You may be surprised by these five mistakes people make with myofascial pain (pain that comes from muscle and connective tissue). As a longtime myofascial trigger point therapist, I've seen people miss out on faster, more complete relief because they went the wrong direction. I have to admit I've made these same mistakes myself when I've been in pain. Keep these mistakes in mind next time you have pain, to get out of pain faster.
Five Mistakes People Make When They Have Myofascial Pain
1. Not recognizing that pain can be myofascial in origin: Often, people think that their pain is coming from something else — arthritis, tendinitis, bursitis, carpal tunnel syndrome, TMJD, etc. Even if they have one of these, their pain could be coming from the muscles. Back pain, neck and shoulder pain, elbow and wrist pain and headaches can all come from trigger points (hyper-irritable spots in muscles and connective tissues) and can be relieved with simple pressure techniques and gentle movements. They may have the underlying problem, as well, but the pain can often be relieved, and mobility restored. Lesson: Pain can be coming from muscles.
2. Not realizing there is something they can do about myofascial pain: This is related to mistake no. 1. When pain is myofascial, you can do something about it. The first thing is realizing that your pain could be myofascial. The second thing is knowing that something can be done. Many people think that they need to live with it, suffer in pain, or take medication to cover up the symptoms when really they don't need to do any of those things. I've even made this mistake when I've been in pain, and I should know better - I treat people with myofascial pain all the time. But it's different when you are the one in pain. Somehow you think nothing will help. That's untrue. Lesson: You can do something about pain that comes from muscles.
3. Believing the muscle is "weak" and trying to strengthen it: I've seen this countless times; it comes from a misunderstanding about muscles. When a muscle is in pain, yes, it does become "weak." The muscle becomes painfully contracted, and can't lengthen to its full capacity. When a muscle can't fully lengthen, it can't fully contract, so it appears "weak." Strength is demonstrated by how well a muscle can contract. To get the strength back in a painful muscle, first you must get the tension (i.e. trigger points) to release. Then you need to lengthen the muscle, by having the muscle go through it's range of motion. When range of motion is comfortable, and the length of the muscle is restored, the muscle will have the capacity for contraction again, and strength will return. Then you can add strengthening exercises, if you want to. Just don't do strengthening exercises when the muscle is in pain, which only adds contraction and pain to the already painfully contracted muscle. Lesson: Release the trigger points first, lengthen the muscle, and strength will return on it's own. Then add strengthening exercises if you want, when you are out of pain for a while.
4. Stretching too hard: Okay, you know about releasing trigger points and you know you need to stretch, but now you've gone all gung-ho and decided to do a strong stretch to lengthen the muscle. "More is better?" Not so. Muscles need to learn how to lengthen. They've learned to be tight, and they need gentle reminders to loosen up. Stretch too hard and your muscle will protest with "rebound" tension. You could end up in more pain. After releasing trigger points, the best way to remind the muscle that it can move again without pain, is to move it, without pain. Only allow your muscle to move in a comfortable range of motion. There should be no pain while stretching. Don't hold the stretch very long, just a few seconds (even just move in and out of the stretch slowly without holding it). The idea is to remind the muscle that it can lengthen without pain. Best done frequently through the day, 2-3 repetitions (not 10-15). Lesson: Lengthen the muscle by reminding it that it can do movement in a comfortable range of motion, frequently through the day.
5. Overdoing it when they are feeling better: This is a tough one for so many people. You're feeling better. Your pain is going away. You feel up for doing all those chores you've been putting off because of the pain. You decide to do it all — paint the bedroom, plant bulbs in the garden, play tennis, clean the entire house and then, ooops! The next day you're back in pain and can't understand why. Well, muscles need time to heal. Pain can often go away quickly with the right treatment, but until out of pain for a couple of weeks doing just light activity, it is not a good idea to jump back in to doing everything again. It's easy to think, "It's not hurting anymore. I can do this." Better to take your time and let it really heal, than go through all the treatment and healing time again after you overdo it, right? Lesson: Don't overdo it when you are just starting to feel better. Learning the right balance of "doing" is crucial. Overdoing it is not a good idea, and could be what got you into pain in the first place.