Permission To Move
Quite a bit of my time with my patients is spent not just explaining how best to move, or that they need to move more often, (which is a crucial point in itself), but actually giving them ‘permission to move’.
Now what I mean by that is that I reassure and encourage them to ‘move’ at a time when they are wary or actually downright terrified to do certain movements/activities etc.
Often when people have pain they will (understandably) avoid or do as little a possible to bring on or exacerbate their pain. Not many of us really like pain, unless we fall into the category of masochism or are just trying to be full on hardcore!
But continuing to move and doing what you can, little and often, is so important in maintaining your strength, mobility, CONFIDENCE and resilience whilst your body recovers.
Your body is more robust than you think and falling into that trap of fear about moving is something I do my best to steer my patients away from. Even if you feel worse pain as you move during normal activity, e.g. walking with back pain, you are unlikely to cause any harm at all and have mostly benefit to gain. It might just take a lot of perseverance and be unpleasant at the time.
Muscle or joint pain can definitely be eased and helped with more movement.
A very recent example of this for myself was a tight, twingy knee that was telling me it didn’t really like bending much and almost ‘threatened’ me with ‘flaring up’ a bit.
My response………Ok let’s do some gentle mobility exercises, some squats and nice stretches……my knee’s response…….hmmmm feeling easier and happier thank you!
In nearly all cases of muscle/joint pain, it is best to keep moving regularly, as opposed to lots of rest and sitting about. That said, a certain degree of doing things more mindfully and avoiding more strenuous activity whilst you are in the worst phase of pain is a good idea, and allowing rest periods when needed are certainly advised.
It’s important to remember that when it comes to the majority of cases of musculo-skeletal pain (with no pathological origin), the degree of pain does not necessarily mean that there is damage being done internally.
I make the distinction from musculo-skeletal pain and other types of pain. For example, continuing abdominal pain is not to be ignored and ‘worked through’. It needs quick investigation with a doctor!
There are also other exceptions where continuing to try and move as much as possible is NOT recommended, such as undiagnosed hip fracture, or recovering from major surgery.
Also, there are some cases when a joint is so badly worn that the owner of that joint will only really achieve relief through joint replacement, but keeping active until that happens is still a benefit in other ways.
One of the sad things that I get to hear about with some of my patients is that once upon a time another practitioner/family member/their mate down the pub etc said “oh you need to just rest and not do that activity (sports, hobbies etc) anymore”. Embarrassingly, in my early days as an osteopath I have been guilty of being that bad advice.
Instead, it is often better to get that person back to doing what they love or need to do, unless medically contraindicated.
And yes, sometimes a patient’s hobby or occupation can play a part in causing their pain levels, but that is a whole new conversation!
Fortunately I have ‘seen the light’, and with what we know and understand better about pain and the importance of movement, most osteopaths know to encourage movement, not discourage it.
We do of course consider each and every patients capabilities, beliefs, preferences, and current health status in our recommendation of what level of movement based activity is suitable.
But……in nearly all cases I give those patients who have felt that they MUSN’T or CAN’T move…..yes you’ve guessed it……..‘permission to move’.