From professional athletes to musical entertainers and beyond, high-energy performers execute complex motions with relative grace and ease. Whether it’s LeBron James dribbling down the court or Bruno Mars dancing on stage, their coordination and precision are due to the incredible motor control and movement pattern memory they’ve gained through countless hours of training. However, these well developed movement patterns can be altered in the presence of injury, fear, and more!
At my clinic in Boulder, Colorado, I was recently working with a middle-aged man who was experiencing low back pain when lifting more than 40 pounds from the ground to the trunk of his SUV. This pain was interfering with his ability to perform work tasks as well as household chores. Within 3 treatment sessions, he was able to mimic the mechanics of the lifting motion without any pain. During visit 5, he performed the 40 pound lifting task repeatedly pain free. However, the following day at work, his pain immediately returned when attempting a lift.
The above example, demonstrates the complexity of pain. This client objectively demonstrated proper strength and mobility to perform the lift in clinic; yet, when attempting the lift at work, the pain returned. When I asked him about the experience he said, "I don't know why it hurt at work...I felt tense as if my muscles were protecting me from the movement...I was anticipating the pain...Since I was injured at work, the lift scared me." At this point, I reminded him of the many factors, including fear, that can impact his experience of pain.
"Fear and pain have a very intimate relationship"
Martial artist and actor Bruce Lee illustrated this idea beautifully: “You must be shapeless, formless, like water. When you pour water in a cup, it becomes the cup. When you pour water in a bottle, it becomes the bottle. When you pour water in a teapot, it becomes the teapot. Water can drip and it can crash. Become like water, my friend.” Water flows freely and fearlessly. Water doesn't stiffen or guard itself for protection. Water is smooth and fluid. Water is powerful. When learning how to move out of pain, you must challenge yourself to relax and allow your body to become like water!
While this may sound funny or unrealistic, it is important to learn how to relax with movement. For precise movement to occur, certain muscles must activate, while others simultaneously relax. Practicing the ability to move without stiffness can bring awareness to the movement and create learning opportunities that strengthen the connection between your brain and muscles.
When dealing with pain, do not forget about the contextual factors! Practice and repetition of movement will decrease the protective response from your nervous system and improve the mind-muscle connections!
Dr. Jim Heafner PT, DPT, OCS
Heafner Health Physical Therapy
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