What is the difficulty in resolving your particular muscluloskeletal issues?
Much like the “Recovery Methods” I am often asked:
“Ok Coach, be real with me…how bad is this gonna suck and how long is it gonna take?”
So the following outline is a realistic preview of what you are in for. Yes, for some this might provoke some element of fear, but the literature in a tangential area (“Realistic Job Previews”) is clear on this subject: if you have a realistic scope of what is in front of you and proposed tools to get through it, you are more likely to succeed long term.
In doing so, we have to recognize a couple of things:
1) Your pain and someone else’s pain has a different history, speed of resolution and likelihood of full resolution
2) Your pain might be roughly equivalent in terms of scope, history, etc. but more INTENSE and thus the frameworks below skew to the negative.
3) Everything below is my opinion. I don’t have the slightest idea if any of this is backed by research. This is my estimation based on my experience across hundreds of hours of training myself and others
4) This is also across the broadest of circumstances, so someone with compounded, linked and recently aggravated symptoms is far worse off than someone with a mild “tickle” that makes it uncomfortable to play golf sometimes.
So what is the utility of this? To give you a broad high level view of what you are in for to temper your expectations for your own pain free journey.
If the above wasn’t enough preamble, here are a couple more things:
1) The areas discussed are not strictly anatomical and many overlap. Their references will be the “functional outcomes” that manifest, not the literal structures involved.
2) The exercise list is not a prescription, more of a preview.
3) All of the outcome variables (i.e. how long it takes to recover, or risk of reinjury) are directly related back to the user inputs. That is, if you have a mild case of plantar fasciitis for “no reason” your risk of reinjury and duration to recover is more mild than someone who puts in 50 miles a week running and has no intention of stopping.
One last thing and we’re off and running — scoring.
We have 5 categories:
General Risk of Score — what is someone’s likelihood to experience problems here at all
Strain Score — How strenuous is the process overall
Duration Score — How long will this take
Reinjury Score — once injured, chance of hurting it again
Ouchy Score — considering everything in front of you, how much is this gonna suck?
Then there is a brief description on my estimation as to why the above is the case.
The scores are on a 5 point scale of essentially very low, low, moderate, high, very high. The lowest score is 5, the highest is 25. As such
5 to 10 — not too bad
11 to 15 — a bit spicy
16 to 20 — fairly ouchy
21 to 25 — look…this is going to probably suck
Let’s begin!
Part 1: The “easy ones”
Location: Shins
Description: Pain on the front of the lower part of the leg, most commonly Shin Splints
General Risk of Score: 2 — Low
Strain Score: 1 — Very Low
Duration Score: 2 — Short
Reinjury Score: 2 — Low
Ouchy Score: 2 — Low
Overall: 9 — Not too bad
Overview: Shins will almost manifest in shin splits and those will almost always manifest through ground contact sports that involve running or jumping. The solutions are pretty straight forward, they aren’t very difficult to complete and you don’t have to suffer much to get there. Sometimes they even go away on their own as you get stronger in the natural course of your activity.
Location: Neck
Description: All things below the base of the skull/bottom of the ear line to the top of the shoulders (i.e. where the back of your shirt rests)
General Risk of Score: 3 — Medium
Strain Score: 1 — Very Low
Duration Score: 2 — Short
Reinjury Score: 3 — Moderate
Ouchy Score: 1 — Very Low
Overall: 11 — A bit spicy
Overview: The only reason why neck is so low is because neck issues are very often a symptom, not a cause. That is, once you strengthen the shoulders, back and rotators your neck can get relief and is otherwise undamaged. This doesn’t stand if you get into a traumatic accident or your sport requires neck resiliency. But for your average person with average “stiff neck” outcomes, hitting the surrounding tissues with some very basic attention to the neck can provide a lot of relief.
Location: Calves
Description: All things from the top of the heel to the back of the knee
General Risk of Score: 2 — Low
Strain Score: 2 — Low
Duration Score: 2 — Short
Reinjury Score: 3 — Moderate
Ouchy Score: 3 — Moderate
Overall: 12 — A bit spicy
Overview: Calves are relatively straight forwards in that they do a fairly small selection of things. People with repeat ankle injuries will have a harder time with this because it is the primary issues they are facing. But for someone who is just a little tight or sore from activity, a little calf raise action goes a long way to relief.
