The human body undergoes daily wear and tear. Many blame these aches and pains to age, work and lifestyle. Some take pride in the battle scars or battle through it by using pain medication, ice and anything else that gives us temporary relief. Instead, taking charge and using healthier recovery options help restore and rebuild the body. The pain threshold (PT) is the minimum amount of pain or unpleasant feeling experienced by an individual. This may be changed by continuous stimulation. A person with chronic pain may have a high PT or a low PT. There are three different theories of pain symptoms that have been researched.

Lee uses three theories:
1. Neurophysiological theory suggests that continuous stimulation will induce a high PT because pain will inhibit.

2. Cognitive theory is an adaptive theory, proposes that if a subject often experiences uncomfortable sensations, their ability to perceive pain improves, which leads to a chronically increased PT.

3. Hypersensitivity theory suggests that the PT will decrease due to exaggerated reactions in patients with chronic pain.

A trigger point is a tender point in the muscle fibers that divides active and potential trigger points, also known as active and latent trigger points. An active trigger point is a point which moves during the performance of activities of daily living, while a potential trigger point is that one that is not felt until it is stimulated, by the application of pressure on the skin. Most people have similar potential trigger points despite having different lifestyles, which may be the main reason for pain. Physiotherapists must consider the potential trigger points when they create exercise plans for healthy people as well as patients.

Lee (2014) used fifteen healthy participants that were recruited and randomly divided into 3 groups: aerobic exercise, strengthening exercise, and control. The subjects in the aerobic group walked on a treadmill for 40 min at 6.5 km/h. The subjects in the strength group performed circuit training that included bench press, lat pull down, biceps curl, triceps extension, and shoulder press based on the perceived exertion for 40 min. The subjects in the control group rested without any exercise in a quiet room for 40 min. The PPTs of 5 potential muscle trigger points before exercise, and immediately after 10 and 40 min of exercise or rest were measured using an electronic algometer. The PPTs of all subjects decreased after 10 min of exercise, but the difference was not statistically significant. The PPTs of the control group decreased after 40 min. Furthermore, the PPTs of 3 muscles increased after 40 min of aerobic exercise and of 6 muscles after 40 min of strengthening exercise. No significant difference in PPTs was noted among the groups. The results show that 40 min is a more appropriate exercise time, although the efficacy of controlling pain did not differ between strengthening exercise and aerobic exercise. This study used treadmill walking as the aerobic exercise mode and circuit exercise was chosen as the strengthening exercise mode. These forms of exercise are frequently chosen as self-exercise. The same testing method was employed for the 2 tests that differed in duration (10 min and 40 min), and it was repeated at a 2-day interval.

COR provides exercising as a group, that provides many health and additional benefits for each individual in the group, and for the group as a whole. When you engage in a group you have a built in support system that will provide encouragement and motivation for continuing with your fitness routines. This can be especially helpful for those off days when you just do not feel like exercising.

Reference:

1. Lee HS. The effects of aerobic exercise and strengthening exercise on pain pressure thresholds. J Phys Ther Sci. 2014 Jul;26(7):1107-11.

Written by Chris Barber, CPT