Tag Archives: pain

Types of Pain

Posted on March 9, 2011 | 1 comment

“Is this supposed to hurt?”

It’s a question I’m sometimes asked in my bodywork practice (like this one), and find myself asking too in some scenarios. It’s such a huge part of human existence, and yet it seems to me that our education as a society in the realm of pain is pretty lacking. It’s an area that in my experience we could use a little more breadth, and a lot more depth, in our understanding.

Just turn on the TV, right? The quest to rid ourselves of pain is an enormous, multi-gagillion dollar industry. The message is fairly basic and clear: “You’re in pain. Pain sucks. Take this and you won’t be. That’s way better.”

And, of course, yeah it’s better! Anyone among us save the masochists don’t want to endure suffering for its own sake (and even them, I’d venture; truly for its own sake? I doubt it). So it’s certainly not my intent to say we should be taking some sort of high road with this, or like seeking to end our pain doesn’t make sense; it makes about as much basic sense as basic sense gets.

That said, the idea that our pain may be telling us something vital is not a new one. So … what’s it saying?

I think some more words for pain and its many forms would be useful. This expansion of breadth of ground covered, similar to the notion that the native Eskimo have so many more words for what we usually just call “snow.”

I’d like to propose a partial list here. If you have anything to add, please add to the comment section below. Thanks to Tom Myers for his interview with Massage and Bodywork for the inspiration for this inquiry.

– the dull pain of lack of sensation (i.e. numbness)

– the quick pain of a new injury being prodded, like trying to walk on a sprained ankle

– the burning pain of an old injury being uncovered (in the physical body, this might be having deep work done on old scar tissue; in the emotional body, this might be seeing a lover from years past with someone else for the first time)

(quick note: I think it’s the difference between those last two that is one of the most important distinctions we can make as therapists working with clients, equally in our understanding and that our clients get the feeling of ‘oh wow, that pain isn’t coming from this work, but this work is uncovering the pain that was already there, stuck’)

– the pain imposed from the outside, that wasn’t there before (garden variety trauma, like you threw a rock and it hit my leg)

– the scouring pain of loss, of something that was psychologically “mine”

– the kind of sweet pain of coming clean, the fire when we tell the truth after lying to ourselves or others for any period of time

– the immediate and searing pain of torn myofascial tissue, or a broken bone, similar to that imposed from outside only its clearly and entirely contained within your skin

– chronic, lingering, in-the-background pain, like with autoimmune diseases or cancer (this is the only one on this list I haven’t experienced first-hand, so if you can educate me more about this, please do)

That’s it for now. Not quite like the 40 words I’ve heard the Eskimo have, but … it’s a start. I’d love to hear your thoughts!

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The Right Question

Posted on February 12, 2011 | 1 comment

“My back hurts … what do I do?” Fair question. More on this in a moment. But first …

I’ve been reading a fair amount lately about the topic of asking the right question in a business setting. To illustrate: your company is asking for feedback about the structure of staff meetings. Most of your fellow employees are likely going to give feedback quite pertinent to the structure that’s set up, like “I don’t think Robbin is the best facilitator to lead the marketing review; Larry should do that” or “Five minutes isn’t enough time for a realistic bathroom break for 70 people” or even “I want blueberry muffins.”

Right? Two things.

1) This feedback will likely all be addressed in a satisfactory way. For every question (which is what the feedback is, essentially asking “can we do it this way instead?”), there’s a very legit, real, true response

2) All of those questions, and therefore all of their answers, are completely moot if someone asks another question—”Is having a meeting really the best vehicle for doing what we as a company want to do in this case?”—and the answer is no.

The rug is simply pulled out. I love this! And while it seems pretty clear and Four Hour Work Week-ish in the office—spend your time on business, not just busy-ness—it may be less so when it comes to leveraging our own strengths in our health.

I’m certainly finding this our for myself. How many times did I as a college athlete count how many grams  of protein I’d need for each twenty minutes of plyometric training? How many mg of ibuprofen to combat the inflammation in my knees without giving me an ulcer? How do I release my left hip that’s been seizing up when I’m two hours into a grueling workout?

While all of these questions received legit answers (eight, 600 and a heel lift for my right foot), there were more fundamental things that needed addressing that probably would’ve made these questions moot. In short in this case, I was overtraining, and my form would get so poor at the end of long workouts I was wrenching my knees in my best attempt to just get through. I was also really favoring my right leg.

