Now, the next part of this module on the body is about preventing injury home injuries, sports injuries, work injury. There's a lot of areas where we can get in trouble and injure ourselves. And you know the phrase, use it or lose it. You can also have a phrase called, abuse it or lose it. And injury is something that's very common in our society right now because we do push ourselves to some extent. It's different than repetitive strain or postural strain. In this case, you do have a potential where you have a broken bone or you pull a muscle or tear a muscle. Which often does lead down to the path of chronic pain. So, it's important to distinguish a direct injury such as a broken bone or a tear from what's called delayed onset muscle soreness. Now, delayed onset muscle soreness is really post-exercise muscle pain. And this is just a normal response to unusual exertion and you have pain, you have stiffness after you exercise, maybe a day or two after the exercise. And it's a process where it's an adaptation process that leads to greater stamina and strength. And muscles do recover and build strength or bulk over time, as you push it. But it is important to be able to distinguish between what is a muscle injury or a joint injury and that post-exercise muscle soreness. So, let's kind of compare and contrast these a little bit. If you have really a muscle or joint injury as you're exercising or playing sports. Such as a torn muscle, a pulled muscle strain, sprained muscle or joint, sprained ankle for instance. Whereas delayed muscle onset soreness might come from post exercise, overexertion or overuse. The characteristics is, in this case, the injury will have abrupt onset. Whereas delayed onset muscle soreness is a gradual pain after exercise. You may not feel it the same day, you may feel it the day afterwords. In a muscle or joint injury, it's a sharp localized pain. You know that it occurs right then and it's very localized. Whereas delayed onset muscle soreness is more of a diffuse soreness over the entire muscle or joint or region that you exercise significantly. Now in addition, function, you'll not able to continue the activity, and you cannot put any force on the area. If it's an ankle, you can't put any force on that. If it's a leg, if it's a back. In addition, however, with delayed onset muscle soreness. It can continue, if you choose and, but, and, and you can still put some force on it but it may hurt just a little bit. And then, the muscle or joint injury you have weakness and tenderness and continued pain, whereas, in delayed onset muscle, the muscles are at the same strength. There is typically no swelling, no bruising and, you can continue the activity. Whereas in the muscle or joint injury you can have, swelling and bruising where as in a delayed onset muscle soreness you have no surface signs of any injury. So, it's important to be able to distinguish between these two conditions because you don't want to push an injury beyond the initial injury. You need to let it heal. Whereas with delayed onset soreness, there is something that you need to do to, to loosen the muscle up and to continue to use it in order for it to recover. And I'll go through this a little bit more in detail. So, how do you prevent sports injury or other home home or work injuries? Well first of all, you do some warm up exercises. In one study done by college, female college soccer players they reduces knee injuries by 50%. By some really standard warm-up exercise and its not your typical static stretching, you need some type of dynamic warm, warm-up exercises like yoga where you're moving, and stretching at the same time, coupled with like a gentle walk or jog. Then you can do your static stretching to increase range of motion of various joints. So, the combination between a dynamic warmup exercise to get your blood going, coupled with stretching, will, to increase range of motion will help prevent sports injury particularly. So, how do you deal with preventing injuries from becoming, becoming chronic? So say, for instance, you have a sprained ankle or you strained your back or your neck muscles during an activity. My son, for instance, was playing basketball the other day. And he reached up too high to get the ball. And he pulled a muscle in his neck and his shoulder. So, I ask him, is there any acute pain right there? He says, well it just feels really stiff and sore. So, I know there is not a serious injury there. It's more of a strain. So, in these situations, you want to what traditionally we've done was what's called RICE. It stands for an acronym. That says for rest, putting ice compression and elevate. And this is really appropriate for sprained ankles, or, you know, broken bones, or pulled muscles. Where there is that characteristic abrupt sharp pain. However, in most muscle, musculoskeletal injuries or strains, we'd rather use an acronym that stands for MEAT. And, in this case, we want to move it, we want to gently exercise it, we want to use some analgesics, and of course, treatment, treatments such as massage, or heat, placed heat on it or ice, whatever, but still keep it moving. So, there's a difference between this where your resting it, and in here you're, you're moving it. Like in the case of my son. So, what we did was gently, first of all, stretch it out, gently, let it relax, I massaged it slightly, and I had him move it around and walk around a little bit, with the shoulder. And within about, ten minutes or so, he was back in the game, playing, so it was really appropriate. After the game, he felt perfectly fine. So, it was an acute strain at the time. Wasn't a tear, wasn't a major injury. But he felt a lot better and was happy to contribute back into the basketball game. So, and this is an example of how we use movement exercise and treatment to improve the problem. Now, we also need to deal with other co-morbid conditions that can cause chronic pain. And, there are many, many different types of conditions that are associated with the development of chronic pain. And, of course, you know the most common ones are myofascial pain and muscle pain and arthritis. But there are a variety