Pain sucks! I’m sure that I can get a resounding consensus on that. Whether it’s a headache, a stubbed toe, or your damn hips. Pain hurts. According to Dr. Greg Lehman, pain is defined as, “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. So what does that mean? It means that there is most likely some amount of tissue damage, but there are also other factors that play into your pain such as past pain experiences (not a bad thing).
Before my first hip revision surgery almost a year ago, I was panicked. I was envisioning that all of the pain that I was having was equal to the amount of damage in my hip. I visualized my hip disintegrating as each passing day until my surgery. In my head, my pain equaled the damage in my hips.
But one of the most liberating pieces of information that I came across during my recovery was this idea of self-efficacy in relationship to pain. In fact, I shared a blog back in February from Ben at Cor-Kinetic. He stated, self-efficacy is a “sense that ‘I have got this’ or ‘I can do this’. This is self-efficacy in relation to pain, such as the perception of the ability to remain functional and perform activities of daily living whilst you have pain, or it could be treatment related activities such as a specific activity or exercise.”
Recently, I also had talked with my PT regarding pain science and the idea of a 1:1 correspondence. The idea of 1:1 correspondence basically means that your level of pain is not ALWAYS equal to the same level of tissue damage that you may have. He encouraged me to watch a TEDTalk by Lorimer Mosely “Why Things Hurt”. Lorimer talks about our crazy, incredible, miraculous bodies and how our nervous system relates to the pain we feel. I encourage you to watch this TEDTalk!
I also did some additional research. The pain science gurus talk about “nociception”. Basically, “nociceptors are like the look-out on a ship. They report when they see something. They don’t always care if it’s a massive ship or some small dingy. The look-out just says that there is a light off in the distance and sends that information on to someone else. Some higher up then makes a decision about what to do. That captain’s response will be influenced by where the ship is, what their orders are” (Lehman). So your brain is the "higher up" that controls nociception. It is your nervous system's reaction to a stimuli (painful, harmful or not). Nociception can change too! For example, the amount of nociception becomes less reliable as the injury lasts longer. “You can start to have more pain with less nociception. Or more pain with the same amount of nociception. You can even have pain with no nociception (Lehman). If you watch Mosely’s video, you will see the link between past pain experiences and beliefs about pain and how your brain uses those to create the pain message. Pain sucks! But understanding it gives you that self-efficacy – that "I’ve got this" attitude.
I buy into “motion is lotion”. I feel worse when I am not active and don’t move. I hear many people tell me that I need to slow down with the inference that I’ve caused my own issues. But they don’t know my body. I am able to envision my movement on the elliptical or in a yoga class as helping create healthier hips by encouraging joint fluids to lubricate my joint. I have not caused my own issues and I listen to my body and its pain messages, but sometimes I send those pain messages my own talking points – you will not dictate my hope and my health. I am strong and my body is strong and capable of healing. My “I’ve got this” attitude honors those nociceptors but does not give them 100% control of my pain. I am the captain of this ship!
For more information, here is also a free download: http://www.greglehman.ca/pain-science-workbooks
Cormack, B. (2018, September 11). Self-efficacy - A Well Used Term, But Well Understood? Retrieved October 12, 2019, from https://cor-kinetic.com/.
Lehman, G. (n.d.). Reconciling Biomechanics with Pain Science. Retrieved October 12, 2019, from http://www.greglehman.ca/.
Mosely, L. (2011, November 21). Why Thing Hurt. Retrieved October 12, 2019, from https://youtu.be/1uNIID5R4pM.