Is a decrease in pain levels the only way to measure improvement?

Throughout my time as an Accredited Exercise Physiologist, I have noticed that many of my clients measure their progress by the pain they experience. How much pain they get when asked to move their shoulder into flexion, the pain they are in after completing their new gym program or the new pain and muscle fatigue they experience after returning to work from being off for two months. Pain is a difficult outcome to measure due to its multifaceted and subjective nature, because of this I personally like to focus on other outcome measures, aside from pain when measuring patient progress.

It seems that many people believe that pain is the be all and end all with their progress .. if you’re still experiencing the same amount of pain you did in the beginning, you’re not progressing… right? Well not exactly.
Measuring progress while dealing with pain can be tough and often frustrating. At the end of the day nobody wants to be in pain, although I’m here to try and flip your thinking when it comes to your progress and see whether it is as stagnant as you believe.

Take some of these statements below for example:

Pain may stay at a similar intensity (e.g 6/10 on a 0 to 10 scale) but if you can now perform more of an activity without having to stop, that is progress.

If your pain is now less frequent (4 days per week rather than the previous 6) that is also progress.

If the first thing you think of when I ask how you’re progressing with your exercise program is the amount of pain you’re in, have a think about whether any of the statements below apply to you. If so, you are making more progress than you probably realise.
• You can do an activity for longer – “I still have the same amount of pain, but I can now walk my dog for 30 minutes instead of the previous 15 minutes”
• You can do more repetitions of an activity or exercise – i.e you can now complete 3 rounds of 12 repetitions, instead of the previous 10 repetitions.
• You are more consistent with your exercise/rehab program – i.e consistently attending the gym 3 times per week.
• You can perform more exercises in a shorter amount of time (requiring less rest breaks)
• You have more energy when you get home at the end of the day
• You are more confident that you will be able to reach your goals
• Your pain comes on less frequently throughout the day and/or week
• You notice yourself thinking about your pain less
• Your pain lasts for shorter periods of time
• You no longer need to rely on medications to deal with your pain
• You can now walk for an hour before the onset of pain, when previously the pain started after the first 20 minutes
• You are squatting the same amount of weight, but your injured knee doesn’t ache the day after like it use to

Spending more time focusing on how your function is improving, not just what your pain levels are can provide you with that extra confidence you need to reach your goals. Your brain is such a powerful thing when it comes to your recovery, once you can shift your focus and feel proud when successfully completing that additional round at the gym, or walking that extra 200 metres on the treadmill, the pain you experience will have less power over you, putting you in control of your pain.

Remember: “Your life is controlled by what you focus on” – Tony Robbin

If you would like any additional information on progress and how to measure it, or need assistance with an injury or pain through a holistic approach, please contact Absolute Balance via info@absolutebalance.com.au or call 9244 5580 to speak with one of our friendly team members.

Channai Graham (B.Sc-Ex.Sp.Sci,Post.Grad.Dip.(Clin.Ex.Phys))

Accredited Exercise Physiologist (AEP) (AES) (ESSAM)

 

References:
Younger, J., McCue, R., & Mackey, S. (2009). Pain outcomes: A brief review of instruments and techniques. Current Pain And Headache Reports, 13(1), 39-43. doi: 10.1007/s11916-009-0009
The Science of Stubborn Aches, Pains & Injuries. (2019). Retrieved 16 October 2019, from https://www.painscience.com/