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Pain vs Function: Which to use to know I am healthy

Today I wanted to talk to you about pain vs function. Many people I encounter in the clinic will typically use pain as the main driving factor of their decisions on whether or not they should be coming to or leaving therapy. However, I’m here to tell you that pain is not the best measurement of how a person’s physical health is doing

The best and most representative test or criteria we should watch for is physical function. I’ll talk a little more about this idea in general later on, but one analogy that I wanted to share with you is something I share with many people. Imagine if you had your finger stuck in the door for a second, and then the door is opening and closing on your finger. That finger might become very bloody, sore, swollen, thus getting all of the attention as far as wrapping the finger, cleaning, icing, and so on. However, the finger is not necessarily the problem. There are two other reasons for the pain that I could think of off the top of my head. One is the fact that the door is opening and closing on it. If somebody simply held the door, my finger wouldn’t feel any pain. The other thing is if somebody would have knocked some sense into me and got me to pull my finger out of the door, then I wouldn’t be having any issues with my finger. 

This analogy is helpful to differentiate between the VICTIM (what might be the loudest and most concerning) and the VILLAIN (what needs to be addressed)

PAIN DOES NOT EQUAL A PROBLEM. In other words, your pain may not necessarily be where the problem is by dealing with the ‘villains,’ which may be elsewhere; the pain ends up going away or is prevented. This relationship means that the villain or the area that is not FUNCTIONING well is more important than the actual painful spot. 

These non-painful but poor functioning areas are to blame for why many people would question where their injury came from. They often wonder, ‘I didn’t fall or get hit, it just started to get worse and worse, I don’t know what I did!’ This can be very frustrating. 

All this to say that doing the most thorough job to get better and stay feeling better requires an analysis of neighbouring areas that might not be painful but are not functioning well.

Similarly, people who are not necessarily in pain can benefit from a thorough assessment to highlight vulnerabilities in their function that can eventually turn into pain. This is even more important to consider where you are constantly performing repetitive motions at work or play. 

I hope this helps shift your understanding from pain to function when determining how ‘well’ you are doing or your goals for future physiotherapy. 

For questions or comments, please email me at andrewk@admphysiogroup.com, and I’ll be happy to answer your messages. Take care!

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