Location: Toes
Description: All the little piggies
General Risk of Score: 2 — Low
Strain Score: 1 — Very Low
Duration Score: 4 — High
Reinjury Score: 5 — Very High
Ouchy Score: 1 — Very Low
overall: 13 — A little bit spicy
Notes: Once you injure a toe, you will be dealing with that for a long time. Because it is mostly connective tissue and very little actual musculature, you are dealing with tissue that is slow to adapt. Likewise, because they are so small they are quite sensitive to reinjury especially if this is due to sport. The good news is that they are fairly simple in their function so there isn’t much to do and because they are so small, not much stress can be placed on them. Most of the activities can be done while watching TV, for instance.
Location: Ankles
Description: What is not the calf or foot, but mostly related to the ankle joint
General Risk of Score: 3 — Medium
Strain Score: 1 — Very Low
Duration Score: 3 — Moderate
Reinjury Score: 5 — Very High
Ouchy Score: 1 — Very Low
Overall: 13 — A bit spicy
Notes: When you get into the joint of the ankle, it will tend to take longer and, like toes, be susceptible to reinjury. The good news is that the ankle doesn’t do a lot of things, so the inputs are limited. As well, because they don’t handle a tremendous amount of load, there is not a high stress requirement to make them adapt. They are very similar to toes in terms of time, reinjury and stress to address.
Location: Fingers
Description: Mostly explicitly your fingers, but can extend to the hand (hands are surprisingly not very often a problem)
General Risk of Score: 2 — Low
Strain Score: 1 — Very low
Duration Score: 4 — Long
Reinjury Score: 5 — Very High
Ouchy Score: 2 — Low
Overview: 14 — A little Bit Spicy
Notes: Fingers and toes are basically the same with the fingers being slightly more difficult due to the active use in life whereas the toes are easier to avoid use. If you injure your thumb, for instance, you will find it very hard to stop using it completely and will get jolts of pain doing ordinary activities forgetting to guard your thumb. The good news is that because they are so mobile and present right in front of your face, it is easier to remember to move them and stress them for adapation.
Location: Feet
Description: Not your ankle, mostly the bottom of your feet
General Risk of Score: 2 — Low
Strain Score: 1 — Very Low
Duration Score: 5 — Very Long
Reinjury Score: 5 — Very High
Ouchy Score: 2 — Low
Overview: 14 — A little bit spicy
Notes: We’re looking mostly at plantar fasciitis here. This can be incredibly persistent and tough to resolve because it is difficult to stay off your feet. Small factors will make a big difference as well — being overweight, highly engaged in sports or having persistent symptoms for a long time will make the process to strengthen and heal more difficult. Similar to fingers, toes and ankles, the lack of blood supply in big meaty muscles make it more difficult to address aggressively. Patience is key.
Location: Upper Back
Description: the space between where the collar of your shirt rests and “right in between the shoulder blades”
General Risk of Score: 4 — High
Strain Score: 3 — Moderate
Duration Score: 3 — Moderate
Reinjury Score: 3 — Moderate
Ouchy Score: 2 — Low
Overview: 15 — A little bit spicy
Notes: Everyone “carries their stress” here. The good news is that it generally feels great to address this area as it is a weak area that will tend to singularly pull in one direction (down and forward), so any relief to that tissue tends to feel great. The trouble is that they are also difficult muscles to target as they cant be seen and people will often lack the mind muscle connection to move with good intent to target them effectively.
Location: TSpine
Description: Thoracic Spine. All things from between the shoulder blades to your mid back
General Risk of Score: 3 — Medium
Strain Score: 3 — Medium
Duration Score: 3 — Moderate
Reinjury Score: 3 — Moderate
Ouchy Score: 3 — Moderate
Overview: 15 — A little bit spicy
Notes: Probably the least problematic of the spine as the low back and upper back (still Tspine, but the top half) will take the brunt of the forces and result in pain. The Thoracic spine will limit most people in twisting motions. And, due to lack of motion, the low back will take more force than is optimal and tightness or a tweak might manifest there. Most people will get automatically stronger here with general weight training due to the natural bracing that takes place. As such, it is more “intense” due to the loads that will accompany training these muscles.
Part 2: The “Hard Ones” comes out next week!
