Why Physiotherapy Fails For Chronic Pain

This week's topic may be contentious, and you likely have your own views on this subject. Please do share them with me by replying to this email.

With physiotherapy, I'm also going to include chiropractor, osteopath, surgery and steroid or epidural painkilling injections. All of these treatments are great for an acute injury, such as reconstructing a damaged ACL from falling off a mountain skiing, or repairing a fractured limb after a road traffic accident.

BUT, they're nearly always much less successful at providing long-term relief from chronic pain. I used to count down the days to my next osteopath or sports massage appointment so I could move comfortably again, but the improvements never lasted longer than a few weeks. I became dependent on my therapists to sort out my stiff, achy back.

It's costly in every way - finances, time and energy.

Why don't these usual musculoskeletal treatments work for chronic pain and injuries?

ANSWER: Because you're relying on someone else to fix you.

Chronic pain typically has many factors, and always involves the central nervous system. This is actually good news because you can retrain your brain (neuroplasticity) to override it's old habits and replace them with new, more helpful patterns.

The most effective way of reprogramming the nervous system is where you're an active participant in the learning process. Restrictive instructing is replaced by open explorations, connecting the powerful subconscious mind with the more rational conscious cortex.

Building self awareness cultivates self monitoring and, eventually, self regulating. Now your brain can adjust your musculoskeletal system to calm down pain so you're no longer dependent on others to fix your body for you.

How Can You Teach Your Brain New Skills That Stick?

I wrestled with this for many years with myself and clients. 

I was able to retrain their movement patterns, but the changes didn't always stick around long-term. I now realise this was because I was working with their conscious minds.

However, the subconscious mind is responsible for 90% of our decisions and habits, completely without having to think about it. Your brain does many things without telling you so you can crack on with life.

Imagine if you had to remember how to walk every time you wake up in the morning, or if you needed to read the driver's manual to operate your car. None of us would ever get anywhere fast!!!

The same applies to your posture and movements. Which muscles you recruit, how you walk, sit, stand or do anything is all controlled by your powerful subconscious cortex.

So if you want to truly alter how you use your body, you need to create these changes at the level of the subconscious.

This part eluded me until I accidentally discovered somatic movement.

What's Somatic Movement?

Have you heard of any of these practices?

• The Alexander Technique - F. Matthias Alexander
• The Feldenkrais Method - Dr Moshe Feldenkrais
• Rolfing Structural Integration - Dr Ida Rolfe
• Clinical Somatic Education - Dr Thomas Hanna

The Alexander Technique is the oldest somatic movement practice, and possibly one of the best known for correcting posture and pain. Through his technique of breaking movement down into its component parts, Alexander set up an important somatic principle: "Function dictates structure."

Moshe Feldenkrais built on Alexander's work, studying proprioceptive awareness to improve the quality of movement. He also wrote about the connection between dysfunctional movement patterns and anxiety, highlighting the powerful link between the body, nervous system and emotional states.

Thomas Hanna was a student of Feldenkrais. His studies in neurophysiology taught him how the brain triggers patterns of muscular contraction. He coined the term "somatics" in the 1970's to describe the discipline of movement re-education through fostering self-awareness of one's own body.

Hanna's clinical work with his patients demonstrated that many conditions written off as structural or pathological are actually functional in nature. As you re-educate the sensory-motor cortex to improve the communication between brain and muscles, your musculoskeletal system and overall health starts to improve.

He developed:

• A description of 3 universal reflexes - specific patterns of muscle tension in response to stress and how we become habituated into these postures
• The principle of Sensory Motor Amnesia (SMA) - a condition where you lose voluntary awareness and control of your muscles
• A method of releasing persistent muscle tension that harnesses Nature's reset button that all mammals use to release muscle tension

What Does Being Somatic Mean?

"SOMA" is a Greek word meaning "body".

To be "somatic" is to be aware of yourself on all levels - physical, mental and emotional.

