Anyone who’s lifted weights or been remotely active in their lifetime would have experienced pain in the form of DOMS (delayed onset muscle syndrome). Anyone who is female would have experienced period pain – oh the joys of being a woman.
I’m going to put it out there and say that active females are overall better at coping with pain than active males. Because we have ovaries.
It gets to that time of the month and for many women, ibuprofen is our best friend for at least 24 hours. The pain is temporary and acute.
Similarly, if you’re a bro ‘never skips leg day’ you would be familiar with the slight agony caused by lowering one’s bottom to the toilet seat to relieve oneself, with day-two-DOMS. Painful but also acute.
Now imagine you’re an active female, perhaps even an athlete. You do weights to muscle failure 2-3 times a week, or other similar muscle-fatiguing training. You know DOMS, in fact you experience it for approximately 50% of the week. Oh AND you get period pain once a month. So all up, you’re in some degree of physical pain for at least 60% of the year. And you get used to it.
But wait a minute… that’s an awfully big generalisation to make Emma. Hmmm, yes it is. Google time. And, result!
Well now this is interesting…
Pain is subjective – and diagnosis requires you to say how much pain you are in, where it is located and so on. So the gender differences reported in some studies, like the ones above, could therefore be down to a reporting bias – in that men simply don’t like to admit to being in pain and only turn to their physician when it gets really bad. Men are still often expected to suppress certain emotions and action, such as crying for example, and these beliefs may also affect how pain is expressed, viewed and responded to.
Regardless of who experiences pain more frequently or to a higher degree, pain sucks. And chronic pain sucks even more.
I’m unsure really of when my hip pain started. You could say that it started back in my mid-20’s when my hip muscles used to get really tight, a bit of sciatica here and there, all low-level stuff. I was always active, exercising 6-7 days per week, but also mostly desk-bound at work. All pain was fixed from a visit to the physio who would stick a few needles in my bum, the muscles would go PING, then relax and the pain gone. I always thought this pain was just because I wasn’t using my gluteus medius muscles (used to abduct the hip, i.e. open the legs) and wrongly overusing my piriformis muscles.
Maybe that chronic misuse was just the body’s instinctive (yet still incorrect) way of protecting the joint? A method that actually doesn’t help because the tight muscles crush the bones together – a mortar and pestle comes to mind – instead of being supple enough to move the head of the thigh bone in the hip socket.
THIS IS WHY EVERYONE SHOULD DO YOGA (joking, not joking). Any muscle is only truly strong if it can tense firmly and also release fully.
Since September, my pain comes and goes. Sometimes a dull ache at the front of my hip, sometimes searing jolts down my shin, sometimes absent altogether. It’s definitely a lot better than how it was when got up from the couch paralysed mid-September, but it’s not as ignore-able as it was 5 years ago. Over the last six months I’ve learned what aggravates it:
- Stress, mental or physical
- Activity – with incorrect muscle activation
- Excessive activity – with correct muscle activation
- Prolonged sitting
- Fear or anxiety
- Everyday activity where I’m not conscious of proper muscle activation (let’s be honest, I’m not thinking about proper glute mede activation when I’m having sex)
What do you do when you experience pain? Well, advertising would have us believe that the answer is DRUGS.
And sure, drugs help in acute circumstances but they’re not everything. I find myself taking anti-inflammatories (NSAIDs) a few times per week and more often than not, in a preventative way. For example, usually my hips are feeling a little tight on a Friday night – it’s the end of the working week, I’ve been sitting for at least 30 hours – so I’ll do some stretching before bed and pop some pills. This is so that I’m not woken at 1am by the pain.
What helps me the most when the pain is about an 7-8 out of 10, is physical and mental activity.
- MOVE: some gentle yoga, stretching or swimming to alleviate the pain.
- THINK: tell myself that “I’m ok, I’m ok” as I walk around our apartment at 2am because the pain has woken me up.
To me this treatment makes sense, as my pain triggers are both mental and physical.
The research around pain continues to evolve rapidly and there’s growing mass realisation that only pumping someone full of drugs is not the answer. An attitude of helplessness and passive behavioural pain-coping strategies have been shown to increase disability and depression.
There’s various pain management strategies, both active (“I can do this to fix my pain”) and passive (“This thing will fix my pain”). Some people may use more passive strategies, some people may use more active strategies. The thing is, many people (including me!) don’t know of all the strategies and health professionals (surgeons, physios, yoga teachers, PTs, chiropractors) generally have a preferred type, i.e. the type they specialise in. [The PainHEALTH website is a great resource for anyone experiencing pain]
The only person who can decide the best treatment of my pain is me. And if you’re reading this and you’re in chronic pain, it’s you. No one else knows what your pain feels like.
There’s a good Insta-inspo quote that’s relevant here (it’s also currently graffitied on a Stirling Hwy billboard). Something one of my yoga teachers bangs on about often, something that is otherwise known as compassion.
I reckon yoga’s been the second most helpful thing to date with treating my pain. I like to think that my own pain management aligns to the components of Kriya yoga:
- tapas (discipline) – discipline to keep moving, to go to the gym/pool/yoga mat when I can’t be bothered because I know movement makes me feel better
- svadhyaya (self-study) – noticing what triggers my pain, noticing my reaction to those triggers and my instinctual, emotional response to pain
- ishvara pranidhana (devotion) – letting go, allowing myself to fully feel the pain rather than avoiding it because eventually, that I’ll have to deal with all that shit.
But in my mind meditation wins as ‘most helpful pain management strategy’. All other techniques to alleviate pain and find physical/mental peace require something else – an able body, a health professional, a pool, hell even a bottle of wine! Meditation requires nothing.
And speaking of which, I’m signing off… to eat dinner, drink wine and meditate. Something I can definitely get better at.
P.S. For anyone reading this and thinking, “If all these active pain management strategies are so great, why are you still getting a hip replacement then Emma?” well, that’s the next topic of this blog…