Don’t let someone invalidate your pain.

We all experience pain and sensations differently. Understanding why is important.

Ok guys…last week we chatted about tension and tightness…but what happens when it stays tense and tight for a long time?

We get pain!! (Usually…)

Pain is super interesting because everyone experiences pain in a wide variety of ways and at different times (watch the video below - It’s one of my favorites on pain to share with folks).

We have different receptors in our bodies that senses tension, pressure/compression, heat/cold, stretch but specifically we really don’t have “pain receptors”.

We have receptors that detect tissue damage or threat of damage and respond to local chemicals release from that tissue damage.

We have different parts of the brain that help us interpret what we are feeling too. If it’s something we can relate to a previously bad experience (like if you feel something whack your leg walking through the woods and previously have stung by a bunch of wasps) - your brain will think it’s a wasp first until you look down and you see it’s not something bad, just a leaf that has fell down.

The amygdala is the part of the brain that perceives danger. It is considered the “smoke detector” (sometimes this can be triggered more easily depending on your previous experiences and trauma history).

The difference between us as humans and animals is the pre-frontal cortex. This allows us to decide what the right step really is and whether it’s appropriate for us to fight, flee, freeze or talk our way through the situation.

Most of the time - animals just respond before they consider the whole situation. Sometimes we do too…and sometimes our bodies are so conditioned to fight or flee, we don’t even realize it’s happening.

Now imagine that leaf sensation/scratch over and over and over…your body is already in a state of reaction because it does not like that sensation…it wants to get away based on previous experiences (remember you were hurt before).

Initially, if you did get injured by the wasp, you did have tissue damage and you did have something the body needed to respond to. But, over time, the body should heal itself and we shouldn’t have sensations of pain.

When it doesn’t - we call that persistent pain (see video below). The tissue at the location is not really injured any more based on our way or measuring. It’s more of a nervous system and brain up regulation. This can mean the body (or body part) is very easily triggered or sensitized. It can get stuck in fear mode without you realizing it!

I see this all the time…

Let’s start simple with a couple examples of real life, every day stuff more common.

Shoulder movement - Most people finally seek help (let’s say females) when self-care is hard. Things like brushing hair, hooking the bra, reaching into the backseat, or even wiping their own behinds can be the issue for which the seek help.

Over time, they will avoid doing things with that arm that could hurt even when it may not. Research also supports the thought of it hurting can also trigger this reaction and can be more harmful than the true action they are avoiding.

The muscles become tighter, weaker, desensitized (we ignore that body part completely or disassociate with it) or hyper-sensitized (very little touch or even the though of touch can provoke symptoms), atrophies (shrinks) and less mobile or functional. The joints become stiffer and less mobile as well. The arm becomes less useful to us. However, with the arm, we cannot ignore it because it’s such an important part of life and we finally seek help.

I hate pushups and shoulder raises.

I tell ya what…I hate push ups and lifting with my shoulder. I mean I would rather do 50 lunges than 20 push ups. BUT, the other day I did 10# lateral raises but it DIDN’T hurt!!

That left shoulder has bothered me like 2 years. It comes and goes and it’s mainly when I sleep funky or an on my phone pushing my shoulder in a crummy position. But, since I’ve been working out consistently, I have had like 98% reduction in my pain. I undersold my own capabilities and it felt amazing to lift something that I would have sworn would have lit me up.

Now let’s relate this to pelvic pain or pain with intimacy.

Every time something approaches the body part (or even something that could lead to potential approach/touch) that hurts - muscles contract or the body recoils in preparation for pain.

The brain learns to avoid the very thing that hurts it - touch, penetration, or pressure.

The medical diagnosis is “dyspareunia”" for painful intercourse and “vestibulitis/vulvodynia” for pain at the opening of the vulva or vulvar region.

The tissue becomes tighter, less mobile, desensitized (we ignore that body part completely or disassociate with it) or hypersensitized (very little touch or even the though of touch can provoke symptoms) and the brain is further fed with the idea of pain with touching or involvement in that area.

Intimacy can be affected directly with this p
ain response.

Why would you brain let you enjoy intimacy when it’s fearful of pain and injury? The body’s immediate response is to fight, flee, or freeze…we can choose which one if we’re in a safe environment. Sometimes we have to learn how to create this and work on techniques to help this response. Pelvic floor PT can help.

So how do we help it??

(It may be beneficial to go back to my last Blog and read body awareness or scanning too…and keep up to date because I have more coming on this topic)

Recognizing your beliefs or limiting beliefs.

Are you really avoiding it because you can’t or you THINK you can’t?
Are you really more limited due to the fear or pain or due to true pain?
Have you tried? How did it feel? What were you worried about? What was your brain and body’s reaction? Tears, sweat, tension, breath-holding, pain, goosebumps, pleasure?
Does it look scary so you just give up before you even start?
Has anyone talked to you about graded exposure? Trying something a little at a time to give the body time to accommodate is how we best introduce this topic.
Can you remember a time when it wasn’t painful?
Can you pinpoint when it started and figure out a cause or trigger?
Where do you feel the pain? Can you pinpoint it?
What makes it better?
What do you think about how it makes you feel? Do you feel frustrated, shameful, sad, overwhelmed, nothing? It’s good to recognize these emotions and be aware.

What limits are you placing without even trying first?

I work closely with a couple therapists as well who can help with past experiences or trauma if it’s something deeper routed than a general orthopedic injury. A lot of times collaborating with other providers give us the best outcome. If you’re interested - I can pass along their information.

Reach out… I’m here for you. More to come…

Pain - real or all in your head??