EP80: If It Hurts Don't Do It (True or False) || WBWL

I'm sure you've heard this statement before from your PT, doctor, or health practitioner.

"If it hurts, don't do it"

Now is this true, or false?

The general consensus is the former, but I'm going to share 3 reasons why you might consider the latter and how it will benefit you to turn away from this statement so that you can be pain-free and enjoy life.

Tune in now!

PS leave us a rating on Apple, Spotify, or your preferred podcast app, especially if you've enjoyed these episodes.

Transcript

0:01

Hey there, welcome to the Won Body Won Life Podcast. Hi, I'm your host, Dr. Jason Won, lifestyle physical therapist. I specifically help business owners, executives, as well as any professionals, not just get rid of chronic pain, but also to become stronger, more resilient and to enjoy life more fully. So if you've been tuning in, you'll see that lately, we've been doing a lot of episodes around pain relief, strength training, as well as habits. And I think that a topic of popularity, especially amongst my clients and many people that are following me is this statement, the statement that we've pretty much heard from even childhood, from the times that we fall, fell down and we injured our knee to breaking a bone and a whole lot of things. The statement, if it hurts, don't do it. It's something that is very commonly stated as true, and I get it. I understand because if we're constantly irritating something that doesn't want to be moved, then we might want to just avoid it for a while. But what I'm going to share with you today are three reasons. Why you may consider going away from the statement and instead thinking about potentially pushing into pain or learning how to modify in certain ways. So right now a lot of my clients that have chronic pain, that's lasted longer than three months. A lot of them are living potentially in a state of anxiety, right? Because they have been dealing with this pain for a while. It perpetuates depression. It causes a lot of disability. A lot of people even consider leaving their jobs because they can't handle their jobs. It really interferes with a lot of their quality of life. And I think that a lot of people are told this exact statement, which potentially, it does protect them, potentially in the short term. But it creates a lot of long term repercussions. And again, what I'm going to share with you are three reasons why you may turn away from the statement. If it hurts, don't do it. So the very first thing, the very first reason why you may consider not following the statement is because it perpetuates fear. And so fear avoidance or potentially what we call kinesiophobia, which is specifically fear of movement, is very common. Amongst a lot of people that were either told the statement Or they're a person that has repeatedly injured a certain area. So I'll give you an example is that if I repeatedly hurt my lower back with various things, whether I take out the trash and I twist the wrong way, or let's say I pick up my child and all of a sudden I feel my, I guess the quote unquote is they throw their back out and then now they're in a very debilitated state. It does make sense that our brain starts to turn on our protection signals and it starts to create fear of bending forward, for example. And another example is people that have knee pain, and then they're told, I used to run, I used to squat. And then their doctor or health practitioner says if it hurts, just don't do it. And I think that statement creates and perpetuates them down this path. That causes more fear instead of more empowerment. The way that I've always been able to help my clients is to try to turn away from the statement and instead think about how they can potentially still modify the way that they do things to still be able to do that activity. So for example, if they're a runner and it may be a lot of different factors, and that's why a physical therapist or coach like myself may be able to help them because we potentially get them on a treadmill. We see that they're having some knee pain, but then we can alter the mechanics. We can increase their cadence. We can change out their shoe wear. And for people that have low back pain we can simply not blanket the statement of anytime that you bend forward, you're, you're going to hurt yourself, which again, perpetuates that fear and that kinesiophobia. Little do people know that maybe as they avoid it, yeah, they're not dealing with pain, but it actually could cause long term repercussions. From the brain signals that are telling the body to protect them from doing those things. In fact, a lot of the research shows that when somebody has a fear of bending forward, is that it actually changes the way that they do that specific task. Like maybe when we're picking up a pencil, which is very, a very small object, they may approach it with really tightening up their core. They may try to keep their trunk very upright. They may try to really just stay as upright as possible and not even bend forward whatsoever. And again, when you alter the mechanics that way, it can actually cause more pain. It can tighten up the lumbar perispinals and cause more pain as a result of a more protected version of doing a simple task like picking up a pencil. Okay. So my, my, my states on everything is that if we can potentially just modify the way people do things temporarily, but then slowly kind of transition and slowly gradually expose themselves to that fearful movements, then I think that then they can potentially get back to that activity. So if you've been told, if it hurts, don't do it. And let's say you see that your brain is protecting you from doing certain things like. Okay. running, bending forward, whatever, wherever your pain is, whatever your doctor has said don't do this thing, then you have to think of it as now I want to think about how can I do this thing? How can I get back to this activity versus avoiding it overall? Okay. So number one, again, it perpetuates a lot of fear, really internalizing the statement and perceiving the statement as it's mutually exclusive, it's black and white. If it hurts completely, just stop doing your activity. All right, so let's talk about number two and number two is it creates long term weakness. Okay, so the first one it perpetuates fear Number two, it creates weakness Okay Because let's say you're a person that weight trains a lot and your doctor says if it hurts don't