EP 76: Window Of Opportunity: The Key To Overcome Injuries And Pain Faster || WBWL

This is another great episode I made last year that people got a lot of values from. I wanted to put this one back on just in case you have missed this.

Has an injury, strain, or pain ever plagued you for weeks or even months and it seemingly took forever to get past it?

Do you often sit on the sidelines for an injury to fully heal, jump back into an activity, and then hurt yourself again?

Listen in on a key concept called the Window Of Opportunity, which when mastered and utilized, can shorten your recovery from weeks and months to just days…

This is something unique to my program and philosophy, and I’m providing some paying-client resources to you.

Some concepts here you may disagree with when you first hear it. But if you actually apply what I say, it may change the way you approach injury and pain forever.

Transcript

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Welcome to the Won Body Won Life Podcast. Hi, I'm your host, Dr. Jason Won lifestyle, physical therapists and pain relief coach. And we help healthcare workers, professionals, and busy parents around the world, eliminate chronic pain and fully recover from injuries without injections, surgery, or manual therapy. And the goal for my company is to simply teach our clients how to get rid of pain by themselves and be fully independent with keeping their body strong and mobile as they age. So today I have a very important Topic to talk about, and you may not know what it is, but I'm going to define it for you, which is called the window of opportunity. And this is something that I think if you had any form of chronic pain, you feel like every time you get into some sort of activity, you always get knocked down by some sort of joint pain, by some sort of injury, or by some sort of flare up. This is going to be a very important podcast that I think you'll love. And so where we're going to start off with is first, what is exactly the window of opportunity? The second I'm going to cover is why it's so critical to find it each and every time for any specific injury, pain, flare ups, or setbacks. I'm also going to describe when it's not safe to find that window. So there are some rare circumstances where we may not try to find that window, but instead try to seek out something else. And also give you a couple strategic methods on how to find that window each and every time. So that way, you If and when there is some form of injury or pain that occurs to you is that you should be able to recover much faster than maybe sometimes just resting it up, maybe taking some pain medication or just saying that I need to rest this up for three to six months. I've heard that so many times where somebody has like low back pain or an ankle injury or knee pain. And they sit themselves out for three to six months. And I'm wondering, why do you do that? And maybe pain continues to ensue, but I think pain continues to ensue because those people, and maybe this is you have not found that window of opportunity. So let's dive into the definition of it. And in research, what I define as the window of opportunity is any given circumstance of pain, injury, strain, or sprain, and there should be rarely be any sort of avoidance of moving, loading, or stressing that area to find that window of opportunity to get past a certain pain experience. And another way to say this, the window of opportunity is how many opportunities of movement that are. Body and mind are confident in. So what does this kind of look like? And so what I usually give is somewhat of an analogy, and analogies are easier to remember. So when we were little children, when we were six to eight years of age, We can literally do whatever you want. So when we were on the play structures, we can jump from eight feet up, land straight on her feet, or just roll over and not even second guess it. We can jump onto, we can like just jump from a bar. We can land straight onto many different areas and we could be completely fine. I remember going up, like going, running up a slide. Jumping straight off, like almost seemingly two stories up and then just landing on my feet, feeling absolutely nothing. And that's because our joints were more mobile back in the day, but that's also because we didn't have any sort of like fear or any other psychosocial factors that kind of played into the equation. If you've ever hurt yourself, hurt your back, for example, picking up something off the floor, your body remembers that experience. It was a negative experience. And so when you, Decide to pick something back up. You remember that experience from previous times and therefore it can change your movement patterns and you can start to second guess yourself, right? It causes, creates more hesitancies, fear, and anxiety, right? So that's what happens as we get older is we start to play it safe. Maybe people start to tell us to play safe because of our age, or maybe we just go through continuous injuries. So what I'm trying to say is that when we define the window of opportunity, as little children, our windows are really big. Anything that we want to do, we can do it. But as we get older, or we go through injuries, pain, surgery, start to have symptoms of joint pain or stiffness, we start to see that window of opportunity get smaller. And in order to increase that window, we need to learn some of the things I'm going to tell you today. If you've been somebody that's stuck in chronic pain, there's a lot of limitations that you have, your window right now is fairly