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Is It Ever OK To Ignore Pain? (Part 2)


Is It Ever OK To Ignore Pain? (Part 2)
MrGrigg via Flickr

In part 2 of this article, About.com talks to Courtney K. Dawson, MD, and Kathy Flippin, NCTMB, about pain--and when it's OK for mountain bikers to ignore it. (Read Part 1 here.)

About.com: What are some reasons athletes might choose to ignore pain?

Dr. Dawson: Athletes might choose to ignore pain due to their competitive drive and desire to continue participating in activities.

About.com: When might it be OK to ignore pain?

Dr. Dawson: It might be OK to ignore pain if it resolves completely in a short period of time and does not recur or persist.

About.com: When is it not OK to ignore pain?

Dr. Dawson: It is not OK to ignore pain that persists or worsens over time. If the pain limits your ability to participate fully, you should stop and see your doctor. Delaying appropriate treatment can lead to more serious problems.

About.com: What can untreated pain lead to?

Dr. Dawson: Untreated pain can lead to chronic problems that may keep you out from activity for a longer period of time.

About.com: When is it advisable to seek professional treatment for pain?

Dr. Dawson: It is advisable to seek professional treatment if the pain does not improve after a short course of rest, ice and activity modification. A medical professional can help diagnose the problem and begin early treatment for the underlying cause of the pain.

About.com: What type of healthcare provider should an athlete see to treat pain? Why?

Dr. Dawson: An athlete should see an orthopaedic specialist for early evaluation and treatment in order to keep them active and in full participation. In some situations, pain is more chronic in nature and may benefit from evaluation by a pain management specialist.

Kathy Flippin, NCTMB, is a sports massage therapist in Orange County, Calif. Prior to working with the U.S Swim team at the London Olympics, Flippin has done massage for 15 years, working with top downhillers, trials bikers, Ironman triathletes, and Olympic and National champ road, track and time trial cyclists. She’s treated injuries that were expected to be career-ending, as well as little complaints that planted seeds of insecurity about their invincibility.

Flippin says, “Pain is hard to measure. Athletes LIKE pain. And it's often who can suffer more that determines who wins. But there are actually two different kinds of pain, and learning the difference, and how to walk the line, is the key to longevity in sport.

There's the kind of pain when you're working hard, your lungs are screaming, your legs are whimpering, and like Jens Voigt, you just tell them ‘Shut Up!’ and keep going. This is the ‘good pain.’ It comes from muscle fatigue, which generates lactic acid buildup, and it's short-lived. Your body clears it quickly, within 20 minutes to two hours. You might be sore within 48 hours, but that soreness clears within a couple of days. This is a normal reaction to turning yourself inside out for the fun of the chase.

But when we go beyond the muscle fatigue, we start stressing the connective tissues. We put strain on the tendinous attachments, and ligaments that are literally holding our bones together against the force generated by our own power and by gravity. And this can create more significant cellular damage. It causes inflammation that lasts longer, gets worse with activity, and makes us wonder if what we're doing is good for us.

Don't ignore any pain that lasts more than five days, especially if it has one of the other listed symptoms below. A small pain may be a clue to an underlying muscle imbalance. Say your knees hurt after you climb. This could indicate a weakness in your kinetic chain that will continue hammering that little problem until it turns into a big one, doing permanent damage to your deeper knee tissues such as the meniscus. If you shore up that weakness in the quad muscles, you will protect that meniscus forever.

If you have any one of these symptoms, or a combination, then you know you need to go and see a professional:

  • Pain lasting more than 10 days;
  • Severe Pain;
  • Point Tenderness;
  • Swelling;
  • Limited motion;
  • Numbness or Tingling

See an orthopedic specialist if possible, because they're specialized in diagnosing musculoskeletal problems and will get to the bottom of it quickly. A general practitioner will often just tell you to take aspirin and rest for six weeks. So if that wasn't the answer, then you've lost six weeks of your training time just dilly dallying.”

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