorse in every movement you make. However, you can’t forget that the muscles are at the mercy of the governing nervous system. Everything you feel is actually an experience created by your brain and nervous system. For this reason, muscle memory is somewhat of a misnomer! Muscle memory is a term used to describe how our nervous system and brain work together to build strong connections and develop movement habits for specific activities. For example, if someone repeatedly practices throwing darts at a target, they will most likely improve their accuracy over time. While the fingers and forearms feel the movement, the 'memory' is really encoded in the brain. At the same time, if someone postures their muscle is a certain position for working for multiple hours each day, the movement or posture will remember this position. 

Your Nervous System ​is the Boss!

In many cases, your muscles and connective tissues behave similarly to the employees of a company, while your nervous system acts as the boss. 
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The nervous system tells the muscles how to act and what to feel. If there’s tightness, stiffness, guarding or pain in a muscle, it’s often because the boss is unhappy and the employees are just carrying out the boss’ orders. ​For example, think of the last time you exercised when you were tired, stressed or hungry - it probably wasn’t a great workout. If the boss (your brain and nervous system) is in a bad mood, the employees (your body) feel the strain. Allowing the boss to calm down or letting the boss rest can reduce stress on the employees. In response, the boss can stop the overbearing micromanagement, which is causing the employees to revolt. 
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Following an Injury, Your Muscle Memory is Altered!

In order to perform an activity, even a simple activity such as reaching for a cup a water, thousands of small connections must happen in harmony. These simple activities are often taken for granted. We learn them gradually as infants, and the muscle memory is properly stored in the brain.
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While you do not remember this learning process, it occurs through countless hours of practice and repetition. As a new father, I see these repetitions happening in my baby daughter each day. While my daughter is not picking up a cup of water yet, she is starting to see objects, identify her hands, and reach for the objects. Over time, each piece of the puzzle will come together and her 'muscle memory' will be encoded.
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In your own body, think of this “muscle memory” as an internal GPS that’s aware of every movement you make. When an injury occurs, your internal GPS is often reprogrammed to make you move in different ways. With an injury, there can be different messages sent between the brain and the muscle, meaning your “muscle memory” has been disrupted. After some time, your internal GPS may no longer be able to accurately identify certain roads on your body’s map. While the injury is healing, the brain and body often coordinate alternative, compensatory strategies for certain movements like a limp, awkward bending mechanics, stiff movements, or limited range of motion. These protective phenomena are much like how a GPS detours to an alternative route because of a road closure.
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The movement detours may feel uncomfortable or less efficient, much like driving down a heavily trafficked and overcrowded street. This is because your brain isn’t familiar with the detour, which may place new or different stresses on the system. By building new and confident movement strategies, you can experience minimal issues while the main road is being repaired. However, once the body’s healed and the route’s obstructions are cleared, it’s important to return to the main road without fear. ​

Keys Points and Takeaways

  1. Muscle memory is a term used to describe how our nervous system and brain work together to build strong connections and develop movement habits for specific activities.
  2. ​When an injury occurs, your internal GPS is reprogrammed to make you move in different ways.  
  3. Mindful movement practice strengthens the 'muscle memory' after an injury.
Author:
​Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
Boulder, CO 80301
IG: @heafnerhealth

Learn more of these analogies from the Sticks and Stones book by Jim Heafner and Jarod Hall. 

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Practicing Pain is Like Shooting Free Throws

8/2/2018

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After being fouled in a basketball game, players find themselves at the free-throw line to take a shot. Overall, the shooting motion looks relatively similar among players, but there are small differences that make each player’s technique unique to them. If you watch closely, you may notice that each player has their own stance, pre-shot routine and shooting mechanics. 

A professional basketball player spends countless hours practicing this shot and developing a routine that makes them feel comfortable and confident.
There’s a saying in neuroscience that’s applicable here: “Nerves that fire together, wire together.” With practice, their brain creates a crisp and fine-tuned program for shooting the free throw, and repetition makes approaching their shot second nature. The less thinking required for the actual shot mechanics, the less they’ll try to make small adjustments in response to stress, pressure, fatigue and fear that could interfere with making the shot. This ability of the brain to adapt, change, rewire and refine is referred to as neuroplasticity. ​
The repeated experience of pain is fired and wired together similarly to practicing free throws. The more you experience, think about and focus on pain, the more you can improve your brain’s ability to activate that pain program. Just like the way practice refines the shooter’s skills, the more you expect and believe pain will occur, the more likely pain will actually occur.
Luckily, neuroplasticity is a two-way street. Through physical activity and mental rehearsal, you can literally “practice pain away.” The repetition of practicing pain away allows you to have a greater capacity to better respond to work stress, lack of sleep and other daily stressors. Focusing on new and different ways to think and move can create a stronger program in the brain that better understands the experience of pain. Remember, nerves firing and wiring together can be good or bad, depending on what you practice. ​
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Learn how pain is like an alarm system!
Pain is Like an Alarm System

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Want More Analogies Similar to This One?

