rbibbs
04-25-2004, 05:49 PM
How much activity, how much inactivity, how much pain, is too much? The answer is what Bob Dole said when MTV asked him the Bill Clinton question, "boxers or briefs?"... depends. :lol:
What makes me an authority on this? Naw, I'm not writing as an 'authority', just to be provocative. The real answers and insights will have to come from the readers. I do deal with all three of these "too muches", all the time. My upper body is almost always on the verge of overtraining. My legs are almost always on the verge of developing tension-chains if they're inactive for no longer than the time between commercials on standard cable channels. And as a 'skinny old guy' training BJJ several times a week, there are very few times when 'something' doesn't hurt.
For all 3 of these parameters, I believe "too much" is achieved when dysfunction results. But now we're back to the 'joke' answer above, "depends"... because the line between function/dysfunction, between comfort/discomfort, is subjective and individual. The nervous system has an innate threshold of pain at which it inhibits further exertion. Now, we seem to have 'simplified' the topic to "what level of pain causes you to alter your intended behavior?". The ideal conscious response 'depends' on how we arrived at dysfunctionality.
Since this tends to be an athletic forum, we're probably most familiar with overuse dysfunctions. With muscle-overuse pain we can probably continue to train, although it's questionably advisable since the pain is there for a reason. It will only take 2-5 days; let it subside. Enough muscle pain to inhibit exertion signifies localized damage. The damaged area won't get any stronger by continuing to exert it while it's still damaged, and the undamaged areas will be limited by the damaged area in what they can accomplish. Connective-tissue overuse (tendon or joint strains) which produce a level of pain that inhibits exertion should be completely resolved before resuming active training. With connective-tissue overuse, we need "active recovery"... unloaded motion... to maintain flexibility during healing, and to avoid acquiring lasting neurological inhibitions to motion we'll have to 'unlearn' later.
Pain/dysfunction from underuse is the most insidious. It encourages us to do more of what got us in trouble in the first place, not moving. It takes patience, sensitivity, and determination to resolve. This morning watching the Sunday TV pundit shows, every time I stood up to walk my left hip just wasn't cooperating. A transient weakness/sleepiness in the abductor created enough pain to where all the nearby muscles wanted to shutdown and take my leg out from under me. But after 3 awkward, hobbled steps it would 'wake up'. I had to be patient with it... not force it and expect it to work anyway (I would have fallen)... and not sit back down and give up (it might still be 'asleep' eight hours later). It's fine now, thanks... my legs are just like that... any length of immobility is enough to make them dysfunctional. If I were to succumb to that tendency, I'd be in a wheelchair. If I tried to ignore it and walk 'as if it weren't happening', I'd be in a cast with a broken hip from falling. We have to be able to distinguish transient inactivity dysfunctions and 'coach' them back to functionality.
Misuse dysfunctions are the most complex to diagnose. A misexertion in the shoulders can pinch the brachial nerve, and the result is very difficult to distinguish from a torn rotator cuff. I've been "professionally misdiagnosed" with exactly that condition. Unloaded motion 'as close as you can get' to the dysfunctional range seems to be the best protocol. I've had brachial plexopathy 3 times. The first time, it lasted the better part of 2 years. I let it 'make me inactive' and didn't attempt to move. It took another 2 years after the nerve actually came back online to recover the full range-of-motion in that shoulder. The second time, I continued trying to move it and it only took 6 months to fully recover. The third time, barely 6 weeks, as my ability to articulate and explore the dysfunction had improved a great deal by then (see "WW" and related materials). My conclusion from this has to be, if you're sidelined with a misuse dysfunction, don't ignore it... but as my surfer-buddy's doctor dad used to say back in 1970, "don't favor it". Do what you can, and your ability will expand back towards full functionality. Accepting dysfunction virtually guarantees that it will be with you for a long time. (Of course, acute trauma should always be referred to a medical professional.)
