When I recently took part in a “Love Your Body” blog post for Girls Gone Strong, it struck me how *none* of these fitness goals/body image crusades have ever actually helped me.
When my fitness goal was being lean and getting that six-pack, I initially felt a new sense of control because of it; yet eventually I realised it wasn’t the answer I needed. When my fitness goal turned to what I could do over how I looked, I initially felt empowered by it; yet eventually I realised it too wasn’t the answer I needed. The current “trend” of learning to “love your body flaws and all” seems wonderful and liberating … but I’ve come to realise that after the initial surge of feel-good hormones, I can’t seem to actually do it! Why doesn’t anything stick?!
If nothing really changes after I get an answer, perhaps I am asking the wrong question. Or maybe I’m hoping the answer to one question will be the answer to all questions.
I have managed to be on both sides of this: both the seeker and the answer-giver. I started to feel less like I was really dealing with the right question when I was left feeling dissatisfied and empty with each answer. Each time I’d think: “yes! That’s that’s where I should be”. At best I’d end up faking it hoping to one day wake up “there”… but why do I feel I need to fake it? What do I think “it” will bring me? And more importantly, what was wrong with where I was at?
These fitness/body image messages all rely on the same concept: the reader believes that there is something wrong with themselves. If “Fitspiration” messages appeal to you, somewhere there is an underlying belief that you will improve yourself only if you look a certain way (i.e. you need improving); if “acceptance” messages appeal to you, the message only makes sense if you believe there is something wrong with your thinking or feelings about yourself (i.e. “you shouldn’t want to change, you should love yourself”). Rather than actually help, they seem to feed into fear, into perfectionism, into the underlying message that something must change: either yourself, or the way that you think about yourself. It’s still saying that you will feel better when you’re here; it’s what you need. But where is “here” and why is it somewhere you want to be? It’s just confirming over and over again what you already feel: where/who you are isn’t enough!
For me, I’ve realised that I tend to feel an enormous pressure to keep earning my value from places that don’t offer me any. These goals make me promises that they’ll be just what I need. It goes like this: I want to feel valued so I look for what’s valuable … and I try that. What does it mean when I don’t make it? It reinforces my belief that my value is contigent on achieving something else; it’s “evidence” that I’m still not good enough.. The goal is not the answer, it’s a condition to another condition that takes you further from even asking the real question.
I see all these goals/achievements and narratives we formulate about ourselves as bricks that we build up around us like a giant cold wall (maybe with paint on the outside). We build a version of ourselves who we like more, who we maybe even love. But there are always a few cracks or missing bricks (getting damaged in storms like failure, self-doubt, cognitive dissonance) that we desperately try to fill in just to keep our true selves from being seen. We keep looking for new bricks and before we know it, we are locked behind this wall feeling more anxious, less loved, maybe more alone. We might even wonder: “why don’t I ever feel good enough?!” or “why can’t I just be happy?”.
What if the wall fell down, maybe I start pushing some bricks away. With those “badges of honour” shaken off, there I am naked and vulnerable, full of shame for being less than I think I should: Can I love myself now? It feels mighty uncomfortable and I feel small and insignificant… but I am also feeling the heat of the sun on my skin, and radiating a healthy glow. Can you see me past your wall? Can I see you?
Perhaps the better questions I need to ask myself are:
What do I think I lack that these things (being leaner, being stronger, loving my body) will give me?
What does it mean if I don’t achieve these things?
What does it mean if I do?
Why are any of these things important to me at all?
As Timothy Keller put it:
“To be loved but not known is comforting but superficial. To be known and not loved is our greatest fear. But to be fully known and truly loved is, well, a lot like being loved by God. It is what we need more than anything. It liberates us from pretense, humbles us out of our self-righteousness, and fortifies us for any difficulty life can throw at us.”
Over a year ago I switched off my video camera and for a while I didn’t think I’d “put myself out there” ever again. Then, as I was thinking about what I want to do with my life now that I am in the U.S, I realised how I gave up on my dream. My dream was to keep producing content to help people and make a living from either training people directly or over the internet. One of the things I enjoyed most about my blog was that I got to share the ins and outs, ups and downs of my life. I felt passionately about expressing these things because it just might help somebody else see that we all have insecurities, doubt, joys, and trials. I feel like I stopped believing that anyone would want to hear me.*I* didn’t want to hear me, and so I stopped… I let my own self-doubt and self-analysis stop me feeling safe to be e-vulnerable.
