Chronic Pain

The article below was conceived and written entirely by a past patient of York Rehab. We did not solicit the article nor has the patient received any compensation or special privilege for the submission of this piece. His motivation to write this article was because his treatment outcome has been life-changing and he wants to share his story so that others suffering a similar fate are aware of the possibilities for healing. We are immensely grateful for this individual’s thoughtfulness and his time spent to produce this article, especially without the need for recognition or reward.

I’ve wanted to share my experience for a while but had not discovered an outlet until now – thank you York Rehab for allowing me a platform! Here goes: A friend (and soccer teammate) of mine recently turned the corner on a year of suffering from an injury. Feeling unqualified to share my opinion while I observed his situation, I bit my tongue only gently offering suggestions on what he might consider re-evaluating with his treatment approach. My advice was usually politely dismissed, and understandably so given my untrained perspective was different from his surgeon’s. When his lack of recovery reached a point where he was getting ready to give up playing soccer (a game he loves so much), he was then willing to listen and try anything. I won’t provide any specifics of his injury and experience, that’s his story to share. But I told him about McKenzie Therapy, which he had never heard of (as is the case with most people). The short story was that after a year of debilitating pain, one visit to a trained McKenzie physiotherapist reduced his pain by almost 70%, allowed him to return to play within a week and restored hope that recovery was possible. Helping my friend led me to want to help others by sharing my own story. Although not related to McKenzie Therapy (a treatment approach I’ve significantly benefited from many times), it’s another type of treatment that changed my life in an unimaginable way. I want my story out there to let people know about the possibilities of healing from long-term and chronic ailments.

Now my story. I’ll start with some background information. First off, I should quantify my reference to “soccer career”. I’m not a professional, I don’t make a living playing soccer, I play the game for its pure enjoyment (for over 4 decades). It has been and will continue to be an important part of my life until my very end. Let me add that although I may watch the occasional game on TV, my interest and love for the sport lies in my ability to get on a field and play. If I never see another professional league game for the rest of my life, no sweat…if something happens that prevents me from playing soccer, my life would feel like it’s over. And that’s the direction things were heading about 4 years ago, leading up to my visit to Glenn Woodland (a chiropodist at York Rehab).

My problems started about 2 years prior to my first meeting with Glenn (Chiropodist at York Rehab). I had been really struggling with recovery after my weekly soccer game. The typical minor muscle and joint pain from my once-a-week calling on underused body parts like knees, ankles, and quads had been manageable in the past, but a new problem was surfacing…Achilles pain and it was escalating. Initially, I assumed the cause was from the ankle braces that I had been wearing for the past 15 years to protect me from chronically rolling my ankle during play. A result of loose ligaments from repeatedly spraining my ankles when I was younger. I figured the brace was the culprit because it was rubbing on my Achilles in the area the pain was originating. I began to become more concerned when the pain began to limit my ability to play and the post-game recovery process which consisted of 2 days of waddling around like a penguin to minimize the pain coming from my throbbing Achilles. My self-imposed number of days between games which I set to 3 days to allow for the usual recovery was becoming insufficient.

As my pain continued, my thinking changed from the ankle bracing being the culprit. Maybe the progressing pain and discomfort was something that simply came with age. The pain was starting to become more intense and drag on for days and the thought of taking some time away from the game started to surface. That became a very depressing thought! My wife sensing my panic with the thought of having to stop playing the game I love suggested I go see a chiropodist. Maybe orthotics could help she said. I then remembered a teammate of mine from 15 years ago had Achilles issues, got orthotics and his problems went away. I knew of orthotics but always figured it was for someone who had inherently bad foot design issues. I always considered myself more of an athlete (all in my head) with a perfectly aligned body and would never need to rely on devices like orthotics to correct my movement.

So, my wife’s suggestion brought me to Glenn’s clinic for an appointment. His assessment began with observation and minor contact of the affected area…he noticed how swollen my Achilles was, how sensitive they were to mild contact (as they had been for 15 plus years), and how bumpy (scaring) they felt below the skin from the recurring trauma due to the demands of playing soccer. He then started to focus intensely on the design and movement of my legs and feet and measuring parts of them with instruments I’d never seen before. He took stock of:

• How I stood up still.
• How I walked on the treadmill.
• How my feet moved as I tiptoed.
• He looked at the soles of my shoes.
• And finally, he moved my feet and toes a few different ways

This data gathering process led him to a few conclusions all of which he shared with me in detail to ensure I understood his reasoning.

• First, he noted that I have a slight bow to my legs, i.e. when I stand up straight with my feet together, my knees don’t touch – this by itself wasn’t news to me I’d always known this but never thought anything of it. He explained that the bow was likely causing me to wear the soles of my shoes on the outside edge – something I’d also observed all my life but never knew why it happened – I was now really listening. Glenn suggested that shoe inserts (Orthotics) would help – they’d correct how my feet make contact with the ground.
• Because of my slight bow, my feet hit the ground on the outside edge which is part of the reason why I would roll my ankle so easily when playing soccer. According to Glenn orthotics would help to correct my chronic ankle rolling too. I was hopeful but skeptical, after all, I’d needed ankle supports for the last 15 years of playing soccer. And I didn’t wear them for a game, without fail – I would roll my ankle. I was super dependent on them.
• Lastly, because I was so dependent on ankle supports, my ankles were very weak and unstable – which was partly leading to more strain on my Achilles. Orthotics would help to reduce the strain on my Achilles which would reduce the inflammation.

Although Glenn felt that orthotics would help, he wanted to test how I would respond to some adjustments to my current footwear. So, he hand-crafted some temporary inserts on the spot for me to use in my shoes for the next two weeks (he had me bring in the 2 pairs of shoes that I’d wear the most during that time: running and soccer). I left Glenn’s Chiropody clinic with my inserts, slightly hopeful of pain relief but still full of skepticism that a solution to my pain and injury rested in a couple small pieces of cork (the material the inserts were made of). What happened over the next several days was pretty miraculous.

