Now I’m sure this is an expression that many of you have heard before and have quite potentially said yourself. It’s that little mental game that we tend to play without ourselves to try and make pain seem like it isn’t as bad as it is. It great when we are trying to push ourselves particularly at the gym or when trying to increase our fitness. But there is also a time when pushing ourselves isn’t such a good thing.

I know that I’m not a stranger to that ‘being a bit sore when starting to exercise’ feeling. This may be felt a little bit more if you are going straight into a hard workout without warming up. So to prevent feeling achey when you start out in exercise it is always good to do a warm up, and even a warm down to make the next session that little bit easier! If you are feeling sore at the start of exercise, take it easy to start with and make sure you are warming up well. If you don’t and push through the pain (to try and make the gain) then there is the chance that you may damage your muscles or ligaments. Stretching and doing a warm up is a really essential part to making sure that pain doesn’t cause you an injury or aggravate one that may still be sitting there niggling away at you.

If you suddenly get pain whilst doing anything, particularly when working out, then this isn’t such a good sign and normally is telling you that something is wrong, but I’m sure everyone would have guessed that anyway. If this happens to you it is generally best to stop what you are doing and rest. This sudden pain can happen for a number of reasons. It can be because you have somehow injured yourself in a new way or may be trying to get back to sport too quickly after a pervious injury. What I tend to see day to day is people who have had previous injuries are better at stopping if they get pain, but it’s those who aren’t expecting it that tend to push through. There are a whole different range of causes for this sudden pain and is probably a good indication that it is time to see a physio or other health professional to get it properly diagnosed and to ensure that it won’t become that annoying pain that prevents you from doing things like you normally would. If you don’t get it treated it can turn into a chronic injury which often takes longer to treat and fix than a fresh injury.

Pain whilst exercising can also indicate that you aren’t doing the activity exactly as you need to, which is common with weight training. Backs are often the first thing to complain at you if you are lifting or bending incorrectly with weights, but it can involve any part of the body. This is often the hardest pain to understand. If you are weight training, you will be wanting to get that burn, but listening to your body is really important to be able to decide if pain is good or not so good. Technique is so, so important with exercise, especially if exercise is something you do for fun rather than as a job.

So yes, we do want to induce some pain to know that what we are doing is working, but we always want it to be a good pain and not a bad pain. A good indication of a less ideal pain is if it is present for more than 48 hours and doesn’t ease with rest. If you are unsure with your pain and know if it is something that will help or hinder you then book in for a free phone consultation or come and see us in clinic.

In New Zealand, the term “Acupuncture” is generally considered to be a broad “umbrella” term which encompasses different philosophies of needling.  You may hear it being referred to as:

• Traditional Chinese Acupuncture (TCM)
• Western/ Medical Acupuncture
• Dry Needling

Physiotherapists’ in New Zealand may practice one or a mixture of these.

At North City Physiotherapy we can provide Dry Needling.  This involves “rapid” short term needling to dysfunctional tissues in order to improve or restore function.  This is a practice utilised by both Traditional and Western Acupuncturists.

When Physiotherapists’ use Dry Needling, a needle is placed into the trigger point in the affected muscle until a “twitch” is felt in the muscle, aiming to reproduce the patient’s symptoms and the needles are generally not left in place.
The muscle may then be stretched or activated to improve muscle function.  Heat or ice packs may also be applied after treatment to help relieve post-treatment soreness.  As this is a very strong stimulation of the nerve endings, the patient will usually feel a very strong aching sensation and may also feel the twitch response as the trigger point is needled during the treatment.  Post treatment aching may continue for up to 48 hours.
See the table for a summary of Dry Needling and it’s comparison to Acupuncture:

These are exciting times for Physiotherapists as it means we can be more accurate and effective in our treatments.  It also means that we can justify using certain techniques and methods and; it also means that the revolution of Physiotherapy that introduced certain methodologies are now being proven as to why they are effective.  It therefore seemed an appropriate time to introduce some of the Guru’s that Physiotherapists base their practice on so, over my next few newsletters I would like to introduce Brian Mulligan, Robin McKenzie, James Cyriaz and Paul Chek (who is more of an exercise guru but still influences Physiotherapy practice).

Brian Mulligan is the father of Mobilisations with movement.  A concept where joints of the body are moved into what is considered their best position and then the joint is moved.  Then, if we are accurate the joint will move more freely and pain can be resolved.  It almost sounds like witchcraft but evidence and research support this concept and, anecdotally, I have seen countless occasions where a mobilisation with movement technique has almost instantaneously solved an injury.  So, who is this man Brian Mulligan?

Brian Mulligan trained as a Physiotherapy at the New Zealand school of Physiotherapy in Otago.  Graduating in 1954 he then opened his own private practice in Wellington where he continued to practice until the year 2000.  Throughout his career manual therapies were always Brian’s interest and background.  In 1968 Brian and (the above mentioned Robin McKenzie) formed the New Zealand Manipulative Therapies Association which went onto start and teach a post graduate programme for the Diploma of Manipulative Therapy.

In 1983 Brian ceased his teaching role on the Diploma programme and began teaching his own techniques in the field of Mobilsations with movement.  The techniques and Brian’s teaching became world renowned and gave rise to the Mulligan Concept.  This concept now forms the basis of many Physiotherapists practice and I can vouch for the success of it and applicability to acute, subacute and chronic injuries; so, if there are any aches and pains or old injuries that have never full recovered please come and see us and perhaps the Mulligan concept can help.

Best wishes and yours in health

The Team @ North City Physiotherapy