Since leaving Saudi just 4 weeks ago, I can already tell that something has shifted inside me and I am ready to do *something*! I am ready to get back on the horse, turn my camera back on and let “the world” see me as I am, where I am at, and invite you to walk with me once again as I try to put into words (and action) the lessons I have learned, the things I *still* struggle with, and how I decide what is worth taking with me or what I ought to leave behind.
Today, I filmed a workout in my basement with my NEW Kettlebells. It was very simply 3 rounds of 5 exercises. I started the workout thinking I’d just do it and edit it afterward, but something made me start to give training cues and I kept the video running for the entire workout so you could see and hear me struggle, succeed, chat, and laugh. Maybe it will motivate you to pick up a KB and join in 🙂
I am neither as fit, strong, lean as I was, but I want this to encourage you because I want you to accept and celebrate that your body is an otherwise empty vessel and it’s what’s inside you that gives you value, because that’s where you are.
It is because of who I am that I am doing these things with my body; doing this things with my body does not make me any more or less valuable. And this applies also to how I look.
So, let’s get on with it…
Complete 3 rounds of the following:
Goblet Squat: x 10 reps
Push-Ups: x 10 reps
Dynamic Squat: x 10 reps
Two-Handed KB Swing: x 10 reps
Plank Jacks: x 10 reps
Good as a short and sweet blast workout for high intensity or general fitness, or as a finisher to a longer strength workout.
You don’t have to read these five strategies in order, but if you want to, you can read the previous ones here: Part 1 and Part 2.
I have often felt under some kind of slavery to my pain; like it was a cruel master taking away all my freedoms and my happiness – it’s the pain’s fault that I feel this way! This is a way of life I did not choose and it was one from which I could see no escape.
There are different ways you can respond to things like this … and, if I’m honest, I tend toward being negative. It’s hard for me to break free of thoughts and actions that actually make things worse. Now that I know that emotions, stress, worry play into a pain experience, it’s no wonder being helpless and self-obsessed (always thinking about my plight) only drags me down and makes me hurt more. Am I really a slave, though? Even if I was, is it possible to think in a way that at least frees the mind and soul which filters through to the body? YES there is!
Become as a child and….
Play/ use your imagination
When I was too sore to do any kind of weight training, I resorted to swimming. I love to swim, but I love lifting stuff more 😉 The compound has a nice big pool and the summer nights were hot enough to enjoy a few dozen laps… but I didn’t feel much better! Actually, swimming up and down was pretty boring! So one night, when the pool was empty, I decided to become that mermaid I used to imagine as a child just diving, tumbling and creating a narrative in my head about what I was *really* doing in this “sea”. I began enjoying the challenges of chasing imaginary fish and swimming from imaginary sharks. I did handstands, swam along the pool floor and broke all the rules of normal adult swimming etiquette.
Guess what happened to my pain? I have no idea, because while I was in “play mode” I lost all awareness of it.
And so, rather than go to the gym and second-guessing my movements, posture, alignment etc, I simply transported myself into another world where push-ups were part of a competition or some other kind of fun thing. I began thinking about these movements in a completely different (and imaginary) situation.
As a child, I was super imaginative and I could be or do anything! I’ve lost a lot of that in adulthood, but I want it back! I want to use play and imagination to break down the walls I have built around myself.
A friend of mine (who I will hopefully interview on his pain experience) has used play remarkably well to move without pain. He uses the natural environment to create situations that he has to use many of the typical exercises he would have performed in the gym. He told me how when he’d go to the gym, Chin-ups and Pull-ups became impossible because as soon as he went to do them, his pain got really bad. He changed the environment (to a tree) and could leap over to a branch and do a muscle-up type movement PAIN FREE!
Not only is this awesome because it’s fun; it’s awesome because it proves that pain doesn’t always = injury. He had no structural problem that would justify the removal of that type of movement from his training. And just because you have more pain at certain times, doesn’t mean there is some injury getting worse. Remember: pain is an indicator of perceived threat by the nervous system and there are many systems and factors that influence your brain’s decision on whether pain is “necessary” and how much pain is “needed” <– and sometimes this decision is based on an over-reactive system.
