Get Ahead of Pain
On this episode, I had a chat with Lauren Romeril, a Physiotherapy. We had an insightful conversation about rehabilitation and how to get ahead of pain.
About Our Guest - Lauren Romeril, Physiotherapist
Lauren first began her journey with physiotherapy as a small child recovering from surgery and has been passionate about the benefits of physiotherapy since.
She graduated from Brigham Young University with a Bachelor's in Exercise Science and then went on to graduate from the University of Queensland, in Brisbane Australia, with her Masters in Physiotherapy. Since then she has continued her education with training in vestibular rehabilitation, concussion assessment and management, yoga for pain care, clinical Pilates for rehabilitation as well as acupuncture. She focuses on evidence-based practiced and functional treatment that not only works with you to improve your health but to also keep you engaged in your own treatment. She is passionate about wellness and well-being and how those impact our physical being.
In her personal time, Lauren has a passion for running, boxing and practicing yoga as well as staying active. When she is not working she is most often found reading or listening to music with her two children.
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Important Discussion Points
Get Ahead of Pain | Question 1 - I understand that you've lived a lot of your life in pain or suffering through pain. Were you able to translate some of those experiences into the way that you help others?
Yeah, 100%. So, when I was 18, I was diagnosed with endometriosis, which ends up being chronic pain. And, there are times when it's better than others, for sure. And, it took a while for me to kind of accept that and learn how to deal with it. Because, I think initially when we're in pain, we just think that everything's gonna be about that pain. But, it doesn't have to be.
So, over the years, I've learned so much about how to manage my own pain and how to have it where it's just kind of background noise. Sometimes there is pain and sometimes, you know what, there's so many other things that are more important in my life that it's not really there. And so, being able to learn to manage that and finding that there's so many ways to deal with chronic pain has helped me.
It doesn't have to be the focus of your life. It can be part of your life but it doesn't have to be your life. This has given me that insight into how to help other people.
Because that I can look and say "hey, I've been there. And, you know what? It's hard and it sucks, but there's so much that you can do... it doesn't have to be your future."
Get Ahead of Pain | Question 2 - You've talked about how physical pain can start to manifest itself in other areas of your life, like mental health, if you don't get ahead of it. Can you speak to that?
Yeah, so, I think that's one of the big things that we don't always recognize. If we have pain, we just think "oh you know, I'm sore." And, sometimes, we just let it go on because we're trying to tough it out. But, when you're in pain physically, it starts to take a toll on your sleep and if you're not sleeping well, then your pain can become worse. And when you're in pain all the time, it takes a huge toll on your mental health because it's draining. Pain is exhausting. And, not just that physical exhaustion, that mental and emotional exhaustion. Every time you can't participate in something because you're in pain, it takes a little bit out of you. And especially with mental health, the more you're in pain the more likely you are to suffer from anxiety or depression.
It just impacts so much and we know physical pain can manifest itself in those ways. But also, anxiety and depression can manifest in physical ways. So, it goes both ways in that, if we're not managing one of these areas, it's gonna affect everything.
Get Ahead of Pain | Question 3 - I believe there's still a misconception or confusion as to what rehab really, really is. So, how would you define rehab?
That's a big one. So, I think some of the things defining rehab is it's not just exercise. A lot of the time people come in and they think, oh you're just gonna, I'm gonna come in you're gonna make me do exercises like with Therabands and it's just gonna be painful and then it's gonna be terrible. But really, when you're coming in for rehab, it's me getting to know you and getting to know what are you here for? What are your aches and pains? What are your goals? What functional things are limited? What do you do every day that you can't do? And then, it's creating goals around that. And, the goal with rehab isn't for me to see someone forever. I want to see someone as few times as they need to be successful. And so, I want to make it so that they have the tools to take care of themselves.
So more often, rehab isn't just some exercises. It's more us making a plan. How are you gonna manage at home? What are you gonna do if your pain flares up again? What can you do proactively or preventatively as well? So that you have a long-term plan to take care of things and that, I'm just there as a resource for people to come, kind of check-in as needed once we get them back on track.
Get Ahead of Pain | Question 4 - Let's say an individual wants to be proactive. What can you do to kind of stay ahead of pain?
Yeah, there's actually a lot. So, there's kind of this movement right now in the physio world called “prehab”. And so, it's more of that proactive or preventive rehab and starting ahead of time. So, especially for athletes or people that participate in a regular activity. It's great to get ahead of things.
So, someone that's doing like a ball sport and they're doing a lot of the same movement. So, if you're always like pitching a ball or throwing and your arm’s always up. We want to do everything we can to strengthen the rotator cuff around the scapula. You're really protecting and building the strength. So, it's looking at what you use often and how to build those muscles to prevent injury in the future.
