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December 17, 2019

050 | 3 Truths You Need to Believe About Pain

3 truths you need to believe about pain with Annie Miller

3 TRUTHS YOU NEED TO EMBRACE ABOUT PAIN

The topic of pain is so important to discuss as professionals in the health and fitness industry, and really, as a human being. If you’re human, you’ve experienced pain. And it’s so multifaceted because pain is, in a physical and emotional sense, perception. It’s subjective. Which for me is beautiful because it really takes away the comparison of one person’s pain to another.

My objective today is to challenge some of your beliefs around pain, from both a fitness and emotional viewpoint.

And to hopefully give you some efficacy within your pain. You’ll be able to look back and reflect on past experiences with pain, as well as be better equipped the next time it enters your life. Again, from a fitness or emotional perspective.

My personal experience:

I have to state that I’m not a doctor or psychiatrist or mental healthcare professional. I’m just a girl who has experienced her fair share of pain through injuries and life experience. And I happen to be a certified strength and conditioning specialist who has one puny year of internship in a physical therapy clinic, and a whole lot more time as a patient in physical therapy (cue torn LCL, meniscus, 4 broken arms, years of ankle sprains, and a double roll over car accident, after which I went on to compete with my team at a competitive cheerleading completion, ending in a neck brace, followed by 9 months of chiropractic, PT and massage three days per week…and disc injuries ever since).

That lovely list is NOT to brag, but to simply to say I am not whipping this pain stuff out of thin air. I am speaking from experience both as a repeatedly injured human and as a current strength professional who does not want you to be in pain and/or be a victim to your pain.

Okay, now that we cleared up that this is not medical or mental health advice, let’s dive into the three things I think are monumentally powerful when talking about pain and how we experience it. And these are all HUGE for coaches or professionals who work with humans that may experience pain in the gym, so listen up.

I also want to give credit where credit is due. I have had these beliefs for the better part of 10 years, but they were re-instilled in me at Prehab 101 with Dr. Jacob Harden. And some of the verbiage I may use could be from him. So, strength coaches, PTs, chiros, go follow Jacob. @dr.jacob.harden on IG.

If you’re looking for another organization of professionals in line with these philosophies, check out Active Life Rx. They’re doing VERY big things and I actually just completed their Immersion Course for Coaches where we touched a lot on client communication and programming around pain.

So, holy cow, #1. I swear there will be tactical take aways here.

You are not your injury or diagnosis

Might sound simple but it can be freaking profound because it is WAY TOO COMMON for people to identify with their injury or diagnosis.

Hear me out:

I believe this for physical pain as well as emotional pain: you experience depression, you are not depressed. You have a disc injury currently and you go around saying “I have a bad back” like it can’t be fixed.

You are more than one aspect of your life. I don’t struggle with anxiety or depression but there are many other types of emotional pain someone can experience. If you’re human, you probably have some baggage and have experienced pain in some facet of life. And I believe it’s part of the human existence.

It is imperative that you view pain as an experience. Not as a permanent condition. Now, if we get into the weeds here and talk terminal illness or injury, it could get dicey. And I respect that. But that is not what I am referring to here.

My point is, that when you make it a permanent thing, you’ve removed the possibility of change. You’ve already limited yourself. And ultimately I don’t think that’s what you want.

So, plain and simple; that’s #1. You are not your injury or condition.

Moving on to #2

You have a sensation of pain

Pain is subjective both in the physical and emotional side of things, like I stated at the start of the episode. And they can 100% be intertwined. I’ll explain in depth…

On the fitness side, this pain can, more often than not, be addressed with proper load, volume and dosage. Meaning the weight used, how much work is being done, and how often.

Hear me now, this was said at Prehab 101 and it blew my damn mind, even though on an anatomical level I already new it…

❌Pain DOES NOT equal tissue damage.

❌Damage DOES NOT equal pain.

We can have pain without damage, and damage without pain.

👉🏽 I have degenerative menisci in both knees, NO KNEE PAIN.

👉🏽 I have shoulder pain from time to time in the absence of tissue damage.

I repeat:

🧠 Pain is a SENSE-ory response and is multifaceted.

🗣The way we as coaches & practitioners FRAME what may or may not being going on with a client’s body can have a HUGE influence on how they perceive that pain moving forward (the words we use and our demeanor is V important).

We hopefully want to be building client efficacy. Educating them and not leaving them in the dark. Make them feel empowered without belittling the pain that they are indeed experiencing.

