Blog

About 3-4 weeks back, I had my worst nerve injury that affected my ability to walk or even stand on one leg to change my underwear. I’m happy to say, at this point, I’m about 90% recovered!!! 🥳 (Yes, this amount of exclamation marks is essential.) I’ve returned to beach volleyball and am finally able to jayrun across the road!! 😂

I’ve never been so appreciative of my legs before this incident. 

“Dear legs, I’m sorry for the years of fat-shaming and blaming you for getting tired, weak and old. I’m sorry to call you ‘used and old’ for the creaky noises in the joints. I understand that the soreness, pain and noises are warnings from you that I’ve chosen to ignore because I’ve more ‘fun and important things’ to do than to rehab and condition you. Thank you for your recovery and I’ll do better so we can grow old together.” 

I took this chance to trial and error with my body to understand more about pain and recovery. We all know ‘motion is lotion’ and to keep the tissues happy, motion (or movement) is essential. 

If you are in pain for a long time, you know that you need to move. You really want to move but you are trapped by pain. And, that’s when we need to be clever about the activities we choose, the way we pace ourselves. 

Here are the basic principles that we can use as a guide*:

  1. Decide what you want to do more of.

Choose just one activity, for example, walking, playing with your children, gardening, dancing. For me, I chose beach volleyball.

2. Find your baseline

A baseline is the amount of activity that you can do and know that the pain won’t flare up. A flare-up which is an increase in pain can leave you debilitated from hours to days, “feeling really desperate and doing desperate things” (I love their humour). To find my baseline for beach volleyball, I asked myself the following questions:

    1. Will running create a flare-up?
      • Yes, I will not be able to walk without pain the next day.
    2. Will jogging create flare-ups?
      • Probably.
    3. Will walking create a flare-up?
      • No.
    4. Will jumping create a flare-up?
      • Yes.

So, with that in mind, I played beach volleyball with minimal jogging and no jumps. However, I made a mistake in my calculation – I did a tedious 2 hours hike the previous day, and I forgot about the side steps! So yes, I suffered flare-ups during class and for the next couple of hours. However, on a positive note, knowing that I suck at side-steps motivated me immensely to train the associated muscles like gluteus medius. See, we should not fear pain; pain gives us information. And, it depends on how you use that information:

  • to stop trying, 
  • no pain no gain, or
  • understand pain so you don’t fear it. (obviously, this is a better solution!)

3. Plan your progression

You need to plan your baseline increases in advance. Using my example, the reasons for my flare-up were:

1. Overuse of lower limbs for 2 consecutive days

2. Lack of strength and stability in muscles associated with side steps

In my weighted strength training for lower limbs, I went through the same self-questioning process as mentioned in step 2. Will XX kgs give me a flare-up? Will X sets of Y reps give me flare-ups? I planned my progression and increase my intensity gradually. Always do more than you did yesterday, but not much more.

I also planned ahead for my volleyball classes with open-communication with coaches. Here is a very simplified version (not including side steps to prevent confusion):

  1. Minimal jogging, no jump, no run
  2. Slightly faster jogging, no jump, no run
  3. Slightly faster jogging, jump a little, no run
  4. Run, jump a little
  5. Etc

Planning ahead prevents you from exceeding the limit and flaring up. On good days, it is important to resist breaking the plan and exceeding the limit. Otherwise, this will lead you right into the boom-bust trap. Be patient. 

4. Don’t flare up, but don’t freak out if you do!

It is very difficult to avoid flare-ups completely because your nervous system is very sensitised. Remember, a flare-up happens when your nervous system is trying to protect you. During flare-ups, it can be tempting to give up and seek quick-fix treatment. Be relentless and believe in yourself.

5. It is a lifestyle thing.

 Eventually, you can start participating in fun and happy activities because they will have positive physiological effects on your nervous system. Challenge yourself in feared activities when you become more confident in your body. 

For people who have been in pain for a long time, the simple steps above are not as straightforward as it is. However, these principles will gradually guide you back to life as before and help you to overcome your pain.

Trust yourself and your plans, and be persistent about it!

* It was during my recovery process when I chanced upon Explain Pain 2nd Edition. While I was finding difficulty in explaining my recovery process in words, stars aligned and I found this guide of basic principles by David S. Butler & G. Lorimer Moseley that reflects very closely to my recovery process. I’ve added my own experiences in the list but I would highly recommend you to check out the book!