Most of us know about physical pain. Very few rotator cuffs function comfortably an entire lifetime. Knees ache. Back strain is common. Elbows get funky. Carpal Tunnel stings the wrists and forearms, and there's always the legendary pain in the neck, speaking literally not figuratively.

The prevalence of pain is such that, yes, there is an American Pain Society. "At least 45 percent of all Americans seek professional advice for persistent pain due to injury or other physical problems like arthritis at some time in their lives," this organization reports. "Consequences of pain include depression, over-utilization of medications and other therapies, hospitalizations, unsuccessful surgeries due to misdiagnosis, and disability."


Musculoskeletal Stress

Pain occurs when nerves transport a message through the spinal cord to the brain informing headquarters of a cellular injury. Acute pain is often sharp and tends to strike suddenly, but lasts only temporarily. These are minor injuries such as muscle strains or tendinitis (an inflammation centered in the tendons, the link between muscle and bone) that heal within days, weeks or months.


Overuse and Repetitive Motion

Our joints are not designed to withstand a given motion over and over, all day long. Repeating the same motion for extended periods tends to overstress the involved joint or joints. This can result in damage to associated muscles, tendons, nerves and other structures. In athletics, these injuries are known as overuse injuries. In the work place they are known as repetitive motion injuries.

Risk of overuse injury increases when repetitive motions are coupled with poor posture and body mechanics (such as lifting heavy objects improperly), which put excess strain on joints. Joint stress also increases when you apply force with motion. This is why properly aligning your body on each exercise and making only slow, controlled movement is advised. Your Fitness Express repetition schemes are not likely by themselves to overwhelm any joint. It's more common in sports: running, tennis, or anything that uses a particular joint repeatedly. Wrists, backs, elbows, shoulders and necks are the most common sites of repetitive motion injuries.

Overuse/repetitive motion injuries typically begin with mild to moderate discomfort in the affected joints, especially at night. Other symptoms include swelling in the joint, muscle fatigue, numbness and tingling. Early symptoms may come and go at first, gradually becoming constant.

Symptoms of more advanced damage include intense pain, muscle weakness and nerve problems. At this point, it's time to see a doctor. Fortunately, however, since they develop slowly, most repetitive motion injuries are identified early enough to be successfully treated.

Acute pain, handled properly, will subside in due course. Conversely, chronic pain is persistent, perpetual, and demands a management program.


Three Forms of Arthritis

One of every seven Americans suffers from arthritis. This is the primary cause of biomechanical limitation, affecting everyone from children to elite athletes who may end arthritcally impaired at earlier ages due to overtraining, overuse or injury.

There are actually more than 100 varieties, but the unholy trinity of arthritic disease is osteoarthritis, fibromyalgia and rheumatoid arthritis.

Osteoarthritis is the injury-induced form. The cartilage that covers the ends of bones in the joint deteriorates, causing painful bone-on-bone contact and probable loss of movement. This type of arthritis affects larger weight-bearing joints. In fibromyalgia, pain affects the muscles and attachments to the bone.

Rheumatoid arthritis is a whole-body disease in which the joint lining, or synovial membrane, becomes inflamed as part of the body's immune system activity.

In addition to the symptoms already mentioned, rheumatoid arthritis also causes fatigue, weakness, fever, loss of appetite, anemia and weight loss. Damage may also occur to the connective tissues, heart, lungs, nerves and eyes.


Exercise Rehab

Exercises can be designed to accommodate most limitations, working around pain in an effort to minimize it. Range of motion is almost always limited to pain-free arcs. Rarely is there a pain that hurts at every point along the range of motion. The goal is to gradually nudge out the painful area by encroaching on it little by little at each workout.

In cases of tendinitis, sometimes movement itself is ill-advised but strengthening can still occur. An isometric contraction can be arranged by blocking the weight stack, or holding the weight motionless for something like 30 seconds. This sacrifices full-range strengthening, but still stimulates the muscle.

Water consumption is critical when battling injury. Joints need lubrication. Consistency in working out also takes on added importance, as does eating right and getting enough sleep. Rest is one of the most valuable therapies for injury and pain management.

More information can be obtained from the following sources:

The Arthritis Foundation: 800 283-7800
The American Pain Society: 847 375-4715
National Chronic Pain Outreach Association: 301 652-4948

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