small. Okay, that's not just from a physical standpoint, but also a psychosocial standpoint. Here's another way to explain the window is how we are in relation to the intensity. So it's correlated with the intensity of the pain, and it's actually positively correlated. So the large, basically the larger amount of pain that there is. There tends to be a smaller window. Okay. So that actually, sorry, that's a negative correlation where the larger amount of pain or the larger amount of disability is associated with a smaller window. Okay. But if we can try to find ways to get past our pain faster, or let's say I teach you an exercise, or let's say you been following me for a while. You do a certain exercise that I showed to you. And also they're like, wow, my neck feels a lot better. That officially has opened up the window of opportunity for you to do more things. So you don't want to just get stagnant or cocky. Oh, my pain's gone. So I'm just going to go with my day to day. You want to see how much larger you can expand that window via strength training or different mobility exercises. Also, when you do different exercises that lays down new memory paths, that also improves stability. It's a new novel stimulus to the body movement. Variability is actually pretty essential as well. So the more movement variability you can do, the larger that window is going to be a great way that I can explain. This is like when I had a client with an ACL injury and he had a reconstruction. Obviously that window is super small when that person just had surgery, but as they're doing leg extensions, as we get them sooner into a single leg balance, now they have the confidence and a larger window to say, Oh, my surgical knee can tolerate more. Then he starts to walk without his crutch or without his back. brace. So now that larger, that window becomes even larger. Then we get into the fun stuff, which is let's say that person's goal is to run again. We start to get into squats as a two legged variation versus a lunge or a single leg squat. That's movement variability, right? So that person starts to again, expand that window. We start to expand that window by doing lunges with rotation. Or lateral lunges. So we're now we're getting him to move side to side. So there's a lot of variability to it. So that knee is going to become more accustomed to different types of stressors. And that is going to be also a big indication of lesser injuries, being used to certain movements and certain day to day things that might put that person in a certain situation. All right. The next thing I want to point out is why is it so critical to find it each and every time? And I think I alluded to it, but some of the aforementioned reasons besides that is there are mindset issues, right? So more I've, I'm going to say this time and time again, you probably heard it. I say it in previous podcast, but oftentimes fear and anxiety of pain is worse than the pain itself. Okay. So fear avoidance. will lead to more atrophy, right? Anxiety around a certain situation or around certain movements, like getting back into running. If you have anxiety around that's oftentimes worse than the pain itself because you're not even trying to run. You're simply letting fear and anxiety stop you from that. That's only going to lead to more atrophy, more joint stiffness, because you're not actually stressing out. That injured area. So mindset is huge. And then what I alluded to is if you don't find that window, like I said, there's a lot of people that I know that I play basketball with them and they're resting their knee for three to six months. I don't know why, because they haven't found that window, but when you don't find that window, there's actually weakening. Of the integrity of that involved area. If you got a tendon strain if you don't load it, that will probably lead to a more chronic form of tendonitis, which is called tendinosis, right? Which is more like atrophy tendons. The tendons tend to be more disorganized. So your ability to load that tendon becomes a lot less muscle strains. Believe it or not, is that. There's research to show that when you've had low back injuries multiple times and you start to fear and you start to, that back starts to get weaker, is that muscle that you previously strained develops fatty infiltrates. All right. So people with chronic low back pain on MRIs often have fatty infiltrates, which means lesser percentage of muscle, which means actually weaker muscles overall. Okay. Next thing, bone contusions, right? So if you bruise the bone, but you don't load that bone as soon as possible, or try to find a window of opportunity long term that can lead to bone loss, which would be osteopenia or osteoporosis and you get what I'm saying, right? So for like ligament injuries, that ligament can become weaker nerve injuries, that nerve can become more tense, right? So you not loading that nerve or stretching out that nerve. If you've had a nerve injury, is that it's going to lead to more nerve tension over time that can affect your sensor sensation associated with that nerve that can affect your motor function as well. And there's just so many other qualitative detriments like quality of life, not getting back to the activities you love to do, not being able to do strenuous tasks anymore, not being able to travel, right? So there's all these other limitations out there when you keep that window super small and when you don't know how to expand that window. Okay, so next thing I want to jump into really quick is just when you should not find that window. And essentially it's