My questions in some ways were quite obvious to the situation. But there were much more fundamental questions I could’ve been asking, which would’ve pulled the rug out on the other ones.

And so … “My back hurts. What do I do?” If you ask a room full of experts in their given fields, you’re likely to get just as many answers, and all of those answers totally legit, actual, and empirically true. Yes, there’s a molecular thing happening with the actin and myosin; yes, T4 is locked in rotation; yes, your fascia is bound is a particular way; yes, your posture may well reflect your deepest emotions and beliefs about the way the world works …

See how fundamental and out-of-the-box you can get with your question first. It’s the most empowering and true thing for all of us.

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Mind Asleep, Body Awake

Posted on January 14, 2011 | 5 comments

I had an interesting session today in which my client wasn’t actually there. I mean, he was there in that his body was there, but my client as I knew him was checked out, in dream-land. And I was left to have a conversation with his myofascial system.

I’ve never had anyone fall asleep on the table. Either the sensations of the work are so intense, or I’m asking them to engage specific muscle groups, or something … no one’s fallen asleep until today. Today I was left to work entirely with the body—Karl’s body, in this case (not his real name)—devoid of any consciousness of what I usually think of as this entity called “Karl.”

The interesting part, for me, was what a conversation I had with Karl’s tissues, the systems underneath my fingertips, my forearms. In particular, while working his right hip abductors, I found his musculature doing things that I had always been certain were informed by the conscious mind: actions like prolonged guarding and pulling back.

As I sank slowly into a trigger point in Karl’s gluteus medius, I felt a familiar slight recoil of the tissue (meaning “too much!”). I backed off completely for a moment, then began slowly to put slight pressure on the same trigger point, only to have the whole structure pull back and guard again, like you might envision a jellyfish pulsing in the ocean under a false attack.

I had always been sure that this stuff was conscious mind stuff, like “okay, it’s too much because he’s anticipating my next move, thinking about how he’d better guard that area” … but Karl, indeed, was snoring away quite loudly throughout this whole “conversation” I was having with his hip. He was gone.

The body seems to have a personality of its own, wisdom aside.

Anyone else who’s had this experience, please comment or shoot me an email. I’d love to hear it, as this is all new stuff for me.

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‘good’ pain vs ‘stop that’ pain

Posted on December 7, 2010 | Leave a comment

Jeremy asks, “How do we tell the difference between the pain of injury, and the pain of correcting an injury in the context of exercise and rehabilitation?”

A fine question, good sir.

In my experience, there are a few key concepts to help guide us.

1. Change usually carries some kind of discomfort with it. Not always, but often … you know this already, as it’s what you point towards when you talk about ‘pain of correcting an injury.’

2. Correcting an injury is often a series of well-planned micro-injuries. An example of this is unfreezing a ‘frozen shoulder,’ or rehabilitating an broken-then-casted ankle, or even just working out. We’re often micro-tearing the soft tissue (muscles and connective tissue), re-aligning it, and bringing in just enough inflammation that our body ‘sees’ this area again and brings nutrition, and even better neurological pathways.

Too much of this micro-injuring and we’ve re-injured ourselves. Think of running stairs for an hour off the couch … too much too soon (for most of us, anyway). It takes forever to recover, much more time than it would’ve taken to, say, split that workout up into two sessions over a few days.

3. Pain, even a pleasurable sensation of stretching, does not necessarily equal rehab. As in, you could spend plenty of time stretching out the ligaments in your otherwise-healthy and normal-ROM ankle, and it would have that rehab-stretch kind of pain feel, but would certainly do you no good. You would increase mobility in an area that doesn’t need it, which would actually increase risk of injury like a sprain.

In other words, whatever exercises you’re doing should be intelligent ones, corrections that make sense and not just shots in the dark.

4. In general, any sudden or sharp pain means ‘stop doing that.’

5. You’re the best one to understand your own body in a subjective way.

Put all those together and I think you’ve got this: Correcting an injury should should be part of a well-thought-out process, and happen within the limits of what your body can effectively deal with. Just enough so there’s an increasing range of motion or fiber re-alignment or whatever … not so much that your body’s inflammatory response brings you back two steps. If you’re not recovered from whatever kind of workout in a few days, it was probably too much.

That’s my take … keep me posted!

And, to anyone else reading this, I’d love your two cents.

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