Todays blog is the first blog I have written in a few months! Apologies for the lack of content in written format 🙂 I am aiming to write more about my clinic experiences and provide content that I believe will support those of you who are experiencing chronic pain and symptoms.
I AM LOVING being back in clinic in Dublin. There have been some amazing results with clients which is great. A common theme among almost all of the people that I have seen has also been emerging. This theme is in my opinion, one of the BIG contributing factors to the amount pain and symptoms that people are experiencing. So if you are experiencing pain on a daily weekly or monthly basis – this one is for you.
In Ireland, we are very traditional about how we view healthcare and in particular hands on treatment. It seems that the prevailing national consciousness believes that you have to get a “damn good rub out” aka soft tissue work, or get “cracked back into place” aka an adjustment to the joints of the body, or the most common “get to see the Doctor as soon as possible” when we experience pain.
This typically leads to us taking medication for pain relief, getting regular soft tissue work or performing self myofascial release with sliotars, tennis balls and foam rollers or getting regular adjustments. All of this is the current normal response to experiencing pain, and in my opinion is not the only option!! (more on this later and probably in another blog too as it is a massive subject)
Practically every person that I work with has typically had treatment or a consultation with either a doctor, physiotherapist, osteopath, chiropractor, consultant or surgeon, in an effort to resolve their pain. In some cases they have been very successful, however, the majority of people are still looking for answers.
EVERY person that I meet has been affected by these previous experiences. Sometimes very positively. The majority of the time, what I hear in clinic amazes me. Clients relay the diagnoses and meanings that have been made by themselvesor handed down to them by the people they they have been to see.
“If you turn your neck too quickly or without control to that side, there is small change you might actually die” – said to a client who suffered a whiplash, by a specialist.
“Your vertebra is crumbling and there is nothing we can do for you” – said to a lady who has osteoporosis and has suffered a cervical fracture.
“Your Sacroiliac joint (SIJ) is unstable and you shouldn’t bend forwards” – I have probably heard this one hundreds of times.
“You are just going to have to live with the fact that you have degeneration in your spine and its going to get worse as you age” – again said to multiple clients by a wide variety of therapists, doctors and specialists.
“You have ARTHRITIS – of course you have pain” – this one seems to be a particular favourite here in Ireland, most commonly delivered by doctors it seems.
“Your knee joint is BONE on BONE and will need a knee replacement by the time you are 40 – you shouldn’t run, and I would avoid any activity that excessively puts force through your knee” – said to an otherwise healthy client who had since suffered on and off with knee pain for over 20 years.
I could go on, and I am sure that at the time of writing I am forgetting some absolutely corking statements that have been relayed to me in clinic. This post is not aimed at apportioning blame to anyone who has said anything like this to you either, my point is about the beliefs and understandings that this creates for people who hear them.
I firmly believe that no-one out there who is working in a healthcare setting is intentionally frightening the life out of people to create dependance and therefore income for themselves. A lot of this type of language is due to a lack of awareness about how language and the words used in a clinical setting, impact upon the people that receive them. I have been guilty myself of not considering the impact of the language I have used with people in the past – again completely unintentionally, I always have wanted the best for everyone I work with. I simply have have not known what effect the words that I use could potentially have.
Fast forward to the present day and after a lot of self study over the past few years, combined with attending many courses to give me different understandings about the human body and mind, I now practice and aim to use language and imagery that is supportive for people who are experiencing pain. This is a daily practice for me and I have been working hard to become better at this for years now.
Most often when I meet people who are in pain I ask them the following question:
“When you experience pain in your body, what does it mean to you?”
Most often people do not understand the question at first, and begin to tell me about what they do when they experience pain. When we get to the core of this question, most people then begin to repeat what has been said to them by family members, friends who have had pain experiences, therapists, doctors and specialists.
“My pain means that I have probably damaged my discs again”
“My pain means that I have some muscle injuries again”
“My back/neck is out of place again”
“Its another flare up of my back, and theres nothing I can do because it runs in our family, its genetic”
“Its my bad knee/hip,shoulder, I probably overdid it”
“My core strength just isn’t improving and I keep injuring myself”
These beliefs are incredibly important for us to explore in a therapist client journey. As the reader, I am sure it is logical to expect that most of these beliefs lead to predictable changes for the people the are affected by them.
