I've never given much thought to how I am moving whether I am pain-free or in pain. I've been more focused on the results of exercise and just getting from Point A to Point B. It was almost like I had amnesia in my body and felt disconnected from my body. And then later on, when things were hurting, I would wonder why I felt worse.
I was also afraid to move my body in any way where previously I felt pain. This fear of movement is called kinesiophobia. Since I experienced pain from an activity, I expected that pain would surface again if I tried that activity again. I knew that this wasn't logical, but between what my brain was telling my body and then how my body reacted to this story, I fell into a pattern of limiting or completely modifying what I did. It wasn't until I took a training module with my teacher, Neil Pearson, on pain, that I could finally both understand what pain is and then how to create evidence of safety as a point to move forward from.
Movement Guidelines
One of the practical takeaways from this training and subsequent trainings, was the Movement Guidelines. This is an evidenced-based system for relearning how to move with safety. There are 3 aspects of the Guidelines that I will discuss below, Awareness, Regulation and Discernment. These 3 aspects include step by step instructions which can be used in every aspect of your life.
The goal according to Pain Care Aware, which is Neil and Lisa Pearson's training and certification program is "a process of exposing the person to gentle increases in stress and physical load, rather than protecting the body when there is pain. We guide students to be aware of “what’s happening now,” and how to regulate new gentle stresses that will help to decrease the sensitivity of protective mechanisms and allow the tissues to regain health." Other benefits are better overall health and well being, including better health of the organs, bone structure, muscle tone, cognitive function, resiliency and ability to navigate life's ups and downs, better moods and emotional balance and even better relationships with others.
Awareness
The first aspect is Awareness, a sort of mindfulness that one can use in movement. It begins by coming to an edge where you might feel pain or discomfort. When you feel that, you would ask yourself, "Do I feel safe?" or even reflect if you will pay for this later. You would check in with your breath quality - is it calm or feels tense? Then check with your overall body tension, not just at the site of pain. Are you feeling tension or holding tension in your body. I also like to check in with my thoughts, for as we know, everything can influence pain and whether or not we feel safe. Continue to cycle through these observances while staying at the edge of pain.
This is also a good time to explain, that the Movement Guidelines takes practice. Repetition will make it easier to discern what you need to do when you feel pain. In the beginning, it may seem a little awkward, but stick with it. Remember how I never gave a thought on how I was moving at the beginning of this article. I still can sometimes revert back to old habits, but more and more I use these Guidelines to break free from fear of moving.
Regulation
We are now at the Regulation part of the Movement Guidelines. This is where you would change any aspect of yourself to change your pain or tension. While you are at the edge, you can begin to change your breath so that it is calm, your body tension (maybe letting your eyes soften), your thoughts and emotions. In all of these changes or regulation is to answer "Yes, I do feel safe right here, right now". Cycling through awareness during this stage is also important.
Discernment
The final aspect of this system is Discernment. This is like fine tuning a piano. If I adjust this piano key, how does that affect the sound? With discernment, you determine if you changed your breath, did it change your pain, tension or thoughts and emotions. Or if you changed your body, did it change your breath, thoughts or emotions? It is like you are giving your brain (who is there for your protection) evidence that what you just changed, changed something else. And if that something else helps you feel safe in movement, then it becomes a positive feedback loop in your brain. Or more evidence of safety.
Moving Onward
And guess what? When there is evidence of safety (perception of safety by the brain), then your fear of movement decreases, you move more, you have less pain, and better overall health and well being. Consistent adherence to Movement Guidelines not only reduces pain but also cultivates resilience and confidence. As individuals witness improvements in their physical abilities and pain tolerance, their fear of movement gradually diminishes
The Movement Guidelines have emerged as a beacon of hope, providing structured recommendations to manage chronic pain effectively while minimizing fear and enhancing overall quality of life. These guidelines encompass a spectrum of activities tailored to individual needs and conditions, promoting gradual progression and ensuring safety.
For more information on Pain Care Aware, visit their website. At Pain Care Collective, all of our classes, both live and on-demand share the Movement Guidelines in the practices. Also check out our Skills classes and the new 5 class series which provides experiences to try out the Guidelines.