In the last couple of weeks, I have had several patients ask me, “Why did I suddenly start hurting? I didn’t do anything different than I normally do, but activities that have never hurt before are now causing me pain.”
Often, the answer is that we’ve gotten stuck in a movement rut and it has reached a critical point where it has now begun to cause pain. Imagine for a moment that you set down a house in the middle of a field with no roads. The first time you drive to town, you may knock down a few weeds and someone will see the path, but those plants will likely be back to normal in a few days. However, if you drive that same path every day, those plants will eventually die and there will be a dirt path. As you continue on, you may start to wear grooves in, and eventually the ruts may become so deep that they may eventually cause damage to your vehicle.
This can also happen in our bodies. Certain movement patterns are fine when used occasionally while you are also doing many other movement patterns. However, if you use the same one over and over again, some muscles may eventually become short and tight and others become long and weak. This is a process that takes a long time, so you may not see the wear and tear as it happens, but your “ruts” are getting deeper, and eventually they will cause you pain. Sometimes there is an incident that causes the pain to get worse, like moving a certain direction or lifting something the wrong way (in our rut analogy, it would be like a rain storm making those ruts significantly worse). Other times, the normal wearing down on the body eventually leads to a point where something is injured.
Unfortunately, there are many areas in our lives where we are stuck in movement ruts or repetitive movements. One of the most notable ones is all of the sitting that we do in offices, on commutes, and behind screens. Others are the things that we really enjoy, but that are repetitive. These are activities like golf, cycling, running, lifting. We often can’t get away from our office and commute duties, and we don’t want to give up the repetitive sports and recreational activities that we really enjoy. My recommendation is not that we have to get rid of all of these things, but that we first need to be aware of them. Then we can see what we can do to minimize some of the problems.
One of the examples from my own life is that I like to ride a bike to stay in shape, both in the gym and (better yet) outside when my schedule allows. However, I know that cycling is a repetitive motion, so I know that I need to think of ways to offset that in the rest of the day. On a bike, I am more or less in a seated position. On days that I am riding, I am going to look for ways that I can avoid more sitting, especially sitting that puts my hips and knees at the same angles as the bike (e.g. sitting on a chair). I will stand to work on my notes and even to work on my patients. If I have to sit, I’ll try to sit on the floor so that I am using the joints at different angles. I will also try to stretch out the muscles that are particularly tightened up from being on the bike.
Sometimes we get stuck in our movement ruts because we are not thinking about what we are doing and how that will affect our bodies. With a little thoughtful planning, we can find ways to get out of the rut before there is pain.
Monica Clinesmith, DPT, is a staff physical therapist at Great Moves. She graduated in 2005 from the University of Iowa. She is Level 2 certified in dry needling, and is also certified in the Functional Movement Screen.