Why Expectation Matters For Movement and Pain

The concept of Predictive Coding - think of the film "The Matrix" - is a fascinating model for movement and pain.

Efficient movement relies on an accurate perception of where your body is in space and being able to coordinate different areas of your body into a cohesive, fluid movement pattern. This skill is called proprioception.

Pain is the brain's interpretation of how much danger the body is in.

Predictive coding is the science of perception. By understanding how our brains use predictive coding to make sense of what's happening in the body we can change our perception of what is and isn't painful.

There are 2 ways that our brain makes sense of our environment - both the world around us and what's happening inside our body.

1. Bottom Up = Body -> Brain
2. Top Down = Brain -> Body

1) Bottom Up Perception

Sensory information is constantly detected by nerve endings in the skin, eyes, ears, muscles etc. and relayed up to the brain.

Hunger, thirst, heat, cold, pressure, sound and light are examples of sensory information being delivered to the brain. 

Pain is another sensation that is detected by the brain. For example, you're out walking and roll your ankle stepping off the kerb. The sudden twisting and stretching of the soft tissue around the ankle joint triggers a nociceptive (potential danger) response that's sent to the brain. The brain concludes that the ankle has been injured and creates painful sensations to protect you by making you either limp or stop walking completely.

But there's a missing link from this story. It totally disregards how complex and highly evolved the human brain has become.

That's where Top Down Perception and the Predictive Coding model comes into play.

2) Top Down Perception

The brain runs on subconscious algorithms created by our life experiences that colour how we experience our external and internal environments. The brain is always refining these programmes with each new experience that we encounter. 

Here's an example of how the brain's expectations can override sensory information from our senses:

Another example is the mysterious power of placebo's and nocebo's.

If you believe a treatment will help you, your body will feel better. And if you expect pain, you'll be much more likely to feel pain.

What Is Predictive Coding?

Bottom up and top down perception creates a 2 way flow where neural activity from the brain meets sensory information coming up from the body. 

When these 2 streams meet a comparison is made between what has been predicted by the brain and what has been sensed by the body. The difference leads to a comparison or prediction error.

If the error is small enough it's dismissed as being "close enough" or "not significant enough to notice". The experience is perceived and felt exactly as expected.

But what if there's a bigger error detected?

The higher levels of the nervous system are alerted that something surprising has happened, and the brain's attention shifts to the incoming sensory data so that perception and action can be adjusted accordingly.

Confidence and attention also matter. If you pay attention to a certain stream of sensory information you're much more likely to pick up even small errors.

If you have a very strong belief or high confidence about your predictions you're more likely to disregard significantly large errors. 

How To Use Predictive Coding To Reduce Pain

Predictive coding can help to explain why pain is influenced by other factors like past life experiences, thoughts, expectations and beliefs, and not just tissue damage. 

Let's see how this works in practice.

For example, you hurt your back and start feeling pain when you bend forwards (spinal flexion). You may also be told by your doctor and well meaning friends not to bend over or pick up anything heavy off the floor, otherwise you might make your back pain worse.

This begins to build an expectation that you'll feel pain whenever you bend, even if your back isn't actually producing that much nociception (danger signals).

What you're expecting to feel has now become your reality, turning the initial injury into a persistent back pain.

You can change this by creating a prediction error which disrupts your expectation that bending forwards is going to hurt your back. 

One way to do this would be to explore flexion in a different context, say bending the spine in all 4's kneeling or lying supine on your back, whilst paying attention to how your body feels during the movement. 

When your nervous system is confronted with a significant prediction error it can do one of two things:

1. Update the brain's algorithms to align with the new information = changing perception
2. Alter the action in a way that delivers sensory information consistent with the new prediction = changing movement

Imagine you're about to sit on a chair. As you begin to lower your hips you're expecting to feel the chair touching your bum telling you that you've landed, but your buttocks remain sensation-free This creates a prediction error.

You can either change your perception by looking to see where the chair is (maybe you misjudged it's position behind you), or you can change the movement of your body by lowering your hips further until you feel the chair underneath you.

Your brain and nervous system will always want to reduce prediction error to keep you safe.

The BYB Method uses the Predictive Coding model to shift your brain and nervous system's experience of movement by asking you to pay attention to sensory information from movement patterns the body is designed to do but in a novel way.

This re-programmes your brain's expectations for what sensory feedback you'll get during the movement, so you can dial down danger and pain signals.

This requires practice actually doing the movements, structured guidance to help you pay attention to the relevant sensory information streams and then to reduce the resulting prediction errors by changing your perceptions and actions appropriately. 

NEXT STEPS

Look out for a free E-guide "How To Relieve Back Pain & Muscle Tension in Just 10 minutes a Day" that I'll be offering to everyone on my mailing list very soon.

I'm planning new weekend workshop retreats for 2024. Each workshop retreat will help you to:

- find stability, balance and safety in your body

- reduce pain and release muscle tension

- move with ease and freedom

The workshop retreats will be a deeply relaxing, fully immersive mind-body experience with guided meditations and a sound bath at the end of each day.

You can also:

• Book into a Stretch, Yoga or Pilates class with me - these are a good introduction to The BYB Method and take the first steps to your pain-free body.
• Attend a mind-body retreat - these are deeply relaxing, fun, social small group experiences typically held in various locations within easy reach of Worthing, West Sussex. The next retreats are "Rest & Reflect" half-day winter retreat on Sunday 3rd December (FULL) and "Sun & Moon" mini retreat on Sunday 17th December (last 4x spaces left). Click HERE to read more about them,
• Subscribe HERE to receive "The Movement Chronicle", a weekly e-newsletter delivering mobility and pain reduction tips directly into your inbox every Monday morning,

To find out more about my classes and retreats, or to join my email list you can contact me via any of these channels:

• Email at norma.pearson1@ntlworld.com
• DM me on Facebook Messenger 
• WhatsApp message to 07801 867361.