More detail on RPE, and questions about perception

[Connie Brown]

Patti and I were chatting about RPD and she came up with what I thought was a great idea.

First idea: to explain each level of RPD in more detail, similar to the way RPE is in the CT4CS book.

RPD 10: worst pain you ever felt; passing out from pain
9: intense pain
8: severe pain
7: pain that lingers
6: definite pain
5: twinge of pain
4: moderate discomfort
3: mild discomfort
2: twinge of discomfort
RPD 1: no discomfort

and where does a doctor visit come in?

Second question: perceptual distortion. I know our RPD scales are unique to the individual, but when and how can we trust our perception. One extreme would be the overexerciser who loves the high so much that he or she works right through torn muscles - is an RPD 3, masked by a painkiller high, a helpful measure? On the other extreme, the underexerciser so unused to exertion that low discomfort feels like more.

[Pattimeow]

Connie,
Thanks for bringing this topic over here. This is a real struggle for me. I feel confused, concerned, and scared. So hopefully discussing this will help me sort it out, and maybe help others as well.

According to the chart you laid out, my pain in my triceps the other day would have been a 7/8, but in my log I recorded it as a 4. I thought that an RPD of 5 meant you needed to go see the doctor and it didn't feel that painful at all.

This RPD chart that you have made, is that now what I should adapt to?


perceptual distortion. I know our RPD scales are unique to the individual, but when and how can we trust our perception. One extreme would be the overexerciser who loves the high so much that he or she works right through torn muscles - is an RPD 3, masked by a painkiller high, a helpful measure? On the other extreme, the underexerciser so unused to exertion that low discomfort feels like more.

good questions Connie, I look forward to hearing what others think on this.

thanks,
Patti

[Jarlo Ilano]

Just some random input, from my experience in therapy...

Pain, exertion, and discomfort scales are as subjective as it gets.
There's an old running joke among therapists, about patients always saying they have "a high level of pain tolerance" (Get these folks all the time). Quite invariably, these are the folks who seem to focus on pain/discomfort the most.

I have also had some little old ladies (LOL is a great acronym! Thanks Connie), after surgeries and falls, grit and bear everything without complaint.

RPE's and RPD's are very personal. We often use a pain scale of 1 to 10 with 10 being the worst ever and you would go to the E.R. as the topmost. (I love the folks that say 11. :lol: )

To make this short, you can't "trust" your perception objectively, but your perception is all you have. Meaning it will always be appropriate for that day you feel it. Which I think, is part of the intuitive training that Coach Sonnon talks about. In the beginning you will feel more discomfort and as you progress, hopefully, it gets easier. But it doesn't make your initial RPD invalid.

Also, because of this subjectivity, RPE's and RPD's cannont be compared with other individuals. It is strictly a personal measure. As in Patti's comment that her rating of a 4 was equal to a 7/8 according to Connie's definition. I would say its the same, just scaled differently, because Patti's perception of 5 equals 9 or 10 on Connie's scale.

As long as you are consistent within yourself, your RPE and RPD scale is fine.

(Just my opinion, sorry if I interpreted the questions/comments incorrectly)

[JasonE]

Connie - great topic!

The following comments are my own opinions and no one else's. I'd like to hear what everyone else thinks about this, as it's a "fuzzy" area of CST that deserves some discussion.


First idea: to explain each level of RPD in more detail, similar to the way RPE is in the CT4CS book.

RPD 10: worst pain you ever felt; passing out from pain
9: intense pain
8: severe pain
7: pain that lingers
6: definite pain
5: twinge of pain
4: moderate discomfort
3: mild discomfort
2: twinge of discomfort
RPD 1: no discomfort

and where does a doctor visit come in?

Your scale is much the way I described it to the individuals I've used in CST case studies. It's a subjective scale that most people seem able to relate to. For beginners, I generally recommend not exceeding a 5 or so if they are injury-free. If they have a prior injury, I recommend that they don't exceed a 3-4.

As they become healthier, more competent in their practice and subsequently more perceptive and honest about their body's feedback, they may safely handle more intense discomfort. Coach Sonnon's record attempts at Mills are an example of this. :shock:

:arrow: A doctor's visit should follow any new, sudden sharp pains or decreases in ability to function. A doctor's visit is a must if both come together. :!:


Second question: perceptual distortion. I know our RPD scales are unique to the individual, but when and how can we trust our perception. One extreme would be the overexerciser who loves the high so much that he or she works right through torn muscles - is an RPD 3, masked by a painkiller high, a helpful measure? On the other extreme, the underexerciser so unused to exertion that low discomfort feels like more.

This is a very good question. We have people starting at all levels here, from Kelly (siameeser) on the high end of performance (2-finger pullups w/ a broken hand) and some other folks coming from many years of inactivity on the low end. It's fair to say that some of us would require hospitalization if we tried to keep pace with Kelly right away. :lol:

I don't know that Kelly's "3" is inappropriate for her... that's part of her education in CST. Perhaps she'll later decide that "3" is really a "5" or just a "1", just as Patti looked back and revised her own RPD. If someone practicing CST is able to honestly perceive their body's actual level of discomfort, they will become aware of how it affects them over time and learn how to best track it.

I think RPD is a holistic approach to accounting for both one's physical and emotional discomfort with exercise. The body may be willing, but if the spirit isn't there... it may not feel good, or it may even hurt. A person in perfect health and decent shape may record a high RPD because they simply don't like the exercises they are doing and lack motivation to exert the effort. As the spirit becomes willing and able to handle more emotionally, or even learns to enjoy the exercise... the body's complaints will seem less immediate, and may apparently vanish altogether. At this stage, the athlete needs to pay attention to their RPD between work sessions, as this is when they won't have the benefits of an exercise high to mask that awkward twinge in the hip or the numbness in their fingers...

[Arluk]

Wow I just had a really interesting though about comparing the pain scale to the decibel scale.

Basically the decibel scale is a measure of either an electronic or acoustic signal. Acoustically as the power of the signal is increased the loudness increases at an exponential level as compred to the level of power. It seems very similar with pain as the scale is ascended the need for response increases at an exponential rate. The difference between a 1 and a 2 is not too necessary to fret over, the difference between 7 and 8 is substantially more important and the difference between 9 and 10 means the overload and shutdown of the system. I need to do some research and some thinking, I'll get back later and give an update on my thoughts.

[Scott Sonnon]

Well done, Connie.
Marty, a solid potential article subject!

[Arluk]

I'm on it, I have some ideas that've been brewing ever since I stated using the 1-10 scale in my practice.

[imported_siameeser]

Funny this subject should come up now as I've been thinking how to chronicle and evaluate pain during my hand rehab. I like how clearly the suggested scale spells out pain levels. When it comes to pain, it's usually a zero or a ten for me...I'm pretty good at not paying attention to and pushing through the "in between" numbers.

I have several competitions I would like to participate this year (TSC, GS, deadlift/pullup and OCS) and I need to be able use both hands...keeping a relatively "objective" pain log, especially during rehab, will be very helpful.

Thanks to Connie and Patti for opening this discussion - I would not have thought to do so.