How does a PT who understands pain react to an “injury” while working out? part 3

I’ll answer some of the questions that I posed in my personal low back “injury” story as well as a couple someone else asked.

Why did you lay down to the turf and start doing mobility exercises after?
And more importantly what were the mobility exercises? Do you have diagrams or a website or link that had these listed? And would you suggest them for someone who suffered chronic pain or just immediate onset pain during training?
There are a couple of reasons for laying down on the turf and doing some “mobility” exercises. There are some practical and theoretical reasons. First thing is, I wanted to decrease my pain. My system was very sensitive, a lot of movements hurt that don’t usually hurt. I wanted to try to calm the system down. Usually, but not always, there are movements or positions that someone can do to decrease their pain at least for a short time. Laying down off loads my body physically and is a good starting position to start experimenting with my new system. I say “new” because it’s different now than it was before pain. My system reacts differently to movement now. Movements that are safe and don’t usually hurt now all of a sudden hurt. This means my system/organism/self is hypersensitive.
Second reason is to start experimenting with my new system and see what it can and can’t do without further exacerbating my low back pain. I called them “mobility” exercises to for the sake of simplicity and to differentiate between stretches, but really it was just moving my low back in every which way it can move to see what hurt and what didn’t hurt and doing that repeatedly. Seeing how the new system (that’s me, as a whole person) reacts to repeated motions. If i did a motion multiple times and it significantly increased my pain after doing multiple reps, I would change/adapt the motion to what my new system can tolerate. For example, when I tried a full bridge, it hurt a lot, repeating it a few times again increased my pain further. So I did a bridge (lifting my butt off the ground while laying down) to the point of pain and stopped. I repeated that for a minute or so and it didn’t increase my pain. I also did the following exercises to a range which my system can tolerate (meaning it didn’t further increase my pain after doing it multiple times)
cat/cow
quadruped rocking
lumbar rotations
Supine bridge
All of these exercises are safe. When I say safe I mean it is very unlikely I am going to physically damage my body further by doing these. But these exercises can still increase or exacerbate your pain depending on how sensitive your system is. Remember, pain and tissue damage are not entirely dependent on each other. For a patient with chronic low back pain without any recent trauma, its ok to experiment with all movement and these are a great place to start. See what they can do, see what they cant do, see what hurts, see what doesn’t hurt, see what decreases pain. Important to do many repetitions to see how the pain reacts. You have to pay attention to the “trends” of the pain with multiple reps. If something feels good the more you do it, then do it more, if it feels bad, don’t do it. If these hurt, that patient should regress (make it easier) the exercise. Doing it slower, with decreased range of motion, to the point of not feeling pain is a good way to regress.
The way that patient reacts depends on a lot of different factors and its hard to predict. There are no exercises that everyone should do or exercises that will work for everyone or exercises that I can say will consistently decrease someone’s low back pain. For some, doing these will immediately eliminate their pain for others it can exacerbate it. So I wont say these are right for this kind of patient or that patient, I will say its ok to try them for most people. The most important concept to understand is that its ok to move and to experiment with how you feel when you move when you’re in pain. Fear of movement is the biggest predictor of chronic pain. People being scared of further hurting themselves with movement is one of the biggest factors that can make someone’s acute pain a chronic issue.
And I want to touch on a couple of reasons in theory…
3rd reason: I want to mobilize the build up of inflammatory chemicals in the area of pain. These chemicals are normal and are the systems way of treating an injury, you want these! But they do make your nerves more sensitive which can increase your pain and directly activate danger messengers going to your brain. All this can lead to increased pain.  You don’t want to completely stop the process but you want to move it along.
4th reason: I want to teach my system that movement is ok and not to consider it a threat. The best way to do that is to move. I will go into detail on this in the future…

If anything doesn’t make sense or if something sounds like bullshit, call me out on it, question it.

Disclaimer: This is not medical advice.  This applies to me in my situation at that particular time.