Jan 2017 07

Chain reaction

By: Dave Wheeler

Where we feel pain isn't necessarily the site of injury - or at least  not the original injury that's responsible for the problem.

You might notice that a physio, sports massage therapist or osteopath will often ask a lot of questions. Whilst this might be frustrating when all you want is the pain to stop, what we're doing is trying to make sure that we're treating the root cause and not just the symptom.

2 cases that  I had over the Christmas period illustrate the point.


The woman with "Glute strain"

A lady came into the treatment just before Christmas complaining of persistent debilitating Glute pain. It had been going on for months and was stopping her  from keeping to her training schedule. She'd already seen a couple of physios (one of whom  was in Harley Street) and  one of the country' best known Sports Massage Therapists. No pressure then!

The problem was really affecting her lifestyle and she was quite insistent that she wanted  to get it sorted. 

Hidden away in a lot of detail about her training and her injury,  she made a throw-away comment  about  her hamstring "going"  about 3 months before her glute.

Hamstrings attach to bone at the bottom of the pelvis, which of course is  where the Glutes attach. Although the two are separate muscles with separate functions, the fact that they're next to eachother in a line called the superficial backline means that one can easily be affected by dysfunction in the other.

I prodded around in her upper hamstring and sure enough, there was a bloody great muscle tear that was a few months old. It  felt like feeling a ploughed furrow in the field of muscle.

What had happened is that  because the woman had kept up her exercise regime despite the torn muscles, other nearby muscles had helped out in order to keep her going. The Glute is right above the injury site and actually does a bit  of the same function of the hamstring in terms of providing power to the legs to propel us forward when we run or walk.

Now her Glute was being overused. After a while it gave out to a kind of mild RSI. 

The previous treatments had unfortunately just treated the symptom - so whilst she felt better for a bit, once she got back into her usual activity pattern,  the muscle overuse occurred all over again.

After such a long time with the hamstring strain, the only thing I could do was to break down the scar tissue around the original tear (which hurts like hell) and then get her to ice religiously and to rest for 48 hours.

2 weeks later the lady came back for a follow up appointment and was pain free, which was a result!


The man with the Achilles tendon pain

Less of a result was the 80 year-old man that I met who had pain in his Achilles tendon.

It turned out that he'd not pulled into a parking spot far enough, so instead of getting back into the car and moving forward he decided to push it. It's not surprising really that he then tore a muscle in his calf. Because he carried on with life and didn't  rest or ice the injured calf, the Achilles, which is an extension of the calf muscle became overused - another case of RSI, if you like.

In this case, it would have been too painful to break down the original scar tissue which was about 6 weeks old, so the only thing to do was to rest and allow things to return to a near-normal state. The older you are, the longer this will take.


The moral of the stories

In both cases, if they'd have sorted out their initial injuries quickly, things wouldn't  have developed and spread. Thinking that they'd just "push through" meant that they each ended up with months more pain.

If you injure yourself  rest it and ice it. If it's still not better after 48 hours go see somebody that can help.