Do you know that you can experience a HUGE amount of pain, yet have no damage or injury in your body?
Have you ever heard of phantom limb pain? It’s when someone experiences pain, yet they don’t even have the body part? Think of someone who’s maybe had their arm amputated but still feels pain there. How can that be?
Or maybe you’re someone who has been diagnosed with fibromyalgia. No obvious damage or injury can be found yet absolutely, you feel pain.
Do you know the reverse is also true? You can have NO pain and yet have ‘damage or injury’ in your body?
Have you ever found a bruise on your body yet had no idea how it got there? Or maybe you broke a bone playing one of your favorite sports but didn’t really feel pain, until you got to the hospital? There was obviously tissue damage, yet no pain. At least at first, perhaps.
Maybe you’re someone who has disk degeneration, yet no pain. According to this study (brinjikji et al 2014) if you’re 60 years old, 88% of people whose back has been imaged will show disk degeneration, yet experience NO pain. If you’re up to 70 years of age, it’s up to 95% who have what looks like damage or injury and yet has NO pain.
When you have a headache, think of a really, really painful headache, … do you think you have something broken or damaged in your head? Likely not.
So why do we think that way about other parts of our body?
Pain is weird, for sure. And complex. And our understanding of it does not always match with what’s going on. Often, we are confused by it, don’t know what to do about it and just live with it.
Don’t get me wrong. You NEED pain. Otherwise you would likely not survive. You need a mechanism to tell you something is up and you need to attend to it.
It’s the persistent chronic pain that seems to be the trouble. In Canada and most places around the world, 1 in 5 people live with it. If it were an easy fix, we would have done so by now. Two areas that the evidence tells us seem to be most helpful are: understanding pain and movement. We’ll cover both.
Well, there is more to it but if you’re curious to know how you might change, how you can influence your own experience of pain, I’d love you to join a new 6-week online program starting July 22, 2020.
Advantages of this being online?
anyone can take it in the privacy of their own home,
at their own pace
all the content is yours to keep forever, and
I’ve made it affordable and accessible so anyone can enroll. $25 week, for 6 weeks (both a payment plan and options are available).
If you or someone you know might benefit, click the link below for all the details.
I could really go on and on about breath, from many different angles and actually have been sent down the rabbit hole for a few days now wondering how I might approach this, in a single blog post.
Our breath, the in-breath and the out-breath happen quite naturally, right? Of course, they do. It is one of the most important things necessary to our survival. We do not have to think about it. It is just one of the many wonderous systems in our body, working behind the scenes.
However, if you look at how a baby breathes, and how many of us older folks breathe, you might notice a difference. How in babies and young children it almost seems like their whole body moves when they breathe. How their big, soft bellies expand with each inhale. For us, often, not so much.
What’s different?
There could be a whole mess of reasons, but the one I’ll explore here is one you’ve perhaps been exploring over the past week.
Muscular tension might be involved when we hold our breath, or when it doesn’t flow so freely.
Generally, muscles and tissues may become strained, fatigued over time if they are recruited, or over-recruited, ‘switched on’ a lot. We may not be aware of this, particularly if ongoing over a long period of time. It often becomes our usual ‘pattern’ rather than what might be a responding or releasing (and relaxing) as required.
There are also some areas of the body where this tension might get in the way of a full, easeful, ‘natural’ breath we see in a baby. I think of the stomach or belly area for one. How many people unconsciously hold or constrict in this area for a multitude of reasons? This, which happens to be the area containing your primary breathing muscle, the respiratory diaphragm. Or might someone hold tension unconsciously in their pelvic floor (diaphragm) muscles, again for a variety of reasons? I think of all those ‘core exercises’ we’ve been told are good for us or how often women socially, culturally, ‘suck in their stomach. Or perhaps you’ve been told to do kegels at one time or another, or hold, strengthen or tighten up your pelvic floor muscles. Which may be useful. Or maybe not.
Both diaphragms are meant to move with each breath yet with tension and tightness in one or both, might this change how we breathe?
Holding tension might not allow for a full, deep breath such as when our respiratory diaphragm moves down, creating the in-breath. Maybe, we hold tension in the pelvic floor, without realizing it and again, not allowing for optimal breath.
Now, think about what is more important to our body, to our brain, but breathing. And how this regular intake of oxygen not only provides nourishment our body needs to survive, but it also forms or influences our physiological state. For instance if we are under threat, or even perceived threat there are immediate changes to our physiology, including our breath, that takes place to aid in our survival.
Which is all great when we’ve broken a bone, need to pull our hand away from fire, stay clear of toxic fumes or something similar. Back in the old days, we would need all our senses, these sensations, to help us stay clear of dangerous predators like tigers and the like.
What happens now though, is often we are unaware of:
1. The threats (real or perceived) that we encounter on a daily basis. These aren’t likely threats like running from tigers, but threats in terms of our relationships, our jobs, our finances, our communities, our environment. How much of the news do you see, threatens your sense of safety? Does this create a sense of tension, stress, holding of your breath perhaps, in your body?
