Fewer prescriptions, more movement: how to get out of pain (without medications)

Issue #92: How to get out of pain without medications

Read Time: 6 minutes

Good morning, 66.1ers.
Today's issue explores a contrarian approach to pain management.

A quick refresher for anyone who's new to the newsletter: 66.1 is the average health span (years lived without a serious disease) in the US. We're here to extend that.

In case you missed it:
Wednesday's issue of 66.1

In this week's issue of 66.1:

A closer look at the conversation around walking and building your health

-The importance of developing a mobility practice in your life
-The dangers of muting pain signals by taking medications
-How walking should fit into your exercise routine

Setting the scene

A couple months ago, we published a guide to help remedy your back pain.

Central to this guide is the idea of a mobility practice.

The back pain guide focused on the probable cause of your back pain and touched on how to treat it. Our goal with today’s newsletter is to take it one step further and deliver an approach you can use to identify the source of any joint pain, treat your pain without medications, and disrupt the cause of this pain so you can live pain-free.

Notably, “joint pain” does not refer to joint pain caused by arthritis or other diagnosed medical conditions.

If you’ve been diagnosed with such a condition, please speak to your doctor before you enact the advice that follows.

What follows is my take on the value of a mobility practice in helping you live pain free.

What is a mobility practice?

A mobility practice is a series of low to moderate intensity exercises that are designed to expand your range of motion and restore your body to natural postures.

It also has the added benefit of reducing pain.

When I think of mobility training, I think of dynamic and static stretching, as well as using tools like foam rollers, lacrosse balls, and Theraguns to alleviate tension and soreness.

They’re not terribly different from torture devices.

Use them wisely.

Why mobility?

2 reasons:

1. You’ve been in pain recently
CDC says roughly 59% of Americans have been in pain in the past 3 months. And the vast majority of that pain can be grouped as “musculoskeletal” (muscles and bones).

I’m writing this from an airplane. According to the CDC statistic, of the 5 people in addition to myself sitting in row 18, 3 of them have dealt with musculoskeletal pain in the past 3 months. With me, we’re at 4/6.

Put another way, of the 1,299 people subscribed to 66.1, 766 of you are suffering from some sort of joint pain as you read this.

2. Self-reliance = freedom

Making yet another appointment with the chiropractor or being a lifetime subscriber to a pharmaceutical is expensive. And outsourcing your pain management means you don’t have control of your body (or your life).

If, every time you take a long haul flight, your back goes out and you need a medical professional, you can kiss your dreams of international travel goodbye.

Another example: if, every time you throw the football with your son, your shoulder feels like you got hit by a bus, you’re going to spend less quality time with your son.

Such compromises to your freedom end here.

Maintenance required

I’m a firm believer that you’re able to remedy 95% of your health challenges yourself. The key is to catch them early.

Of course, if you have any questions about the advice that follows, you should talk with your doctor before diving in.

In a world that depends on computers and smartphones, it’s impossible to stay out of postures that cause pain. But I’m not giving you permission to take 1000mg of Tylenol 3x/day for the rest of your life. To live free in a healthy body, you’ve got to be able to perform self-maintenance.

As Laird Hamilton says, “Pain is a message.” If your back hurts, that’s your body telling you something’s wrong. Not broken, just a little off. It’s like the maintenance required light in your car.

You wouldn’t just turn off the maintenance required light and keep driving for another 20,000 miles, though. That would ruin your car.

But people do this with their bodies. They numb their pain without treating the source. This numbing enables them to return to the unnatural postures that are causing pain in the first place. Eventually, you’ll get stuck in these positions. They’ll be your default. Over time, your joints will wear out. You’ll sustain more injuries.

Let’s not do that.

A 3-step approach

Step 1: Diagnose

Step 1 in your mobility practice is to figure out why your “maintenance required” light is on. Why are you in pain? Sit with a journal and write down everything you’ve done over the past 24-48 hours. Did you spend extended time at your desk without breaking up the time you were hunched over your laptop?

According to the Hospital for Special Surgery, “Frequent breaks once or twice an hour” is the best thing to do for sitting-related back pain.

