The Adapt, Accommodate and Compromise Spiral to Pain

Many people hurt, some with serious, chronic, long-lasting pain. Most try numerous treatment approaches without eliminating the pain, even with all the advances in modern medicine. What are we missing? Do we really have to accept that most people live with aches and pains, tightness, arthritis, achy knees and shoulders, backaches, or headaches? Is it “just life” catching up with us?”

Because we often believe this, we keep doing the same things over and over, Adapting, Accommodating and Compromising as best we can (and, of course, to be as comfortable as we can) in the hopes that we might get a different result: less pain. Unfortunately, that does not usually happen. Life is catching up with us, but not in the way we usually think. Let’s look at what this means.

Most chronic pain has muscular origins

Chronic pain usually involves muscles and their function. Injuries “heal” but muscles “learn.”  Muscles allow us to do everything we do. Our bones, all stacked up nicely, do not move by themselves. Bones only move when muscles that attach to them move. How we use our muscles forms a pattern for them to follow whenever they repeat a particular task over and over, i.e. bending to put on our shoes, getting in and out of a chair, or practicing a tennis serve or golf swing, This repetitive movement allows that action to become easier and easier until that movement becomes a “habit” that will repeat itself when we take the same position or do the same movement again.

If the muscle habit is one of being “short,” that means it does not release after a contraction or relax to a position of no tightness. If we feel tightness in a muscle when we are not using it, that means it has remained partially contracted, not returned to a full resting position by stretching.

If we spend a lot of time bent over the kitchen sink or a work bench, the front chest and mid-section muscles go to a short position. Then, we begin to use the shortened muscle position as though it were normal. The muscle has “learned” to be short, so we may curl up sleeping or slouch in a chair. This reinforces the habit of the muscle to continue functioning short. Since we don’t have pain when we keep muscles short, we make more accommodations, by sitting leaning forward, or walking with our feet turned out, and work at the computer in whatever posture keeps us as comfortable as possible.

If the muscles are comfortable, why is that bad? Unfortunately, it causes a continual downward spiral resulting in pain.

Adapt – Results in limited muscle movement

 First, we stop using the part of our body that hurts or we modify how we use it:

Examples:

•   Shoulder pain – we avoid reaching the arm above shoulder height
•   Back pain – we avoid bending over or lifting anything heavy
•   Plantar fasciitis – we wear stiff shoes to avoid bending the foot

Accommodate – Results in muscle weakness

 When adapting no longer works, we accommodate or adjust to the problem often by shifting the burden to another part of the body:

Examples:

•   Shoulder pain – we begin using the other arm and shoulder, as in opening doors
•   Back pain – we keep our back straight or stiff, even turning the whole body instead of twisting or turning
•   Plantar fasciitis – we walk more on the outside of our foot or walk with a flat gait rather than a heel-toe roll

Compromise – Results in pain

 Finally, when all else fails, we compromise by eliminating movements and activities:

Examples:

•  Shoulder pain – we stop playing tennis and pickleball
•  Back pain – we stop running and playing golf
•  Plantar fasciitis – we eliminate activities involving being on our feet including walks and exercise classes

“Since we have taught the muscles bad habits of functioning short just to be comfortable, then we should be able to get them stronger and eliminate the pain. We can start walking or going to the gym and get stronger, then we will not hurt so much, right?”

Actually, no!

Working out or exercising means working to “strengthen” our muscles so they get stronger. Strengthening muscles actually adds contraction, meaning they get tighter. They will then have less contraction power: half tight means half strength resulting in muscles that are even weaker. Those muscles will hurt more when we try to do even normal things like stairs since we are working with only partial power available.

There is a way out of this spiral!

Two things are important to know when we are dealing with muscles:

(1) Muscles are like a bucket of water – we can put in a million drops and nothing happens.

But once full, every drop of water added after that is an overflow, and it continues to overflow. Think of each of our muscles as a bucket. Every time we contract that means we have put tension in the muscle. Then we do another movement, and another, and another. The bucket of tension gets fuller and fuller. Remember, we said “life catches up with us!” Well, eventually the muscle bucket of tension is full or getting fuller and almost full, from all the little things all day, day after day without emptying it. Once we go to the gym or work out, the bucket fills faster and faster, eventually filling to the brim. It is “full” and now everything: lifting, running, working out, walking, stairs, or getting in or out of the car, everything we do after that, no matter how simple or familiar, will produce pain. So, what is happening here?

(2) It is not so much what we have been doing, it is what we haven’t been doing! Stretching, emptying the bucket! Muscles must be capable of contracting and releasing on every movement we do. Remember, we do not do anything without using our muscles. But, if they contract more than they release, they start filling the muscle buckets with tension. Do we “listen” to our muscles or body at that time? Do we stretch and elongate our muscles, so they are refreshed and ready for more work? Usually not. After all, we can still change positions sitting or sleeping and be comfortable, so not a problem. However, we are now teaching the muscle that old habit of functioning short. Remember that a short muscle is not as strong as a longer or full-length muscle, so we must work a little harder to do things that were easy when the muscle was long,

“Life catching up with us?” Not really. It is as easy as stopping for a few minutes of stretching throughout the day (not just once a day or when we are exercising), of teaching muscles habits of contracting when we use them, and then stretching them to return to full length afterwards. Combining strength and stretch provides full power, endurance, and flexibility.

Keep in mind, once the muscle bucket is full, and we do not take time to empty it, the consequence is pain. We can take meds, rest, and quit activities we used to enjoy, but none of that empties the bucket of tension. It is the movement of stretching muscles, correctly, of course, and the frequency of stretch movement that is the key to teaching and keeping the muscles in a performance balance.  The good news is that muscles will do whatever we teach them to do: a muscle that has learned to be short and pain producing is more than capable to learn a new habit of staying long and strong. Then our lives will be on the path to pain-free adventures!