Moving Beyond Pain
Between one third and one half of the UK population will experience chronic pain in their lifetime (Fayez 2016). This can range from things like low back pain, joint pain, osteoarthritis, fibromyalgia, spondyloarthropathy, endometriosis, generalised chronic pain and more.
Chronic pain can feel frustrating, limiting and sometimes a little scary. Those experiencing chronic pain may begin to restrict movement and reduce physical activity, which can negatively impact physical and mental wellbeing.
Ahead of our upcoming workshop, with guest presenter Trish Formby, this blog discusses how we as Pilates teachers seek to support those with chronic pain to help you enjoy the benefits of movement and physical activity beyond pain.
Validation and Understanding
The most important thing to understand when talking about pain is that people feel pain in different ways. What might give rise to a mild sensation in one person might translate to a feeling of significant pain in another.
We commonly associate pain with some sort of harm or damage occurring, such as if you were to sprain your ankle or place your hand on a burning hot surface. But for chronic pain conditions, the pain experienced is much more complex than that and is not always indicative of damage or harm occurring. Our sensitivity to the pain experienced can be impacted by many different things, both physical and emotional. Chronic pain can flare up and abate at different times, with the reasons often being multifactorial.
As Pilates teachers it is important that we understand that everyone’s experience of pain is different…and everyone’s pain is valid. We listen to what feels good for you, and what doesn’t. We provide reassurance where needed, and work with you to help find the right balance of work that is best for your own body.
Looking Beyond the Pain
The impact chronic pain may have on an individual can be significant. People with chronic pain may also experience disturbed sleep, low mood, poor concentration or short term memory, a sense of feeling overwhelmed, or hypersensitivity to light, touch or sound (NHS Inform).
As teachers working with clients who may be experiencing chronic pain we need to be aware of this and consider the wider benefits of Pilates in helping this individual move and feel well.
Not only can we help someone with chronic pain maintain a level of physical activity that is appropriate for them, we may also be helping that person feel a little lighter, sleep a little better and connect more with their body and mind. This can be a very valuable tool, and a reason why we are passionate about helping people with chronic pain continue to move well.
Creating a Safe Environment
Pain is an emotional experience, not just a physical one. Think about a time when you hurt yourself. Maybe you stubbed your toe (ouch!). At the time you might have shouted, or even sworn in pain. You might cry, or even feel angry. You might start to feel nervous about stubbing that toe again, or give the table leg a wide berth when you walk past it in future. These are all emotional responses to the pain you experienced.
Therefore, as Pilates teachers, it is important to us that we consider your emotional experiences as well as your physical ones when you are in pain.
We have designed our studios at Lavant House to be as welcoming and “homely” as possible; aiming to bring you a sense of ease as soon as you step in the door. We train our teachers to ensure we communicate effectively; using supportive language, taking time to ask questions and listen to our clients, to use gentle tactile feedback and reassurance. Our focus is on what you can do, not what you can’t, and we will support you with positivity and encouragement. We recognise that every experience of pain is valid.
Our studios at Lavant House have been designed to feel warm and welcoming; putting you at ease the moment you walk through the door.
Helping You Connect With Your Body & Overcome Fear of Movement
This last one is a biggy. Ok, technically it is two things but they both link together so I’m going to discuss them in the same section.
When an area of our body is giving us grief, whether that is because it is causing us pain, not working as well as we would like or maybe even doesn’t look the way we might like, we tend to disconnect from it. Mentally, and sometimes even physically. We stop thinking of it as a part of our body that works with us as a unit, and instead disassociate from it or even start looking on it negatively, as if it were something working against us.
We may even develop fear of using the area that experiences pain, for fear of causing damage or making the pain worse.
Both disconnection and fear can negatively impact our physical and mental health. We might stop physical activity altogether, or avoid using the part of the body that experiences pain. The resultant loss of strength and mobility in the area might make us more susceptible to pain flare ups in the future. Disconnection and fear can affect the wider body; creating tension and rigidity in our movements, or giving rise to compensatory movement patterns. Not to mention the impact of stress hormones.
Compensatory movement patterns are something I see a lot in clients who come to the studio with chronic pain. Visibly “leaning away” from the painful area,. This can have an impact on how their whole body moves and give rise to other issues and niggles in other parts of the body.
So as Pilates teachers, how can we help you reconnect with your body and reduce the fear of movement? This for me is the most important role we have as Pilates teachers working with clients experiencing chronic pain, as it helps to empower you with a sense of understanding and trust in yourself. There are lots of different factors that come into this, so I have briefly summarised the key ones below:
Listen and adapt: As teachers we check in with you to understand how your pain is TODAY. Chronic pain is not linear, and often has periods of pain flares and periods of relative calm. Checking in doesn’t mean just asking how you are feeling at the start of the session, but also checking in at relevant intervals during the session. We need to be prepared to adapt based on how your body is feeling at that time. This might be a different spring setting, changing the focus or tempo of an exercise, omitting some exercises or adding in others, swapping the order we do the exercises in or the number of repetitions.
Reassure & Encourage: We want you to keep your whole body strong and mobile, but it won’t do anyone any favours if we go in too hard and heavy. Remember the fear of movement I mentioned? We want to help you move beyond that fear and reassure you and your body that you CAN move well without causing pain. We take a gentle, progressive approach - and we are always prepared to adapt based on how you are feeling that day, or how you felt after the last session. We encourage you to look on the pain area kindly, and gently provide your own gentle reassurance. Build trust in your body and in your ability to know what to do when you are experiencing pain. This can be a gradual process, and may mean allowing yourself to gently ease into movement and listen to how your body responds. Work with your body and not against it.
Empower with education: Understanding what is happening in your body can help you connect a little more with it, and understand the sensations you are feeling. We help you understand what is happening in your body, within the scope of our role as Pilates teachers. We encourage you to be curious. Ask questions; to yourself, to us and to your healthcare provider
Focus on what you CAN do: We want your experience to be a positive one. Rather than concentrate on limitations, we look at what you can do and go from there. Most people are surprised at just how capable they really are! Our frequent check ins aren’t just about identifying when you are in pain, but also when you are not. Connecting in with your body can help you realise that sometimes the pain isn’t there, or that you can do some things pain-free that you didn’t expect to.
Know When to Refer: We are Pilates teachers, not physiotherapists or doctors. Whilst a good Pilates teacher will have completed a thorough level of training in anatomy, physiology and musculoskeletal conditions we cannot diagnose conditions. It is outside of our scope. When working with a client experiencing chronic pain we are trained to be on the look out for certain flags that may indicate you need to be looked at by a healthcare professional such as a physio or doctor. This can be patterns that suggest your condition has changed/progressed, or indicators that that pain you are experiencing could actually be due to an acute injury rather than a chronic pain flare. We will always encourage you to listen to your own body, and if something doesn’t feel right then seek the opinion of your healthcare provider. As teachers, we respect that there is a huge degree of trust being placed on us, and we want you to trust that we will never make you do something we do not believe your body can or should do, and if we are unsure we will always seek advice.
If you have any questions about working with us at the Pilates Studios at Lavant House please do get in touch.
Want to know more about “Moving Beyond Pain”? We are delighted to have renowned sports physiotherapist, rehabilitation expert and author of the fantastic “Body Fix, Body Fit” Trish Formby join us at the studios for an empowering workshop full of information, tools and gentle movement to help you move beyond pain. Our in-studio tickets sold out in minutes (!) but we have online tickets available that allow you to join on the day, or catch up later with 14 day recording playback.
Wednesday 25th June 12.30pm