Or maybe you were traveling. Sitting in car and plane seats leads to tight hips, shoulders rolled forward, and neck craned forward. All these postures tend to exacerbate back pain.

Here are a few other postures that cause joint pain (visual from Kelly Starett’s book Deskbound):

Of course, there are many other triggers that could cause such pain. Write them all down, imagine yourself doing each of the activities you write down, and consider which 2 or 3 are the most likely culprit.

Step 2: Stop slamming the door

Chris Sommer, USA gymnastics coach, says most musculoskeletal pain comes from a particular stimulus that occurs frequently. Sitting at a desk, for example. He likens said stimulus to slamming your hand in the door of a car. That hurts. You wouldn’t keep doing it. You’d take your hand out of the door before you closed it again.

So, too, with that computer posture. You’ve got to get out of it. I’m not saying quit your job. I’m saying take frequent standing breaks. Experiment with an exercise ball, a standing desk, a treadmill, a split keyboard, and elevated monitors.

Put your body in a variety of positions, and make those positions as healthy as possible. We’ll cover this topic in more depth on a future Saturday.

Step 3: Treat

Now that you’ve done a “posture audit”, it’s time to get to work. We’re going to decrease your pain, and we’re going to do it quickly.

An important rule to guide your mobility practice comes from the aforementioned Kelly Starrett. He advises working “upstream” and “downstream” of the pain you’re targeting with your mobility practice. For example, if back pain is your culprit, you might experiment with loosening up your shoulders and your hips. Your shoulders are upstream, your hips downstream.

Exactly which exercises you must do to loosen up your hips and shoulders is a topic beyond the scope of today’s issue. I encourage you to purchase Kelly’s excellent book, “Becoming a Supple Leopard” to guide you. While you wait for your 2-day shipping, check out The Ready State’s YouTube channel.

Getting started

3 steps to getting started with your mobility practice.

1. Start small
You will be tempted to spend 30 minutes on a foam roller tonight. Don’t do that. You’ll be really sore and you won’t come back to it. You might even unsubscribe.

Rather, do this:

-Pick a painful area you can trace to an unnatural posture you’ve spent time in this week.

-Spend 3 minutes stretching (Kelly Starrett is your resource for this!!) or utilizing mobility tools to loosen up your body at the next joint upstream of the pain.

-Do the same for the next joint downstream of the pain.

2. Pair it with a cue

When a behavior is new, it’s hard to remember.
A simple way to combat this challenge is to pair your new habit with an existing habit.

Personally, I enjoy executing a 10-minute mobility routine before bed every night.
It’s easy to remember.

3. Treat it as an experiment

You’re likely not going to have a magical moment and totally evaporate your pain after one mobility session. What’s important here, though, is to monitor what works. Do more of that. Throw out what doesn’t work for you, even if experts recommend it for your problem. Remember: no one is more of an expert on your body than you are. Listen to your body and adapt accordingly.

3 tools to get started:

You can do plenty of work without any mobility devices.
But if you'd like to experiment with adding tools to your practice, here are 3 I use:

1. Foam roller
A lot of surface area. Use it to roll large muscle groups like your legs, glutes, and back. Support yourself with your arms on the ground. Experiment with different levels of support to modify the amount of pressure you apply via the foam roller.

2. Lacrosse ball
Less surface area than a foam roller. Use it to roll in tighter areas (around your hip capsule, your shoulders and neck). Warning: less surface area = more pressure = more pain. Discomfort is ok, but pain means you're overdoing it.

3. TheraGun
For the folks who like gadgets. It’s somewhere between a meat tenderizer and a mini jackhammer. I like using the Theragun on my hips because the small surface area allows me to focus on the tight spaces around the hip capsule.

Housekeeping:

An announcement:

66.1 Saturdays will go behind a paywall starting next week.
Annoying for you, I know.
But it's the highest-integrity way for us to remain independent and continue to publish great newsletters.
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We appreciate your support as we advance the mission of 66.1 to live healthier, for longer.
More to come in an email later this week.

That’s all for this Saturday.

Have fun out there.

Marcus

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Why 66.1?
66.1 is the average health span (years lived without a serious disease) in the US, as of the start of this newsletter publication.
We're here to extend that.