Hi friends,

Pain is something that every human experiences at some point in our lives. The IASP defines pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

The notion of activating pain fibers that cause the body to feel pain is now antiquated. We’ve since discovered more about pain and realize that it involves the complex interactions of biological, psychological, and social factors.

Most of the time we are annoyed by pain, and rightfully so, but the alternative of never feeling pain can be catastrophic. It tells us that we are potentially in danger and should change our behavior to avoid damaging the body. In the short term, this is a beneficial adaptation for survival.

But when pain persists for months to years, it changes how we feel, think, and move. I see all different types of people in pain every day at my job as a physical therapist and consistently see that people with anxiety and depression suffer from chronic pain more frequently than people without those comorbidities. They are typically fearful of movement to avoid pain, but if this persists, they can become debilitated.

One of the most important things I assess with my patients is how fearful they are of movement to protect themselves from further injury. And yes, you do want to protect yourself if you break a bone or have a serious illness, but most of the cases that I see are more or less physiologically and anatomically stable and able to exercise and move the painful body part.

If you are overprotective of an injury and do not move or exercise the tissues, then they may become more dysfunctional and debilitating. My orthopedic fellowship program director Pieter Kroon said, “Fear of pain may be more disabling than pain itself.”

My general rule of thumb is that you can exercise and push yourself up to the pain, but don’t push through it. Exercise helps to promote blood flow to the injured tissues, growth of new collagen fibers (helps to increase the strength of the tissues), and releases endogenous opioids that help to decrease pain!

The psychological framework that you have about your pain and injury will greatly influence the rate of your recovery. Thinking things like, “I’ll never be the same,” or “I can’t do anything because of the pain” will do nothing but hinder your rehabilitation.

It seems trite but it is unequivocally true—thinking positive thoughts will have a positive impact on your recovery and will likely lead to improved outcomes.

Disclaimer: Please consult a medical professional if you are suffering from acute or chronic pain. This email is intended for general informational purposes only and should not be taken as medical advice. If you are recovering from an injury or illness, see a physical therapist who can provide a specific rehabilitation program and provide safe movements for your situation.

Until next week,

Kevin