Rehab Stetching on Vicodin
 

I'm currently healing from PN, finally after many, many months, and I recently was informed that my muscles and tendons had atrophied because of the PN. It then made sense some of the other problems I had in my legs were due to this tightness.
Anyways, this main problem is rehab stretching while having recovering nerves and being on vicodin. I'm experiencing pretty bad pain while stretching.
Current thoughts:
1. Since the nerves are still damaged, but healing, I may still have hypersensitivity in the nerves, which is creating intense pain while stretching. Someone referred to it on the boards as sort of excess pain that we learn to deal with. I am not usre if this is that excess pain or not.
2. Maybe stretching tendons, ligaments, and muscles creates excess pain that is needed. Most people stretch for flexibility which involves only muscles, but since I'm working on ligaments and tendons too, then maybe that's why there is more pain.
3. Taking vicodin would cease the pain and make me go crazy on stretching, potentially being dangerous, as if the pain I already had isn't causing danger.

I just don't know what to do basically. I'm not sure if the pain is BAD pain, or allowable pain.

Also, does anyone know the optimal way to stretch tendons, ligaments, and muscles for best healing time? Stretching is supposed to be done 3 times for 1 minute, but that's for muscles. How elastic are ligaments/tendons in comparison, and how much stretching do they need?

I don't think its a good idea to over exert, or do exercises using a med that masks pain.
Use after exercise to reduce symptoms, maybe.
But if you take Vicodin on a regular schedule- exercise
to the point of 'pushing it' is a bad idea.

Nide, is THIS pain even real, or is it excessive?

One should know their own level of pain. . .
 

Correct me if I'm wrong, but it seems that one of the things you are struggling with is having pain and not knowing what to do about it. No one knows the difference between allowable pain vs. bad pain except the one experiencing it. If you are already on Vicodin you may be lucky to be missing some of the pain but if you are still experiencing pain, try to rate it on 1-10 scale used at doctor's offices, hospitals, etc. Then use the scale to track your pain before, during and after excercise and on days and nights you don't excercise at all.

As far as excercise goes, I agree with Nide44 - do not push it or you may experience pain that you just don't want to have - trust me!

Good Luck to You,
nancyh

be careful
 

People vary in how elastic their tendons are. One stretch does NOT work
for everyone.

You may feel some discomfort stretching...sharp pain, you should NOT.

I have a severe tendon injury that is STILL healing...it is taking a LONG time.

There are support nutrients for tendons/ligaments.
SAMe is good.
Some silica in the diet (like bananas, green beans)

I found Biofreeze very useful after PT sessions. I had my injury in the groin, but they really hurt my KNEES with their exercises. So I used the Biofreeze gel
liberally and that helped alot.

I would do stretches very conservatively. Some studies I have seen, show
older patients do not do well on stretching..others do.
http://www.seniorjournal.com/NEWS/Fi...tchingHelp.htm

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

I think moderate motion/use is important. If you feel pain, pain strong enough after to use Vicodin...then this may be a warning sign, not an improvement.
Starting slowly, moderately, may enable you to progress to other levels eventually.

Do you keep a pain journal?

Pain journals can help both doctor and patient to recognize pain and pain triggers/sources and treat it properly.

There are several types of printable forms that are available online to make keeping a pain journal easy....

here are a few links to sites that discuss pain journals and some links to printable pain worksheets, and some links to the 0-10 pain scales and what each number means-
http://www.breastcancer.org/pain_diary.html

http://www.geocities.com/HotSprings/1712/pscale.html

http://www2.rpa.net/~lrandall/B1.html

http://www2.rpa.net/~lrandall/fmslog.html

http://www.painresearch.utah.edu/can...rovtoolsF.html

http://www2.rpa.net/~lrandall/painscale.html

Rehab, doing what you should vs. what....
 

you CAN takes some time. Finding a therapist who understands [even a bit] about neuropathies will help heaps. ASK! Don't be shy with your life and safety.

There used to be an old axiom regarding race horses [running athletes totally]: for every day off due to injury, it'll take 3 days to get back to that point safely. It's true for people as well. Rehab doesn't occur overnite.

First off - the Pain: Look up this site to get a handle on where you are to compare the 'before' PT and the 'after' PT issues. Really THINK about it hard. It's hard to be so objective about yourself when you plain-old HURT all the time, but give it a shot. Try to put it all in perspective, it's a which/what/where/what-kind of pain inventory...sorting it all out. Web up: 'Mankowski Pain Scale' and see how those #'s/ratings relate to where you are at any time... We all know about those times when we're a "15"!

Wittesea and MrsD have posted good sites to check out. I know well the breastcancer.org site well as a very useful site. There's lots of info there easily read....BC survivors often acquire PN as a result of chemo and rads... A good deal of neuropathy research is being done as a result of the vocal, active participation and clout of cancer survivors and their groups. We all should be VERY grateful. Don't discount it all, pain is pain.