Play and imagination might help “rewire” the circuits, because if a certain movement, in a certain situation has been causing pain, you can begin to show your nervous system that this movement doesn’t hurt in a different scenario. My friend was still doing pull-ups, but it was in a novel situation that then might allow his system to adapt and reduce pain if he returns to the gym. Maybe he can imagine he’s back in the forest, like I imagined I was a mermaid in the sea 😀
But that’s not all!
When I’m not exercising, I have found that being light-hearted, care-free, silly, and even just being caring and generous toward others (basically, forgetting about my own problems), I do not notice my pain, unless I happen to move in an awkward way.
You might say: “well, it’s impossible to be like that all that time!” and I agree. But what this knowledge has done for me is reduce the anxiety and catastrophising that I do because I *know* how much I can affect the suffering that accompanies my pain. I might have some level of pain each day, but I can remember how that pain can seem less or more simply by what “mode” I am in. While there have been days that I felt I couldn’t take any more, every day has been a day that I *have* overcome – and that is victory!!
I truly hope you will try this strategy and I pray that you can be “as a child” 🙂
My chronic back pain is no secret. In fact, it was one of the reasons I started to exercise. I was told I had Ankylosing Spondylitis (albeit a mild form) and that exercise would “stop your spine from fusing”. The doctor did a good thing encouraging me to move more, it’s just a pity he also didn’t explain how pain works. Perhaps I can use my experience with pain to help others who have pain in a way I could never have done before. What I am going to share over the next few weeks aren’t just 5 things that have helped me (although they have); these are quite possibly some of the best options out there to help your current pain or any future pain.
Before I begin I want to underline something very important: these methods don’t work overnight and ought to become part of every day life so that you can begin to change how you think and respond to pain. When I first saw some success from these methods, I was filled with hope and confidence in them and I felt “cured”… but what I hadn’t adequately prepared for was the occasional relapse. It is during the “bad” days that you need these strategies to be well ingrained and for that faith in the process and the journey to keep your nerves “intact” (pardon the pun). It’s very easy to allow the distress of pain to rob you of hope in the bigger picture and for you to fall into the trap of assuming that you have regressed to square one and you no longer believe that the strategies are working. That is why it is so important to always count your blessings and remember each improvement and set your mind on positive things, rather than always on thoughts like “am I still in pain?”.
I wanted to make this one blog post, but after writing out the first strategy, I realised it might be better to split this information into smaller parts to help you assimilate it all. It can be a lot to take in.
1. I learned more about pain
For years we have heard from Doctors, Physios, Chiros, Massage Therapists, and even Trainers (and I am guilty too) of spreading misinformation about the causes of pain.
“Your leg length is off”
“You have flat feet”
“Trigger points”
“Your pelvis is out of alignment”
“you’ve blown a disc”
“Your back is a ticking time-bomb”
“I just have to look at you squat and my knees hurt”
“Watch you don’t wreck your back when you deadlift”
“Your diaphragm is dysfunctional so all your pain stems from there”
“You have bad posture and that’s why you have neck/ shoulder/ back pain”
“Oh, you have back pain? Your Glutes are weak and you have tight hip flexors.”
The list of things I have heard is endless.
Basically, what seems to happen is that therapists correct what they think is “off” and pain might initially improve. So they rationalise this like so:
– You have pain and X is tight
— Work on X’s tightness
— pain improves
—-therefore X was the cause of pain
Bingo!
Hmmm, NOPE!
There is a rather large body of evidence that now shows us that posture, structure and biomechanics are poorly correlated with pain. Meaning, they are unlikely causes of pain and improving or “fixing” these play less of a role in healing pain than was believed for a long time. And, if someone tries to explain your pain’s origin as a tightness, imbalance, weakness, poor motor recruitment, poor breathing, poor alignment – close your ears. Treating said tightness etc might help, but that is not proof that it was the cause!! This is very important to remember. Think of it this way: Are you sore because you’re all twisted up or are you twisted up because you’re in pain?
Being somewhat lazy and a little rusty on how to reference properly, here are a few blog posts that have great authors who did that work for me. If you’re anything like me, you might appreciate reading a blog article that is making sense of the research, rather than reading the research itself.
And, of course I enlisted the help of my very smart and handsome husband, Dr Jonathan Fass, DPT in an effort to iron out some commonly held myth-beliefs about pain and injury. Find that HERE and remember to check out the list of resources at the end of that article too.
Yes, there are other resources, but I like these ones because they cover all the basics. And that is always the best place to start. Lay the foundations and build the rest as you begin to understand it.
