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The Catch 22 of Movement

The Catch 22 of Movement

Exercise and movement for someone in pain can sometimes feel like a catch 22. Take knee pain for example; someone may tell us that because we are having knee pain, we should not take the stairs or squat. However, stepping or squatting may be exactly what we need to do in order to build up strength around the knee and get some healthy movement through the joint. In fact, if we don’t step or squat, the knee may become stiff and weak and we may lose the ability to do these movements all together. So, we may be risking A. more pain/stiffness/weakness in the long run and B. decreased function of the joint all together (along with a loss in our overall ability to be functional). BUT, when we squat or step it hurts. What do we do?

There is no simple solution to this, but I believe there is more to do than we think. Often times we hear that we shouldn’t do something and, in response, immediately debilitate ourselves; we treat it as a cut and dry situation and think there are no other options. However, maybe what our body really needs is to take a break from these movements for a short time and then ease our way back into them by means of graded exposure (choosing a modified and tolerable version of a movement, building mental and physical confidence here, and then slowly progressing).

With all this being said, it is necessary that I leave a hard disclaimer: this should only be done with the assistance and support of a qualified heath care professional (a Physical Therapist, for example). There are certain situations where pathology may trump this idea and it will actually cause more harm to the joint. However, this is less common than we may believe.

Let’s get back the idea of being functional. What does this mean? The short answer is: it depends on who you ask. Everybody’s functional is different depending on what they do in their lives, so there is no real standard. For example, a professional weight lifter’s functional is going to be different than a stay at home mom or dad’s, just as an avid hiker’s functional is different than a sedentary salesperson’s. The lost ability to squat or step may be more devastating for the weightlifter or hiker, but it will still effect the lives of all parties. Generally speaking, stepping and squatting are important movement patterns and are difficult to avoid in the real world (think stairs, going to the bathroom, picking something up, etc.) When we lose our ability to do this, we lose our ability to do a lot of activities of daily living (ADLs).

Commonly, we see people try to interject and make changes such as moving to a ranch with no stairs or raising the toilet seats in their home, but this may just be feeding the problem. Maybe we cannot do something because we are not doing it.

Stephanie Spoto, CSCS

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