How the Brain Heals

Triathlon Magazine Canada - - Front Page -

In­jured­triath­letes can of­ten take ad­van­tage of their heal­ing time to in­crease their ef­forts in one or two dis­ci­plines that don’t ag­gra­vate the in­jury. None­the­less, pain is com­plex and it is im­por­tant to know that feel­ing some pain doesn’t re­quire stop­ping ac­tiv­ity. Re­ha­bil­i­ta­tion that ne­ces­si­tates train­ing with some pain might not only be ac­cept­able but nec­es­sary. The chal­lenge for triath­letes is to know when to per­sist through re­ha­bil­i­ta­tive pain and when to avoid it. To help make this de­ci­sion we need to un­der­stand more about pain in gen­eral.

Pain is the brain’s re­sponse to a per­ceived threat. It is cre­ated by the brain from in­for­ma­tion the body, senses, emo­tions and en­vi­ron­ment pro­vide. Fol­low­ing an in­jury, pain usu­ally re­stricts our move­ments to pro­tect an in­jured area and en­cour­age heal­ing. How­ever, even af­ter that heal­ing has oc­curred, we are of­ten left with a sen­si­tized pain alarm sys­tem.

In this state, the body is still try­ing to pro­tect it­self from what the brain senses to be fur­ther dam­age. The pain felt at that point is a poor ref lec­tion of any resid­ual tis­sue in­jury. This is be­cause pain man­age­ment is a learned habit. Our thresh­old for feel­ing pain can de­crease even if we have a high pain tol­er­ance. This is an is­sue for many triath­letes who can tol­er­ate a great deal of pain – their tol­er­ance is high, but their thresh­old is low­ered.

A low­ered thresh­old to pain is like hav­ing an overly sen­si­tized fire alarm. Alarms aren’t meant to tell you what the prob­lem is, just that there might be a prob­lem. The brain’s pain alarm will still go off even though the trig­ger for the pain episode is long gone. Pain and dam­age should never be viewed as hav­ing a di­rect re­la­tion­ship with each other. Peo­ple born without a leg can feel pain in a foot that has never ex­isted. Many hard work­ing triath­letes have ex­pe­ri­enced bro­ken bones, stress frac­tures or torn lig­a­ments without feel­ing pain.

This com­plex re­la­tion­ship be­tween the per­cep­tion of pain and tis­sue dam­age can be ex­ploited for train­ing and re­ha­bil­i­ta­tion.

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