Fibromyalgia and the Pain Factor

by Louise A. Roach

Last year I told an acquaintance that at the age of 46, I had taken up running. The reply was, "Oh, that's awfully hard on your knees." At first I was taken aback. Yes, I knew if I didn't stretch, warm-up or wear properly fitted shoes, I might experience pain or an injury. But the person telling me this was overweight, had borderline high blood pressure, and never worked out. I wondered if this friend realized by living a sedentary lifestyle, the odds of developing heart disease, osteoporosis, diabetes and some cancers had substantially increased. Not to mention that being overweight actually placed this person at a higher risk than me for developing knee pain from osteoarthritis and heel pain as a result of plantar fasciitis.

I'm no spring chicken and sometimes my running resembles a dawdling old hen. But I do know it's necessary to take precautions at any age to guard against injury when participating in physical activity such as running. Because the truth is, sometimes pain happens. When it does, you can either use pain as an excuse or you can use it as a diagnostic tool to help improve and go forward with your performance.

There are three classifications of pain. In simple terms, these can be described as the following:

Nociceptive Pain: felt after an injury to body tissues such as cuts, sprains, broken bones, bruising, surgery, and sometimes cancer. Most pain is of this type.

Neuropathic Pain: resulting from an injury to nerves, the spinal cord or the brain, examples being Phantom Limb Pain and shingles - which affects nerve tissue.

Psychogenic Pain: is related to a psychological disorder where the type, intensity or proportion of pain experienced is greater than the injury. Some chronic ailments may be related to this type of pain.

Pain can also be defined as acute (an immediate response to an injury) or chronic (a pain lasting more than six weeks). The majority of injuries from physical activity fall into the category of acute nociceptive pain. Although some overuse injuries such as Plantar Fasciitis or Runner's Knee can become chronic if not properly treated or allowed enough time to heal. Most injuries to body tissues are minor and can be treated with nonsteroidal antiinflammatory drugs (NSAID), such as ibuprofen, and ice therapy or R.I.C.E. (rest, ice, compression and elevation) to decrease pain. Cuts, bruises, strains, sprains, swelling and inflammation can generally be treated in this way. Severe acute injuries, such as fractured bones and ruptured tendons, should always be treated by a medical professional, as is the case with injuries resulting in chronic, neuropathic and psychogenic pain. If you experience minor pain or inflammation during an activity, this is a good time to evaluate what your body is saying and respond in a positive, strengthening manner. Try asking the following questions:

What particular part of my body is affected?
Does the pain happen only during a certain activity or is it constant?
Am I experiencing pain when running or walking on a certain type of terrain?
Is this a new pain or one that has happened before?
What measures can I take to correct or strengthen the affected body area?

I used this list of questions to understand a reoccurring pain on the outside of my legs. After a little research and a trip to my local running specialty store, I learned the pain was IT Band Syndrome. The IT Band is a long fibrous muscle, located on the outside of the leg. When it becomes inflamed, pain is felt at a point near the knee joint. I knew the pain usually happened when I was hiking downhill for long periods of time and it went away after a few days of rest. This signified several areas of my body that needed work: weak leg muscles, a tight IT Band, and not enough arch support to stabilize my knee during an activity. I have incorporated the following positive measures to help strengthen my body's weak points:

Wearing well-fitted running and hiking shoes with strong arch support.
Adding leg strengthening exercises to my daily routine.
Wearing neoprene knee braces on a long hike with a lot of downhill climbing.
Increasing my daily stretching routine, with particular stretching for the IT Band.
Doing stretching and warm-up exercises before a strenuous hike or run.
Cross-training: running, walking, hiking, biking, weight lifting and using the elliptical trainer to provide a variety of exercises to all leg muscles.
Using ice therapy immediately after a hike if I feel pain.
Working up to a strenuous hike by doing shorter hikes on hilly terrain weeks before the big day.
Maintaining a normal weight so as not to place added stress on my legs.

Don't let pain, or your fear of it, be a factor in whether or not you are an active person. Not exercising will result in far worse consequences. Use pain as a guide to become a stronger, more aware and healthier person.

Disclaimer: This information is not intended as a substitute for professional medical treatment or consultation. Always consult with your physician in the event of a serious injury.