Understanding Chronic Pain-The Role of the Fitness Professional

I actually wrote this for the Women in Fitness Empowerment blog but I thought I would share it here as well, much of it (about me) you may have read before…

I write this article, from both sides of the coin these days; an unfortunate irony, you might say.  I started life in the Fitness Industry in 1998 as a Health and Fitness Instructor at a hotel club gym.  I have taught swimming, aqua, ETM, dance; a keen club athlete and competitive latin and ballroom dancer. My degree was a predominantly Biomechanics, Sports Science BSc and I have been back in the last few years to lecture on the very same course.  I trained as a sports therapist and then I opened my first Pilates and Fitness studio in 2004.  In 2008 I joined forced with Fitness Inspired Teacher Training and authored their Pilates course, which I continue to tutor as well as the Yoga qualification. I then expanded the studio in 2011 to larger premises with an apparatus studio and Yoga studio, 2 treatment rooms for sport therapy and physiotherapy.  I was well educated about fitness and health, physically fit and invincible, or so I thought…

My background is relevant, because you have to understand; that when I slipped in leisure centre in 2014 and fractured my spine, I never thought that 18 months later I would be writing this having just spent 2 hours at a Pain Management Information lecture, for people who suffer from chronic pain.  I have worked with people who have suffered from all kinds of physical dysfunction; from Multiple Sclerosis and Parkinson’s disease, to pre-op and post-op surgery participants.  I have also worked with people who have suffered chronic pain and I have to admit; I didn’t get it.  I thought I did, but I didn’t.  I do now…

Hands up who has been guilty of thinking that those people who have complained constantly of pain in certain area of their bodies, were hypochondriacs?

‘It’s all in their heads’,

‘They just like having an identity’,

‘If they just lost a little weight or exercised more, they would be fine’….

I can assure you, it’s not ‘all in their heads’, and no one enjoys being in constant pain.  It is miserable, let me tell you and people often end up suffering from depression or anxiety as a result.  As for exercising, it is scary to undertake an activity that might render you incapable of even moving for several days! Chronic pain sufferers NEED to protect themselves from activating their pain responses, read on to learn more.

What is Chronic Pain?

Chronic pain is defined as ‘pain that lasts longer than 3 months’. Some experts define it as lasting longer than 6 months.

Chronic pain usually follows an injury or illness which causes movement inhibition and reduced flexibility; but most injuries or illness related symptoms resolve within 8-10 weeks. Residual pain is often the result of a hyper-sensitive nervous system.  So, pain in the area that the sufferer indicates as problematic, may be structurally sound; or at least, not requiring surgical intervention. The pain felt is inconsistent with the degree of structural dysfunction; it is significantly higher because the pain system is in overdrive.

The pain is real; but pain is initiated by the brain because that it what controls our neuropathy. So brain re-training can assist in reducing pain, but this is not to be confused with having a mental health disorder.

Pain sufferers will often use analgesia to help supress the nervous system and reduce the pain signals from the problem area, but one of the most relevant approaches that I have heard was from Prof. Eyal Ledermann (Osteopath); at a lecture at Westminster University in 2011,

‘Chronic pain sufferers should be encouraged to move, but only within a pain free range’

What he was saying, was this; movement is important for general health, muscular health and psychological well-being, but if movement initiates pain; we create an association between certain movements and discomfort.  The pain system will naturally, increase the signals to the brain warning of potential injury, limiting the individual’s capability to move freely.  But, if we offer movement practises that are pain free, we disassociate from the pain and it allows the pain system time to‘re-set’, i.e. brain re-training.

Many pain sufferers are taught to ‘pace’ i.e. consider activities which aggravate their pain system and limit the activity to within a pain free time scale. E.g. working at the computer is fine but after 30 minutes the back starts to hurt.  So the sufferer will pace their activity and only work at the computer for 20 minutes, so as not to facilitate an inappropriate pain response from the nervous system.

As fitness professionals, we have an important role to play in helping sufferers of chronic pain manage their symptoms.

  • Empathy: Chronic pain is miserable; no one chooses to live that way. Be gentle in your approach, considerate; listen to your participant and let them guide the session.  They know their bodies.
  • Well-being: Re-consider what the aim of your work is with a chronic pain sufferer. The only objective they have is to live without pain.  Find movements that do not cause a pain response and work within those parameters to ensure an endorphin release; to manage low mood.
  • Inclusion: Chronic pain is socially isolating, the number of activities sufferers cease as a result of needing to protect them from pain is extensive. If a sufferer has made the decision to take charge and participate in an activity, try not to make a judgement about their lack of physical ability. It may be very upsetting for them to feel inhibited and less able than others, your positivity and enthusiasm can be extraordinarily powerful.
  • Pace: Allow your participant to decide when they’ve had enough. Pushing a chronic pain sufferer will have neuropathic consequences, so support them and appreciate that they need to work differently.

Overall, understanding chronic pain will make sure that sufferers feel safe with you as a professional both from a physical and emotional perspective.  Be kind, be gentle, be considerate and chronic pain sufferers can potentially start to manage their symptoms and improve fitness levels without fear of aggravating their over-active nervous system.

As for me; I had to give up the Studio I have devoted over 12 years of my life to.  Teaching Pilates and Yoga every day, was driving my pain responses too high and the pain killers I was taking led me to push myself too hard; and tear a disc.  I now work specifically, with people suffering from illness or injury that is preventing them from participating in activities that they enjoy.  Using Pilates and Yoga practises, I am supporting their rehabilitation and aiming to get them back to functional movement.  I also support others in the industry that are working with injuries and pain through Mentoring, Tutoring and Team Training.  For more information about my work, or if you’re are looking for professional support go to;

www.themovementspecialist.co.uk

Big respect for Marie-Claire, her knowledgeable teacher training, the course was great….. it has given me some really useful extras to incorporate into each of the various levels of classes I teach. Tracey, Mini Balls Course

Get In Touch

Email: marieclaire@themovementspecialist.co.uk

Tel: 07919 286419

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The Movement Specialist