On a personal note, my chiropractor (after a L4-5 injury + some considerable SI pain), was what I hope every chiropractor aspires to be like.

Now, context is important.

I was a senior in college getting my exercise and sport science degree and interning at University of Portland as a strength and performance coach, which is also how I got word of this chiropractor.

You might know of him. If not, look him up immediately. He has a course called “fix your own back”. His name is Phillip Snell and his goal was to get me back under a barbell and never need to visit his office again. THAT, that is what I needed. I needed a trusted doctor to tell me I’d squat and deadlift again. That I could get surgery but didn’t need it, and it was as simple as retraining my body to understand a few things that I’d been missing before. We needed to teach my body that spinal flexion was safe, that hinging was safe. That wording empowered me. It didn’t give me false hope. Because he made clear the work that it would take.

Because my of background and eagerness to learn + apply whatever the heck he was going to have me do, we worked together to make my rehab plan for 12-16 weeks.

If that’s not your chiropractor, stop and research to find one who empowers you vs just popping your freaking back and saying see you next week.

So, to close out point 2 – pain is a sense. It’s a perception and does not mean tissue damage. It’s simply a signal that something, somewhere might need attention.

Moving on to our last truth – you might not like this one but this is my podcast and I believe it to be so freaking true to the depths of my soul. So here we go.

Our belief + expectations around pain are THE MOST important

Expect pain, probs feel it. Expect to improve pain, focus on other aspects of a lift/movement, probs less pain, probs building a higher threshold/tolerance. Probs winning.

It doesn’t mean we ignore pain. It simply means that we can become hyper aware and hyper sensitized to a movement causing pain to the point that we expect it.

You experienced pain or got injured deadlifting and now you expect to have pain when you deadlift. Even light weight.

You were told not to squat by the doc so you expect to feel pain in your knee when you squat. It’s a thing, and it’s not helping you.

Your beliefs can be monumental when it comes to pain. And you might dismiss that, yet you believe things like acupuncture fix your pain…again, hear me out. 

This is also why… this is kind of like 3.5…

Most passive treatment works as a placebo – for fitness, this is massage, foam rolling, acupuncture etc 👉🏽 (tissue is not being altered, but that doesn’t mean they don’t RELIEVE PAIN [temporarily])…just know the WHY (they turn up a competing noise to your pain, and you gain a sensory response “lowering” your perception of pain after the treatment). If we make any tissue adaptations, it will be long term, through active training.

This is a little different with life pain. But I want to touch on the fact that “time” in both instances can get more credit than it deserves. “Just give it time.” This may be true in some instances with injury but at some point, you must WORK. The injury is there for a reason, and now, we need to enter back in and find an appropriate load capacity ratio and build from there. You’ll have to do the work. Do the hard stuff.

If you just let “time run its course” you will likely experience the same injury, over and over and over. THE SAME IS TRUE FOR PAIN IN YOUR LIFE. Right? If you’ve gone to quality counseling, you know time is no match for the dirty work. The work that brings it all up so you can process it, find where the pain is coming from, and work IN THAT. You have been hurt by a very important person in your life. A person who was supposed to be safe. That HURTS. That’s scary, that sucks REALLY BAD. And if you don’t do the work to relearn that close relationships CAN indeed be safe, you will either avoid them forever, or continue a cycle of finding unsafe humans to get close to.

Now, I am not a doctor or psychiatrist.

So take this all as aggressively as you wish. But as a human who has done some hard work on both the emotional and physical side of experiencing pain, I just see A LOT of parallels between the two. And I’ve found that when we do the long term work, the sucky, boring sometimes, PAINFUL work, we both have less pain and are better equipped to handle it when it does come about.

Pain is a SENSE-itive topic…do you get it?

But one worth talking about, especially for those of us in the health and fitness industry. So I hope today’s episode was helpful, insightful or reassuring.

If you find value here, on The FitsPRO Podcast, then pretty please head over to iTunes, subscribe, rate and review the show. It means the world to me when you spread my message to more humans.

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3 truths you need to believe about pain Ep 50 of The FitsPRO Podcast with Annie Miller

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I'm an adventurous introvert from Vancouver, Washington who lives on sleep + "me time." I'm a lover of lifting weights, dinosaurs, real talk and traveling with my husband. I am here to help you move better, lift more, bust the myths of the fitness industry, and inspire you to love the process.

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