basically like any form of like very severe injuries or when it's more of a medical emergency, let's put it this way, if you completely torn your Achilles tendon and you cannot move your foot at all, it's probably not right for you to load that foot. You probably need to get it either surgically reconstructed or you need to get it casted temporarily. So those tendons are contacting each other and potentially that tendon has the ability to reorganize itself, but you shouldn't be stretching that tendon or loading that tendon. There is a temporary. Amount of rest that you need. Confirm fractures. So obviously if you like fractured a bone and it's completely split in half, that's also another thing to not try to stress because that's only going to displace that bone further or cause more pain to you. Things like cancer, for example, red flag items that we often see that we actually that we rarely see in a clinic or that we see in a physical therapy would be like bilateral numbness and tingling going down your legs or down your arms, recent neurogenic weakness. So if you've noticed that your foot just completely went dead, the nerve the signals from the brain down to the foot are no longer talking to each other, you may need to get an MRI and see exactly what's going on because that nerve is no longer communicating from brain down to the foot. And it may not always be, but it's always good to be better safe than sorry to see if there's any form of more severe injury that's going on via an MRI. saddle anesthesia. So if you have any like groin numbness, if you've lost sensation to your groin, if you notice like bowel and bladder control issues, like you have no control and you're just peeing and pooping in your pants. To be frank, that is a serious sign of some sort of upper central nervous system disorder. There's some things that are not being connected. You're losing autonomic function. So again, those are times not to find your window of opportunity again. Okay. But outside of that, like I said, 80 and more than 80, probably 90 to 95 percent of the time, just these elusive elaborate numbers, 90 to 95 percent of the time, I'm usually finding my own window to get past an injury faster. I teach my clients how to do this. Like basically my clients that previously rested something for six months. If they feel some sort of injury or they feel some sort of strain, I actually teach my clients how to get past it within just two to seven days. And they're right back into the activities that they want to do. All right. So the last thing I want to cover, and hopefully all this makes sense. Slow this down or rewind this if you need to, because there are a lot of high level things here are essentially some strategic methods to improve your ability to move through or around pain. That is essentially another way of saying the window of opportunity. I am going to give you a couple easy, more broad parameters that you guys can take home, but at the same time, this, I don't want to make this podcast too long. So future times I might be able to break down. break this down even further, but let me just dive into like maybe six to seven great points that I think can help you find in that window. What can you do? Let's say if you injure yourself in the gym or you injure yourself while running. Okay. First thing that I usually do is like volume and intensity modification, trying to either decrease your repetitions, maybe even decrease the intensity of the workout. So either decrease your speed, decrease the amount of load that you're doing. That usually is a really good way of just. Leaving the gym with confidence that you're still able to do it. It's just that you can't do as much because you injured a tissue, right? But if you injured a tissue, you usually can try to modify volume and intensity first. And that's the first thing I would usually do, especially in my own strength splits as well. Movement planes. So sometimes when you're going from, let's say a single leg deadlift, for example, is that it's usually a single plane movement, but it's still incorporates like anti rotation. So there are three planes. So it's called the sagittal core, the sagittal plane, the coronal plane, as well as the rotational plane or the transverse plane. So essentially we're 3d structures. We're not like. Put on a piece of paper so we can move side to side. That's more the frontal plane. We can move forward and back or run forward or even squat down so that our butt goes back or knees go forward. That's a sagittal plane and we have our rotational planes, right? So usually if you're trying to do something really complex, that's either like uni planners or you're doing single leg movements. Or you're trying to do something that's like a diagonal pattern, right? Or let's say you injure yourself while playing baseball. So that's a mixture of like rotation, swinging a bat, plus a number of different patterns that you're using. So if you strain yourself, you might want to constrain yourself to doing more one plane. So basically sticking to basically a side to side plane, but not adding any form of like diagonals or multi planar movement. And also if you're just, for example, you're doing like a rotational lunge or a lateral lunge, you might just want to try a regular squat because a squat is more of a straight uniplanar sagittal plane movement where you're saying to yourself, Oh, I tweaked my knee, but I might be still be able to get away with squats, even bodyweight squats. Because. The knees go forward. The hips go back. You're staying in one plane. Everything is under control. You're