During this week I have obviously been more limited than usual and haven't been able to do much other than walk and do body weight leg exercises. In order to prevent a spiral into madness I have been filling the time I'd normally be training with as much information as possible, catching up on the backlog of podcasts I have been wanting to listen to. One of these in particular jumped out at me as I clearly had injuries on my mind and this solidified some of my own thinking and gave a great insight into why some treatments for chronic pain injuries don't seem to have great effects.
Ben Coomber had Perry Nickelston as a guest on his podcast, Perry is the man behind 'Stop Chasing Pain' which UK readers may not be familiar with, I certainly wasn't! Whilst I shall try to summarise some of the key points here I urge you to track down the podcast (Ben Coomber Radio ep.114) and listen for yourself as there is a heap of great info discussed.
Perry explained how so many of us experience pain in some area of our body, for me I have battled with patellar tendonitis in my left knee for months now, so we target our treatments and interventions at the site of pain. This is certainly true of what I have done to try and improve my knee, I've used icing, compression, floss bands, strapping, mobility etc etc. Whilst this may seem sensible Perry makes the point that the site of the pain is probably not the place we want to be targeting, in fact the site of pain is likely the most functional area. Instead we need to start thinking upstream and downstream of this spot to try and identify the problem.
Using me as an example, to look for the root cause of my knee problem we need to look at the ankle and the hip and the musculature in-between. Most people would turn to mobility exercises here to try and improve functioning and ease the pain. Whilst this does have some effect it tends to be short lived. This is certainly my experience, the life of a rugby player is filled with endless mobility exercises and I have rotated in several specific exercises targeted at my left hip, knee and ankle, all of which have given temporary respite but soon the pain returns.
Perry makes the point that we often focus on mobility but neglect stability. Mobility may help briefly but unless we are also stabilising the structures in question the body will quickly tighten things up again. Mobility without stability is an injury risk in itself so this is a protective mechanism of our body. If you have areas which are consistently tight then it is a good sign that these areas aren't stable enough and you need to focus on them.
Interestingly this is something that I had started to do intuitively (read fluke timing!) as after my latest squat cycle I had introduced some single leg work to try and help iron out any muscular imbalances. This had decreased my incidences of tendonitis which, according to Perry, would make sense as I am adding stability to the areas which require it, which then allows the mobility work I do alongside to 'stick'.
So to summarise, if you have chronic pains then start to look above and below this point. Aim to stabilise these areas before mobilising. If you have areas of tightness then that is a good indication that you need to focus on stability before stretching. This week give yourself a quick once over and write down an action plan. There are loads of amazing resources out there to help. I'd suggest listening to the podcast first then go and check out mobilitywod for some video content on specific body parts.