Awareness comes from a 1st and 3rd person perspective:

a) First Person Perspective = the body as experienced by the individual from the inside through sensations, emotions and bodily processes.

b) Third Person Perspective = the body viewed externally, for example by another person looking at you or observing yourself in a mirror.

Somatics says that everything you experience in life is felt by the body.

Physiological, psychological, emotional, environmental, lifestyle and societal factors all play a role in determining our health and how we move our bodies.

Tips For Creating A Mindful Somatic Movement Practice

As you've seen there are several different somatic practices. Personally, I felt that Hanna's Clinical Somatic Education made the most sense to me.

I now realise that one of my musculoskeletal mentors was actually describing some of Thomas Hanna's work, but using different terms. His background is sports and soft tissue therapy.

Here are some tips for creating an effective mindful somatic movement practice:

• Create a comfortable space for your practice that's free from distractions
• Move slowly to allow the brain to easily notice the quality, range and comfort of the movement
• Somatic movements are natural and always on-painful. If somethings hurting you, try reducing the effort. Rushing, forcing, pushing or pulling are counter-productive and simply create more tension!
• Keep your practice simple - the aim is education, not a keep fit routine!
• Come with an open mind and genuine curiosity. Give yourself permission to explore and play with the movements. Remember, you're learning a new skill and this requires patience, repetition and a positive mindset.
• Observe your habits both on and off your mat. Are there any similarities? For example, do you find it hard to do the exercises slowly, and are you always rushing breathlessly through your day? Maybe, you notice that it's hard to relax your muscles, and you also tend to overthink and be self-critical.
• Work with a somatic movement teacher, either 1:1 or in a group class. Although you need to do the work, you can't teach yourself everything on your own! A teacher can hold a mirror to your patterns and habits that you're blind to because you've done them for so long they seem normal to you. Some of the most profound shifts I've created have come from working with a good coach.

A somatic movement practice isn't confined to your mat.

I've used somatic awareness to teach my body to squat with a barbell in BodyPump pain-free after struggling for 5 years and almost giving up the class many times. And my practice is helping to regulate my nervous system so I can get to sleep earlier and cope better with life's stressors.

How would cultivating a somatic practice benefit you and improve how you live?

WAYS TO WORK WITH ME TO RELIEVE PAIN & PREVENT INJURY

If you're ready to learn somatic movements to find lasting freedom from chronic pain and stiffness, a good place to start your journey is my Unlock Your Body breakthrough session

This is a one-off powerful 1:1 session designed where I'll help you understand the root triggers behind your persistent pain, and how to begin reversing them. This breakthrough session is ideal if you have a specific pain or injury that you're struggling to resolve, even if you've already tried other treatments.

We'll work together to find new ways of moving without pain. You'll leave with a deeper knowledge of what's driving pain in your body, and a clear action plan to get lasting relief. 

For some of my clients, a single session is enough to reset their body out of pain. For others, this is their first step to learning how to move their body without pain after months or years of struggling.

Apply HERE  and I'll be in touch to arrange an initial complementary consultation to discuss whether an Unlock Your Body breakthrough session will be a good fit for you. 

I also have other options for 1:1 coaching if you wish to dive deeper into moving without pain (your muscle tension probably didn't happen overnight, and it won't magically disappear on it's own!).

Other ways you can find help with managing pain or an injury are:

• Book into a Stretch or Pilates class with me - these are a good introduction to some movement explorations from The Befriend Your Body (BYB) Method for pain relief and relaxation. This is my signature framework that I use to help my clients get out of pain and back to the activities they love.
• Come to my brand new class "Restorative Movement" at Field Place, Durrington. This starts on Thursday 2nd January from 7.15pm to 8pm.  
• Subscribe HERE to receive "The Movement Chronicle", a free weekly e-newsletter delivering movement and pain relief truth bombs directly into your inbox every Monday morning,

You can connect with me through any of these channels:

• Email at norma@unicornhealthandfitness.com
• Follow me on Facebook and DM me on Messenger https://www.facebook.com/norma.pearsonfitness
• WhatsApp message to 07801 867361.