do it So then you start to avoid things like squats for your knee pain or your deadlifts for your low back pain Is that over time? Yes, you're feeling better because you're just not doing that activity But over time, you're going to realize that you're going to lose the capacity to do those things over time. You have trained yourself however long you've been exercising or working out. Let's say you play volleyball or let's say you play basketball. You're probably doing that on a relatively consistent basis. But let's say you over train or you overdue or you overstepped your bounds. Every person is human. So we all have a specific capacity for tolerating certain stresses and certain forces and a specific amount of load. And that's just the name of the game is that exercise we know is important to us. It's important for our musculoskeletal health. And our health in general for literally every aspect of our body, including just living longer, but when we have a certain pain, and when we accept this statement of, if you're first, don't do it, then that's what creates that long term weakness. You stop doing that activity, you eventually lose the capacity to do that specific desired activity. And so when you allow things to calm down, let's say it was some form of tendonitis. And let's say you just completely just take a break, you take completely take a break from that activity. And let's say you take a break for one month, let's say you take a break for two months, or let's say you take a break for three months. Now, over time, not doing that activity, you eventually lose that capacity to do it. So when you decide, man, my tendonitis feels better. And that should happen because over time, if you just completely rest a painful joints or painful muscle. That area is going to calm down, your body is going to regenerate itself, and that area is no longer going to hurt. But guess what happens when you go back to that activity? And oftentimes, we don't have a certain sense of transitioning slowly into an activity. Some of us are just more stubborn, and we just say, Hey, if I play basketball, I'm just going to play two hours with my friends. Or if I run, I was already running a mile three months ago, so now I'm going to run a mile again. That's it. You're going to realize that muscles and mitochondrial density and all the endurance aspects in that muscle have faded away over time. Therefore, that tendonitis may just come back with a vengeance, or maybe you're going to hurt another area like a ligament or a specific cartilage area. So these, that's why I say that when it hurts, don't do it. And some, let's say it's a runner that comes in, I'm rarely telling them to stop running. I'm always telling them that like, why don't we just try to get back into running literally tomorrow or the next day, but let's do it under certain guidelines and those certain guidelines are specific parameters where we are pushing that painful area a certain amount so that it induces positive adaptations. to strength, mobility, et cetera. But we're going to say that we're going to do this in a controlled environment so that you're not overstepping your bounds. You're not flaring yourself up. And that therefore this term that we always say is that we want to train smart. We don't want to necessarily just always train part. So when we train smart and when we're taking a specific painful area to a certain limit, but we don't surpass those limits, What that does is that it pushes those limits up, and now we're slowly building capacity despite pain, and we don't have to wait for pain to completely go away before we go back to a certain activity, okay? Sometimes we have to use, we have to use like knee braces. Sometimes we have to temporarily use external objects in order to feel better. Sometimes we need to be a little bit more concerted with Doing some soft tissue work, like some mobility. I'm not promoting this right now, but maybe like a massage gun or a foam roll, like you make that area feel better prior and you thoroughly warm up that area so that when you go back to that activity that was previously causing you pain. It may not be as painful because you're learning to adapt. You're learning to incorporate better warmups. You're learning how to take care of your body better. And that's the whole point of just learning through exercise and fitness, just learning by experience that it's okay to push through a little bit of pain in order to make gains in the right direction. Okay, so let's talk about number three. I'm going to give you a term that maybe you might not have heard of. And so number three, why you may turn away from this term, or the statement, if it hurts, don't do it. It's because it decreases your window of function. Okay, so notice that I use specifically this window and this window here was a very large window. I'm going to give you an example. This window of function is essentially this term that I use. to depict what activities are available to you. So example is my son who is three years of age right now. He legit has not even lived enough life to, to create bad habits right now to create bad habits around movements. He doesn't really have a lot of fear around falling down or like falling off the play structure. So his limits are pretty limitless. He's willing to jump off a play structure and just land on his feet and just be like, So what? I did it. But if you have a history of knee pain, and you're a parent, you're likely going to second guess yourself by jumping off like a high play structure and be like I wonder how my knees are going to feel after this, right? My son doesn't have that fear. And because he essentially has almost seemingly a limitless amount of opportunities and the limitless amount of things that he can do functionally, his window is like very large. That window of function is extremely large. However, if my son, over time he sprains an ankle, or let's say he breaks up, he breaks his forearm by falling off the monkey bars, he may eventually learn that I need to be more careful. On these monkey bars. Okay. He may learn a specific manner with which he's more careful and that he's like really gripping it hard. And again, we want to make sure that we can push people to their absolute limits while also making sure that we're not causing more fear, anxiety. Or again, perpetuating weakness by telling him you hurt yourself on that monkey bar, so don't do it anymore. If you said that to a small child, he may