2. The response of your nervous system and subsequent physiology that accompanies this. You may have read that stress is not good for the immune system, for your mental health, etc. but there are also effects on other areas or systems that occur including your pain system. If pain is meant to protect you, yet you ‘feel’ threatened, stressed, and tense might that turn UP the volume of pain? Have you ever noticed a correlation (not saying cause, here) in your stress levels and your pain?
Conversely, how might a sense of safety, turn DOWN the volume of pain? Even a few simple words from a parent to a child such as “you’ll be okay” often turns down a pain response.
Can we learn to notice our breath and what that might tell us about how we feel?
Can we find a breath that is supportive for us, when it’s called upon?
Can we find a breath that is supportive for for us, when we need rest, find calm, sleep?
There is no right or wrong in this.
Rather, can we find a responsive, flexible breath that supports us for whatever it is we’d like to do? To live in an optimal state of health? As a first step, can be begin to notice this at all?
If you’d like to read in-depth about the breath, yoga therapy, current findings, and research about breath related to pain care, you might check out Chapter 8 by Shelly Prosko, in Yoga and Science in Pain Care – Treating the Person in Pain.
Personally, attention to breath and subsequent practices has had the most influence I find, when working with people who experience persistent pain. Time and time again. Though as Shelly rightly points out “the practices must be individualized to meet the unique needs of the person.” Telling people to take big, deep breaths, may not be ‘the answer’ or ‘the fix’ for everyone which is often what I see out in the main stream media. Suggesting there is some kind of ‘ideal’ breath, for all people, at all times.
I was looking at this tree (pictured above) in my back yard at lunch time today. It sways and flows. Appears strong, yet supple. Not rigid, brittle, tight or constricted. Takes in nourishment, gives back some. Might we be like this tree … A breath in. A breath out. Responding as need be, in any given moment to what life is asking of us.
I’ll be diving into this in more detail with information, a little bit of research and experiential practices in Week 4 of my upcoming online ‘Creating New Pathways‘ course. Want to learn more?
Interested to learn more about this thing called ‘yoga therapy’? Some FAQ’s plus links for ways yoga therapy can help, information for healthcare providers, where we’re at in terms of current research and yoga, yoga therapy.
Such a beautiful tray of food. No wonder eating comes naturally to me. Rather like breathing. But it may not be so for you and I suggest that perhaps our breathing is not always natural either, but is rather responsive and adaptive.
I experience this in other areas of my life, as well. For instance, everything about being a mother did not always come naturally for me. It began with a struggle to breast-feed our first born. I became anxious, stressed and upset when this did not go according to plan. I had to make a call for support and learn from someone. All was well, soon enough.
Next, however, was being home alone all day in the dead of a cold Canadian winter with a baby, requiring so much time and attention. Not only exhausting (compounded by sleepless nights) but the social isolation I experienced was new to me as well, and did not come naturally. Knowing what to do, how to best raise this human being was a challenge. Parenting as being ‘natural’? In some ways, yes, of course. In many ways, not so much. When it didn’t feel natural, I felt like I failed, somehow.
Back to food and eating though. As I said, it does come quite naturally to me. In fact it comes to me far more often than I might need. Hard to resist when images like the one above, presents itself.
Mostly, we don’t pay much attention to these natural things we do until they become a problem, an issue somehow, in how we might like to live our life.
For today’s exploration let’s combine breathing with eating. How might that go?
Much to my family’s dismay I have a tendency to choke, fairly frequently, when eating. Part of it, I’ve noticed, I’m often rushing. Second to that, I’m often talking. Our dinner time is ‘family time’ and usually consists of our coming together prepared for much debate about the events and/or news of the day. When given the opportunity, I do as well, love to talk. Rather similar to the eating thing.
Meanwhile, what’s more important to survival than breathing?
Breathing is going to sneak in ‘as needed’ whether we want it to, whether we make time and space for it, or not. Whether we’re conscious of it or not.
I wonder how eating might go for me if instead of paying attention to what I eat, how much I eat, or when I’m talking, I might just notice how I breathe when I eat.
What might that bring to my awareness?
Perhaps there is something around eating that might be noticeable for you. Maybe instead of choking like me, perhaps you have a tendency to over-eat, or it could be you under-eat. Or perhaps you have some digestive issues.
Try this: Set aside one meal a day in which you do not feel any time constraints. Let yourself breath slowly as you eat. Notice how it feels to allow your belly to release as you chew and swallow your food. Monitor your breathing if you can. Notice what you feel during and after your meal. Again, try not to judge anything. Perhaps there is nothing to notice or perhaps there is.
Curious, isn’t it?
Check back on Friday when we’ll do one more exploration and it is a worthy one, I think. Also, I wonder how the movement and breathing exploration went for you, from earlier this week. You can sign up below to get all these posts.
