Dear Pain, it’s time to get moving…

The human body is made for movement, and as humans, we have explored the glorious potential of that movement. Picture a Cirque de Soleil acrobat, a gymnast, a marathon runner and best of all – a child at play.  The human body did not evolve to sit in a chair, or car, or remain static and still for hours at time.  Our bodies crave movement, yet when we feel pain, we begin to be afraid to move. 

We are taught to listen to our bodies when they tell us something:  it’s hot, don’t touch it, my bladder is full so it’s time to pee, my back hurts – better stop using it for a while.  Hmmm.  The brain and the body can be fickle lovers. When all is in sync, the body can perform amazing feats, yet when the body and the brain disconnect we can be left feeling fragile, weak, vulnerable and afraid to trust our own tissues.  

This happens, in part, because the brain is built for survival.  This means if you hurt your knee, but you have to keep moving to survive, you will limp and put more weight on your other leg, but you won’t stop because of pain – you may not even feel any until you are safe.  What the brain often forgets to do is correct that limp or imbalance once the injury has healed. 

What happens if that important movement adaptation following an injury isn’t corrected?  In some, it starts a cascade of compensation – a series of unfortunate events such that the way we move now creates a situation for pain.   Note that I said “creates a situation for pain” – not creates pain. Pain is 100% an output of the brain. ALL PAIN IS CREATED BY THE BRAIN!  Huh – isn’t it the tissue injury that causes the pain? No, it absolutely is not. 

We’ve all heard stories of people in life threatening situations report they felt nothing of their broken leg, or arm, or torn muscles, they just kept going.  How can this be?  Well, the brain only produces pain when it perceives danger or threat.  For the person with the broken leg who perhaps is deep in the woods – not getting out of the woods is greater threat to their survival than the broken leg.  So the brain doesn’t produce pain in the leg. It just isn’t essential for survival at the point in time. 

A simpler example of this is the paper cut.  Have you ever paused in your work day only to look at your hands a discover a paper cut?  You have no idea when or how it got there, you certainly didn’t feel it at the time, yet now as you look at it, it starts to throb a little?  In this case, once your brain visually recognizes an injury, and because historically these cuts have hurt – it produces some pain.  Yet if someone were to hold your arm down and slowly give you a paper cut while you watched, the pain you would feel would likely be tremendous!  Same injury… two very different experiences.   

The pain produced by the brain in an acute injury lets us know something is wrong and slows us down so that the tissues have a chance to heal – but only if there is no greater threat to attend to.  After 3 months though, the tissues have done what they can to heal – so why do some of us still feel pain?  This is a complex answer, but it happens in part because of the way we move, or more importantly, don’t move! 

When we perceive that moving is a threat to the tissues, we won’t move, and the language we use around injury often perpetuates this – “my back is OUT”, “my discs have degenerated”, and “my nerves are pinched”.  As we perceive soreness as a signal that there is risk to safety, we change the way we move, again, heading down the rabbit hole of altering the way we move out of fear of damage, and creating a situation for pain because of the way we move!

Part of the role of Physiotherapy is movement re-education.  About 75% of my time in clinic is spent on brain training around pain, and movement re-education.  The goal is to rebuild the brain’s trust in the robust nature of the body and release the perception of fragility.  The most empowering part of this shift from constantly chasing the tissues as the source of all dysfunction is how fast change can happen.  This doesn’t mean there is no role for working on the muscles and the joints – they can be barriers to supple movement but that’s different than fixing pain.  Changing the brain’s story from “I’m sore so I better stop” to “I’m sore but I’m safe” can be life changing.  It’s the best part of my day when this happens. 

So the next time pain from an old injury flares up – take a moment and take stock of why your brain is perceiving threat. Are you upset? Stressed?  Scared?  Remember the brain can’t distinguish between emotional distress and physical threat so it will often signal your conscious brain by creating pain in an area that has previously been injured.  Crazy?  Not so much.  That pain is 100% real –but it’s not coming from where you think it is.

If you’d like to come in and explore this further and see if I help – book an appointment at www.rebirthwellness.ca

Angela

Angela Growse, Physiotherapist

As an experienced manual Physiotherapist and proud mother of one, I love being a part of the team at Rebirth.  Multidisciplinary care has personally helped me to optimize my health and wellness in both pregnancy and everyday life, and has made me a better therapist for my clients.  As with most things in life, achieving your health goals is always easier with trusted and empathetic support. I received my Masters of Science in Physiotherapy from McMaster University and have been a member of the College of Physiotherapists of Ontario since 2003. As a Fellow with the Canadian Academy of Manipulative Physiotherapists(FCAMPT) I have engaged in many years of advanced orthopedic clinical reasoning and manual therapy skills, and I am currently an instructor with our national training program. I also hold a Certificate of Contemporary Medical Acupuncture and am a Certified Pelvic Health Physiotherapist. When choosing a treatment approach I like to consider your body as a whole within the context of how you move through your day, not solely focusing on the area you are struggling with. I love a challenge and appreciate the complex nature of pain with both acute and chronic issues. You will be invited to be an active participant in your rehab and I will only use techniques with which you are comfortable. I may use techniques such as manual therapy, acupuncture, spinal manipulation and therapeutic exercise to help you move well and fully participate in your life's adventures. My goal is to empower you and help you regain independence with your health.