eventually just deem that as true and he may just avoid that. But what that ends up doing is that he doesn't develop good grip strength. He doesn't develop good forearm strength. Let's say he breaks that forearm might forever stay weak. And this is what happens with like even ACL reconstructions. I used to do that a lot when I was working at my previous job at a sports clinic. Okay. And these people, a lot of the other practitioners around me would say, if it hurts, don't do it. And guess what happens? Guess what happens with these people with ACL reconstructions? They end up living in a state of fear. They don't go back to certain activities. They oftentimes have quadriceps or even hamstring atrophy. What that means is that muscle loss. You can physically see that the muscle in the right quadriceps is different and is different from the left quadriceps. The left quadriceps being the surgical knee and that left leg circumference wise is actually physically smaller. Okay. Now, is that because of improper rehab? Maybe. Is it because they weren't loading it effectively? Maybe. But also, if we're telling our clients and potentially our patients, if it hurts, don't do it, or you've been told that, you may realize that area is more vulnerable to stress. You're protecting that area more. That's not the right way to go about rehabilitation. So if you are somebody that has had developed some fear or develop some uncertainties, maybe that area has gotten weaker. Guess what? You are going to decrease that window of function. Okay, that window becomes smaller. That means that certain activities, even day to day activities, even instrumental activities, shopping and all these things, even your sports and your activities, Those become more limited as a result of abiding by the, this is, if it hurts don't do it type of statement. That induces fear. It induces also weakness, but not just that. It decreases your window of function. So you can slowly increase that window of function, potentially in a controlled manner. You can do this yourself. Simply write out, write on a piece of paper. This is the activity that I've been avoiding. And then put The date on the left side, then you simply put an activity right next to it, create another column and list off literally the parameters by which you're getting back to those activities. Because sometimes we just go off of guessing and guessing how much our body can tolerate is a recipe for disaster. That's why I'm very structured and very mathematical where you would say, for example, August 21st. And then you put running and then what you do is you'll put the parameters that you're going to abide by. I'm going to test out a 3 minute run, followed by a 1 minute walk. And then I'm going to do that twice over. So it's 6 minute run, 2 minute walk. And then the notes or the symptoms, you can put that on the last column. You can simply say, yes, my knee was a 3 out of 10 pain, but it wasn't horrible. And then you can mark like the next day, say. My knee was fully recovered the next day. So you're now empowering yourself that man, my body is capable of running. But if you don't put down those parameters, let's say the six minute run, two minute walk, let's say in your notes section, you say, man, my knee swelled up. It was painful, it was throbbing at night. The next day I could hardly walk. Okay, guess what you just learned about yourself. Six minute run, two minute walk was too much. You were just overstepping your balance. And you learn from that experience. It doesn't mean that you have to be fearful. It simply means that you have to potentially dial down those parameters further. Maybe you have to change your shoe wear. And again, then you can start to make really good decisions around how you can get back to those activities that you love and not continue to abide by this really large blanket statement that I keep telling you about, never do it. I often say that statement is quite frankly, false in about 95 percent of situations. Like maybe if you have a broken bone, maybe if you just tore your Achilles, maybe if you have cancer, for example, maybe you have like severe peripheral neuropathy and these other comorbidities that may be preventing your healing process, like type two diabetes, uncontrolled diabetes. maybe have a ventricular tachycardia, anything where you actually have true precautions that may say, maybe the statement, you might take it with a grain of salt and say, there is some truth to it. But like I said, for most people's situation that most of the clients that I see 95 percent of the time, the statement is absolutely false. And you could potentially, because of these three reasons, empower yourself to get back into those activities. sooner rather than later or potentially get back to those activities that you thought, man, this is the end of it. I'm no longer going back to activity. So hopefully that's this episode, this training here really empowers you to learn that your body is extremely resilient. Your body is capable of handling stress. You just have to empower yourself to do if you feel like you want some help to do this in a controlled manner that's where potentially I come in and we were able to do an evaluation. Literally, we actually helped over 2000 people worldwide. So anybody that is wanting some form of coaching or some ability to be able to get back to those activities without pain of limiting them. Then let me know, feel free to drop us a line in Texas at 415 965 6580, or you can also email us as well, you can email support@flexfactoryday. com. Let us know which episode you listen to and just say, Hey, I'm looking for potentially some help from us. So that's it, what I got for you guys today. If you have any questions, feel free to drop us a line. Also, this will be on the one by one podcast. So if you feel like this was extremely helpful episode, Definitely leave us a five star rating as well as leave us a potential review that allows other people that may be searching for relevant topics like this can be able to find that a little bit quicker. So that'd be great if you can support us by leaving a five star review either on Apple, Spotify, Google podcasts, YouTube music, anywhere on those ends, that would be greatly appreciated. So I want to leave you. With how I always leave this podcast, we only have one life, one, one body make every action you take be one that makes you a better version of you. Take care and have a beautiful rest of your day.