So what is Pain?
I felt it was important to talk first about what pain isn’t (a signal that comes from the muscles, joints or bones) so that we can better grasp what pain is (a signal that comes from the nervous system, and is governed by the brain). Pain is not always indicative of tissue damage/injury, and it is not proportional to damage.If you have more pain today than yesterday, this does not mean there is more (or any) damage. When you have pain, your brain has received danger information from one or many locations within your body (via the vast network of nerves) and has decided that it warrants some pain to change your behaviour and protect you from something that is *perceived* as a threat.
And I get how confusing that is!!!
When I first heard this stuff (a couple of years ago) I failed to assimilate it because I got defensive and thought it was suggesting that my pain was all in my head (as in, imagined). But actually, *all* pain from is the brain (and nervous system) – even if it’s just a stubbed toe.
At this point I want to highlight something so that you don’t misunderstand me. I am not saying that pain is somehow not physical. It is physical, but these physical changes and responses happen within the nerves and brain. Before, I always thought pain came from damaged tissue and it told my brain it was in pain, but this is not the case. The nerves deliver a message about what’s happening (toe got stubbed on the table) to the brain and the brain then decides whether pain is needed. However, sometimes this system doesn’t operate as we would expect.
For example:
You stub your toe just as a lion jumps in the room. Are you going to have pain in your toe? NO WAY! Your brain will delay that until you are safe enough to tend to your toe.
And there are many other times when the brain and nervous system respond in ways that really do not make sense if all pain is from injury:
Have you ever discovered a cut or bruise that you didn’t know how you got?
Does your pain get worse when you’re stressed?
Does your pain get worse when you’re tired?
Ladies, do you feel more pain before or during your period?
So, pain is a response (like an alert) from the brain to a danger signal from the body. BUT, the “alert” may be very very quiet (only a little pain) or VERY VERY loud (lots of pain). And if you’re like me, and your pain seems to get worse for no apparent reason, it can be very disconcerting and cause much unnecessary confusion and angst. This is why knowing how the nervous system interprets information will help reassure you that when you get a bad pain, it may not be because something has gone seriously wrong.
So what amplifies that “alert”?
Now consider each of these things potentially “ramping up” your nervous system’s alarm sensitivity, making that alarm ring a little bit louder:
– Not knowing about how pain works and what it means
– Stresses (family, work, money, health worries or fears)
– Thinking the worst (catastrophising)
– Fearing movement because you believe it is causing damage
– Depression and lack of sleep (this can be a vicious cycle for someone who already has pain)
– Loss of motivation to train (maybe because of fear or depression or hopelessness – or being told not to train by a well-meaning physio or doctor)
– More pain
– Fear of pain itself
– Beliefs about your pain and/or diagnosis
– Oh and even hormones, temperature and your immune system can contribute to your pain *experience*.
There are more things that could potentially go onto this list, but you get the gist.
Factors like these can play some sort of role in your pain experience. Even if you do have an acute injury, it is still helpful to understand why some days your pain may seem worse, even when healing is under way. Pain does not mean something isn’t healing. The body is very good at healing its tissues, but sometimes after an injury the nervous system becomes more sensitive as a way to guard from a repeat injury. After all, if anyone has ever been in severe pain, you’d do anything to prevent it happening again, right? So, depending on your circumstances, your beliefs, your history etc etc your pain experience will differ greatly compared to someone else. But you also have a lot of control over many of these factors – and that is great news! And even if you can only influence your knowledge about pain, that has been shown to help pain.
Pain as an experience.
No one has the same experience of pain because there are so many factors involved in pain’s creation: memories, beliefs, smells even. But guess what? That means *you* (the person dealing with pain) have more control over it than you may know. It is quite helpful to become proactive about your pain triggers – without obsessing on them. If stress is a trigger, then you can use some of the other strategies to help with that. If beliefs are an issue for you or fear, then this educational strategy will really help.
For years I expected someone else to fix me. Either by massaging away my tight fascia, teaching me “good alignment”, correcting my “dysfunctional breathing or movements” or by prescribing me better medicines. These strategies are called “bottom up”. While many of those things can help pain, they don’t get to the root of it and you often end up seeking more treatments and getting more investigations, which don’t have as much success long-term. Since pain is governed by the brain, then surely we ought to focus our attention there to see what can turn down the alarm. The best pharmacy, after all, is right between your ears.
