When Pain prevents Rehabilitation, What should a therapist do ?

       In the rehab world, we like to talk about Rehabilitation and what to do when injured but how many talk about the neural response to pain when an injury becomes chronic.

Tonight, I was rehabbing my right hip from a sacroiliac injury and noticed that although I was doing the exercises right, my right glute kept firing the whole time. This is where I realized that the law of facilitation was present the whole time during my rehab session. I was once told that pain was a strong inhibitor. Tonight, I realized it while doing a simple mammalian crawl on the floor.

 It is true that choosing the right exercises are important when rehabbing an injury but not a lot of therapist emphasize the importance of inhibiting the pain on a neuromuscular and (muscle)cellular level. To Illustrate my point, here is an example. If we start with the basic understanding that 80% of human beings will experience lower back pain in their lives, the first thing that the client will do because of a strong neural pain response is to clench the butt cheek on the side of the injury. In a rehabilitation session, you could be fighting months even years of this habit.

So the conclusion is simple, we need to inhibit the muscle in question by stretching it or by any other means in your arsanel as a therapist. Then instruct the client to release it neurologically by pointing out which muscle should not be firing. This is where considerable gains were made by my part when I did my squatting pattern and mammalian crawl afterwards. Like always, thanks for reading this blog!