Have you ever been playing a sport or doing your favorite activity when suddenly a muscle goes into spasm and quite literally “grabs” your attention and steals your movement mojo?
If so then you know what it’s like to experience a muscle strain, or “pulled” muscle.
There is one thing you absolutely MUST do to recover quickly – and one thing you must NOT do.
I’ll get to those in a moment.
First, it’s important to understand WHY strains happen, because – while I am sure some of you are here and currently experiencing a strain or pulled muscle – I am hoping the rest of you will use this information to prevent this from happening in the first place (can we make prevention sexy please?!)
In order to understand why and how a strain happens, we have to understand how muscles work.
Reciprocal inhibition – the key to understanding muscles and injury recovery/prevention!
I’ve had my eye on this process for over 5 years as a guiding touchstone for how to help people in pain and it’s never failed me. I’ll certainly do an entire episode dedicated to just this because the topic seems sorely lacking in the field of pain relief and injury recovery/prevention; but for now we’ll explore it in relationship to strains and pulled muscles.
Reciprocal inhibition is a process by which opposing muscle groups (and the nerves that act on them) work synergistically on a joint: one group flexes that joint while the other extends it.
In order for one muscle or group to contract, the opposing muscle or group MUST relax and stretch.
The simplest example of this is: when you contract your hamstrings your quad has to stretch and relax, right? The opposite is true as well: in order to stretch the quads, the hamstring must contract. (Think of a standing quad stretch).
So you’re in pain or dealing with an injury and you want the help of someone in the bodywork field to sort you out. How do you choose the BEST person for you?
This can be a daunting decision, with thousands of choices that often looks similar on paper (or the web).
If you’re NOT in pain, then my opinion is simple: see whoever you want! Do what feels good. See the person you like the most.
When you’re in pain, however, there are a few critical distinctions to make and important points to consider if you want help actually getting out of pain AND finding the root cause so it doesn’t come back.
How to choose a body worker for pain relief:
First of all, here are some very basic things to consider:
MANY (I would say the majority of) manual therapists – massage therapists and other body worker practitioners – are not necessarily trained to help people eliminate pain.
Having said that, there certainly ARE capable manual therapists and body work practitioners out there who have been trained to relieve pain at its source, and this post is designed to help you find THOSE people and learn how to differentiate between your average massage therapist or someone you would go to for relaxation vs. someone who can help you get and STAY out of pain.
First off, let’s weed out the therapists who probably CAN’T help you:
Before I list these, I want to be clear I’m not knocking these therapists or discounting their work – I think there’s room for ALL of us and room for every modality. I just think it’s important for all of us (clients and practitioners alike) to know who we are seeing and WHY, with an honest look at scope of practice. I was a massage therapist for a year (8 long years ago!) and in that time I never helped my clients eliminate their pain for good. I wasn’t trained to do that and I went through a very comprehensive training that included myofascial massage, orthorpedic massage as well as the typical deep tissue, swedish etc.
Here are the modalities and people I would NOT consider seeing if you are looking for pain relief:
Your corner massage chain or generic massage therapist.
This includes therapists whose work consists mostly of Swedish, deep tissue or very general whole body massage.
Here are the practitioners and modalities you might consider, CAREFULLY: (and use my interview questions to make a wise decision here!)
Massage therapists or massage businesses who list “sports massage” or something like this as an option (often an “upgrade” that you pay extra for). A lot of the time these therapists are allowed to say they practice “sports massage” when they had a few hours of training for “athletes” while they were in massage school. This does NOT mean (in my opinion) that they know how to find the root cause of pain. MAYBE THEY DO. Some people have had extra training that gives them the authority to make this claim with confidence. This is where I want to encourage you to interview people, because you never really know from the average website bio (see below for questions to ask and what to look for when interviewing practitioners).
Manual therapists who say they do “myofascial massage.” Like I said above, I was trained in myofascial massage but NONE of that training included teaching us how to find the ROOT cause of pain. Generally speaking, THIS IS SIMPLY A MASSAGE MODALITY or technique. It does NOT mean this person will be able to release your fascia (it takes a very skilled person to do this with their hands. They absolutely ARE out there and if you can find one of these that’s AWESOME!)
All other modalities that do not (necessarily) include training to find the root cause of pain, from energy work to deep body work – reiki, craniosacral therapy, shiatsu, trigger point therapy, thai massage, reflexology etc. I like to speak from personal experience and personally, I haven’t directly experienced eliminating physical pain with any energy technique. Maybe I’m not open minded enough. That said, I have friends who have and I believe them. The mind is extremely powerful! If you believe in energy work and believe your practitioner is saving your ass, then they probably will! I definitely believe in energy being stored in the body, as well as emotions, trauma etc. My personal preference is to access that energy in a very physical way. So – if energy work is your jam, carry on! As for some of the other ones I listed above, it’s for the same reasons as the above two that I list these: most of the time the training for these modalities does not include how to find the root cause of pain. This doesn’t mean there aren’t some really skilled practitioners out there who specialize in shiatsu, Thai massage or trigger point therapy that can help eliminate pain. So once again – please refer to the interview questions to help you determine if one of these practitioners is right for you.
