Tissue Damage vs. Tissue Adaptation

What does that mean... and why it is an important piece of pain management.

I talk about this quite often. So let’s define some terms: Tissue damage is anything that damages, causes injury to, a body part. Like a broken bone, torn ligament, etc. You’ve likely attended numerous appointments where they have done an assessment for other aspects of ‘tissue damage’ (muscles that don’t work right, imbalances in the body, and joint movement all included) that they will then somehow be able to treat. A biomedical perspective.

*Now, if you’ve been reading my posts up until now, you know where that last statement is heading in terms of treating persistent pain. It is an inevitable part of persistent pain, and rightly so, from the view point of evolution we are meant to look for the damage when we are experiencing pain. It is the correct course of treatment in terms of acute injuries (actual events of tissue damage).

This article is a different perspective based on the healing process required for persistent pain. Mainly how the nervous system has become so sensitive to any sensation that it sets off the danger alarm as soon as there is anything different. Even something as healing and beneficial as tissue adaptation.

But what the heck is tissue adaptation?! Tissue adaptation is a gradual process where your body adapts to different activities (at home, work, or recreationally). It can refer to any tissue of the body: bone, muscle, tendon, fascia, and nerve. Through this process, sometimes there can be soreness. You know the feeling when you try something new or push a little harder one day, you likely feel it a bit the next day. That is a sign of your tissues having been working a little harder than usual and, if you repeat the new thing… Your tissues take that as a sign that they need to get a little stronger, so naturally they adapt to the new movement/load and the soreness doesn’t happen anymore. And you are stronger!

Note: The opposite is true as well, if you don’t use your tissues (muscles, range of motion, etc) they will atrophy (the tissues will deteriorate/shrink/get weaker). Granted this is usually a less painful direction, until the day comes when you want to do something.

So let’s step back and look at the picture of pain. The cycle that brought you into persistent pain was likely one of pushing through that daily pain sensation to get through your day, what you end up with is persistent pain. Please read my article on the pain alarm for a better understanding of what happens when you push through pain sensations. When you start to do any new movement or exercise, that new sensation of tissue adaptation will show up, but then the nervous system sees it as the only thing it knows: a clear sign, evidence, of tissue damage. So the pain levels may increase. A very frustrating cycle.

How do we mitigate this response? We work slowly with the new exercise/movement/load and practice reminding ourselves that the sensation does have a cause, but it is a positive one and THAT IT IS A SAFE sensation. Again, this needs to be practiced, but it is effective.

But there is one more catch… that alarm system that has been over active for years, it isn’t just the sensation of tissue adaptation that can set it off. But also the sense of calm, of releasing tension. When your nervous system sees danger everywhere, the last thing it is is relaxed. You can feel that tension, it just sits there all day. When you begin to learn to connect your breath to the sense of release, the sensation of feeling grounded and calm, one of the first things your nervous system does is panic. It feels like it can’t let you lose control. It may send you a pain signal. Again, we need to practice knowing that we are safe. Don’t force it. Again, you’ve likely pushed through pain for so long that this one takes patience, and the ability to play with the connection of your breath and the sense of calm.

So where does that leave us? If you are experiencing daily persistent pain, as much as you feel unmotivated, it will do you good to move your body. BUT! Keep in mind that this is more than just doing your exercises, it is about practicing the knowledge that what you are doing is safe, having patience with the process, and paying attention to sensations calmly and seeing those ‘working’ sensations as positive tissue adaptation… Not tissue damage.

Any questions? Does anything pop into your mind while reading this? Message me, let's chat!