Second - exercise...IF your PT sessions put you in a back 3 days steps worth of pain and ability to move compared to just before the sessions, talk to the head therapist or go and actually visit other outpatient PT sites to get a sense of the place in action and how therapists work with folks there. If you're having home sessions AND problems with a therapist...call and talk to the prescribing doc to see if there are alternatives. Therapists, like docs, can be insensitive to what/how we feel and have to do or CAN do in the 'getting better' processes.

IF nerves are re-generating, you really HAVE to use the muscles - those nerves, to program new nerves or re-program damaged nerves. You have to re-teach them all WHAT TO DO AND HOW! That can't be done if they're not in action. If, a Therapist wants me to work up to 5 reps of 10, say, on your own-do 10 reps of 5, then up that to 15 of 5 etc. The little 'bits' during different times of the day will cause less overall stress. And YES you have to stretch! IT IS A MUST! DON'T Try to achieve a view of 'perfection' right off the bat. Think of almost aged rubber bands, too much too fast and they break..You have to sort of soften them up before doing the stretches...tho probably rite now they feel as if they are curling up all the wrong way...go gentle and safe and YOU WILL get there!

Late today or early tomorrow I'll dig out some good stretching & building sites that are pretty much what most PT'ers do, so the pics and what each exercise does can help you experiment with what works well for you. IF it feels right in any way, try it and do it; If it doesn't DON't - trust your instincts about good and bad for you APART from the pain.

You will get there, I have and have to again after my recent knee injury!
Don't despair or give up...we all just have to learn what we have now in the best possible ways, in the safest ways possible!

Go for IT! - j

Only you can make that determination, not I.
PN is not a cut & dry diagnosable with specific terms-condition.
It varies from one individual to another. There are over 200+ causes, and many cannot be pigeonholed to any one individual. That is why we come here, to compare notes, Dx's, Rx's, symptoms and for advice.
The above advice from Melody, Mrs D., and Wittesea is good. The concept of a pain journal may be helpful, Mrs D's advice about her long trem battle with her problem is invaluable.
I always go by the tenet- If it hurts- Don't do it!:eek:
I am not a 'no pain-no gain' proponent. :icon_mad:
Never have been, and don't think I ever will be.:p
But I've never had to have intensive PT reahab. My only problem has been a broken finger that trapped a tendon, and is only repairable thru surgery :mad:
(I'll live with a slightly bent ring finger, thank you. The 'knife' is a last, and final resort.:( I still can play guitar & banjo, as badly as I ever did.:icon_wink: )

optimeg,

I agree with Nide44 100%. Do not stretch or exercise while on pain masking meds! (I don't use exclamation points very often) If you think you're in bad shape now, imagine how you'd feel and how long it would set back your rehab to have a torn ligament or tendon, or even a muscle tear.

I've seriously injured myself in yoga repeatedly (with my stupid male ego) just trying to force a "bit" more stretch. The latest example is getting a herniated cervical disk that resulted in muscle spasms and cramping throughout my left shoulder. The pain was incredible, and was only relieved by Fentanyl orally, and lidocaine patches to allow me to sleep, followed by months of physical therapy. I'm ready to start yoga again after more than a year off. That's how much a stretching injury can set you back.

Work with an expert. They know how to relax muscles to maximize the stretch, and how to stay safe. Generally, stretches should be held for about 20 - 40 seconds.

Easy stretches allow the muscles to relax and extend their range. Forced stretches cause reflexive muscle tightening, reducing the effectiveness of the stress and increasing the chance of injury.

Stretching is safer when you're warmed up. You'll find that you're much tighter in the mornings. Stretches then are beneficial, but you can't go nearly as far and so would have more of a tendency to overdo the stretch, injuring yourself.

One goal of stretching is balance so that your joints stay properly aligned. If you do a forward bend to stretch your hamstrings, you should balance it with at least some gentle stretching for your quads.

Progress in stretching is measured over months and years. Expect to see little progress day to day. Most likely is a loose day or two followed by a tight day or two or five. The tight days are the dangerous ones where you tend to hurt yourself trying to turn them into loose days. The tight days are from your body trying to protect you from further damaging micro-torn tendons, ligaments, and muscles. Listen to your body, going only as far as it tells you to go. If you take pain killers before a stretching session, it's harder to be sensitive to what your body is telling you.

In general, work with your body using your intelligence and sensitivity. Fighting your body and your tightness will only result in what fights always result in, hurt and injury. It's telling that the very first and most important precept of yoga is non-violence. Non-violence applies to how you deal with yourself.

Don't forget exercise. Stretching is only one component of being physically fit. Your muscles, nerves, and bones cannot be healthy unless they're used rhythmically for blood flow and nerve patterning, and against resistance for strength, posture, and body alignment. Strong and healthy muscles and bones protect your joints, help your general physiology, your skin and hair (better blood supply), and your PN.

Good luck and namaste (Indian for "I salute the spirit within you").

Any time your able hit the old swimming hole.
Lanny