For this analogy and 50+ others, I highly recommend checking out my new book with co-author Jarod Hall. The book is titled Sticks and Stones. It is a collection of analogies & stories to help people gain a deeper understanding of the complex nature of pain. With each analogy and metaphor covered throughout this text, you’ll find multiple stories that help relate the complex topics of pain, tissue breakdown, posture and more. Through each story, you’ll notice a strong focus on the power of language. 
Learn more!
Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
Boulder, Colorado
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Understanding Nerve Pain

7/2/2018

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Sciatica, carpal tunnel, neuropathy...these words all have scary connotations! Fortunately, the majority of nerve-related symptoms are not threatening. Each of these diagnosis' are a symptom describing the specific tissue that is irritated. They do not address the underlying issues that cause the pain, nor how to treat it.

For example, if someone comes into Heafner Health with wrist pain, and I identify they have carpal tunnel syndrome, I know the median nerve is receiving extra stress. While the compression or tension may be at the wrist (where the person is experiencing pain), the issue could be ANYWHERE along the nerve- in the neck, the shoulder region, forearm, or the wrist. Since the nervous system is a continuous structure, providing education about the nervous system and treatment anywhere along the nerve can result in a successful outcome! For this reason, understanding how nerves move and work can make a huge impact if you are experiencing pain. 
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Nerves are like Garden Hoses

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The nervous system functions similarly to a garden hose. Just as the garden hose delivers water, our nerves are responsible for feeding the muscles, joints, skin and other soft tissue. If the garden hose becomes kinked or compressed, the amount of water flowing through the hose is reduced. Your nerves respond in a similar fashion. If nerve pressure or irritation rises to a certain level, blood flow to the nerve and electricity through the nerve, known as the axoplasmic flow, is interrupted. This alters the amount of nutrition through the nerve and leads to an aggravated state.

The nerve’s response to reduced nutrition can be a vague array of symptoms, most commonly described as numbness, burning, heaviness or tingling. 

​To improve nerve nutrition, you must improve the flow of electricity and blood in the nerve. This is accomplished through gentle and specific movements and exercises. Fortunately, just as the garden hose returns to full function when the kink is released, nerves also respond favorably to the decreased compression and increased movement.


-Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
Boulder, Colorado

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Enjoyed this post? Check out more analogies from the Sticks and Stones book by Jarod Hall and Jim Heafner. 

Sticks & Stones is a collection of analogies & stories created by Dr. Jim Heafner PT, DPT, OCS and Dr. Jarod Hall PT, DPT, OCS to help people gain a deeper understanding of the complex nature of pain. 

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The Story of How Sleep Deprivation of Medical Residents Began

6/12/2018

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Recently, I have been fascinated with the subject of sleep, specifically the positive and negative health benefits of sleep. 

The research is overwhelmingly in favor of getting more sleep than not. According to the National Sleep Foundation adults need 7-8 hours of sleep each night (1). The good news: I am finally on board with this idea! I have dropped my old machismo ideations that I can force my way through fatigue. I know longer view exhaustion as an admirable, but rather an indication that my health is being compromised. The bad news: This is unfortunate and ironic timing considering I had my first child 6 days ago...! Regardless, I am finally prioritizing sleep.

On my journey of learning about sleep, I ran across a fascinating story about medical residencies and sleep deprivation.

More and more physical therapists are attending demanding residency programs! The physical therapy residency training model appears to be largely based off our close friend in the community: medical residents. 

In 2013, I graduated from the Harris Health System Orthopedic Residency program in Houston, Texas. Our program was tough, but our director, Dana Tew, did an excellent job mentoring my fellow residents and I on all aspects of life. We worked extremely hard at the clinic, but there was at least the opportunity of a work-life balance. Dana, who is also owner of the OPTIM Manual Therapy Fellowship, understood that our success and efficiency in the clinic directly correlated with our ability to sleep and manage stress outside the clinic. 

