The 5 Types Of Pain - Part 2
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Injury pain is… wait for it, the pain we get when we injure ourselves. Sorry for being Captain Obvious. But the injury pain topic is potentially a lot more complex than you might think.
There are two very distinct types of injury pain – and it’s vitally important to distinguish between the two if you’re looking for good long term pain outcomes.
Simple Injury Pain
You are 25 years old and you’ve never had any major pain or injuries, apart from a broken arm when you were five. One day you are tearing down a steep forestry track on your mountain bike when your foot catches on a tree limb. Your perception instantly shifts into that psychedelic slow-mo.
The forward momentum turns your foot outwards severely and you distinctly feel the break happen. In your reflexive attempt to save the doomed ankle you veer away from the tree and off the track. Your body lands in the undergrowth… and you eventually catch it up.
It’s immediately obvious the ankle is not good. It looks badly out of alignment and has already started to throb severely – confirmation that you are headed for the hurt locker.
It turns out that you have a fractured tibia, but worse than that your ankle joint is severely sprained. It’s too swollen for a cast, and 2 days after the accident your ankle is the size of a small melon species. It takes you 6 weeks and 2 metal plates to get off crutches, and 10 months to get down the next forestry track on your mountain bike.
Simple injury pain is what you get after a 100% healthy body part is suddenly injured. When you are injured your body fires pain signals and releases inflammatory chemistry to let you know what has happened, and you feel all that as pain.
Damage to muscle, tendon, ligament, bone, joints and nerves can all cause simple injury pain. In some cases, even microscopic trauma can cause bad pain. Some injury pain comes on immediately, and other times it comes on after the fact.
Acute injury pain is common. The ankle sprains alone impact millions upon millions every year.
The most common mistake we make with simple injuries is not fully rehabilitating them. Even the majority of simple ankle sprains require months of attention to address the strange forms of weakness that tend to sit in the body after injuries. Attention that they seldom receive.
Most of the injury rehab we do in our culture is measured in weeks that should be months, or months that should be years. This is the root cause of ‘re-injury’. It is also a major ingredient in many chronic pain cases.
By the end of this post, you will have a much clearer sense of why our injuries require so much rehab. It’s largely due to our environment. We’ll also delve into what we should do about it.
Simple injury pain is nowhere near as common as most people think it is. Complex injury pain is far more common.
We’ll discuss this in the next video below, so make sure you watch it.
In the meantime – if you feel you need to have that pain looked at – give us a call now on 04 385 6446 to make an appointment now!
Complex Injury Pain
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You are walking in town with some friends, combining some fairly juicy gossip with a road crossing. Just as you go to cross the road, you misjudge the curb and feel a hot stab of pain as your ankle rolls. Not fancying an additional flattening by car, you ride the adrenaline to get yourself across the road. By the time you find somewhere to sit the ankle is already starting to blow up.
48 hours of ice and painkillers later, your osteopath diagnoses you with a grade 3 ankle sprain. The recovery is very slow, it’s two weeks before you are off crutches and eight weeks before you are able to get back in the gym.
A year later, you still feel frequent pain in the ankle when you ‘overdo it’; and the ankle remains slightly puffy. At a certain point, you recall that it’s the same ankle you sprained badly playing netball 25 years ago.
Complex injuries can happen as a result of relatively minor incidents, like misjudging a curb. Which is a clue to their complex nature. Millions of people misjudge curbs every single day and only a small percentage sprain their ankles – the ankles that sprain are generally the weak ones.
A complex injury is an ‘injury’ where the body part was already severely weakened or damaged. Complex injury pain and complex biomechanical pain are almost the same topics. The body gets weakened over time – and eventually gives up the ghost when something minor happens.
In the same way that a heart attack ‘sit quietly’ waiting to happen – weakness and wear & tear can sit quietly in the body. Until you do a new gym workout, lift something heavy, or suffer a minor trip or fall. Then suddenly you know all about it.
After 20 years of looking very closely at peoples injuries, I have ended up with an unusual way of looking at most of them. I believe that for every simple injury we suffer, there are several hundred others where the tissue was already weakened or damaged.
I believe that we have a strong tendency to ‘fall’ simply because we are weak and unsteady. And I believe that to tend to ‘tear’ simple because the tissue was already damaged.
I don’t necessarily expect you to believe it right off the bat. It certainly wasn’t a belief that I came to quickly or easily.
You can assess the likelihood of an injury being simple or complex with certain questions. Think back and imagine for a moment if you will … on a time you can remember injuring yourself. Looking back at the injury event, ask yourself the following questions…
Based on what happened – After that event… do you think that a strong and healthy ankle/back/shoulder would have ended up as injured as yours was? Or do you sense that you were a bit more injured than you might expect?
Based on what happened – Do you think that pretty much everyone you know would have fallen/slipped/dropped the way you did in that situation? Or would many of them avert disaster?
If you were hit off your bike by a dump truck the answer will be yes to these questions. But if you were picking up some shopping or you just missed a curb, maybe the answer is no to one, or both?
If you sense that the injury was a bit bigger than the event, it’s possible that what you experienced was a complex injury pain, as opposed to simple injury pain.
It is worth looking at your own injuries, and the injuries your loved ones suffer in this way.
I cannot express in words how important it has been for many of my patients to make these distinctions. I have met countless people who have suffered from decades of severe pain and disability; primarily because they simply didn’t realise that their injuries were all being caused by preventable weakness.
Now you know a whole lot more about the origins of the pain you may be feeling.
If you feel you need to have that pain looked at – give us a call now on 04 385 6446 to make an appointment now!
BTW – if you missed Part 1, you can check it out here: What Are The 5 Parts of Pain – Part 1
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Pain is a symptom. Symptoms are the feedback that the body generates when it faces problems with its delicate internal balance (homeostasis). Without symptoms like pain, thirst, nausea and fevers, it would be very difficult for us to maintain a healthy body in the same way that it would be hard to drive a car safely with no dashboard display.
John is one of those rare gentlemen who has continued to play competitive soccer well into his late 50s. He is in really good shape, which you need to be to play football at that age—good shape except for his left leg. His left leg is not in good condition at all. In fact, once you get to know his left leg a bit better, it becomes apparent that it’s miraculous that he’s able to run at all, Let alone the type of running required to play competitive soccer against younger men.