• I played my first soccer game two days later with the inserts and without my ankle supports. I started the game very timidly because I anticipated I’d roll an ankle (or two). Halfway through the game, I was going full tilt and had forgotten I didn’t have on my ankle supports…I finished the game without any ankle injury (I was amazed but thought it must be luck) and minimal Achilles pain.
• I had another soccer game 3 days later and again I played without ankle braces but this time with less in trepidation and more intensity…and again no injury. I didn’t even notice my Achilles weren’t hurting. It’s strange how quickly you forget you had pain once the healing process begins. It wasn’t until the next morning when I instinctively stepped down from my bed slowly anticipating pain…but there was none…that’s right, none!

Fast forward to 3 months later and regularly using my actual pair of orthotics. I was able to jog and play soccer twice a week with no issue and no pain whatsoever. Playing without my ankle supports has allowed me to play like I’m 15 years younger – my mobility, agility and speed have both improved immensely. And no longer does it take me 15 minutes to suit up to play – lacing up my ankle braces was always a hassle. I’m ready for play in 2 minutes…it’s a new lease on life. And the Achilles pain is gone…so is the swelling and tenderness. I haven’t been able to touch my Achilles for decades because they were so tender.

It’s been two years and my ankle and Achilles situation has permanently changed for the better. After a lifetime of wearing out my soles on the outside edge (since I was a kid!) it no longer happens! I thought I’d be playing soccer with ankle braces for the rest of my life, but I don’t need them anymore. I don’t even carry any in my gear bag just in case. Ankle exercises and the mere fact that I’m not restricting my ankle’s mobility has allowed my ankles to strengthen nicely. There are other small changes that are actually big things to me. Like the fact that I can put up my legs on a table or ottoman and cross them so that my Achilles rests on the front part of my ankle without me wincing in pain. I’m also playing soccer as I did 20 years ago because my ankles are no longer restricted, the mobility and agility that I once knew are back – things I thought were lost as I age. I also wake up the next morning after a game and can simply walk (no more wobbling to avoid pain). I never imagined that a small shoe device could do so much for me – they have made the inconceivable possible. By sharing my little story, I hope others who are suffering from chronic pain take a small step forward and visit a chiropodist (or physiotherapist if the pain is elsewhere). I must include “physiotherapist” because I’ve had a couple of life-changing recovery experiences with one as well. I am motivated to share my story because like many people I assumed your body slows down and falls apart with age – but I’ve learned that it’s the other way around. Your body falls apart because you slow down as you age – simply put, don’t slow down. Walk, run, and play forever because if you stop using it you will lose it.

Thank you, Glenn!

Do you have a bum shoulder? A bad knee? Do you have a pain from an injury that has persisted for months or years? You may have talked to friends or co-workers about it and likely heard “Oh that’s chronic pain and it’s something you just live with” or “Well, what do you expect, you’re getting older”. Many people who develop such pains assume that because their injury was a long time ago, their pain is set in stone and there’s nothing you can do about it. Or, as you get older, it will be more difficult to get rid of it. Well, there is hope! These long-lasting pains don’t have to stay around forever; there are several courses of recovery that can take place depending on the nature of the original injury and the natural repair process that has taken place since.

In scenario 1, let’s assume you have pain from an old shoulder injury. It got better initially but just didn’t seem to fully heal, and now you’re left with some lingering pain. Normally what happens during the first few weeks of soft tissue healing (for example with muscle or ligament) is your body deposits scar tissue to rebuild the injured site. If we looked at the tissue fibres under a microscope at this point we would find them disorganized and unlike the original tissue where the fibres are lined up in parallel. If controlled stress (stretching and/or strengthening) is applied to the injured site at this stage, it would begin to remodel and look more like the original tissue. Depending on the severity of the original injury and assuming no other complications, after several more weeks of recovery and exercise the injured site can become pain-free and function well.

However, some people mistakenly believe that a tissue will heal fully on its own with time, or initially they misinterpret the pain that occurs with stressing the injured site and avoid it. In both cases, the remodelling process is not undertaken, and the scar tissue remains disorganized and tight, causing pain every time it is stressed. The good news is if you understand what is happening and are guided through the remodelling process with the assistance of a physiotherapist, you can make changes to this tissue and achieve a gradual recovery over several weeks or months. Typically this will involve an individualized and structured home exercise program – which can involve strengthening and stretching.

In scenario 2, let’s say you find yourself with pain from an old knee injury and no matter how much you try to remodel it following the principles above, the pain doesn’t go away. Sometimes what can happen at the time of injury is the resting position of the joint is disturbed so now it isn’t “hinging” properly anymore. Again, the positive here is this situation can be reversed quickly with the help of a physiotherapist who can identify the right movements to return it to its proper position. It’s like a floor rug being ruffled up in front of a door – when you try to open the door, it gets blocked by the rug. So what you have to do is find the right way to move the rug and then the door will open smoothly again. There are cases where pain that has persisted for years can respond to simple movements rapidly due to this problem.

The bottom line is this: just because you have had pain for months or years from an old injury that seems to be unchanging, it doesn’t mean you’re doomed to live with it. There’s hope! You can simply start by making an appointment with a physiotherapist. They’ll listen to you and do a thorough assessment to determine the nature of the problem, and design a recovery plan for you. Remember, you don’t need a doctor’s referral to book an appointment with a physiotherapist. As long as you’re willing to put in the effort to recover, the results will likely follow. Wouldn’t it be nice to leave behind that nagging pain you thought would be with you for the rest of your life?