November
2

The Pain-Injury-Surgery Cycle

When working with people at my facility I always need to help them get over the “no pain, no gain” myth. Actually, I guess I should say that I need to help them understand it better. You see, muscular “pain” and discomfort are alright and needed – if you are not uncomfortable you are not pushing hard enough to elicit a change in the body.

However, joint pain is a totally different thing. Joint pain is a sign that your body is not moving correctly and is much like the “check engine soon” light has gone on in your car. You can ignore it for a while but a break down is going to eventually occur.

So, gutting through an exercise when your knee, low back or shoulder are talking to you is not the type of “no pain, no gain” you want. The vast majority of surgeries and rehabbing going on for mountain bikers are not acute, traumatic injuries like those that occur when you crash. Most of them followed a pattern similar to this:

Step 1: You notice a little pain in an area while you are riding or working out but it goes away after you get into your workout a bit.

Step 2: The pain doesn’t go away as fast and now it tends to linger for a while after training or riding, sometimes for a day or two afterwards. You can still work through it; it is just a bit more annoying now.

Step 3: You have to pop a few Advil before training or riding in order to keep the pain under control. Without some sort of pain reliever you just couldn’t train or ride are hard. You are also much more likely to need a day or two off after a long ride or hard workout to let the painful area recover.

Step 4: You are forced to go see your doctor after the pain relievers stop working as well and you can not get through a ride or workout with some serious consequences. Your doctor says that you have some sort of tendonitis or bursitis or some other “fill in the blank-itus”. You get some physical therapy prescribed and you do the work but it doesn’t seem to get a whole lot better.

Step 5: You are now scheduled for surgery. Maybe the pain just got so bad you couldn’t take it any more or a minor impact injury caused something to “break” but you now have some serious damage to a key joint that is going to impact you for the rest of your life.

This process may take years to get through but the sad part is that a lot of active people tend to go through this cycle a couple of times in their lifetime. Think about how many people you know that have had a knee “cleaned up” or a shoulder “tightened”. This speaks volumes about the poor level of understanding about preventing these injuries in the first place.

With rare exception, bad movement causes pain. In addition, where the pain shows up is usually not where the real problem is. Look at the joint above or below the area that is painful for dysfunction and you will find the real culprit. The low back is a great example of this – low back pain is not caused by a “weak” low back but instead from poor hip function and mobility. Ignoring the hips role in low back pain will never take care of the problem and will result in a lot of pain relieving drugs or, God forbid, surgery.

Going into the off season you have a golden opportunity to address the bad movement that causes you pain and holds you back. Don’t spend the next few months ignoring the pain and simply popping some pain relievers or just sitting on the couch to “let it rest”. Work on your mobility and core strength. Clean up your movement and get strong on that movement.

The secret to riding faster and longer each year is to address things when they are still in the Step 1 or Step 2 phase of the pain-injury-surgery cycle. You’re stuck with that body for a long time so take good care of it – you’ll be stoked when you’re 70 and can still be active and have fun!

-James Wilson-

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James Wilson
Author and Professional
Mountain Bike Coach
James Wilson