As I was going through my residency, my older brother, Tom was completing his general surgery residency. I recall him spending 30+ hours at the hospital on a regular basis. These long hospital shifts often had little (if any) sleep! Hearing this information, I thought to myself, "I would certainly rather have a surgeon at the beginning of a 30+ hour shift than the end. It has to be unsafe to perform a fine motor task that requires mental acuity after intense sleep deprivation." 

Who instituted these unattainable demands of high work and low sleep for people who need to in prime mental health to help others? The story is a quite interesting one! 

I would regularly ask myself, "Who instituted these unattainable demands of high work and low sleep for people who need to in prime mental health?"

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Citations:
1. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary Hirshkowitz, Max et al. Sleep Health: Journal of the National Sleep Foundation , Volume 1 , Issue 1 , 40 - 43
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Movement Should Flow

5/18/2018

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From professional athletes to musical entertainers and beyond, high-energy performers execute complex motions with relative grace and ease. Whether it’s LeBron James dribbling down the court or Bruno Mars dancing on stage, their coordination and precision are due to the incredible motor control and movement pattern memory they’ve gained through countless hours of training. However, these well developed movement patterns can be altered in the presence of injury, fear, and more! 

At my clinic in Boulder, Colorado, I was recently working with a middle-aged man who was experiencing low back pain when lifting more than 40 pounds from the ground to the trunk of his SUV. This pain was interfering with his ability to perform work tasks as well as household chores. Within 3 treatment sessions, he was able to mimic the mechanics of the lifting motion without any pain. During visit 5, he performed the 40 pound lifting task repeatedly pain free. However, the following day at work, his pain immediately returned when attempting a lift. 

The above example, demonstrates the complexity of pain. This client objectively demonstrated proper strength and mobility to perform the lift in clinic; yet, when attempting the lift at work, the pain returned. When I asked him about the experience he said, "I don't know why it hurt at work...I felt tense as if my muscles were protecting me from the movement...I was anticipating the pain...Since I was injured at work, the lift scared me."  At this point, I reminded him of the many factors, including fear, that can impact his experience of pain.

"Fear and pain have a very intimate relationship"

Fear and pain have a very intimate relationship. Pain causes fear, and unsurprisingly, fear can also lead to pain. Together, these forces encourage your nervous system to regress into a protective state. This is felt in the body as stiffness and tightness in the muscles and joints. When you’re in pain, your movements can become stiff, guarded and uncomfortable. Stiffness and guarding will lead to unnatural ways to move. ​ Of course, it’s human nature to fear moving freely to avoid pain in these situations. However, it can be empowering to know that letting go of that fear can allow the body to loosen and encourage movement to happen in a natural and fluid manner. 
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Martial artist and actor Bruce Lee illustrated this idea beautifully: “You must be shapeless, formless, like water. When you pour water in a cup, it becomes the cup. When you pour water in a bottle, it becomes the bottle. When you pour water in a teapot, it becomes the teapot. Water can drip and it can crash. Become like water, my friend.” Water flows freely and fearlessly. Water doesn't stiffen or guard itself for protection. Water is smooth and fluid. Water is powerful. When learning how to move out of pain, you must challenge yourself to relax and allow your body to become like water!

While this may sound funny or unrealistic, it is important to learn how to relax with movement. For precise movement to occur, certain muscles must activate, while others simultaneously relax. Practicing the ability to move without stiffness can bring awareness to the movement and create learning opportunities that strengthen the connection between your brain and muscles. 

​When dealing with pain, do not forget about the contextual factors! Practice and repetition of movement will decrease the protective response from your nervous system and improve the mind-muscle connections!  
Dr. Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
Boulder, CO


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If you found this post interesting, check out the book Sticks and Stones written by Dr. Jarod Hall and myself! The ebook contains 50+ analogies and stories pertaining to pain and movement!

Sticks and Stones will officially be available in early June 2018 at our site: theraPTeutic alliance.


​Pre-order the book at the lowest price today by using the promo code: WORDSMATTER  

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Your Brain is like a Battery

3/20/2018

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I was recently working with someone who had neck pain after a mountain biking accident. During the evaluation, he reported hitting his head on the ground and experiencing a concussion during the accident. He stated "I am having difficulty remembering recent events and multi-tasking is near impossible! It's extremely frustrating!." Performing higher level tasks was easier in the morning and became progressively more challenging throughout each day. Additionally, he reported the desire to take naps throughout the day. When he questioned why his brain felt exhausted, I told him "It is because your brain operates much like a battery." 
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(This text is adapted from "Sticks & Stones," a book by Jarod Hall PT, DPT, OCS and Jim Heafner PT, DPT, OCS. "Sticks and Stones" is in the final stages of development. Final versions of the text to be released to public in May 2018. Please reach out if you are interested in learning more information!)
If you have persistent pain, recently had a surgery, or an injury (such as a concussion), your brain may be working in overdrive!  In each of these scenarios it's not uncommon for patients to report that their brains feel tired early in the day, that they have trouble doing complex thinking tasks such as math, and even mix up their left from their right! Why does this happen? In situations like this you can liken your brain to a battery. This idea can be thought of in two separate ways.

