Archive for the ‘Health and fitness professionals’ Category

The Four Seasons of Chronic Pain

Tuesday, January 22nd, 2019

Written By:
Kevin Murray M.A.(pending), CAFS
Movement Masterminds – CEO
Function First – Director of Education
2012 CSEP CPT of the Year

For individuals’ living with chronic pain, the long-range forecast is often filled with metaphorical rain storms, treacherous winds and long, dark nights. When pain is present, the most noticeable characteristic of a client’s changing climate often revolves around biomechanical restrictions and movement limitations. Perhaps not so obvious (yet often just as burdensome) are the emotional and psychological factors involved with experiencing pain on a regular basis.

As such, in order to create a truly unique, multidimensional strategy for individuals’ in pain, expanding beyond the optics of biomechanics and connective tissue principles alone a becomes imperative. Let’s take a walk through the four seasons of chronic pain and examine how you can help your clients transition smoothly through each one.

The First Season – Winter (fear)
Winter is the first season of chronic pain, where the radical change in climate significantly impacts an individual’s emotional and psychological well-being. The narrative chaperoning this season is generally one of fear; fear of movement, fear of pain worsening, fear of the unknown. This fear can reach such heightened states that just the anticipation of pain is enough to steer an individual away from doing the things that matter most to them. Imagine avoiding an activity altogether because of the anticipation of pain, rather than in response to it!
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When such avoidance behaviors manifest, it’s clear that approaching the chronic pain demographic solely from a biomechanical perspective is an incomplete approach. The neuromatrix theory of pain proposes that the output of pain is regulated by afferent sensory mechanisms in conjunction with cognitive inputs (Melzack, 2001). These cognitive inputs have the capacity to upregulate and exacerbate states of anxiety, apprehension, depression, self-doubt; all of which fall into the category of psychological/emotional stressors.

It’s these stressors which contribute significantly to winters burdensome climate. To clients in pain, winter’s dark and onerous atmosphere can sometimes seem like it’s going to endure indefinitely. Successfully helping clients’ transition out of winter requires an understanding of one critical distinction; the difference between a clients ‘external’ and ‘internal’ problem.

The Second Season – Spring (awareness)
The melting of snow, dissipating precipitation and the alchemy of animals awakening from hibernation are all welcomed signs that winter’s season is changing. To the health and exercise professional, guiding clients’ towards these more desirable climates lies in understanding each client’s internal problem.
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All clients in pain have two global problems. The ‘external problem’ is the biomechanical or anatomical concerns each client reveals during their initial consultation. Consider the client who has been experiencing knee pain for years. That’s the external problem – the knee pain. The ‘internal problem(s)’ however are the area’s in life which hold the most meaning to individuals negatively impacted by chronic pain. The internal problems are the emotional, psychological and social/environmental stressors that are 100% unique to the individual.

For example, consider a husband and wife who spend meaningful time together each day walking their dog. However, in recent months the husband’s knee pain (external problem) has become so problematic that it’s preventing him from participating in the most meaningful aspect of his day, which is connecting with his wife via their evening walk (internal problem).

A clients’ emotional transition from winter into spring begins with his or her health and exercise professionals’ gaining awareness into the clients’ internal problem(s). This awareness then provides an opportunity for both the coach and the client to begin scripting a new, more desirable narrative based on what the individual client values most.

The Third Season – Summer (possibility)
For any seed to blossom and reach its full potential, a conducive climate is required. To clients in pain – fear, anxiety, feelings of hopelessness and negative self-talk are the metaphorical weeds of cognition. If these weeds are ignored, they can uproot any forward progress. During the summer months, the seeds of possibility must be nurtured, and the cognitive weeds must be pulled on a regular basis.
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As with any journey, minor setbacks and moments of self-doubt are to be expected (particularly when chronic pain is present). Because of this, granting clients permission to steep themselves in the process of constructing future-oriented, growth-focused possibilities becomes essential.

The Yellow Brick Road refers to this process as a ‘Possibilities Paradigm’ and involves 4-chapters, each designed to amplify and reinforce a clients’ emotional and psychological resiliency & well-being. When successful, these 4-chapters begin to stir hope & optimism back into each clients’ current and future script.

The Forth Season – Fall (self-regulation)
The fourth and final season bears witness to clients’ returning to pain-free living. And while there are a host of ingredients chaperoning any given pain-free transformation (biomechanics included), a clients’ capacity to accurately assess and regulate their emotional states (self-regulation) is a primary contributor in overcoming his or her internal problem(s).
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Contrast the experiential difference in self-regulation between a client stating, “oh no, I just threw my back out again!” vs. “my back tightened up, but I know it’s just my body trying to protecting me.” These are two completely different emotional reactions, the former reverberating sentiments of fear and the latter signifying the perception of safety and protection.

Preventing clients from experiencing negative emotions is, of course, not possible. However, as health and exercise professionals, we can strive to cultivate a climate that enhances each client’s self-regulation competence and help them identify and overcome the emotional and psychological stressors that contribute to their pain. Importantly, you can begin this process with your client even before you have conducted his or her biomechanical evaluation.

Reference:
Melzack, R. (2001). Pain and the neuromatrix in the brain. Journal of Dental Education. Vol. 65. 12, pp. 1378-1382.