By using the next 4 parts of this series, you will learn a total of 5 “top-down” strategies (education is also a “top down” approach) to radically influence your pain.
Life and death is in the tongue.
Do I still have pain? Yes, but it is MUCH better than it was, but the main thing is that I don’t respond the same as I always did – which was the belief that there was something wrong with my tissues, joints, posture, breathing etc. I thought I was broken and I was at odds with my body. But now I see that my body is healing and movement is good. Avoiding movement (and this happens if you begin to believe that some movements or postures are “bad”) can actually cause you to have the very pain you are trying to avoid.
Which brings me on to another issue that comes from the words and reactions of therapists, doctors, trainers, and even the beliefs within a society about pain. There is a good amount of research into something called the nocebo effect (the opposite of placebo). Basically this means that the beliefs you have about your situation can make things worse. For example: If someone is told they have “blown a disc”, how do you think that will affect their beliefs about their back? It could potentially make them fear moving their back (because they believe pain = damage) and this fear increases the alert which increases the brains output of pain to protect that “weak” and “vulnerable” area. Pain is protecting against a false danger. This person could live for years in chronic pain because they started to fear moving their back. And they may actually begin to get other pains (in their hips, down their legs or their sides) because they have become so stiff and “braced” in order to support their back that these muscles never stop bracing. Can you imagine clenching your fist all day every day? That would eventually hurt, right? So these words can have real negative effects on people’s lives. Instead of being told that discs herniations are very common, that they heal and movement is good, they are told never to lift or flex their back again. Plus backs are strong and the disc may have had very little to do with their original complaint.
But don’t take my word for it – read the articles and set yourself free from believing all pain is caused by tissue damage.
Here’s another little list from smarter people than me who have listed the research.
In Part 1, i discussed a little about my own pain experience and how i have made a commitment to being free of pain or living with it better. Today, I am joined by my hubby to help you apply all the information about pain to your situation.
One of the biggest “AH HA” moments for me was when i realised that pain in the body does not correlate well with damage in the body. If you MRI 100 back, there will be people will disc herniations and inflammation who have NO pain and you will have people with perfectly normal backs who HAVE pain.
This means that pain is not just what is going on in our tissues, but what sense our brain makes of the entire situation.
So, while my SI Joint does show inflammation, that is only one part of the puzzle. The memories, the fears and my understanding of pain and what it means ALL influence and affect my experience probably more so than the inflammation. You see, i have had periods of time when my pain was far less (maybe i was really relaxed or i was feeling like my treatment was working) and i had a repeat scan done that showed just as much inflammation as before – yet no pain. Surely, if inflammation was the cause of my pain, i would have pain all the time. For me, i think it is much more to do with my emotional state and my beliefs about things like medication, inflammation and what i have seen other people do that all impact on my experience.
To help you, i asked my husband, Dr Jonathan Fass, DPT, to answer a few questions and put together a few “tips” that will push you in the right direction to deal with your pain. The first step is ALWAYS to learn more. At the very bottom, i have linked some useful materials that will expand more on this information. It takes time to understand this from a new perspective, so allow yourself that and please let us know if you have any questions. Jonathan will be on hand to help answer them 🙂
Me: In your experience as a Physical Therapist (and research nerd), what are the most common misconceptions about pain?
JFass: Pain seems like a very straightforward experience: If you bump your elbow, you’ll feel some pain; If you break your elbow, you’ll feel more pain, and so on and so forth. The basic story here is damage to your body creates pain. Simple enough, right? You might be surprised that it actually doesn’t work that way at all. Pain is an experience, a signal from your central nervous system that there is a threat to your body’s tissues. Just like the “check engine” light in your car, pain tells you that there is something that is wrong with the machinery, but it doesn’t tell you exactly what or exactly how. Just like that check engine signal, it is a result of a computer analysis (in this case, that computer is your brain) and not a direct result of actual damage: After all, if the engine in your car was already damaged, a check engine signal would already be too late: your car probably wouldn’t be running any longer!
Why is this important? In understanding what the experience of pain actually means, we need to understand where it comes from. Believe it or not, there is a body of high-quality research that shows us when we understand that pain is a signal of distress, not a result of damage, we can actually affect our pain and decrease it, demonstrating greater improvements in pain and function. Our more complete understanding of pain now reflects the inputs not only from our tissues, but how our very beliefs, thoughts, fears and historical frame of reference all work to shape the output of pain. By decreasing fear-based pain beliefs, we can improve our ability to cope and to recover from pain.
