Wednesday, September 16, 2015

Push the Fear Away

If you have never been in serious pain, it is impossible to fully relate to someone that has.  You can "understand" they are in pain, but you can't have empathy.

One of the blessings in life I've realized is that I have been physically hurt.  Through most of my injuries I have come out on the other side with learning lessons, better training philosophy, deeper appreciation for health and overall being a better clinician.

It drives you to read about and understand the mechanism of injury.  Because, at the root of almost everything, people, even myself are always asking "Why me?"

People want to know why they got hurt.  Why is this painful?  How do I get out of this pain?  How do I keep it from ever coming back?

Somewhere along the line, there can take root some serious fear.  The body has an amazing ability to heal itself.  The cast isn't healing the broken bone, the cast just keeps you from doing stupid stuff so the body can heal the fracture.

What doesn't' heal well at times though is the psychological impact of the injury.  The fear of being hurt again.  The fear of the pain that you remember being in.  The fear of the helplessness that you felt while hurt.

This at times is the bigger hurdle.  The battle with fear.  I can remember laying on a floor for days in back pain.  Every time I deadlift it is in the back of my mind.  Every rep I do, I'm beating back that fear.  There can't be avoidance.

I see the repercussions of avoidance everyday.  If this hurts, quit doing it.  If it hurts in this range of motion, maybe go with a slightly smaller range of motion.  Avoidance only feeds the fear.  Your allowing it to grow.  Because of the avoidance other health related issues arise.

After attending a FRR seminar awhile back,   I realized I had associated spinal moment with back pain.  I never broke neutral and held extension.  Good for my back health with lifting, poor for my spinal health in general life.  I had lost the ability to flex and articulate my upper lumbar and lower thoracic vertebrae. I had become so concerned with not having neutrality, that I had lost mobility.  This is an example of fear avoidance leading to health problems unrelated to your original pain/problem.

I've never had such a stark reminder of the power of fear with lower back pain then today.  A patient that was afraid to jump slightly over a small cord.  You may need a 1" vertical to get over it.  This is a patient that had not had actual pain in over 2 years.  They remember the pain and have trained themselves to associate sudden movements with pain.  When I challenged them to jump over, they told me they didn't think they could remember how to.  They told me they were to weak.  This is learning to work through that fear.  Baby steps.  We will work on the psychological as we work through the physical.  It's in a way convincing them to trust their body again.  Trust must be earned.  Today a one inch jump.  Next week a 10 yard jog?  It's taking physical steps to push back the fear.

Sometimes we forget that full healing doesn't necessarily come with just physical healing.  There is a psychological healing that must also take place.   Every time I deadlift I push mine back, every time they jump, they will be pushing theirs back.  Find your way of pushing back your fear and PUSH!

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