also two legged. So two legged is more stable than one leg. So it's just generally less stress to that injured knee or tissue. And I know this is maybe like for another time for me to do this on a live stream and actually show you exactly how that looks, but ultimately like Changing the movement planes, or let's say you're a multidirectional athlete. You play volleyball, you do tennis, so you're moving in all these different planes is that if you injure something, it may be good temporarily to one again, volume, intensity, modification. And number two is to try to constrain yourself to maybe one plane. Okay, number three. I think also isometrics. Isometrics are basically where you are loading the tissue, but there's no movement involved. So think about you trying to push over a wall, for example, or let's say your Achilles hurts, right? So let's say your Achilles tendon hurts. You're like, Oh, running after running, it hurts. So doing an isometric is basically saying you do a calve raise. But you don't repeat the cavities because that stretches out the tendon back and forth, potentially can irritate, irritate things. So isometrics is a great way of loading the tissue to actually reduce the pain. Okay. So you'd be just do a cavities. You hold it for 20 to 60 seconds that can actually reduce pain. I think a lot of people, they resort to more stretching. Or moving away. So basically stretching the calf or stretching the tendon and stretching still till this day has not been shown to improve performance. They actually can decrease performance over time. It hasn't been really shown to reduce pain effectively, but also it hasn't been shown to actually improve physical function whatsoever. So isometrics and loading basically into the pain rather than stretching away from it. That is usually my style and it hasn't been unproven by any means. Okay. All my clients. A few hundred people that I've treated in my programs have benefited more from isometrics than reducing pain. All right, let's see. So next point to find that window is also lifting or strength exercise modifications. So I alluded to this with the uniplanar versus multiplanar movements, but if you lift or you, if you do any form of strength exercises, Let's say there's a certain exercise, like an overhead press that hurts. There are always ways to find like an overhead press variation that can help you. One good example is if somebody is getting some sort of shoulder impingement or like pain while overhead pressing is that what you can do just temporarily is you can put them more in the scapular plane, actually put them on an incline bench. So they're actually resting slightly backwards and they're reclined. But what reclined do is it allows. you would have better subacromial space. So you should have ultimately less impingement. You might not even have to decrease the load at all. You might just be able to lift the same amount of load, but just have support from a bench and also be reclined. So that's usually a great way to continue. To do some sort of like overhead press variation without giving it up for a few weeks or even a few months. All right. So that, again, that's all about that window of opportunity is a person doing overhead press with shoulder impingement can easily start to avoid that exercise, create this mental hurdle. Like I can't, my body's not meant to do overhead press again, create more fear and anxiety and more atrophy and a bunch of other things. And they see Sets that person on the wrong path versus a person that says, before I leave this gym, I'm going to try X, Y, Z, try to find that window of opportunity and then leave with confidence and also probably got some good load and stress into that tissue to allow it to recover better the very next day. Okay. The last thing I'm going to go through are just like support wraps and braces. I'm never a big fan of saying brace, right? That's why that's lower on the totem pole, but sometimes if I've had it time it. I've had a few times where I really sprained my wrist. Like I fell on the wrist. The ligament is actually stretched out. So my wrist bones are actually less stable. So even if I try to modify volume, it still might hurt. Even though I try to do uniplanar movements, it still might hurt. Making strength modifications, finding different exercise variations. Like I probably can find some, but even then it's still hurting. Still might hurt just for the sheer fact that the ligaments are not keeping like the bones in tax, being able to like potentially wear like a brace around my wrist and being able to like, let's say do like chin ups again or wide grip pull downs or bicep curls, but do it with the brace. I kid you not like that helps tremendously. And eventually you can do the same exercise and just take the brace off. So temporary support systems, braces, lumbar braces, a whole bunch of things, tons of things marketed out there. You can use them temporarily. As a window of opportunity to give you better stability during your training. And eventually you can wean off of it. So you shouldn't continue to rely on the brace. Same thing. Like I always tell my runners and my walkers and all of these out there is to wean off your orthotics. I don't think unless you have some sort of there, there are rare circumstances that you need to wear orthotics for your life. Oftentimes, again, 95 percent of the time you can reduce the need for the orthotic. I know a lot of podiatrists and say, keep wearing it the rest of your life. Completely disagree with that. I think most people should be able to find windows of opportunity