The Four Most Common Questions I Get From Skeptical Pain Sufferers
When I first decided to write a book about my journey back to loving movement after decades of chronic pain, I did not anticipate going on TV to talk about it less than one year later. But as I have spoken to more and more people who–like me–did not think that getting active again was possible in the face of pain, it has become increasingly evident that the message of hope and empowerment that is in You’re Meant to Move needs to get out in the world.
What we discussed in this Wellness Wednesday segment on Boston 25 are the questions I hear most often from people who are skeptical that working with me could help them get active again.
Sure, I have some aches now and then, but how do I know if I have chronic pain?
It’s definitely normal to be sore and having fleeting or intermittent pain as we go through life and especially, as we age. Pain is a normal part of a well-functioning nervous system. The clients I work with are typically people who had an injury or surgery a long time ago and even though the physical healing process is complete, their pain persists. However, chronic pain can also arise without any injury at all. Here are some of the signs that you are suffering from chronic pain:
Discomfort is intense and distracting
Pain gets in the way of doing your daily activities
You find yourself making decisions or plans based on trying to avoid pain symptoms
You continue to have pain in an area of prior injury that has long since healed
I think it’s important we talk about chronic pain because it is in my mind a silent epidemic. The CDC estimates about 20 percent of US adults live with chronic pain, which is literally millions of people. And so many of them are going to work and suffering quietly every day because they believe that being in pain is “just the way it is”. From my viewpoint, we should do everything we can to make sure pain doesn’t get in the way of doing the things we love. Most of the people I work with have a disproportionately negative perception of their bodies’ abilities when we start, and they truly believe the things they love to do are out of reach without even trying.
The reality is that pain can improve for people. It's possible for pain to become a neutral sensation that comes and goes rather than something that runs your life. I see it every day.
Pilates is just expensive exercise for rich white ladies. It’s not for me! Why are you using Pilates and how do you see it benefitting people in pain?
Pilates is one of many exercise methods and–it’s true–it has a negative, sort of elitist, reputation. For some, it is downright terrifying. But rehabilitation is at the heart of this exercise approach. Joseph Pilates was using his exercises and equipment to help people recover from injury from the very start. There are a few reasons why I think Pilates is particularly helpful for people in pain, and why I think it benefitted me so much when I was recovering from a disc herniation:
Balanced Programming. The exercises within the Pilates method focus on balanced muscle engagement. In every session, you should be moving and strengthening the joints in all directions. That is unique to Pilates and very beneficial.
Mind-Body Connection. Pilates has a strong breath and mindfulness component that helps participants slow down in their bodies and be present. This is important for stress reduction and calming the nervous system, which is responsible for the pain sensation.
Unique Design of the Equipment. The Pilates equipment is very special. It is almost entirely spring-based which creates resistance. The combination of the positions the equipment puts people in and the gentle spring tension helps them build strength in a low-impact way that doesn’t strain the joints. The configuration of the springs ALSO makes it possible for me to create situations of instability to help my clients improve balance and also face their fears about falling, which is a common contributor to pain.
I have never found a movement program to be beneficial. How is this going to be any different?
In my experience, the hardest part about helping clients to face their pain and make strides toward an active life is not choosing the right movements; it’s getting them to show up for themselves. I have been there and I get it: it is difficult to have hope and keep striving when you have tried so many different things without success. I know that when you are in pain, everything in your brain is telling you to lie down and stay safe. This is a perfectly normal response that has been curated over millennia to keep our species alive. But as long as there is nothing structurally wrong and your physician has cleared you for physical activity, then, my friend, there is nothing to do but to move.
Here is the 3-step program I recommend for getting moving with pain:
Get really clear on “why” you want to move. A lot of us have learned to have a negative relationship with exercise because it felt like an obligation or even punishment for food we ate that we felt was “bad”. But hone in on what gets you feeling really excited about movement so that when faced with challenges you can prioritize accordingly.There must be something you do with your body that really lights you up–a hike, a hobby, dancing at your child’s wedding?
Find some way to move your body in all directions. This could be first thing in the morning in your bed or throughout the day. It doesn’t need to be a long time. Even five minutes of activity every day is beneficial to build a practice of body trust. Consistency is what matters.
Find ways to challenge your assumptions about movement and pain. Do you fear that certain movements will cause you pain? Find a safe way, probably with help, to start challenging that belief. You may be surprised to learn your body is more capable than you think.
The amazing thing about this 3-step program is that as a cycle, it builds on itself. Once you have a clear sense of your movement “why,” sticking with a movement practice will be easier. Then, as you build confidence and start to feel more capable in your body, you will be ready to challenge your beliefs about your amazing body. And once your challenge proves to you that your body is more capable than you realized, your “why” will seem even more attainable, which will motivate you to keep moving, and so on.
Your book talks about stress and fear having a role to play in pain. What does this mean and what should we do about it?
Pain is the brain’s way of alerting us of a perceived danger to our physical selves. So in a way, fear fuels pain; it fuels the sense that something is dangerous. Similarly, chronic stress is a pain trigger for many people. Both fear and stress trigger the sympathetic nervous system or our “fight or flight” response. Constant activation can keep us stuck in a state of vigilance. That state can actually make us more susceptible to pain, often lowering our threshold for pain. So we really cannot move forward with addressing chronic pain and making movement feel “safe” in the body until we also face our fears and stresses head-on.
In You’re Meant to Move, I walk readers through the process of taking a full inventory of the pain experience. This takes time and focus. For example, can you pinpoint the non-physical factors that have often been associated with your pain? Our brains can learn to connect certain stressors with a pain response and we need to recognize that link in order to unravel it. And as already mentioned, finding ways to challenge the beliefs we carry about movement and pain can be absolutely critical to breaking the fear-pain-stress cycle.
When you are a person who has a high-pressure job, is juggling difficult interpersonal relationships, and maybe also had a historic injury of some kind, it is very easy to find yourself in this vicious loop of stress, pain and fear that keeps us stuck. If you are going to go out there and achieve the active life that you both desire and deserve, you have to be ready to tackle the stress and fear implications of the pain you are experiencing. You can do this, I know you can!
