Wednesday, May 18, 2011

No Pain, No Gain? Don’t be Such a Nietzsche!


As a physical therapist I’m in a privileged position to hear what people think when it comes to pain and getting better. Let me tell you, there are a lot of misconceptions out there and they run deep in our culture. Many misconceptions create problems of their own and are therefore worth addressing.

Here’s one: “No pain, no gain.” Do you need more pain to get rid of pain?
The “no pain, no gain” attitude has origins in the strength training realm (“push through the pain!”), the military (“pain is weakness leaving your body”), and even the philosophical (Friedrich Nietzsche’s “what doesn’t kill me makes me stronger”) and the religious (“the last will be first and first will be last”). I would submit, however, that these are themes of overcoming suffering when confronted with it. “No pain, no gain,” however, implies that gain cannot be achieved without suffering and pain should therefore be sought out.

Gains come from creativity and persistence which are often sparked when confronted with suffering, that’s true. But creativity and persistence may be sparked from any scenario. Seeing an apple drop from a tree was what sparked Isaac Newton to first describe gravity, for example. Ultimately, creativity and persistence come from the person and not from the suffering.

So, why is this myth so pervasive? Well, for one it’s a catchy phrase! It’s even outlasted “where’s the beef!” But, through its strength training relation, it’s also tied in with another common myth that says pain is caused by muscular weakness. If pain is from weakness then strength training should fix it. If strength training should fix it then you should push through pain, right? Well, if weakness causes pain and strength is the antidote then power lifters should all be pain free. But, they get pain just like the rest of us, I’m afraid.

The fact is that exercise is a proven method of pain relief for many conditions and when you exercise you do tend to get stronger. However, it’s not the strength that removes the pain. That’s a by-product. It appears that it is exercise’s gradual progression of movement that brings about the improvement. The organized progression of exercise is like built-in persistence, so it is often a successful way forward if applied creatively.

I don’t think this catch phrase will be going away anytime soon, unfortunately. So be creative and persistent when confronted with pain. But remember that you don’t need to seek out suffering to find them. You need only look where they originate….within you.

Saturday, May 7, 2011

Stacking the Deck: An example from this morning's run

This morning while out for a leisure 2 mile run an old runner's nemesis, knee pain, was there waiting for me. I was able to deal with it successfully by stacking the deck.

This week I've been talking about the concept of Stacking the Deck and I've even posted a couple of videos that demonstrate using it during Edgework. I thought this example may help to further demonstrate the concept.

In this case, despite warming up to "game speed" I noticed the discomfort pretty much straight away. Step onto the right foot, pain on the outer knee cap area. Worse on the downhill but also present on the uphill. Pretty standard anterior knee pain. Were I to seek a diagnosis based on my symptoms almost garauteed I'd have been diagnosed with either the vague (and appropriately so) "Anterior Knee Pain" or the more sinister sounding but more specific sounding "Patellofemoral syndrome" or "Chondromalacia Patella."

Also fairly standard, the pain improved a little ways into the run and worsened again towards the end. I ended on a 1/2 mile downhill section which was not the most convenient time for it to worsen.

This is when I stacked the deck and was able to finish my run virtually pain free.

What did I do? I ran harder. I increased my pace and I pushed off with the leg more vigorously.

I wasn't "pushing through pain" nor was I taking a "no pain, no gain" approach. The knee felt better immmediately, not worse.

I stacked the deck. Normally when I push in this fashion I'm either a) feeling good enough to push the edge or 2) trying to meet some training goal I've set and am in expansion mode. Either way, I usually do this when the scenario is favorable. Because of this my pre-conceived notion of running in this manner is not based on survival but expansion.

So, when my body was posed the question "how dangerous is this, really?" I put myself in a context that was not protective. I flipped the context from one of protection to one of expansion. The result was the favorable one that I was looking for.

How did I know this would work? I didn't. But I thought it might based on my understanding of pain. Also, I was willing to explore different ways of moving and did so creatively.

Does this make you think differently about why exercise and paricularly vigorous exercise can sometimes be helpful? What about when it's not?,

Friday, May 6, 2011

How Dangerous is This, Really?

Yesterday I talked about stacking the deck. Context is everything but so is timing. I suggest that a great time to stack the deck is when our body is asking the question “how dangerous is this, really?” (hat tip to Lorimer Moseley at www.bodyinmind.org)

This defines the edge of protective movement.

When we stack the deck so as to answer “It’s not so dangerous after all” the chances are increased that the level of protection will drop. We’re in friendly territory and the guard can be let down, if even just a little.

Thursday, May 5, 2011

Stacking the Deck


Novel movements give us a window of opportunity to create a new impression which can be quite useful when in pain.

But there is no guarantee that the new impression will be a favorable one. It could just as easily become yet another painful, protected, and therefore limited or limiting movement. In order to change things for the better we need to nudge things in that direction. One way to stack the deck in our favor is to couple the novel movement with something to which we already have a favorable impression.

It’s kind of like when the Indianapolis Colts sign a new player I of course assume that they are an upstanding citizen who is the epitome of toughness and fairness. But, if the same player were signed by the New England Patriots I would of course assume that they are prone to cheating and/or underwear modeling. I’m just saying.

Context is everything and can be used in our favor.

What ways of stacking the deck can you think of?