to strengthen their foot, strengthen their ankles so that they don't need the orthotic anymore. So that's what I'm saying about the support scraps and braces. Okay. Last thing is just gradual exposure. So this is the last point I want to make about window of opportunity. Gradual exposure is basically. Exposing yourself to the activity that you want to do eventually, but not doing it in a way where you're going from zero to a hundred. So too many people make that mistake of going from zero to a hundred. They think that they can just rush back into activity and just go full throttle. You know how that goes, right? You usually set yourself backwards again, and then all of a sudden you're out of commission. Again, gradual exposure is basically think of a spreadsheet. Have a spreadsheet or a piece of paper, write the date down, write the activity that you want to do down, right? Either the weight that you want to get back to, or the time that you want to get back to, or the speed that you want to get back to. So have those like measurable parameters and just gun at it, right? So just basically say June 27th, I'm going to do half a mile of running. And I think that's a good gauge of the amount that can tolerate. So 0. 5 miles, 0. 5 miles, at five miles per hour. So be even more specific that way, like the next day, or let's say you take a rest day. So let's say June 27th. Now the next day that you run again, it's gonna be June 29th in order to get past your knee pain. So June 29th, I'm going to do 0. 75 miles, but maintain the same speed. So you're just making these gradual steps, exposing the injured area to further and further stress, right? Rather than taking the stress off of it, I always think that if you just stress the tissues or stress the injured area slowly, but in a calculated manner, and when I do say calculated, I do mean put this stuff in a On a piece of paper or put this thing, put this activity that you want to do on an app and actually measurably measure out your dates, the parameters that you want to get back to, because if you don't, it's like you can have a really bad day and just say to yourself, I'm not going to do as much, or if you have a good day, you might try to go overboard. And then all of a sudden you flare yourself up again. So that's why it's always best to log this on a spreadsheet, log it somewhere. And I have spreadsheets. I have apps that I use literally every single day for the past six months. 10 years. And there's a reason why I don't like, like anytime there is an injury, I always get back to it really fast. I'm always making measurable, like strength gains and mobility gains in the right direction because I continue to log all my stuff, favorite quote, what can't be measured, can't be managed. You don't log your stuff. It's hard to come back from an injury. If you try to rush back into things, you're just like. Oh, why me? My body is not meant to run anymore. My body's not meant to do basketball anymore. It's not that your body's not meant to, it's just that you're too lazy to actually track the things that you want to do. So measure out your progress, make your own gradual exposure sheet, take some of the things I said into account, which is always trying to find that window of opportunity to move more. And that should give you the confidence, the self efficacy to believe in yourself that you can get past these injuries on your own. And of course, This is something I'm teaching. Like I teach self efficacy, I teach people how to be more confident. I teach people these exact strategies to master how to find that window of opportunity. So again, like if you can't find it yourself, that's where people hire us as well, right? We've helped well over 600 people across the world. To eliminate pain, get back to the activities that they love. So if you're interested in that, you have some links down below. You can apply for our program. We can see your application and actually see if maybe it's a good fit to work together. So that's always your window of opportunity to potentially work with us if, or when you feel like, Hey, I might need some actual, like one to one help. I need something a little bit more custom. I've been trying this on my own. I've you take all the information out there. It's just hard to figure out your own plan. That's where I come into play and many other people out there as well. All right. So that is what I got for you guys today. If you enjoyed this episode about the window of opportunity, definitely hit that subscribe or follow button. I release new episodes every single morning on Wednesdays, and I'd love if you can leave a rating on your podcast apps, usually Spotify or iTunes are great. A lot of people on there. If you can leave a five star rating, find the way to do that. That's going to help me so much to inspire more people to. Live healthier lives, and I have an immense passion for this. So leave me a five star review that will push my content to more people that have keywords like pain relief, strength, mobility, is going to push them towards the people that don't know about me yet. And if you have any feedback, anything at all, you want future episodes, you want me to cover text me 415 965 6580. Or you can email me at Jason at FlexidocJ. You can see me on Instagram, Facebook, Twitter, TikTok, YouTube, I'm on all major platforms and there's a lot of free value and videos there as well. And lastly, I'll leave you with all, always these last words of advice. We only have one body, one life, make every action you take be one that makes you a better version of you take care.