Our bodies work by a series of inputs that go into the brain that can influence a resulting output. Various inputs can influence our brain's perception of threats, resulting in pain as the output. As a clinician, I cannot change the outputs of the brain, but we can change the inputs to change behaviors that can alter possible outputs.  (The normal up and down of the nervous system) Due to the high amounts of information and inputs bombarding are systems daily, we may never fully come back down, chronically starting us at a higher set point. (see below)  (This is our nervous system when it is dysregulated) Being stuck in these states means when an oncoming stressor comes in, we may overreact to its input and overreach to combat it, setting us off for larger spikes in nervous system activity. This becomes a learned behavior, where past experiences are taken into account to create expectations of what a particular output should be. When these inputs are perceived to be outside or expectations, dysregulation of our nervous system ensues and we start to run in fight mode to alleviate the stress. If you met a dog for the first time and it bit you hard as you tried to pet it, my guess would be that it really hurt. Well, your brain is going to remember that as a threat and associate it with danger the next time you see a dog. You may get guarded when one walks down the street, you get tense, stiff, and rigid, ready to run away, even though it isn’t harming you. That’s the SNS at work to protect you and gear you up to alleviate that stress. Same thing would happen if 10 years later, you decided to pet a puppy, and they nib at your hand because of teething. Your alarm system may set off causing a painful output even though it was not nearly as hard as the first time you were bit many years ago. This is how past experiences and expectations create a perceived outcome. Most likely, without you realizing it, your body was tensed up before you pet that puppy in anticipation for danger. These small traumas, even if you consciously forget about them, exist in the subconscious.  (I swear my puppy wouldn’t hurt you) Ever wonder how some people can walk on hot coals but you think touching the sand on the beach in the summer is like lava?  VS  They have a connected an awareness with their body and mind to match different expectations based on their perceptions. The examples above occur at much smaller scales in our daily lives without us knowing it because our nervous system is always at work to keep us out of danger and let us know when we are safe. If we feel stressed or rushing around all day, we never truly know what is going on in our bodies as to why we are building up tension to fight danger. We never truly come back down on that wave I showed you earlier. Like I said earlier, the nervous system regulates our bodies as it is part of our mechanism to survive, no matter the costs- emotional, social, physical, psychological, etc. With many of these daily inputs, some may seem innocuous, but are raising our alarm systems constantly. This leaves us in a combative mode of rigidity, muscular tension, and limited abilities to fluctuate through the PNS/SNS spectrum. Being chronically guarded, even when you don’t feel “stressed” may be a way that your brain is disconnecting itself from the body as a means to run away from it a danger, staying guarded in fear that it shows up again. Your are constantly running on 5th gear, over revving the engine for small tasks as past experiences and expectations of various inputs are telling you to do so. Have no fear, there are still ways we can reconnect our mind-body to provide the nervous system with the proper set up to regulate you once again. This following technique is credited to Dr. Seth Oberst. I attended a couple of his courses recently and he is a leading expert in understanding mind body connections while dealing with individuals in chronic pain. Start off by finding a quiet place in your room, laying on the bed of sitting in the chair. Wherever you feel the most secure and supported. When you lay down and experience discomfort in a certain position such as neck tension or headaches, build up pillows around your head to make it feel more supported and secure. Or a towel under your lower back if that feels uncomfortable while laying down.  (maybe this is where you like to lay down) Next close your eyes and start off by focusing on your breath. When an unpleasant or pleasant feeling ensues, STAY with it (I can’t emphasize that enough). See where it takes you and allow yourself to be more in-tuned with it. It may not completely go away, but it will allow you to be able to regulate its effects over time.
Do this for 5 min a day, and start to see if these discomforts bring up past memories of why this may be occurring. Then you can understand why your body is running from something, and be able to better regulate its effects, altering the perception and expectations. So now we have a more in-depth view at how our nervous system can influence or pain, and how our past experiences and expectations of events can affect the outputs. With large amounts of information daily, are bodies can become dysregulated and overreach its need to match a stress, causing heightened SNS activity and inducing more stress on the system itself. Also to learn more about Dr. Seth Oberst check out his website here to gain a greater appreciation of the wonderful work he is putting out there.
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 What’s the deal with variability?
Movement variability seems to be all the rage these days, but how can we effectively relay that to patients? There is plenty of research supporting variability that I believe is extremely useful when accessing different avenues to help treat patients throughout your clinical thinking progress. However, the research may be a little overwhelming when explaining to patients the importance of reducing threat perception by eliciting inputs of a novel stimulus to the brain while performing tasks/movements that are similar to the patient’s daily life. Many people fall trap to performing movements in a routine manner that is limited with very little variations in options to perform a movement such as picking up a shoe off the ground. The repetitive use of the same option of movement can lead to a restriction in your bodies’ capabilities to perform varying tasks in different environment, possibly leading to pain, secondary to repetitive load. We are creatures of habit, but we can break habits and adopt better ones. An example of unknowingly picking up a bad habit may be something as simple as lifting our arms overhead to grab an object from a cabinet. We may not have proper control and range of motion to complete the task, but still achieve it. How so? We may be standing up on our toes or extending our backs to gain reach. We will do this over and over again without realizing it. This will limit our movement options since we only have one way to get the job done. Since almost everyone you see drives, using the analogy of a car can sometimes be an effective way to translate this topic. Picture a car on a road with 2 road blocks on either side of the road, and 2 blocks narrowing the road, causing limited room for this car to move in all directions. These barriers represent the range within your body can move, allowing only a small movement in reverse, forward, and turning left/right. The car could speed up and push through the barrier taking on damage during the way, whether it is a banged up fender, a flat tire, broken headlight, etc. This may not stop the overall function of the car and not cause pain to the body. However, repetitive hits to the barrier will cause more dings to the car. With limitations to turn, we will be spinning our tires trying to achieve some semblance of movement that will cause repetitive stress and load to the tires. The tires, and the rest of the car, are just victims of the limited options in the road. Our bodies should have the capabilities to speed up, slow down, and move in all directions with as much freedom as possible. By allowing the road in which these barriers exist to be expanded, it would take more before we hit the barriers. The goal is to remove the barriers by making the road a one car highway where acceleration, speed, and turns to be made without repercussions. We may need the occasional maintenance such as an oil change (soreness or soft tissue issues) or changes in the brakes (refining motor patterns or increasing capacity) in order to keep us up and running. Novel movements progressed in a safe manner will allow the brain to recognize new options in which to operate to pick up that shoe. It could use a hinge, squat, lunge, bend, etc. Remember, there is always more than one way to skin a cat. Don’t be stuck between barriers. Open up a highway for your body. |
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