Don’t Limp

Over the years I’ve noticed that when people see me limp I get flooded with helpful advice along the lines of:

My Aunt Mable had that and she used to swear by Cider Vinegar

At first of course it’s lovely that people care enough to offer advice, but after the 100th contradictory tip it gets a bit exhausting to keep showing enthusiasm and thanks for the suggestions.  As someone who’s hands, wrists, elbows and shoulders hurt more than his legs I also find it mildly frustrating that there’s an implicit assumption that the only joints and tendons that cause problems are those in the legs.

Anyway the point of this post isn’t helpful hints, it’s a tweet from Matt

@SteveRichards "Have you tried not Limping?" (an adaptation of a mental health picture I saw on "Have you tried being more cheerful")

It sparked an intriguing and meandering set of thoughts as I walked (not limping, but in pain) this morning along the beach, this post is a distillation of those thoughts.

At a simplistic level I’ve always believed that it’s important not to limp, limping causes stresses and strains on the body that are more likely to cause problems than limping is to fix them.  The act of limping though is to minimise the load taken by one leg and that’s important to me because that pressure at random intervals causes spiking pains through one or more of my foot, ankle, tendons, knee that cause my leg to involuntarily crumple causing me to fall.  Even with limping I’ve fallen a dozen times in the last few years and at my age it’s not nice.  Once the pain levels fall below a certain threshold I stop limping, but after sitting for a while this often takes a few hundred steps.

Matt’s tweet goes deeper than this simplistic level though.  If people are depressed we coach them to smile, to be more optimistic, to watch how they think and catch negative thoughts and challenge them.  So when we feel pain should we do the same? 

I think we should, not long ago people suffering from all manner of maladies including post surgery recovery were prescribed bed rest, now they are prescribed movement.  Body builders see pain as a positive sign of progress, of muscles pushed to the limit getting stronger.  The SAS are taught to push through pain, so see it as merely useful information not constraint. Hypnotists can block or condition people to re-frame pain allowing them to undergo normally excruciating surgery without any pain killers.

All that said we feel pain for a reason, it’s data, the issue is trying to decode that data and turn it into useful information.  Sometimes it’s constraint, it’s telling us that further use might cause damage, sometimes it’s telling us we are not managing our stress, sometimes it’s not telling us anything useful at all because the pain systems in the body are dysfunctional.  After 15 years I have a pretty intimate relationships with pain:

1. I always listen to it, trying to understand what it’s telling me
2. Meditation is key to examining the pain deeply, understanding what type of pain it is, understanding how to work with it, not against it
3. Distraction is a powerful technique for dealing with pain, watching comedy and reading a good book while soaking in a hot bath before bed for example helps me get off to sleep
4. Frequently I choose to ignore it and keep moving, I try and frame it as something I have to put up with if I’m going to feel better tomorrow
5. When it’s very intense I respect it, moderating my movement, resting, using a stick, sling, limping but even then I will still try and challenge my body a little through stretching
6. When it’s very widespread but not intense my body and mind are overwhelmed by pain, it’s hard to think, but exercise can moderate it through a combination of relaxation, distraction and natural pain killers
7. Sleep is the best pain killer, but it can be at it’s most elusive when it’s most needed, sleep meds are vital in a flare

All this is still a bit too simplistic though, because pain doesn’t exist in a vacuum:

1. Body pain causes tension in the neck and shoulders that stimulates headaches
2. Body pain and headaches make sleep more difficult
3. Lack of sleep sensitises the body so that it feels more pain
4. Lack of sleep reduces the willpower that’s needed to challenges the pain, to push through it, to do the stretches …
5. Stress at work and at home sensitises the body to pain, reduces sleep, increases headaches
6. Widespread pain and lack of sleep causes more brain fog
7. Inability to work because of pain and brain fog increases stress because you are letting people down, creating a backlog of work that will be difficult to clear …
8. Work normally requires sitting and sitting increases pain significantly compared to gentle movement
9. The most effective pain medication are the opiates which increase brain fog and the frequency of migraines

In summary then I’ve found the best strategy is holistic, work each day to maximise the couple of dozen habits that work together to feed virtuous cycles, minimise the dozen or so that feed vicious cycles and keep innovating. In other words

Live Well