People consciously and unconsciously change their movement to avoid stressing the area that is painful
People consciously or unconsciously avoid activities that might irritate their symptoms.
People become incredibly AFRAID of their own body
People sometimes start to take some mediation to help them “get through” an activity that they cannot avoid like lifting or bending over at work.
People often become unhappy because they cannot do activities that they previously have enjoyed
I hope you can understand that a lot of these beliefs are incredibly unsupportive for a person in pain and lead to them being more afraid, doing less and they also are MORE likely to experience pain as a result!! All of this can be possible because of beliefs that they hold about their body, or that they have been told about the human body that are UNTRUE.
Did you know that for some of the areas that we have dense layers of fascia such as the ligaments around the Sacroiliac joints, the ITB (iliotibial band) on the outside of the thigh and the spinal ligaments, it takes upwards of 900KG of force to deform these tissues by 1%?????? (these studies were performed on cadavers – dead people).
This pretty much means the the amount of force you would need to damage these tissues would require extremely high impact forces such as a fall from height or a car crash. Backs do not go out of place and pelvic bones do not become unstable because under normal circumstances we are not exposed to enough force to cause this to happen. Added to this is the fact that we have a fully functioning nervous system that coordinates movement, muscle recruitment etc to protect us as we move and we have even less chance of damaging these structures.
Also consider that degeneration in the spine, the presence of bulging discs as seen on imaging has been found to have poor correlation with pain and symptoms. This means that most people that you meet, if we MRI them, they will show changes in their spinal joints and discs and this is now considered just a normal response to adapting to the demands of life.
So if these things are most often nothing to do with pain and symptoms then what is causing pain?
The most important factor when a person experiences pain is the amount of THREAT that the conscious and unconscious parts of their nervous system are exposed to. There are many many forms in which this can take such as:
Previous injury to the area
Peripheral or central sensitivity in the nervous system (sensitivity at a previous site of injury/trauma or sensitivity to threat within the brain itself)
Unsupportive and negative beliefs that the person holds about their body
Nutritional and Chemical stressors
Mental health issues such as anxiety or depression (and many more)
Sharp increases in activity levels that are not normal for the person
This list is not exhaustive by any means!!
Anything that increases the amount of threat that is registered by the nervous system or increases POTENTIAL for you to injure yourself (or to actually injure yourself) may result in you experiencing pain or symptoms. Unfortunately, there are a lot of outdated and unsupportive beliefs still prevalent in healthcare circles and although changes happens slowly, it is changing!
Can you now understand how unsupportive beliefs about your body can actually contribute and influence the symptoms that you experience?
-> Negative belief about body – leads to anything from being wary to being terrified about the body
-> Increased conscious and unconscious avoidance of movement/activites – leads to increased levels of threat experienced consciously and unconsciously
-> Increased chance that you will experience protective responses in the body – heightened muscle tone and guarding/bracing, PAIN, changes in movement patterns
-> Decreased ability to enjoy normal activities and hobbies – may lead to unhappiness and in more extreme cases can lead to people experiencing depression and anxiety because their life has changed so much
Can you also see how this whole cycle can in some cases be based on UNTRUE beliefs that people hold about their bodies? And if these unsupportive beliefs are influencing your pain and symptoms, it is a MUST for us to explore these beliefs because they are incredibly powerful and influence your body a lot more than you think!
Promoting awareness about the power of language and beliefs among sufferers of pain and therapists alike, empowers us all to adopt more supportive language and beliefs about our bodies and this is a key piece that will allow everyone to move forwards more quickly towards pain free living and less future episodes of pain. If you would like some help to explore how any of the above applies to you, please get in touch with me by email or phone.
P: +353 85 112 4790
If you have enjoyed reading this, or feel like it would benefit someone you know that experiences pain on a regular basis, please share on your social media.