🤕 Okay, so you have just winced in pain again around THAT recurring painful issue. You have tried everything and nothing works, you are totally despondent so what now?
👌Here’s how I often start to work with my one to one clients with recurring pain and be warned, exercise and poses don’t feature so exit now if you aren’t keen on having your opinions challenged or keep seeking articles with red crosses and green ticks of ‘the best exercises for…’
The first port of call is to take an honest appraisal of how large a role pain is taking in your life, emotionally, socially and financially.
Many people are involved in a carousel of care that they have created and has become a crutch they feel they dare not do without due to fear of regression into further discomfort- even if these interventions have made no long term sustainable improvements.
It may resonate with you to have seen a chiropractor, a massage therapist, a physio, a doctor, a trainer, even to have a weekly or monthly catalogue of people that you see. There is no right or wrong and if these services make you feel better absolutely carry on, however, it is worth remembering a few salient points…
Where we spend a lot of time and money is where our commitment goes and although originally our commitment may have been to find less pain or seek solutions, we may have inadvertently created a a misplaced dependency on the services that we have invested in both financially and emotionally. The litmus test is; have they made a significant and sustainable reduction in your pain?
Remember logic:
💭If there was a single service provider that could fix pain, it would be something we could eradicate from the general population.
💭If there was a specific discipline, such as Pilates or swimming, that could fix pain, we could eradicate it from the general population.
💭If there was a single set of exercises or a number of them you had to complete that would fix pain, we could eliminate it from the general population.
There simply isn’t. You may have found a collection of things that help but go back to the litmus test:
Have they made a significant and sustainable reduction in your pain?
Your care provider, trainer, pain coach, physio or whoever should be focused on providing you primarily with:
🤝Independence
🤝Education
🤝Agency
And everything else should be about reinforcing these foundations, equipping you with confidence to move and depend on your human adaptability.
This is actually returning the power and agency to the person who is suffering instead of constantly depending on external sources to find a solution. ( we are right in the belly of yoga philosophy here with these concepts too)
Sometimes freeing ourselves from the shackles of pain can be freeing ourselves from the shackles of dependency we have sometimes misplaced our faith into.
💊It’s a bit like taking a vitamin or supplement all the time, how do we know it is working unless we stop taking everything and see how we feel, then possibly introduce one back and make an honest assessment about its impact on our health. It may be time to shake up service reliance and lose a few.
Pain doesn’t deserve to take up more space in our lives or to become our whole personality.
Recognise that within your life pain may take up a great deal of space and that, although the size of that pain may not diminish, we can aim to make life bigger around it.
Trying to shrink the size of the pain instead of broadening the size of life is a little bit of an outdated focus with an emphasis on the body as being mechanical when we now know pain is multifaceted and complex.
For example, some of the money or time you are spending on multiple services and maybe not seeing vast and long-lasting changes to your pain could be spent on something fun and enjoyable, which may have the same temporary effect of allowing you to feel more ease as say a massage or manipulation.
⚡️The two big concepts around moving forward and taking the first steps that I use are sensitivity and tolerance.
Both of these are fluid and changeable and both are your friend.
The body is ultimately doing it as best to look after you at all times and often long-term pain is about signalling, a bit like an overprotective parent, panicking, even when there is no danger at present.
Sensitivity is when you notice discomfort.
It might be sharp and shooting, or it could be a little nag that is grumbling in the background.
Your sensitivity is a scale and the best way to think of it is your body giving you a friendly, but sometimes misplaced reminder to look after yourself. Sensitivity is not an indicator of damage.
Tolerance is what you can manage before triggering too much sensitivity and what you can cope with when in low sensitivity .
We can think of tolerance as the teenager trying to get away with just a little bit more. Some days the tolerance will be high and you will be capable of more and sometimes your tolerance will be low.
That is normal flux and understanding your sensitivities more will help you capitalise on your tolerance levels, which will help you understand when you can maybe do a little more in the garden, push yourself socially, get a longer walk in or just the idea of enlarging life.
When it comes to movement and ideas of rehab, sensitivity and tolerance will allow you to understand your windows of opportunity.
When your sensitivity is understood and listened to, you can use it to expand your tolerance to movement.
All movement is good and it is out of date to think of exercises as being prohibitive, instead just scale to your tolerance without over provoking sensitivities.
Think ‘slowly slowly catch the monkey’. In pain research Lorimer Mosley developed the concept of ‘poking the bear’.
If pain is the bear, do you want to run at it hands jabbing at it and waving our arms wildly causing it to panic and startle or do we want to slowly circle the bear building trust and gradually, stealthily getting closer?
Unlike exercise or goals that may have us increasing in time, activity, strength etc, rebuilding your sensitivities and tolerances are about creating a steady baseline with natural fluxes you can deal with rather than picturing a graph with constant increases and improvements soaring upwards.
✨So start today as a new day.
Review how much attention (financial and emotional) you’re prepared to give the naughty toddler of pain, make some plans of what you really love and enjoy to do, what makes you laugh, gives you pleasure and consider stepping away from some of the practices that reinforce the idea that we are dependent on certain crutches.
Notice today’s sensitivity and see what you can tolerate.
Tomorrow might be better or worse, but it is all information you can use to take control of your situation and break unhelpful thoughts, habits and tendencies.
Be in today, not in fear.
