Is your ‘normal’ enough and how do you know?

After any injury, pain or illness we experience, we want to get back to normal. Our natural healing system plays a critical role in any of these scenarios and there will always be a minimum amount of time1 that it takes for your body to recover, tissues to heal, to regain movement, to regain confidence and return to your normal functional ability. People seek help when they are injured or in pain as they don’t know what to do, how long it will take, how to regain their normal function and how to avoid it happening again. But is just regaining your normal enough. Was your normal not strong enough or fit enough to avoid getting injured?
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Our Brisbane Physiotherapy Clinic, services areas including: Brisbane, Tarragindi, Mount Gravatt, Holland Park, Rocklea, Yeronga, Annerley, Camp Hill, Carindale, Coorparoo, Salisbury, Sunnybank, Greenslopes, Seven Hills, Acacia Ridge, Indooroopilly, Woolloongabba, etc.
Because of our expertise in hip conditions, dance injuries and performance, and hypermobility, we also have people visiting us from all over Queensland, Australia and even international visitors. We also have a telehealth service for remote patients.

PAIN THAT DEVELOPS FOR NO APPARENT REASON
The factors that contribute to the development of pain in any individual is as wide and varied as individuals themselves. You may be fit, strong and healthy but you experience pain after an accident or unexpected incident like a motor vehicle accident or dancing at a wedding after a few drinks. When we analyse why people have experienced pain or injury, we look for the factors that could have been avoided and factors we can change to reduce the chance of recurrence. In the above cases it is not intrinsic {internal} factors that caused the development of pain but external factors e.g., the car behind you not stopping or the consumption of one too many martinis! Sometimes we have no control over these external factors and it’s just bad luck. A very fit, strong and healthy athlete can get injured because of the nature of the sport – high velocity & high risk and this is why sports teams have more money than any other organisations spent on sports medicine but still have high injury rates. The athletes are pushing the limits of human performance.
The majority of pain scenarios we see in clinic are not in people who are as fit, strong and healthy as they could be. Everyday people do not generally train just for day-to-day life. Pain or injury can develop seemingly from just going about your daily living. Back pain is one of the most common musculoskeletal condition reported to general medical pracitioners2 and normally from just day to day living. “I hurt my back packing the dishwasher”, “I just started getting hip pain on one of my normal walks I’ve done hundreds of times”. It is these scenarios where it is fair to question your normal - your normal fitness, your normal strength and your normal state of mind. As we age our normal does naturally change. Sarcopenia is a horrible sounding word but important to know as we age - muscle size reduces and fitness and physical capacity declines. Although nature plays this card, we don’t have to just let it all go. As one of my 13-year-old patients quipped one day after I showed him an exercise and groaned getting off the floor – “I’m getting old” I said. He replied without pause, “don’t use that as an excuse – you’re just getting unfit!” Ouch! – and he was right…

How improving strength and physical capacity can help pain and reduce injury risk
When you seek professional assistance for your pain or injury it is highly likely that in addition to a diagnosis and analysis, education about your situation, maybe some manual therapy treatment and advice on how to manage your recovery - you will also be given some exercises to do. Exactly how these exercises change things is a hot topic in our physiotherapy circles, but the general aim is always the same - to improve your functional ability and minimise the chance of your pain recurring. A primary aim of many exercises is to make you stronger.
Strength is the measurement of the ability to produce force and links to my favourite word in rehabilitation – capacity. Oxford says capacity is “the maximum amount that something can contain” OR “the amount that something can produce” If your capacity is not enough to withstand day to day load, repetition or stressors, then something will give. If your capacity is lower than it could be, this could be why you suddenly start to get pain for no apparent reason.
Measuring strength and physical capacity and tracking gains
Measuring strength is easy. With access to modern technology, we can quickly measure individual movement strength (like lifting your arm or straightening your knee). We measure, design a program to make you stronger, then remeasure after a time to check. More complicated measurements can be also done using advanced technology such as the AxIT system. With this versatile hardware (push device, pull device and force plates) linked to a variety of testing protocols, we can measure such things as your maximum lift, balance of a simple squat, jump strength, power and calculate more accurately if you need more strength, more power or more endurance. If you are not an athlete then this equipment is very useful for helping you not just get back to normal -but make your normal better.

“don’t just get back to normal - make your normal better”
Does more strength mean you will reduce the risk of injury? Absolutely yes! In every sport athletes train to improve their capacity to be able to produce more force and withstand the forces put upon them. For day-to-day life, it makes sense that improving your strength, thereby improving your capacity will reduce the risks of those pains and injuries that sneak up on us and affect our enjoyment of living. Aim to be able to lift a little more than you usually need to (washing basket, shopping bags), aim to be able to walk further than you usually need to (commute to work, shopping trips) and aim to be just a bit fitter, a bit stronger and have a bit more capacity. This will help you not only do the things you need to, but also enjoy the things you want to do. If you are fitter and stronger – if you have made your normal better – then not only will you be able to do more, but you’ll have more chance of withstanding those unexpected moments in life when greater capacity is needed to avoid an injury.
Do you you need help recovering from an injury? Improving your performance? Or just getting back to doing the things that you love? Visit us at PhysioTec, and let one of our physios assess you and provide you with a personalised program to help you get on-top of your condition, and feel at your best.
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Author
This blog was written by David Peirce, one of our senior physiotherapists who has over 30 years of clinical experience and a special interest in the Performing Arts, Sports and helping his patients return to the things they need and love to do. You can read more about Dave here.
Other Blogs by David
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Neck and Shoulder Pain in Musicians: Causes and Treatment
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Is your ‘normal’ enough and how do you know?
After any injury, pain or illness we experience, we want to get back to normal. Our natural healing system plays a critical role in any of these scenarios and there will always be a minimum amount of time1 that it takes for your body to recover, tissues to heal, to regain movement, to regain confidence…
Music is Physical – The Importance of Exercise for Musicians
As a musician, you are likely to spend much of your time practicing. But how much time do you devote to keeping fit? Everyone knows that exercise is good for a person’s health, however did you know that fitness and exercise for musicians can also improve your performance? In this blog, we discuss being fit…
REFERENCES
1. Soft Tissue Healing and its Impact on Rehabilitation Peggy Houglum Journal of Sports & Rehabilitation 1992 https://doi.org/10.1123/jsr.1.1.19
2. What are the most common conditions in primary care? Finley et al 2018
Can Fam Physician. 2018 Nov; 64(11): 832–840
3. Lauersen at al 2018 Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis https://bjsm.bmj.com/content/52/24/1557