What’s the deal with chronic pain?
Article by Graceville Physio Matt Fowler
What’s the deal with pain? Why have I had it for so long? Why am I being told to move even though I have pain; shouldn’t I let it heal first? Pain is a very curious phenomenon, and over the long history of humankind the brain has used pain to develop very complex ways to keep the body protected.
Q: So what exactly is pain?
A: Ultimately, pain exists to help the body. It warns us when we are in danger of tissue damage and helps us avoid whatever risky thing we’re doing.
Q: What causes pain?
A: Pain is a sensation that exists in the brain, not the body. Now this isn’t to say that your pain is ‘all in your head’, but what it means is that just because you’re in pain it doesn’t necessarily mean that your body is being harmed. Generally speaking, pain starts as an unconscious signal in the body called ‘nociception’.
Q: How are nociception and pain different, and why is that important?
A: Nociception is the unconscious signal that the nerves in your body experience anytime they are being damaged (or are at imminent risk of being damaged!) These nociceptive signals can be produced by extreme temperature changes, chemical damages, or mechanical damages to the tissues. These signals travel from your body to your brain where an unconscious decision is made to say whether or not you need to be made aware of it. If your brain decides you need to know about then congratulations, you’re in pain!
Q: Why would I ever not want to be aware of nociception?
A: Nociception can be helpful, but your brain is constantly filtering through these signals so things that aren’t actually dangerous to you don’t need to be brought to your attention. In some cases this filter can become weak, and then things that /aren’t/ painful become painful, and things that /are/ painful are worse! A sunburn is a good example of this; your skin can become painful to touch despite it not being harmful for you to do so. Our bodies go through a healthy amount of wear on a routine basis anyway, so it would be simply awful to have to experience all of that.
Q: What is chronic pain?
A: Chronic pain is a very complicated problem, and usually it relates less to what your tissues are doing, and more to what your brain is doing. Just like with the sunburn analogy people with chronic pain become extra sensitive to both nociceptive and non-nociceptive sensations, except unlike the sunburn it doesn’t go away after a week and some aloe vera. The pathways in the brain shift in chronic pain, putting all these signals that would have been ignored into the cerebral spotlight!
As previously mentioned, chronic pain is complicated, but there is some light at the end of the tunnel. Research shows that physiotherapist led programs can help improve not only pain in these conditions, but also overall ability and quality of life . Ultimately, chronic pain is a team effort; it’s important that someone with chronic pain finds a healthcare team that suits them so they can have the support and help they need in their journey.
The first step can sometimes be the hardest, so if you have any questions about your pain then have a chat to your physio today and see what they can do for you.
The role of physio in Golf
By Graceville Physio Michael Christensen
Golf has seen a boom in popularity during the COVID-19 pandemic. The attraction to the game undoubtably varies from person to person, but for anyone that loves to get out on the course, there is no better feeling than a perfectly struck golf shot. Despite golf being considered a low-injury-risk sport, most people who play regularly have experienced some form of ache or pain.
What are common golf injuries?
The game of golf does not come without its risks of injury. Some of the most common complaints by golfers are pain in the lumbar spine, shoulders, elbows, and wrists.
What has caused my pain / injury?
Most injuries in golf can be associated with the repetitive nature of the swing. We place huge forces on our body as we try to maintain our tilts and bends while generating large rotation forces which help us to hit the ball (or try to) long and straight. In many cases our bodies can withstand these forces, although sudden increases in playing times or returning from time off can decrease our body’s ability to withstand loads, which can cause overuse injuries. Additionally, deficits in joint range of motion, strength, endurance, motor control, and conditioning may all be contributing factors. 1
How can Physiotherapy help?
We will identify the underlying factors that may be contributing to your pain. We will undertake a comprehensive functional movement assessment, as well as specific joint range of motion and strength assessments. In the short to mid-term the focus is on settling your pain and addressing specific injury rehabilitation. In the longer term, we will formulate individual exercises specific to your needs aimed at preventing future injury and improving your performance.
How can I hit the ball further?
While a good swing coach is always a good starting point to ensure your technique is optimal, Physiotherapists can prescribe golf specific exercises that can improve your strength, power, force output and control that can improve your clubhead speed and carry distance. 2, 3
I am interested, what is the next step?
If you are feeling any type of discomfort before, during, or after your next round of golf, book in to see us. Our Physiotherapist Michael Christensen can assist with injury and pain management, strength and conditioning, and helping you get the best out of your game. We have convenient online bookings at www.gracevillephysio.com.au or call 3278 1186.
1. Steele, K. M., Roh, E. Y., Mahtani, G., Meister, D. W., Ladd, A. L., & Rose, J. (2018). Golf Swing Rotational Velocity: The Essential Follow-Through. Annals of rehabilitation medicine, 42(5), 713–721. https://doi.org/10.5535/arm.2018.42.5.713
2. Uthoff, A; Sommerfield, L.M., & Pichardo, A.W. (2021). Effects of Resistance Training Methods on Golf Clubhead Speed and Hitting Distance: A Systematic Review. Journal of Strength and Conditioning Research, 35(9). doi: 10.1519/JSC.0000000000004085
3. Coughlan, D., Taylor, M. J. D., Wayland, W., Brooks, D., & Jackson, J. (2019). The effect of a 12-week strength and conditioning programme on youth golf performance. International Journal of Golf Science, 8(1).