I Can Handle the Pain... Part I

Clients often say in one form or another: “It doesn’t hurt thaaat much.” “It doesn't really feel like pain…” “I’m fine - as long as I don’t move too fast.” Any of these sound familiar? Know someone who uses these mantras? All of these and their various other iterations are basically expressions of, "I can handle it." What I offer in response is, "Of course you can handle the pain!" You can push through it and modify your life to accommodate your movement limitations. You can grit your teeth, suck it up, and soldier on.

But, why should you?

Obviously some injuries and aches resolve themselves after a few days of rest and ibuprofen. These are minor (though there's nothing wrong with giving them some attention to, but that’s a different matter) and your body can handle them unassisted. It’s the instances where over-the-counter analgesics barely make a dent. The instances where you’ve been hobbling around for weeks trying to not aggravate your knee. The instances where you’ve stopped being able to pick up your kid, or exercise, or stand to cook. The instances where you have to drive hunched over to the right elbows cocked out to the side head twisted in the left to sit “comfortably” behind the wheel. What purpose does it serve (beyond maybe stroking your pride) to not seek help then?

Defining Pain

Pain is a complex topic that is minimally understood despite the vast amount of research into the topic. It is beyond the scope of this article to discuss the nuances and overall coolness of this subject (check out this article if you would like a deeper look) but we’ll start with some base assumptions that can be mostly agreed upon. First: it is fairly well established that pain isn't especially productive. Even during exercise the "pain" sensation we're aiming for is one of challenge, not true holy-mother-trucker! pain every time you do a squat. Second: pain is your body’s way of calling your attention to an area where it needs help returning to balance. Third: for the most part, pain develops as a response to injury or as a sign that the body can no longer function well within its established movement patterns. Let's go into a little more detail on pain as an indication of impaired function to make sure we're on the same page.

Movement Patterns

Optimal function and range of motion, neuromuscular strain patterns, compensation patterns. All of these are different ways of saying, “your established, unconscious ways of moving.” We train our muscles and nervous systems to effortlessly move through series of contractions and releases to perform all the mundane tasks in our world – from picking up the Britta to plopping onto the sofa - doing these things the same way all of the time because they have been relegated to autopilot free our brains for more sophisticated thinking. This is a very efficient system. Until it isn’t.

An Example

Look at a case of nearly ubiquitous low back pain. One morning you wake up with a tightness clenching your right hip and spreading up toward your ribs. You felt fine when you went to bed the night before, so you brush it off and go about your business. Over the course of the day it gets better, you forget about it, go to sleep. Wake up and the pain is back. This goes on every day for the next month, the pain and tension getting worse as time passes, but you haven’t done anything differently. So what’s wrong? Most people will assume that they have slept wrong and they have just been unable to work out the kink. Maybe. But if you did, that was only the final load that sent your nervous system over the edge. There is also the possibility that you slept exactly the same way you always did. The difference is that was the night that whatever pattern you were holding simply reached the end of its functionality. Either way, in order to protect ourselves from injury the brain will transcribe pain onto the area that is overtaxed as a signal for you to change it up and give those muscles a break; like the need to bend your elbow after holding a heavy book straight out with one hand. If sleeping in a funny position were the cause of the strain, the several hours you spent upright before laying back down to go to sleep would likely be more than enough to correct the issue. However, it persists because you are continuing to load your back in the same ways as you were before you experienced any pain sensation.

It's Not One Dramatic Cause

It didn’t happen overnight. You didn’t turn too fast. These muscles and structured have been subconsciously under stress for weeks, or more likely years, and are continuing to move in those same ways that caused the pain despite the pain. This isn't something you are doing wrong. These movement patterns develop because your subconscious determined at one point that that activation was the safest, most stable, most energy efficient way to get from point A to point B. Pain results because that pattern no longer has the resources to be sustainable. So while this is not something you are doing wrong, suffering for suffering's sake will drain resources from other areas of our life to keep you moving. Symptoms of this resource suck can include spreading or generalizing pain, shrinking range of motion, irritability, fatigue, brain fog and disturbances in cognitive function, depression, and more. So how do you learn to move differently when most of those movements are done without conscious input? Since transformation of these automatic movements is rarely achieved through willpower and mindfulness alone, how do you change your autopilot settings? We'll explore those answers next in Part II! What are the reasons you choose to ignore your aches and pains? What keeps you from taking action to allow yourself the opportunity to live life pain-free? Comment below!