Conclusion? Just that musculoskeletal dysfunctionality has a spectrum of possible causes and a corresponding spectrum of responses we can use to expediate recovery. The better we can define and explore dysfunction, the sooner we can put it behind us.
What makes me an authority on this? Naw, I'm not writing as an 'authority', just to be provocative. The real answers and insights will have to come from the readers. I do deal with all three of these "too muches", all the time. My upper body is almost always on the verge of overtraining. My legs are almost always on the verge of developing tension-chains if they're inactive for no longer than the time between commercials on standard cable channels. And as a 'skinny old guy' training BJJ several times a week, there are very few times when 'something' doesn't hurt.
For all 3 of these parameters, I believe "too much" is achieved when dysfunction results. But now we're back to the 'joke' answer above, "depends"... because the line between function/dysfunction, between comfort/discomfort, is subjective and individual. The nervous system has an innate threshold of pain at which it inhibits further exertion. Now, we seem to have 'simplified' the topic to "what level of pain causes you to alter your intended behavior?". The ideal conscious response 'depends' on how we arrived at dysfunctionality.
Since this tends to be an athletic forum, we're probably most familiar with overuse dysfunctions. With muscle-overuse pain we can probably continue to train, although it's questionably advisable since the pain is there for a reason. It will only take 2-5 days; let it subside. Enough muscle pain to inhibit exertion signifies localized damage. The damaged area won't get any stronger by continuing to exert it while it's still damaged, and the undamaged areas will be limited by the damaged area in what they can accomplish. Connective-tissue overuse (tendon or joint strains) which produce a level of pain that inhibits exertion should be completely resolved before resuming active training. With connective-tissue overuse, we need "active recovery"... unloaded motion... to maintain flexibility during healing, and to avoid acquiring lasting neurological inhibitions to motion we'll have to 'unlearn' later.
Pain/dysfunction from underuse is the most insidious. It encourages us to do more of what got us in trouble in the first place, not moving. It takes patience, sensitivity, and determination to resolve. This morning watching the Sunday TV pundit shows, every time I stood up to walk my left hip just wasn't cooperating. A transient weakness/sleepiness in the abductor created enough pain to where all the nearby muscles wanted to shutdown and take my leg out from under me. But after 3 awkward, hobbled steps it would 'wake up'. I had to be patient with it... not force it and expect it to work anyway (I would have fallen)... and not sit back down and give up (it might still be 'asleep' eight hours later). It's fine now, thanks... my legs are just like that... any length of immobility is enough to make them dysfunctional. If I were to succumb to that tendency, I'd be in a wheelchair. If I tried to ignore it and walk 'as if it weren't happening', I'd be in a cast with a broken hip from falling. We have to be able to distinguish transient inactivity dysfunctions and 'coach' them back to functionality.
Misuse dysfunctions are the most complex to diagnose. A misexertion in the shoulders can pinch the brachial nerve, and the result is very difficult to distinguish from a torn rotator cuff. I've been "professionally misdiagnosed" with exactly that condition. Unloaded motion 'as close as you can get' to the dysfunctional range seems to be the best protocol. I've had brachial plexopathy 3 times. The first time, it lasted the better part of 2 years. I let it 'make me inactive' and didn't attempt to move. It took another 2 years after the nerve actually came back online to recover the full range-of-motion in that shoulder. The second time, I continued trying to move it and it only took 6 months to fully recover. The third time, barely 6 weeks, as my ability to articulate and explore the dysfunction had improved a great deal by then (see "WW" and related materials). My conclusion from this has to be, if you're sidelined with a misuse dysfunction, don't ignore it... but as my surfer-buddy's doctor dad used to say back in 1970, "don't favor it". Do what you can, and your ability will expand back towards full functionality. Accepting dysfunction virtually guarantees that it will be with you for a long time. (Of course, acute trauma should always be referred to a medical professional.)
Conclusion? Just that musculoskeletal dysfunctionality has a spectrum of possible causes and a corresponding spectrum of responses we can use to expediate recovery. The better we can define and explore dysfunction, the sooner we can put it behind us.