3
Chapter
DiagnosisExercise and pain
Exercise and pain Contraindicationsdiagnostic aspect as well, as many musculoskeletal
and systemic diseases affect not only the quantity
and quality of movement, but also the posture.
Likewise posture affects the functions. In a com-
pressed trunk fluid transport and nerve supply to
all tissues and organs are compromised. A poorly
lifted spine also affects the functions of the central
and autonomous nervous system. Good posture
improves the functions of all connected tissues
and organs.Exercise and pain
Pain during and after exercising is a frequently
debated topic. First you need to find out whether
the pain is caused by the exercise being performed
wrongly, or whether it indicates disease. If the
pain persists after the exercise has been adjusted
correctly and to the intensity appropriate for the
patient, a thorough investigation is necessary.
Pain is an important warning signal to prevent dan-
ger to health. It is a complex perception of differ-
ent qualities: it can be an ache or a sharp or burning
pain. Individuals perceive and rate pain differently;
it cannot be measured objectively.
According to Pschyrembel (2007), there are
several categories of pain:
• excitation of sensory nerve fibers and
conduction to the central nervous system
• neuropathic pain caused by damage to the
peripheral or central nervous system
• pain from disturbed function, such as muscle
pain caused by wrong posture or emotional
stress.
Pain syndromes, conditions associated with chronic
pain and lasting longer than 6 months, are catego-
rized as:
• pain caused by inflammation, such as arthritis,
myositis, or inflammation caused by injury
• spastic pain caused by excessive contractions of
the smooth muscles in organs
• neuropathic pain or neuralgia, caused by direct
irritation of or damage to the nerves or directly
from the central nervous system without the
pain receptors being involved• headache
• pain caused by dysfunction or bad posture
• psychosomatic pain, e.g., muscle hypertonia
from emotional stress.
The myofascial pain syndrome frequently occurs
in muscles or muscle groups and can be caused by
overwork or strain of muscles, trauma, cold tem-
perature, degenerative or inflammatory conditions,
systemic diseases, or emotional stress (Pschyrembel
2007 ).
In referred pain the cause is remote from the
area of pain sensation. The most common cause is
the convergence of pain-sensitive nerve fibers from
organs and skin areas, the so-called Head zones.
Excitation of nerve fibers from organs is felt in cor-
responding areas of the skin. The area for the heart
is in the chest, frequently spreading into the left arm
or the upper abdomen (Silbernagl 200 7 ).
We shall now consider pain in connection with
the practice of yoga. First of all you should aban-
don the idea that exercising only helps if it is
painful. Exercising should not be painful, partic-
ularly afterwards. There are very few exceptions
to this rule. Pain should ease after a while; it can
be released with exhalation or sustained sensitive
stretching. As mentioned above, where there are
serious signs and symptoms a medical investiga-
tion is necessary before using yoga as a therapy or
adjunct to a medical treatment. This also applies
to serious pain.Pain during exercise
If stretching muscles or scars causes pain, it is sen-
sible to tolerate the discomfort to a certain degree,
as long as there is no irritation and the structures
are not overstretched or torn. This intensity must
be felt and handled very carefully. For muscles to
lengthen takes 3–5 breaths. During stretching the
pain should be relieved, there should be a feeling of
give. If the barrier felt is too hard, painful, and not
releasing, ease off slightly and continue the stretch-
ing more gently. Often it helps to let a stretch go as
you breathe out.
With the same sensitive awareness, scars older
than 6 months and shortened connective tissue fibers
can be stretched, except that it takes 2–4 minutes