Chronic Pain

How a physical therapist helped me through my lowest point, Part 6

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**If you are new to my blog and would like to start at the beginning of this series, click here.**  

Part 6: Re-adjusting my concept of what is “dangerous.”

When I was running long-distance in high school, I’d really pushed my limits.  Pain didn’t scare me as much as my irrational fear of gaining weight and not training hard enough.  I had rarely let pain stop me, and on more than one occasion, I had paid a price for that refusal.

As a freshman, I had partially torn my hip flexor off of my hip bone during a cross-country race.  I’d had some pain in the few days before the race, but one mile in, endorphins had taken over, and I felt no pain.  Then, as I sprinted down the finish line, my right leg completely gave out beneath me, and I’d had to hop across the finish line on one leg.  After that, I was on crutches for months.

Then, while training for track during my junior year, I’d developed compartment syndrome.  I’d had pain and a feeling of “deadness” in my calves for weeks, and I continued to push it.  Running was the only thing that chased the dark clouds of depression away, and I was excited about the fact that, once track started, I was going to be in amazing shape.  Instead, by the end of the season, I was barely able to walk.

After these injuries, I’d sworn I was never going to let anything like this happen again.  How could I have been stupid enough to ignore all the warning signs?  My body had tried to tell me again and again that it was a bad idea, and I hadn’t listened.  So I promised myself I’d never ignore it again.

But now, in physical therapy, Tim helped me to realize that maybe I’d gone too far in the opposite direction.  There was a big difference, he said, between pain in someone who’s running 40 miles a week, and pain in someone who is basically sedentary.

My nervous system was functioning differently now, as a result of the physical traumas I had endured.  It was as though my body was looking at pain through a magnifying glass.  A little muscle spasm that I might have been able to ignore in the past was now debilitating.

I might have the same amount of pain now, just walking down the sidewalk, as I’d had running at seventeen.  But, Tim explained, I wasn’t subjecting my body to anywhere near the same amount of forces.  I might have the same amount of pain as I’d once had running, but it didn’t represent the same amount of “danger” to my body.

From running, I had learned that the way to respond to something that was agonizing was to stop and rest.  If something hurt that much, it must be on the verge of rupturing, of tearing… tendons were about to come unattached.  Right?

Wrong.  I was doing what anyone in my situation would do—taking the information my nervous system gave me at face value.  But Tim helped me to see that, because my body had adjusted its “criteria” for causing me to feel pain, I needed to change my own “criteria” for evaluating that pain.

Things just weren’t as dangerous, Tim promised me, in someone with my level of physical activity (or lack thereof) as they were in a long-distance runner.  I might be feeling a muscle spasm that hurt just as much as a pulled muscle when I was running, but– given the fact that my nervous system was revving everything up, and that I was not subjecting my body to anywhere near the same amount of forces– it was nowhere near as dangerous.

Tim urged me to stop thinking of pain as a sign that something was ripping or falling apart.  Those types of injuries were definitely possible when I was running a 5K race, or pounding down a track at 5:30 mile pace.  But they were simply not possible in a generally-healthy twenty-five year old who went for a walk a few days a week.

It seems obvious now, but of course, pain is specifically designed not to let us ignore it.  There’s no way to tell, based on sensation alone, whether or not a painful sensation is safe to ignore.  Pain doesn’t come with labels saying “this is inflammation in your joint” and “this is an overworked muscle.”  It all just feels dangerous.

What I love about Neil Pearson’s approach is that it in no part blames the person with pain for what has happened to him or her.  Instead, he suggests that the person in pain ask him or herself, “Is this really dangerous?”

Pain is designed to draw our attention to something, to make us change our course of action.  But that doesn’t always mean that we have to stop using that part of our body completely.  Sometimes, our nervous system just wants us to focus on something; to give it the attention it deserves; to make an educated guess about what is needed.

Maybe it means we decide to only walk for five minutes, instead of ten.  Maybe it means we promise ourselves that we’ll schedule that doctor’s appointment as soon as we get home.  Maybe it means we promise our aching neck that we’ll get a massage soon.  All of these things can actually have an effect on reducing pain.

When you stop and focus on what your body needs, it stops trying so hard to get your attention.  I’m not saying that this is a miracle cure and you’ll never feel pain again.  But you might find that the pain becomes manageable.

When your body sends you pain signals, it wants you to answer the question, “Is this dangerous?”  Your body doesn’t have all the answers; something that’s painful might not always be harmful.  It just means your nervous system thinks it might be, and wants you to find out for sure.

This is why something as simple as scheduling an appointment with a doctor you trust might actually reduce your pain.  Your body wanted you to answer a question, and you took a proactive step towards getting that answer.


Of course, I probably wouldn’t have made as much progress if I had tried to use this approach on my own.  It really helped to have someone else there with a lot of expertise who could help me make an educated guess about what was really going on in my body.  I was completely terrified by the concept of trusting my body, and it really helped to be able to ask Tim what he thought the pain meant.

I trusted him because, well, he took the time to earn my trust.  He didn’t have me in the gym trying to do exercises on my very first day.  Our first four visits were all spent talking about the information in the Neil Pearson lectures, and about my past experiences with injury and exercise.

I’d had many other physical therapists in the past who’d expected me to just get up and do all sorts of exercises right away.   Based on my diagnosis, they said, I “ought” to be able to do all sorts of things.  And when I would refuse, saying I was scared, it would turn into a conflict.  I’d either end up doing the exercises, which would of course increase my pain because I was scared, or I’d get a lecture about how I had to listen to this person if I really wanted to get better.

Tim didn’t ask me to do any exercises until the fifth visit; only after he’d spent the previous four reassuring me that there were, in fact, a lot of exercises I could do safely, and that my body was capable of handling much more than I thought.

He started out by having me walk on the treadmill.  The first day, I only did five minutes.  The next visit, I did ten.  Of course, I was apprehensive, but the important thing was that I didn’t feel like I was being forced to do something.  I knew it wouldn’t turn into some kind of huge conflict or battle of wills if I needed to stop.

From there I gradually progressed to other exercises.  I had been terrified to use the elliptical trainer, although up until the pain became debilitating it had been my favorite machine.

One day Tim convinced me to get on for just three minutes.  Just to see how it felt.  “Is this dangerous?” he asked.  “No.  No way this is dangerous for you, in just three minutes.”

Three minutes ended up feeling so great that I ended up doing ten.

To be continued in Part 7!

**Track meet picture courtesy of oscarandtara on Flickr.**

4 thoughts on “How a physical therapist helped me through my lowest point, Part 6”

  1. This is such great info on pain. I’m not only tying in what you’re saying to my chronic pain, but it’s even enlightening my past struggle with self-harm. Excited to read more!

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