Referred pain is tricky. Referred pain means another area of the body hurts than the part of the body that is actually messed up and causing the pain. So your shoulder or fingers might be bothering you but it’s really a neck problem. But your neck might not hurt at all. Your hips or toes might hurt but it’s a problem at your low back. When your internal organs have a problem you might get pain in a weird place. There are things called dermatomes. A dermatome is an area of the skin that corresponds to a specific spinal segment. If you have an issue with sensation at one of these places on your body, like it hurts, or it’s hot, or it’s cold, or it’s numb….it tells your therapist that something might be wrong with corresponding spinal segment. Or it might not mean that. Here’s a dermatome chart. I got this picture here.
There are also myotomes. Same idea but with muscles. If something is really weak, like your finger or toes or quads or biceps or whatever, you might have a problem at the corresponding spinal segment. Or not. Here’s a myotome chart. I got this here.
All that stuff I just talked about is actually called radiculopathy. But then there’s referred pain. Like when your left arm hurts during a heart attack, that’s referred pain. There ain’t nothin’ wrong with your arm(but there might be). Your heart is crying out for help. Here’s a referred pain chart. I got this here.
I once got a prescription to treat a patient for “deltoid pain.” Any therapist knows how utterly ridiculous that diagnosis is. Very thorough examination there.
After a stroke all of your dermatomes and myotomes will be all messed up and you’ll have a bunch of referred pain because the thing that controls it all, the brain, is f’ed up.
I don’t care who you are or where you came from, going downstairs and downhill is harder than going upstairs or uphill. This is because the muscles that control that motion are working very differently. The same muscles control the action of ascending and descending something, but descending is harder. Ever hear the expression “same shit, different day?” Well, here it’s “same muscles, different action.”
It’s kinda blurry but I really like that picture. It’s from here.
My mom says when her knee is hurting it hurts worse going downstairs. That’s because she using the quadriceps muscle eccentrically. When I climb stairs, it’s much harder and feels much less stable descending stairs. That’s because I’m using the quadriceps muscle eccentrically. If you don’t have a brain injury and tore your ACL or something, going downstairs will be harder. If you have perfectly uncompromised muscular and neurological systems, going downstairs and downhill will be harder. It might seem like it should be easier to walk or run downhill because of the momentum but you have to control the motion with eccentric contractions and they’re hard.
I’ve been emailing with someone who had a stroke and has multiple kids. Now, I’m speculating here and going to write about something that I have not experienced myself and know nothing about. I have no children and I’m not married. I think, maybe, again I don’t know for sure as I have no experience being a mother, but I think that being a mom might actually help recovery in the long run. It will give you a motivation to work hard unlike any other. Maybe, maybe not. I really had very little motivation myself. Getting back to the life that I was leading prior to the stroke was not motivation for me. I hated that life and wanted out. I was going to get out but then one day the universe thought “nah, I’m gonna teach her a lesson and disable her and make her live in absolute, utter HELL for a few years.” Lesson learned, universe, lesson learned. Thanks. Other than my animals, I really had no motivation. That’s when the support and love of a few friends and family members became critical because without that I would’ve been outta here.
This has nothing to do with anything….. So, I googled “grumpy cat lesson” to try to find a GC picture to put in this post and a picture of a schnauzer came up…..I have a thing with schnauzers.
Here’s my schnauzer….
Sorry I’ve been so quiet the last couple of weeks, I’ve had 2 crappy dental procedures and a car problem. Apparently my last dentist was not so great so I had to have this super-duper cleaning procedure done.
For all of my droning on and on about meditation and how super amazing and beneficial it is, I don’t have a post just entitled ‘Meditation.’ It’s always ‘Meditation and…………’ I finally got around to emailing the one neurologist I like in this world. Here is the e-mail…..
“Hi Dr. T!
Do you recognize my name? I hope so! 🙂
I wanted to tell you something. After my stroke, I saw A LOT of doctors, a lot. You were the only one that listened to what I had to say and didn’t treat me like you were superior and knew better. The general consensus in the stroke survivor community is that if you have a stroke, you’re screwed. We feel neurologists can be very arrogant and after the initial period of a couple of months after injury, you’re on your own and no one is genuinely trying to help you. I know this because I write a blog that has become the go-to place as a resource for information and support for stroke survivors. I get emails and questions from people all over the entire world about things to do after a stroke.
I wrote about you after my last appointment with you and have recommended you to other stroke survivors.
Here is what I wrote…
Please, please, please start recommending meditation and breath work to your brain injury patients, please. There is a plethora of evidence about meditation and its effects on the brain and I can’t for the life of me understand why it is not part of mainstream medicine yet.
Please tell your patients that they need to meditate.”
I really don’t get it. Meditation has so much research to prove how good it is for the brain and how it helps with neuroplasticity, I really am flabbergasted that neurologists don’t recommend it. They shouldn’t just recommend it, it should be a standard for brain injury patients. Read this. We have a lot of work to do. Meditation belongs on doctors’ prescription pads, it shouldn’t be just a fleeting recommendation.
Please go here for a better, affordable alternative to learning Transcendental Meditation.