Also, just to let you know, I’ll soon be announcing a new 6-week online course where breath is one of the things we’ll be exploring and working with. One piece of the puzzle, when we explore various aspects to consider if you experience pain. You can learn more about the ‘Creating New Pathways’ program by clicking the link below.
I was having a discussion with a client this week about the breath and how we breathe. We were talking about the relationship between our body, our breath and how breath moves in relationship to gravity. The forces of gravity, the loads we feel.
Breath awareness is often a focus in yoga. Both in yoga classes and also in a more therapeutic practice of yoga. We spend a lot of time noticing breath, feeling the breath as it moves. Noticing the length of breath, the inhales, the exhales. Where we feel the breath move, in our body.
Taking a different path, perhaps we can explore how breath might not always be moving, or moving so well. As in when you’re holding your breath. Which you might not readily notice throughout the day, unless you pay attention to it.
The basis of this inquiry is from Donna Farhi’s The Breathing Book (highly recommend the book). She states the purpose of the inquiry being:
To identify the situations and activities in which you most commonly engage in breath holding. We don’t usually recognize how much tension we invest in simple activities such as talking or cooking because we don’t recognize the situation as terribly stressful. You may be surprised and disconcerted to discover that you hold your breath in almost every conceivable situation.
Let’s check this out.
Starting today and for the rest of this week, take notice of when you hold your breath.What you’re doing when you hold your breath. Where you are, who you’re with. Make a mental note, or actually write it down so you don’t forget.
You may notice it when you’re speaking on the phone with someone. Perhaps your boss. Or you may notice it when you’re leaning over to make your bed. Or you may notice you hold your breath when your attention is really focused on something, like when driving down busy streets.
Then, you might want to see if you can change it in some way. Just breathe a little more freely if you can. Try not to judge anything, just notice.
I’ve noticed this pattern of breath holding in myself, particularly, in these days. Before I started wearing a mask I would sometimes catch myself holding my breath as I walked by someone. Or when I felt they were standing too near to me. I suspect there was some fear involved in my response. It’s like I didn’t want to take breath in, at that moment.
We’ll do more specific explorations, next week. And maybe get a little curious about how this might affect or influence pain.
Check back with me on Monday (June 29th) for more. In the meantime, keep noticing.
My desire for this update is that in some way it might inspire, be of benefit and most importantly, bring hope to you or someone you know who lives with chronic pain.
Approximately 1 in 5 people in Canada suffer from chronic pain, with costs to the Canadian healthcare system between $47 billion and $60 billion a year – more than HIV, cancer and heart disease combined. One might say that my desire, my passion, is in helping people who feel stuck, in despair and without hope in terms of their lived, unique, experience of chronic or persistent pain.
About 5 years ago, I started studying pain. What pain is (or is not), what might contribute to it and what the current evidence and research tells us. My interest began as a result of my own experience with chronic pain, which dates back a few years prior. Well, actually it began about 2010 or 2011, so almost 9 years ago now.
A year ago I decided to undertake training Neil Pearson offered to various regulated health professionals (doctors, physios, massage therapists, etc.) and yoga teachers, combining pain neuroscience education along with yoga practices and philosophy. The first workshop of the certification process he offered in Ottawa last year, happened to be part of the first module in a certified yoga therapy training program, also here in Ottawa (I subsequently applied to this program as well, and will start the second year of the 2-year IAYT Certified program next week).
Fast forward one year and I’m now certified to teach Pain Care Yoga classes!
WHY DOES THIS MATTER?
Neil trains both medical professionals and others in non-pharmacological pain care in the hopes of bringing knowledge, expertise and evidence-based practices into local communities. He is a physical therapist, a Clinical Assistant Professor at University British Columbia, and a yoga therapist. He has been a consultant with Doctors of British Columbia since 2013, to develop and implement clinical pain management continuing education. He is past Director of Pain BC, and the founding Chair of the Canadian Physiotherapy Pain Science Division.
His goal is “to help people living in pain and to assist others with the same desire to serve. We must shift many paradigms. Our views of pain, the people in pain, and the role and effectiveness of non-pharmacological pain care are mostly outdated.”
My goal is to help serve this purpose as well, by bringing Pain Care Yoga to local communities.
The good news about pain is that it can be modulated, there is hope, and as Professor Lorimer Moseley (probably the most cited pain researcher globally, based in Australia) now says “recovery is back on the table”. We know enough now about chronic pain that we can change lives.
In small group classes (or individual sessions), I hope to play my small part towards helping some of the 20% of our population in Canada who live with persistent pain.
Each time I meet with someone, listen to their experience, offer current explanations about pain, help them learn to move in safety with more awareness, attention and ease, it is clear to me WHY THIS MATTERS.
My classes start mid-April in Stittsville, with private
sessions also available.