of conditions that go along with patients who have chronic pain. And, it's a very important to manage those conditions while at the same time you're doing what you can. And reduce your risk factors, and improve your protective factors. So, some of those conditions are such as obesity, or being overweight, will definitely put significant strain on the back, on the knees and ankles, and feet, and contribute to more musculoskeletal injuries and, and chronic strain and pain. Hyper-mobile joints as in this one. And you can determine whether you have hyper-mobile joints by just taking your thumb and moving it down and if you can touch your wrist all the way, or if you can take your hand and move it all the way at the back, typically that indicates you have hyper-mobile joints. And these hyper-mobile joints can often be a problem with regard to the muscles have to brace in order to stabilize it. So, you have to be careful, strengthen the muscles, gentle stretching, trying to avoid, stretching and increasing the hyper-mobility. Osteoarthritis, and rheumatoid arthritis. Joints do begin to degenerate because if they are putting too much strain or if you have an injury in the past. And you need to be treat, manage those appropriately. And there'll be a lecture by Kathy Anderson on that. And then, auto-immune disorders are also very important. Migraine headaches, diabetes, depression, anxiety, addiction, including tobacco, are all risk factors for the development of chronic pain, all need to be managed appropriately. And there are many more, co-morbid conditions. So one thing I want to talk a little bit about is you know, one of the, the most common causes of chronic pain. It is myofascial pain, and that's characterized, as I mentioned before, as acute tender localized areas within top bands of muscle, and as I mentioned before, trigger points around the shoulder, in the back of the neck, the temples, the low back. Even the pelvic areas can have specific trigger points and other areas of the extremities. One of the things that helps them very much with these trigger points is some type of counter stimulation to the muscle. And I've recently discovered trigger point massage with a device called the knobble, has been particularly helpful. And the Knobber, Knobble is a little hand held device, you can see it right here, with a knob at the end. And you can find the trigger find, trigger point find the taut band and massage it. And just rub it back and forth for five seconds, ten seconds, twenty seconds. It desensitizes the trigger points, breaks some of the connective tissue or fascial fibers around the muscle and allows the muscle to relax. And this is one of the more effective treatments that can be helpful. So, to end this part, I want, I, I believe it's really important to take home a few messages that are really critical about making sure that you can use the risk factors and understand the risk factors. Let me start that one over again, if you don't mind. [BLANK_AUDIO]. So finally, within this part, I want to take, send home with you a few take home messages. One of them that's most important is to love the body that you are in. It is our body. It's our characteristics. Some of us are tall. Some of us are short. Some of us are thin. Some of us are, are wider. We have all different characteristics. But it's really important to love the body we are in, and take care of it. It's the only body that we have. So, give yourself permission to love your body and celebrate one thing you love about your body or multiple things that you love and everybody does have trouble parts, parts that are sore and tender, low back pain, for instance, or neck pain or jaw pain. Send love and attention to those troubled parts and then find that cosmetic balance, not everybody looks perfect, not everybody's going to be a supermodel. We need to find that balance between what looks good and what feels good to us. And don't verbally criticize your body. it, it, that happens all the time with people who don't like a certain part of the body. It's not something that's going to help you long term. And finally, accept what you cannot change and then forget about it. And work on improving your body, reducing the risk factors, improving the protective factors. Take care of it on a daily basis, on an hourly basis and it will take care of you. And note, here's a few additional take-home messages for you. Now, follow the 90/10 rule. This means that you want to build 90% of your protective factors, and, everybody has some risk factors. Try to make them as small as you can, only 10%. And posture, live balanced against gravity. Everyday, maintain a good posture and reduce strain to your muscles. Relax when you're using them. Number four is exercise every day. I typically try to do anywhere from a half hour to an hour everyday, and I do it six days a week. I do it regularly. Otherwise I sit on my butt all day long and I'm not, I don't feel good by the end of the day. I need to exercise everyday. And then, when you do exercise, cross train. Do stretching, specially dynamic stretching, conditioning and strengthening. And you can break it up into two half hour sections. Or four 15 minute periods. However you want to do it but it's important to do each one of those. And then massage, massage is great. You can self massage. You can get a massage. But identify and reduce the trigger points that are contributing to that little bit of pain you have and prevent it from becoming chronic. And then, it's important to track. Monitor your pain levels. Where do you have pain throughout the day? You can write it down, you can think about it, but deal with those areas of pain. Find what your range of motion is, measure steps, calories, blood pressure, heart rate, how long do you do your work outs every day, really understand and track what you're doing on a daily basis. And then finally, be positive because it's all about your energy. So the next, I'd like you to just go and review the exercises that we have posted online for you. Watch the videos. Do the exercises. See how they feel And enjoy. Thank you. 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