Me: As a coach (and as someone who has pain), it is sometimes worrying when i hear someone say they hurt when they do a certain movement. Most people here love to exercise, but many of them might also have chronic pain. What pain on during movement might mean? For example: low back pain during certain exercises or knee ache?
JFass: It’s important that we respect the pain experience: our central nervous system is trying to tell us that something is occurring that it believes is a threat. When we ignore pain, our central nervous system digs in and “doubles down,” making that pain stronger and more severe over time.
The first step when experiencing pain is to understand where it might be coming from: is there true tissue damage, such as a twisted ankle while playing basketball, or an identifiable disease state, such as an auto-immune disease. It’s always important to have things checked out by a qualified health professional and not just by asking Dr. Google and deciding that your pain is “nothing;” however, when we can identify clear and obvious inputs, such as “my knees always hurt when I forward lunge, but only when I forward lunge,” then we can try to change our form and position to reduce and eliminate that pain. By affecting the inputs to the Central Nervous System – in this case, nerve signals that come from our knees and legs – we can change the experience that is being evaluated by our brain. So if the brain feels that a certain amount of muscle activity at a particular point in your lunge is a threat to your tissue (remember: it does not actually mean that there is tissue damage, although this is certainly possible just not guaranteed), by changing the movement of that lunge (maybe improving the alignment of your knee, maybe by increasing glute activity during the lunge and decreasing the stress on the quadriceps muscles), we satisfy the threat itself. When that is done, the brain no longer “worries.”
Activity and exercise are good things: sometimes we may find that certain activities are provocative of our specific pain complaint, but exercise and movement as a whole is the best thing that you can do for yourself. Do not fear your activities, just seek to understand them. By doing that, we can encourage better, safer and more consistent and pain-free exercise.
Me: When i realised that i had joint that was inflamed, i set about trying all sorts of manual therapy to try to reduce the pain. Is it wrong for someone to do this right away? What typically follows these misconceptions?
JFass: Manual therapies such as massage, myofascial release, etc can all be very good things. Contrary to what is commonly explained, these therapies almost certainly do not directly change the fascia – our connective tissues that surround the muscles and joints of our body – but instead are more likely to work through altering the sensation and neuromuscular activity through the nervous system. Is this a good thing for pain? It certainly can be; however, what we have come to understand is that since any individual’s pain experience is entirely unique to them, based on their unique physiology and specific influencers – biomechanics, emotional experience, psychological beliefs, cultural education about pain, etc, a “one-size-fits-all” prescription of treatment just won’t work. Based on a proper evaluation which should include a detailed history of your pain, movement assessments and provocative testing, your healthcare provider should be able to identify an appropriate course of treatment which may include manual therapies of some kind.
Me: I typically hear people talk about their doctor’s or therapist’s reactions to hearing about them training when they have been diagnosed with some ligament tear or disc herniation in very negative terms – almost like they have the fear of moving wrongly. What can you recommend to people who have just received a reaction/advice or are about to get scans or investigations into pain – are there any questions we can ask that will help the outcome?
JFass: True tissue damage requires time to heal, and sometimes doing too much too soon can negatively impact that healing process. However, we should never think of any activity or exercise as being “good” or “bad,” but rather assess its value within the context of your situation and potential injury.
For instance, if you have been repeatedly told that “squats are bad for your knees,” it is entirely likely that this information – false in most circumstances and for an otherwise apparently healthy individual – will influence the threat assessment performed by the brain during this exercise or similar exercise. After all, if you were told as a young child that spiders are dangerous, you might develop an irrational fear of spiders, which is known as arachnophobia. Just like the fear condition of arachnophobia, your pain is very-much real: it is produced by the brain, but that doesn’t mean that it is somehow “all in your head.” It is a real experience based on the information that you believe to be true. What’s worse, just like in arachnophobia, even just knowing that the information that you received – either that spiders are dangerous or that squats are bad – is not true, you will still experience your fear or pain, respectively. The primitive brain isn’t interested in being rational, it’s interested in being alive and out of harm’s reach!
In order to make sense of any information that we receive, there are a few questions that we can ask, which incidentally are great questions to apply to any information – health or otherwise – in life.