Get Ahead of Pain | Question 5 - How does an individual who's suffering from pain know when he or she should be going to see a rehab therapist? Putting them on a scale from 1 to 10.
Yeah, I would say because that's different for everyone. Like when I look at a pain scale, someone’s 10 is gonna be someone else's 2. So, I would say when it's not working for you anymore. When it's impacting you and it's affecting part of your life. If it's limiting you from doing something you enjoy, you need to be checking in with someone and getting some help. If, you know, it’s kind of that ache where it's annoying but it doesn't bother you at all. If it doesn't bother you, that's fine. When it doesn't work for you anymore that's when you should seek some help.
Get Ahead of Pain | Question 6 - We like to go to Google or WebMD and self-diagnose. Do you have any cautions for somebody who might be treating themselves based off of advice they found on the Internet?
Yeah, it can kind of go two ways. If the diagnosis isn't what they thought it was, it might just not be impactful or it might potentially do more damage depending on what they're doing.
But, the big one I see is back pain. You hear people say "you know I've hurt my back, it's likely you hear like my discs are out of line" or something like that, which doesn't really match up with science very well.
So, they'll come in and they'll say "well you know I hurt my back and I haven't really done any movement for six weeks and it's not gotten better." And that's one of the biggest problems. Movement is one of the best treatments we can do. Research is now showing that there's not a specific movement or exercise that's best for back pain. It’s movement that's best.
This thought process that people have that they shouldn't move when they're in pain is actually what's setting them back in their rehab. Because, the longer you're not moving, the longer it's now gonna take for us to get you moving and change those pain signals. Yeah. So, I think that's the big one is when people think "oh I have this injury, I should do nothing until it gets better". And if that's the treatment plan they follow,it can take quite a bit longer for us to get things back on track.
Get Ahead of Pain | Question 7 - How does someone decide between a physiotherapist and a chiropractor for back pain?
A lot of it can be personal preference. I know there's a huge variety in both how physio and chiropractors treat. It seems like more commonly now we're overlapping a little bit more where we're both kind of focusing on that initial decreasing the acute pain and then working on building strength. So, I know some chiropractors that prefer just to help in that initial stage with the acute pain and then they'll transfer them back over to physio for us to do more the long-term management.
So, I think it depends what you're looking for. Usually on the physio side we're really focusing on that strength building. So, how are we going to manage the pain, but also how are we rebuilding that strength and getting you moving again. I can't speak as much on the chiro side since I don't have as much experience there. But I know for the physio side, a big thing that I'm doing with people's back pain is movement. How can we find movement that's a gentle movement that's not making your pain worse but it's getting you moving?
Get Ahead of Pain | Question 7 - Okay, can it ever be too late to get into rehab. Like, can you wait too long so to speak?
Not from what I've seen. I guess there are probably some caveats to that. Like, if you're with a stroke, the sooner you have rehab, the better options you have. Within those first two years after a stroke is when you're gonna get the most out of it. And, I find cases like that are a bit different because usually you're in a hospital and you're transferring from care through that. But with more of those everyday injuries that happen at home or in sports and those everyday things, for the most part there isn't.
I've seen people with concussions three years down the road and we've had great success. People that have had shoulder injuries or back injuries and they go “oh you know when I hurt my back fifteen years ago and then it kind of got better and life happened and then it got worse”. And, they'd have had a few incidents as that happened over the years. Just because it's been a long time since the initial incident doesn't mean there's nothing we can do. Usually, there's still quite a bit we can do with it and it just takes a bit more time.
So, the longer we have pain the longer it's gonna take for us to get into rehab
Get Ahead of Pain | Question 8 - Given your experience with pain and the fact that you have kids, are you doing anything with your kids today that sets them up for long-term success in staying away from pain?
Always have your kid in a helmet. A helmet's not gonna prevent a concussion but it's gonna prevent something more serious.
So even if it's, you know, your kids on the bike, get them in a helmet. They're doing anything that could have that contact, get them in a helmet. And then, I would say it's good to just evaluate how often are they getting hit? If they're in a sport that has a lot of contact, are they taking a lot of big hits? And just noticing is there any change with your child? Is it cognitive, is it mood-wise? Things like that to watch because if they are noticing any change, you want to stop the activity and get an assessment just to see how they're doing especially as they're still developing.
Get Ahead of Pain | Question 9 - What is the worst-case scenario if you have pain and you don't treat it?
Well, if you're not doing anything about it and you are letting yourself suffer from the pain. So, you're gonna start losing strength, you're gonna lose range of motion. But, the longer you have pain, so if you're having that consistent pain for three months or longer, it becomes chronic pain or persistent pain. And, at that point, that's when we notice there's more changes in the pain receptors, the signals your brain sending. That's when it's more likely to be affecting your mood your sleep, your mental health.
So, the longer you're leaving that pain unchecked, the more you're doing kind of as damage as a whole.