If you suffer a pain injury whether it be an injury to the muscles, ligaments, bones or joints, the body adapts to that pain problem and changes the way we move. For example, the patient with knee pain who has limped for several months, or the patient who subconsciously stops rotating their head to the left side due to pain.

Often when pain has settled, we find the patient has continued to move differently, take the patient with a limp, when the patient is asked “Why are you limping”? They are often unsure why as they have no pain but still limp and so this can often be an adaptive movement pattern which potentially could lead to chronic changes in the way we load our bodies as well as chronic pain months or even years down the line. 

The altered patterns of movement have been linked to brain activity in that short periods of acute pain show a reduced level of activity in the brain where movement is controlled. Whereas more long-term pains relate to a higher level of brain activity which is associated with learning a new activity or from the pain point of view the brain learning new ways to complete activities of daily living because of pain avoidance.

So, can this help or hinder? In the initial stages, pain changing movement can help with shorter bouts of pain and as pain subsides the body will revert to its norm. More long-term pain causes the changes in movement to be more ingrained and so causing a change of loading to structures which could cause long term adaptive changes and chronic pain.

Studies have shown with patients who have pain for more than three months change the way they move and alter muscle activity. The significance of this is that this evidence would suggest that if the body moves differently even after pain has resolved and this could predispose patients to further episodes and chronic pain.

Our aim here at the clinic is ultimately to resolve patients pain problems. All the evidence demonstrates that trying to correct altered movement patterns, whilst in pain or out of pain are so important in the prevention of chronic and reoccurring pain problems

So often even when you are pain free your Physiotherapist may give you more homework in the form of home exercises to promote normal movement. 

by Steve Briggs – SB Sports & Physiotherapy (Shifnal)