Monday, March 16, 2015

Not All Pain Is Gain

We've all heard the slogan that pain brings gain or something along those lines.


This is true. But only to a certain extent. Because it's also often malarkey. In more than a quarter century of regular daily exercise, I have gotten very used to having sore muscles. That's the kind of pain you push through to get some gain. Better muscle tone, better fitness, etc. But not all pain results in gain.


For the record, I've never liked the related slogan that what doesn't kill you makes you stronger. You may miss winning the Darwin Award because you happen to survive engaging in some idiotic activity, but this does not automatically make it a good thing.

We've also all heard the slogan that it's important to listen to your body because it is always sending you messages about what it needs for optimal health.


Of course, sometimes (frequently?) our bodies send us messages saying that they need donuts and ice cream. So maybe our bodies are habitual liars. Or perhaps they're sending messages in some kind of code that we need to decipher.

I can imagine tiny officers sitting at monitors in the brain's darkened command center with the commander peering over their shoulders.
Operator: Message coming in, sir.
Commander: What does it say?
Operator: Just a moment ... deciphering. It either says that the perfume of the girl passing by is so overpowering as to be gag-worthy or that the subject finds her attractive. Possibly both. What should we do?
Commander: Send a wave of mild nausea. That should work either way.
I recently discovered that when it comes to pain, maybe it actually is good to listen to one's body. A few weeks ago when we were experiencing early spring in February, I took the dog out for a romp on some nearby trails. It seemed like an ordinary but somewhat vigorous walk through the woods, something we've done many times. As far as I recall, nothing unusual occurred.

Later that evening the command center upstairs started getting the message that my left calf was much more sore than my right calf. I'm used to having sore calf muscles, but this felt unusual. In fact, as I walked from a meeting that night I felt like limping.
Command Center: Something's not right with your left calf. You should treat it. Maybe some ibuprofen or muscle relaxer. Check for swelling. Maybe ice it down.
Me: Of course something's not right with it. It's the left calf. Duh! Besides, I've had worse. It's only a flesh wound. I don't need no stinkin' drugs. I'll sleep it off and it'll be fine in the morning.
I slept decently. Then I stepped out of bed onto my left calf and found that the soreness I had felt the previous evening had intensified overnight. I figured that it would start feeling better during my cardio workout, all while the Command Center was sending warning messages.


Not to be deterred, I soon began my regular cardio routine. Not long into my routine I stepped off my low tech stair stepper (homemade from 2x6 boards) and suddenly felt stabbing pain shoot through my left calf.
Command Center: See, we told you. Now you've done it!
Me: Ummm.... OK. That really hurt. And it still hurts every time I step on it. But wait, I can mostly avoid the pain by stepping differently. So it must be OK for me to keep working out, as long as I step carefully.
Command Center: You need to stop and do some rehab on that muscle or you're going to make it worse.
Me: La, la, la, la.... I'm not listening!
I limped for the next few days and modified my workouts to minimize pain. Eventually the calf started to feel a bit better. Nine days after the original stabbing pain I got up in the morning figuring that I would finally be able to take the dog for a serious walk that day.

As I started my cardio workout I figured that since I was feeling much better I could be a little less careful than I had been. Oh, I was still taking care to avoid causing twinges of pain. But I was back in my manly form as I exercised.

Until it felt like something tapped me on my left calf. At the same time I heard an audible pop! resound from inside my calf. I curiously thought, "That can't be good." I didn't entertain that thought for very long because I was suddenly assailed by a sharp shooting pain that made the pain from nine days earlier seem like child's play. It took me to my knees, prematurely ending my workout.
Command Center: See, told you so.
Me: Shut up. I'm going to go take some anti-inflammatory drugs.
After consulting the internet, the source of all truthiness, I discovered that I had experienced a calf muscle tear, likely class 2, and likely only because I had a class 1 tear that I failed to take seriously. "You may think you've just been hit in the leg and potentially hear a "pop." There is sudden pain at the back of the calf." Oh yeah, that's exactly it.


What do I do next? "Then you’ll experience pain, swelling or bruising in the calf muscle, and you’ll have difficulty walking properly or standing on your toes." Difficulty walking properly, check. Holy cow, I can already see the swelling. "As with most soft tissue injuries the initial treatment is RICE - Rest, Ice, Compression and Elevation."
Me: I've got to walk around a university campus today. How am I going to elevate the leg?
Internet: "Anti-inflammatory medication ... may help reduce your pain and swelling."
Me: Ha! I did something right!
Internet: "However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding."
Me: What? Wait! Nooooo! I already took it more than half an hour ago. It's already being absorbed. I couldn't get it back out now even if I was into bulimia.
Command Center: (Snicker.)
A sadder but wiser me reads, "Full recovery takes approximately 4 to 8 weeks with good rehabilitation." I didn't want to lapse into inactivity for that long. But I really, really didn't want to make the injury worse. So the next week was filled with lots of limping, compression, elevation, etc. I altered my workouts to focus on the upper body.

The injury produced an impressive amount of bruising and swelling. I still used firm compression during the second week because I still had some edema going on. When you have an injury in your leg the excess fluid from bleeding tends to pool at the lowest point, in your foot and ankle. Compression, heat, and elevation can help with that problem. I was surprised that the injury involved my ankle and the back of my knee.

More than two weeks after the last injury I now appear to be on my way to recovery. I was able to take the dog on a very mild walk around the block yesterday without limping. The swelling is mostly gone but I am still using light compression. There is still some fairly constant discomfort accompanied by twinges of pain that happen when I step or pivot the wrong way. Little by little I am stretching the muscle as advised by physical therapists.

It turns out that it's not always wise to try working out in the face of the pain, regardless of what the old high school coach stereotype would say. Indeed, it turns out that when you feel pain your body is trying to send you a message. In this case, "Stop that!" I should have listened to begin with.
Operator: I think he's starting to get it, sir.
Commander: Very good. As long as he's paying attention, why don't you put in an order for donuts and ice cream. See if you can get some warm Krispy Kremes.

1 comment:

Karl Lockett said...

Very interesting post. Regarding this "Then you’ll experience pain, swelling or bruising in the calf muscle, and you’ll have difficulty walking properly or standing on your toes." Difficulty walking properly, check. Holy cow, I can already see the swelling. "As with most soft tissue injuries the initial treatment is RICE - Rest, Ice, Compression and Elevation." Sometimes it's already plantar fasciitis, and you need a podiatrist to treat your pain, especially heel pain. Learn more about plantar fasciitis