Friday, August 12, 2011

When Pain Appears Everything Changes



In this previous post I argued that the Ticking Time Bomb theory of body mechanics is problematic. Now this is clearly blasphemy since “sound” body mechanics is seen as a pillar of my own profession of physical therapy. Am I ready to denounce my own profession as well as many others? No. Body mechanics clearly plays a role and many of us use movement every day to help people with pain. So what gives? Am I talking out of both sides of my mouth?

No. I’m saying that when pain appears, everything changes.

Body mechanics is not useful as a pain predictor but can be a useful solution to a problem that is already present.

Regardless of how we move we will all hurt from time to time (a robust foundation of research supports this statement) and the pain will correspond to certain movements. Perhaps it will hurt to bend forward and sit or maybe instead standing up straight and walking will be the nemesis.

Neuroscientist VS Ramachandran said that “pain is an opinion.” Painful movement means that our body is acting on the opinion that we are under threat and should therefore be protected. So, how can we change this opinion?

Movement patterns and postures are often tendencies or habits of moving. They develop over time and therefore give us a glimpse at someone’s typical movement diet. If we give them something new, something outside of their normal diet, we give them something to form a new opinion about. We are channeling their inner food critic!

If we are presented with this something new in a non-threatening context, a context of safety, a context of expansion, we are not likely to come to an opinion of pain.

Pain reduction occurring through body mechanics and postural change is, in my view, yet another example of the power of novelty. It has nothing to do with attaining some idea of perfection and likely little to do with strain reduction and everything to do with non-threatening change.

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