Are Pain And Injury The Same Thing?

Pain is an unpleasant experience and can bring on anxiety and depression. It controls our lives and decision making processes, but it doesn’t need to be this way. You have the power to claim your life back for yourself and start doing those things you love doing again.

When we are in pain we often become too dependant on others to make us feel better. It has been shown that in the long term, we are the only ones who can help ourselves, but we need to know how. Our rehabilitation only STARTS once we’ve finished our hands-on treatment. We need to think differently, and move differently.

So, what is pain? Pain is our body’s alarm system. It’s there to protect us. But sometimes, it can be overprotective. In spite of what seems logical, pain is not an indication that something is damaged. In a 2012 study, researchers took MRI scans of pain free people and found that 91% had disc degeneration, and 64% had disc bulges. Remember, these people had NO PAIN. So, if you thought that tears, sprains and bulges cause pain, this shows otherwise. While this was a study dealing with back pain, the same system works throughout the body.

Movement is the missing piece in most people’s rehabilitation. Movement helps to change the sensitivity of our “alarm system” and tells it that we can do more. A basic mantra that rehabilitation works by is - “if you can’t, you must”. Avoiding difficult movements just makes the cycle that much harder to break and eventually it takes less and less to bring about pain. Our goal is to do those exact movements that give you trouble, but in a different way that won’t set off the alarm.

So, while the brain is largely responsible for pain, the body plays a role too. Why did we need protecting in the first place? It could be lifting from a “poor position”, with a “poor technique” or not being strong enough. Lifting like this may make the body feel vulnerable. You may be playing golf with a body that doesn’t have the flexibility to swing the way you are asking it to. You may be doing a downward dog at yoga with an upper back that won’t allow it to move in that way. You may not be getting the shopping out of your car in a way that the nervous system feels comfortable with. If you can train yourself into multiple, stronger positions, you give it no real reason to protect you - no reason for pain. That’s rehabilitation! 

In the clinic we identify what is setting off the alarms, and work on addressing those movements. Rather than focusing on “the injury” we look at the way the body functions. Changing that focus helps to reprogram the “alarm”, but also gives you a bit of a picture into “why it happened in the first place”. By working on both the body (physiological) and brain (neurophysiological) you can achieve long term improvement and learn how to manage yourself going forward.

Here’s one happy client’s story…

Thank you Andrew for sending your podcast – it was interesting and you definitely spoke your truth. Your continued learning, reflection and professionalism is why you’re successful. Speaking for myself you came along when I was ready to hear your message but also the way you connected with me as a person and not an injury (or in my mind – hopeless case) was inspiring. Essentially I stopped ‘protecting myself’ and started to just be/do (I’ve also stopped believing I can’t survive without my physio). The young builder/surfer you spoke about really resonated with me (and I’m sure so many of your clients). I just wish I heard the message and found you 20 years ago.  

Louise

I had the pleasure of being interviewed by @arbillaexercisephysiology on “The Knowledge Exchange Podcast” last week about my journey in the industry over the years. Follow the link to listen. https://tkex.org/podcast/2020/5/20/andrew-schwartz-always-learning #exercisephysiology #biopsychosocial
Shoulder pain, and the advice that came with it, made Rob stop swimming, which he did most mornings. After a bit of discussion, and proving to him that nothing bad happens when he moves his arm, after our first session he got in the pool for a short swim. He said it was great to get back in there. As @greglehman has said, “the doing is the fixing”. #biopsychosocial #exercisephysiology