Chronic injury and pain – What to do when you’ve “tried everything”?

Who is this article for?

Maybe you’re a cyclist, a road or trail runner, or maybe your thing is hiking. You’ve experienced recurring pain that led you to consult a health professional. Unfortunately, you haven’t had the results you’d hoped for, and the pain returns when you practice your favorite sport.

You feel like you ‘ve tried everything, and you’ve come to the conclusion that this sport just isn’t for you. So what do you do when you don’t know what to do?

That’s a big question, and we’re going to try and answer it. You’ll find four common mistakes (and associated myths) that can prevent you from getting back to your favourite sport 100%. If you think any of these mistakes apply to you, explore this trail, and work the vein until that pain goes away for good!

Mistake 1: Resuming business too soon and/or too quickly

Associated myth: “Once the pain is gone, I can resume my physical activity with the same level of difficulty as before my injury.”

Stopping activity temporarily (for several weeks), then picking up where you left off is a common mistake. When you feel pain, it means that the training load applied to your body is beyond its capacity. In other words, you’re asking too much of your body.

If you stop your activity for several weeks, until your pain subsides, your body’s physical capacity diminishes during this rest period. If you resume your activity with a new level of difficulty similar to that which caused the pain in the first place, the load will inevitably be too high for your body.

I recommend that you have a physiotherapist or coach to guide you through this process! It’s very tempting to do too much too quickly. Having the self-discipline to stop when your body says stop is sometimes the missing piece of the puzzle.

Mistake 2: Thinking leg pain is necessarily due to a local problem

Associated myth: “Knee pain must necessarily be caused by a knee problem”.

Pain in the legs (whether in the hips, toes or anywhere in between) can be the result of a “problem” in the back (more specifically, the lumbar region). This is called referred pain.

If you have referred pain, treatment should focus on the part of the body that isn’t working perfectly. For example, if your knee pain comes from the lumbar vertebrae, then the lumbar vertebrae should be treated. If treatment focuses solely on the knee, it unfortunately doesn’t get to the root of the problem. And the problem may therefore persist.

Mistake 3: Believing that all pain is mechanical in origin

Associated myth: “Pain must necessarily come from a mechanical problem”.

What do you think is the cause of injuries among runners? Muscle lacking in strength or endurance? Reduced flexibility? Poor alignment? Training progress higher than the 10% rule?

The answer is not clear-cut. Despite their best efforts, researchers can ‘t find a mechanical factor that applies to everyone to explain the cause of injuries in runners. That’s not to say that injuries aren’t mechanical in origin, but thatyou can’t predict who’s going to get injured by looking at mechanical factors alone. For example, just because your knee isn’t aligned with your hip doesn’t necessarily mean you’ll suffer a knee injury.

However, one study has highlighted a surprising factor that predisposes runners to injury: mental health. Lack of sleep, stress at work or at home, negative beliefs, fears and other psychological components weigh as heavily as mechanical factors in identifying the cause of injury.

Injuries are generally the result of variables from different spheres: mechanical, physiological and psychological. Coming back to you, if you feel that certain parameters of your lifestyle and mental health can be improved, you may have the missing piece of the puzzle in your hands.

Mistake 4: Thinking that the kinesitherapist should have put me back on my feet but didn’t.

Associated myth: “A health professional will solve my problem”.

There’s this belief that a physiotherapist will solve your problems with his or her magic hands. Unfortunately, this is not the case!

The manual treatments performed by your physiotherapist (massage, dry needling, ultrasound…) are only part of what you certainly need. They’re the tip of the iceberg, the treatments you think of when you think “physio”. They help you feel better, manage pain over relatively short periods of time.

However, this does not allow you to:

• Prepare your body to resume your favourite physical activity;
• Understand and change the factors in your training and/or lifestyle that initially caused the injury

You therefore have an active role to play in your rehabilitation process. Your physiotherapist is there to support and guide you with his/her knowledge of the human body, but he/she also needs your collaboration to achieve your goals together.