Why do my muscles hurt?
The human body is a wonderful thing. It has the power to adapt to the conditions we put it under. As a physiotherapist it sometimes feels like you are a car mechanic for humans. People come to you when their car/body has a problem and would like you to fix it so that they can get back on the road. However unlike a car, the human body has the chance to go away and heal itself. If you take your car to the mechanic with a fault they rarely tell you to just drive it a bit more gently for a few weeks and it will right itself. Parts normally need replacing.
As Physiotherapists we can tell you to simply take things more gently for a little while. There are even sometimes when we might say
“You know that muscle that’s been hurting? “ “Why don’t you do some more exercise with it? “How about these specific exercises I’ve chosen for you that seem to challenge it?”
As a Physiotherapist this is often where I feel that I could lose a patient…
“Yes, Charlie you’ve listened to me.” “Yes, you’ve even gone to the correct limb and moved it around a bit.” “Yes, you’ve poked the sore bit” and said - “I think this is where the problem is”. “You really are a clever man.” “But hold on… now you’re telling me that you’ve highlighted that this muscle is sore and you want me to go home, take time out of my already busy day and work this painful muscle some more?”
I’ll admit it does all seem a little counter intuitive.
Capacity
Quite often when physiotherapists listen to their patients they will hear something in the patient’s story (the ‘history of the present condition’ - they told us to investigate this when we were training at university) where the hero of our story (the person in pain) overreached. Sometimes this is quite literally the case in some shoulder injuries. However in the context of muscular pain, when we talk about overreaching, we are referring to exceeding the capacity of the muscle. This might be done with one sudden act. A muscle can be torn by a contraction that is too powerful for the fibres to withstand or a stretch that was too far for the muscle to lengthen.
Sometimes a sudden event can’t be identified and the pain seems to have appeared from nowhere. It just started one morning, came on at the end of the day, you noticed it doing an activity that isn’t normally painful. So what happened here?
It is quite likely that something has exceeded its capacity. If you ask for more than someone or something is capable of then this will often end in failure. If you run a battery down you either; need to recharge it, get a new one or start out with a bigger battery in the first place!
Would we describe ourselves as feeling 100% when things are aching? Probably not.
What happens as people or their muscles tire? Things strain. Muscles don’t work like they used to.
Look at people at the end of a marathon (No we aren’t looking at Gavin here). This hero has reached the point where his muscles no longer have the capacity to keep him upright. Luckily for him there was a viking nearby. There won’t always be a viking nearby to support us and sometimes we will end up injured. Sometimes we will just end up sore.
So I digress. Remember that car that was broken down. It’s likely your kind mechanic will offer to replace the part. However replacing parts in people is often more complicated and might not be the best option, in this case the physiotherapist will; identify the part that they think is struggling, explain it’s function and when it is working its hardest. Maybe the patient can stop doing that thing for a little while? The muscles batteries can then recharge and things can stop hurting.
The physiotherapist might even send you home with a little poem;
“Let’s reduce the strain,
and see if we can reduce the pain,
If it doesn’t settle down,
would you please come and see me again?”
To this poem, you say. “I know all this Charlie, it’s common sense” and that’s why you’re going to come back and see me again for the next part of this blog…