Health pros interested in learning more about the Yellow Brick Road curriculum through the American Council on Exercise can click on the image
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Corrective Exercise Wall Sit

Wednesday, January 9th, 2019

This exercise is most associated with frying the quads for skiing and boot camps. But it can be a powerful corrective exercise for those with lower back pain. In this video, we provide 3 variations that each offer their own unique benefits and challenges to the body.

Yellow Brick Road PFMS Sister Curriculum

Friday, December 7th, 2018

Written by
Kevin Murray M.A. (pending), CAFS,
Movement Masterminds – CEO
Function First – Director of Education
2012 CSEP CPT of the Year

An Evolution in Coaching Clients with Pain

Written within each client are specific events and circumstances that have significantly shaped what their chronic pain experience means to them.

Elite-level coaches are not only well versed in the realm of biomechanics, they’re also able to recognize, anticipate and consistently meet and exceed the deepest psychological and social needs of their clients; which are often revealed BEFORE the client ever steps foot onto the assessment or exercise floor.

The landscape of helping those in pain is expanding RAPIDLY… Yes, biomechanics are an important aspect of a client’s story, but with much of a clients’ suffering from chronic pain revolving around psychological and environmental factors, the consultation / intake phase becomes that much more imperative when coaching this demographic.

In this 2-min video clip, come behind-the-scenes of our latest collaboration & partnership where we discuss how one’s cognition’s (thoughts, feelings, perceptions, beliefs, values, etc) significantly contribute to an individual’s movement success – or lack there of.

So for the first time, a curriculum that centers solely on the psychological, emotional and environmental factors involved with coaching clients in pain is now available in an online format – exclusively through the American Council on Exercise.

Exclusive Partnership with the American Council on Exercise

The millions who live with & suffer from chronic pain are in desperate need of relief. Together with the American Council on Exercise, the Yellow Brick Road seeks to provide health and exercise professionals an online course that integrates:

• psychological theory,
• pain neuroscience,
• interpersonal relationship-building principles and
• client centered coaching essentials;

So whether you’re a personal trainer, strength & conditioning coach, corrective exercise specialist, health coach, physiotherapist, chiropractor, massage therapist… the entire framework is designed to compliment and fit into your specific area of movement expertise.

Enroll here

Corrective Exercise Static Squat for Posture

Tuesday, October 9th, 2018

This is not your ordinary squat. This version of the squat has a greater focus on spinal stability than targeting the lower body. Although it does build isometric strength into the legs, it serves to facilitate activity and proprioception of the spinal erectors and paraspinals with the body vertical.

Don’t confuse this with the almighty weighted squat. The vertical shin position in this corrective squat has nothing to do with the wives tale of the knee not going over the toes. It has to do with the position of the pelvis and its relationship to spinal alignment.

Not only does this exercise facilitate a lot of muscular activity, but it can feel great on the lower back to many people as well.

Pain-Free Movement Specialist Sampler

Thursday, September 13th, 2018

Here’s a little taste of just some of the great content in the PFMS curriculum.

You can register HERE

Corrective Exercise Abductor Presses

Friday, September 7th, 2018

An unexpectedly powerful corrective exercise that has an immediate influence on the hip joints, sacroiliac area and lumbar spine. The use of the non-elastic strap creates a distinctly different result then when using tubing and allowing the hips to abduct during the exercise.

You will most often find this exercise in our Sub Routine 1 as a Level A exercise in the PFMS curriculum.

Corrective Exercise Ankle Squeezes Prone

Thursday, August 16th, 2018

The Ankle Squeeze Prone is definitely one of our “go to” Level A exercises when it comes to addressing the posterior hip with the chronic pain client.

Proprioceptively, it can highlight left to right imbalances. Depending on the intention, this exercise is great for facilitating the posterior hip musculature or down regulating tone to those same muscles.

It’s also great for disassociating the lumbar musculature from the glutes/posterior hip by assisting in timing of the onset of contractions.

You will find this a great tool in your tool box for clients of all levels. The benefits to the chronic pain client is one of bio-psycho-social characteristics. But aren’t they all?

Leave your thoughts below on what you or your clients feel.

Corrective Exercise Kneeling Lat Stretch

Wednesday, May 30th, 2018

The kneeling lat stretch has many possible variations. In this video taken from the original Corrective Exercises for Powerful Change DVD, we show you several variations to try with your clients that effectively lengthen the lats and lateral line as well as address the thoracic spine.

Stability of the lumbar spine and shoulder girdle are critical here to protect those areas but also to maximize the stretch and tissue compliance.

Corrective Exercise Heel Drop

Tuesday, May 8th, 2018

Another great exercise from the archives is the Heel Drop. This exercise also comes from the DVD Corrective Exercises for Powerful Change and continues to be a highly utilized exercise in our progamming. Don’t let the calf stretching appearance fool you-there are multiple events happening with the positioning and requirements of this exercise. Pay attention to the details because a small change in position can lead to dilution of optimal benefits. Access to this exercise and many more are all part of the Pain-Free Movement Specialist curriculum

Corrective Exercise Abduction Adduction

Thursday, April 5th, 2018

Biomechanics never get old. This is one of the exercises from my very first Corrective Exercise for Powerful Change DVD’s. The content is still very relevant and part of our Pain-Free Movement Specialist curriculum.

The ability to take a step back to stimulate the hip motion without the hips being loaded in a comfortable and safe position can be very valuable for the client/patient with lower back pain.

No comments on my boyish looks then versus now please!