1. Who says so? Does this information come from a qualified professional, or someone who really has no business in discussing the information. I am much more interested in my mechanic’s information concerning my car than I am about my pain. Further, even if this comes from a qualified professional, how does he/she arrive at this conclusion? Is it an opinion, or does high-quality research suggest that this may be fact? Clinical opinions are valuable, but it is important that we understand that they may also be wrong. Asking your health professional why they believe their diagnosis and on what information they’re using, what other possibilities might your pain be stemming from, and seeking out second opinions are all valuable. Ultimately, if the diagnosis is accurate, we should expect a result from the treatment prescribed from that diagnosis. If we are seeing little/no improvements in our pain, explanations such as “recurring injury process” and “scar tissue” etc, etc are more likely to be a result of attempting to fit your musculoskeletal pain experience into a pre-rendered “box” rather than adjusting the diagnosis and seeking out new possible areas of investigation.
2. Is there information that would make this false? If, for instance, you are told that an MRI has discovered a disc lesion in your spine and that this is the cause of your pain, are there any factors that might make this untrue? For instance, it is well-known that findings of disc damage on MRI and other imaging devices are often false-positives: they are not actually the cause of the patient’s pain. A highly valued study found that ~80% of non-symptomatic individuals – regular people without a history of back pain or current back pain – will have identifiable disc injuries when scanned, yet they will have no symptoms. In other studies, “fake” surgeries for identified knee arthritis produced results just as good as real and actual surgical procedures, indicating that the relief that we experience from these surgeries might in fact be entirely a result of a placebo effect and not the removal of the arthritic tissues! Simply seeing something on a scan is not an automatic or accurate diagnosis for a musculoskeletal pain complaint. Clinical findings must compliment these images, or we risk identifying and treating “problems” that were never actually problems in the first place.
Me: I often see this silly quote circulating online: “pain is fear leaving the body” As if there is a belief that you can run pain out of your body by standing up to it and fighting through it. I actually got tagged in a photo with this on it and it made me mad! *shakes fist*
Still Me: Anyway, if this is how the fitness “culture” sees pain, how can we improve our understanding?
JFass: Pain is to be respected: we need to remember that most of us are not professional athletes and our income and livelihood do not depend on our performance on the field or in the gym. However, we can also understand that there are different kinds of pain, too. The pain that we experience after a hard workout, general muscle soreness, is a relatively benign pain signal: we shouldn’t continue to push ourselves when we are sore after a tough workout, but we needn’t fear it, either. However, pain that seems to originate in our joints or as a sharp, sudden pain in our muscles needs to be respected and responded to immediately: they can indicate true damage or the real threat of damage and shouldn’t be ignored. If your knees hurt when you squat or your shoulder hurts when you bench press, this needs to be addressed.
If there is any single take-away from all of this, it’s that pain is not something to be overcome and conquered, it is something to be understood.
Me: Thank you so much for helping us to better understand pain. For training purposes, it is tempting to do one of 2 extremes in response to pain: either stop moving all together or train through the pain regardless. I confess, i have done a bit of both.
The lessons i am learning is to be adaptable during your workouts. If something hurts, just try something else. For example, my hip hurt during goblet squats, so i staggered my stance and the pain stopped. I didn’t necessarily have to stop doing the Goblet squat, but i altered my foot position so my painful side was further forward which shifted more effort to my pain-free side, allowing me to continue without “worrying” my brain.
Don’t get stuck in believing it’s “all-or-nothing”. There are gradients and many many ways to enjoy activity. The biggest problems are our fears and pride. Let them go and be free to enjoy something that doesn’t hurt. Over time, more things will be pain-free and you will be wiser for it 🙂
Here is a list of resources that have helped me:
This video is awesome. Lorimer just has a way of explaining things!
So does my wonderful husband in this very helpful Podcast episode he did with Armi Legge.
Love this wee video. Simple explanation of Chronic pain:
Pain aint so simple. This is great to help show you that each pain experience is unique:
This last one i found very helpful because i am guilty of so much “bracing” and tension that my muscles can’t seem to switch off!
Please let me know if you have any questions. Please realise that neither Jonathan, or I can answer anything definitively about your pain from a distance. It must be answered as part of a whole assessment of *you*. Your pain is unique to you and there is only so much we can do from here. The great thing is that this information is so empowering – it shows that there is hope and just reducing fear (by increasing your knowledge) can reduce pain significantly.
