How To Start Moving Again When You’re In Pain | Kelly Starrett, DPT

Tricking your brain into movement with micro muscle contractions

One thing we’re always trying to do when we have acute pain, or even chronic or persistent pain, is to introduce as many low-level, non-threatening movements to the body as we can. We want to get muscle contractions and activate the body without aggravating the painful tissue further. But when you’re in pain, you may ask yourself:

How can I begin to load tissues and tell my brain that it’s okay to move again?

My brain has determined that something in my body is problematic, therefore my body is trying to protect itself by inhibiting movement and preventing the problem from getting worse. One of the ways we use H-Wave for chronic or persistent back pain is by introducing “movement without motion.” One way to achieve this is if you start by laying down on your stomach or another comfortable but non-weight-bearing position for your back.  Being in a physical position that’s not loading the tissues of the back or around the spine, your brain will recognize this as a non-threatening position.

Sometimes going from an unloaded to a loaded position can be very problematic.  For example, laying down to standing up: the brain interprets very low muscle activity (low tissue loading) to suddenly loading the tissue by standing up and getting ready to move as potentially harmful, and could cause additional pain.

One of the huge benefits of using H-Wave is that we can get a muscle contraction without the brain thinking that there is a problem, since we’re getting that muscle contraction in a safe, non-load-bearing position.  When muscles contract on the low back, it pulls on the connective tissue on the back and around the spine. The spine itself is a remarkable system of tension, musculature, connective tissue, and vertebrae all working together in what we call a contractile field – there’s no one aspect of the system that is more important than the other. Additional input from the lats, glutes, the trunk, and other areas of the body also add to the stability of this dynamic system.

However, when you have back pain your fist thought is “I need this pain to stop. I need relief.”  This can make you want to get into a non-weightbearing position and stay there.  But when we’re not loading the tissue, we’re not engaging the inputs from the lats, glutes, etc. back into our bodies, which would normally tell our brains that “it’s safe to move.”  If we’re consistently not loading, the brain starts to think there is a problem and when we start to load again, it’s a shock to the system.

By contracting muscles with H-Wave in a non-load bearing position, you’re creating non-threatening muscle movement which tells the brain “I can move safely” and “there’s nothing to be fearful of.” Another thing to be aware of is that the paraspinal musculature being contracted by H-Wave is directly attached to the spine, so it’s actually subtly moving the vertebrae itself. This results in numerous repetitions of non-threatening, micro-movements to the body.

All of this tells the brain that we’re getting ready to move – we’re getting ready for muscle contractions and loading the tissue in a safe, non-threatening way.  This helps the body heal and prepares you to get back into weight-bearing movement, ie: back to work or doing the things you love.

So when looking at any intervention we’re always asking ourselves: Does this intervention . . .

  • Block pain so I can move again?
  • Restore and load tissues so I can move again?
  • Give my brain a chance to think differently about what’s happening in my body?

By using H-Wave as an intervention to treat pain and injuries, you need to understand that in addition to providing on-demand pain relief; H-Wave is really preparing the body for moving and loading which is what the body does best.

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