ALL other body work modalities fall into this category of being potentially supportive (if you interview them and like their answers): Alexander technique, Feldenkrais, Bowen, chiropractic, Trager and Rolfing, or Structural Integration, ART, Mashing, Rossiter etc (I’m sure there are many more).
Just because someone was trained in something potentially helpful does NOT mean they are GOOD! Your job is to find out if they are, and their job is to make sure you know it when you call or walk into their office.
Questions to ask when interviewing a practitioner:
The very FIRST thing I urge you to ask any professional before you see them is
What if the FIRST thing you do when pain happens is the LAST thing you should do if you want true relief?
If you’re like most people on the planet when pain happens then you probably do the ONE thing that seems to be in our biology. It’s instinctual, habitual and seemingly benign. But chances are it WON’T get you out of pain, and it just might make things worse.
You go to and touch whatever is hurting:
Your knee gets a stabbing pain, folds you in half and you reach down to touch it.
Your back seizes up and you instinctively grab it and feel around as you try to stand upright.
Your shoulders hurt, so you massage them (or ask someone else to).
Your elbow hurts, and you grab hold of it.
You get a tension headache and hold your head in your hands.
This first act in and of itself is perfectly natural and it makes total sense that we’d instinctively want to make contact with our pain.
It’s what we do NEXT that truly matters.
Do you REACT to the pain and fixate on what’s hurting?
Do you get CURIOUS and try to find the root cause?
The habit most of us have is to fixate on what’s hurting followed closely by an attempt to silence, comfort or eliminate the pain: maybe you take an over the counter pain killer that’s already in your medicine cabinet; maybe you gently rub or massage that area; maybe you ice it (because you probably learned the very outdated RICE protocol in middle school, which for the record I’m not a fan of at all).
When these mild reactions don’t work you might seek out help from professionals who are a little more aggressive than you: perhaps you try a deep tissue massage or a chiropractic adjustment. And while these might seem like very good ideas, if they are also fixated on the site of pain and not looking elsewhere for the CAUSE, then you’re still caught in the same trap.
Or maybe you try to isolate and immobilize the area via a knee, back, wrist or ankle brace or boot…
What’s missing from this approach?
What ALL of these reactions have in common is a complete lack of curiosity about and awareness of THE REST OF YOUR BODY.
This habit of fixating on what’s hurting at the exclusion of the rest of the body is so ingrained that most healing modalities in western culture have adopted it as well.
If you seek out a medical professional for help with your pain, chances are – unless they are very holistic in their approach to pain (and these professionals DO exist, though it’s been my experience that they are rare) – they will look at/palpate and/or X-ray, MRI or ultrasound the site of pain and suggest a course of action that focuses only on the site of pain: cortisone shots, pain pills, surgery, a brace, a boot, orthotics or shoe lifts etc.
Even so-called alternative and holistic methods more often than not (in my experience, and I was one of these when I was a massage therapist) focus on where the pain is, instead of looking for the cause. If you go to a massage therapist for back pain, I’d be willing to bet that a large majority of therapists will go straight for your back. If you go to a chiropractor for neck pain, chances are pretty high they will adjust your neck.
I will say I have sought out chiropractors, massage therapists and acupuncturists who “get” the idea that where the pain is isn’t the problem, so they absolutely do exist; but I had to weed through a bunch of others first who didn’t get it and I still see this mentality being the status quo of both western and alternative practitioners who deal with people in pain.
It’s my position that this is precisely why there are so many people in pain who aren’t getting the relief they so desperately want, because MOST of the time…
Is yours working for or against you when it comes to pain and pain relief?
Mine used to work obsessively to my own detriment. Now my mind is one of my most powerful allies, not just for me but all of my clients as well.
What we think about pain and how we REACT when it shows up, I believe, can and often does determine whether the pain stays, gets worse, or leaves as quickly as it came.
This is not to say that often (or always) there isn’t something physical going on too. Of course there is!
What controls the physical body? The brain and nervous system!
And what controls the brain? We do.
Who we are – our beliefs, stress triggers, past traumas (physical or otherwise), fight or flight response, nervous system habits and muscle memory – all of this and far more is entangled and, when pain shows up, can become a mess of reactivity that has almost nothing to do with our current circumstance.
Before you go dismissing this as a bunch of new age hooey, let me ask you…
Have you ever had something happen in your life that was mildly upsetting, and instead of being calm and assessing the reality of your situation you started obsessing with your mind and before you knew it…the situation went from mildly upsetting to a blazing inferno of “this is so f*cked up!”?
I’m pretty sure we’ve all done this, whether in relationships, traffic scenarios or any time we’re confronted by something undesirable. It’s no different when pain shows up.
Pain is upsetting, right? So it’s logical that we would feel alarmed, concerned and start thinking about it. HOW we think about it and WHAT we think about it determines what happens next. (And…what if pain didn’t have to be upsetting? What if we welcomed it as an intelligent message from our body? More on that later).
I let fear control me for 8 years!
I imagine there’s not a single person on this planet that decides consciously “I’m going to let this here fear control me.” We don’t do this on purpose. I certainly wasn’t aware of what was happening to me until I clawed my way out and looked back at myself with a new awareness. And now…
I believe most of what stopped me from running for 8 years and hiking for 6 was a mental construct. Did I have knee pain? Abso-freakin-lutely!
This wasn’t an overnight mental construct and pain helped create it.