1)    You start each day at 100%, but quickly drain the battery each day
2)    You start each day at 50% or 75%, unable to fully charge the battery

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When you are experiencing persistent pain, your brain isn't receiving adequate rest or recharge each day while at the same time it’s burning through battery life at a faster rate. It could be likened to plugging in your Iphone, but removing it from the charger at 50% or constantly having apps running in the background using up all of your battery charge. Your ability to complete all tasks is limited because you are starting at a lower energy threshold. Factors that can affect battery levels are stress, sleep, diet, exercise, nutrition, and performing complex or high stimulation tasks.
To reverse this process, you must understand that your brain is very adaptable and needs to be charged up just like a battery. To break the cycle and charge your brain battery and get out of pain you must focus on getting good sleep, spending time doing meaningful activities, gradually introducing and progressing exercise, eating well, and finding ways of managing stress. The human brain will continue to remold and remodel to gradually get stronger. However, it is a sensitive structure. As your brain is getting stronger, you must respect the healing process.

Think about the battery on your phone or computer. Certain programs use more energy and cause the battery to operate slower. Similarly, your brain uses more energy to perform certain tasks and process complex scenarios. 

By Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy & Movement Specialists
Boulder, CO


Like this post?
​Check out how Pain is like an Alarm System! 
Pain is like an Alarm System
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Pain is like an Alarm System

3/2/2018

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Most people think pain is an indicator of the amount of tissue damage present in the body. The belief is that high amounts of pain equate to a large injury, and a small amount of pain equates to a small injury. However, through extensive research, it has been shown that pain has little correlation to the amount of tissue damage. For example, a paper cut may cause intense pain, while a broken bone may go unnoticed. In 2013, when Louisville basketball player Kevin Ware sustained a horrific leg fracture, he reported, "it was one of those things where I couldn't believe it. I honestly didn't feel the pain. It was more a shock."

"At the center of the alarm system is your brain, which beeps when it THINKS something is going wrong or is potentially dangerous."

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Kevin Ware’s story perfectly demonstrates that pain is more like an alarm system. It is an evolutionary provided and naturally built system designed to keep you out of danger. At the center of the alarm system is your brain, which beeps when it THINKS something is going wrong or is potentially dangerous. If the system is healthy, it warns you when something is wrong just as your home alarm rings when a burglar breaks a window or your car alarm sounds if a car thief tries to wiggle your door open.

"Just as a smoke detector can be set off in the absence of fire, a home alarm in the absence of a burglary, and a car alarm when you accidently press the panic button, your body’s alarm system sounds off signals of pain in the absence of any REAL danger or threat."

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However, just as a smoke detector can be set off in the absence of fire, a home alarm in the absence of a burglary, and a car alarm when you accidently press the panic button, your body’s alarm system sounds off signals of pain in the absence of any REAL danger or threat. The alarm may sound if a bird flies into a window or if you accidentally open the door after you have set the security code. In both of these cases there is no real danger, but the alarm rings in an effort to protect you. For safety, it is far superior for the alarm to be more sensitive and have false alarms, rather than to be hard to trip and not protect you in the case of a true threat.  
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Just as other alarms can misfire, your internal protective mechanism can do the same. Fear, stress, endorphins and adrenaline, anxiety, depression, lack of sleep, overactivity, poor nutrition, sickness, and many more factors can influence your alarm system’s perception of danger, increase sensitivity, and lead to a greater protective experience of pain. In Kevin Ware’s story, a large amount of endorphins and adrenaline as well as a massive NCAA crowd slowed his alarm system from signaling. Being familiar with the numerous factors that turn up or turn down the sensitivity of your internal alarm system is the first step in understanding how to better calibrate in the presence of injury. ​
(This text is adapted from "Sticks & Stones," a book by Jarod Hall PT, DPT, OCS and Jim Heafner PT, DPT, OCS. "Sticks and Stones" is in the final stages of development. Final versions of the text to be released to public in May 2018. Please reach out if you are interested in learning more information!)

If you think your pain-alarm system is misfiring, contact Heafner Health!

Contact Dr. Jim Heafner
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