PT and Brain Pain

My PT appointment last week was interesting. I was feeling kind of defeated by the last appointments’ events, so I decided to go in and talk about my concerns.

The appointment previous, I had been given some core training exercises that I thought were primarily for core strengthening. This was discouraging to me, because I’ve read about the research pertaining to core strengthening, and my impression has been that it really isn’t clinically important in any sense that is distinguishable from regular exercise. So being given an assignment I had very little faith in was difficult emotionally.

This week, I talked all of that over with my PT and learned a number of important things. First, the exercises were more for muscle coordination than strength-building, which is a principle I can more or less get behind. I’m hypermobile, which means I’m more flexible than most people in a way that is disadvantageous, because it means my muscles have to do more work to keep everything in place and moving normally. Little known fact: a certain amount of stiffness in joints/muscles/what-have-you is good–it means your muscles don’t have to do as much work to keep everything aligned and in place. Too much is, of course, bad. Point being the exercises were to coordinate my core muscles so that they engaged properly in order to counteract my hypermobililty.

The second thing he went over with me was the idea that I’m probably not injured. At least, not anywhere in the parts of me that are in pain. If you’ve got some time, this video goes over the principles of this idea:

He also gave me some papers to read. Going over this with him was incredibly helpful, in particular, because it’s the first time I really got the principle down: just because I’m having a negative pain reaction to an exercise doesn’t necessarily mean I’m having any sort of actual negative physical reaction outside the brain. In fact, if I’m pretty sure I haven’t done anything that could cause a physical injury of any sort, sometimes the best thing for me to do is to tell my brain that. Whether or not your brain thinks something should hurt or should be injurious has an impact on how much it hurts, or even if it hurts at all.

So shut up, brain, you are dumb.

I’m almost a week into my current exercise routine, probably as a result of this. It’s not a particularly impressive routine, but it’s a routine, which is more than I’ve been able to accomplish before.