The “Rules of Pain” is the most important lesson that I teach.
How do you move when pain is present? Follow the rules of pain
Pain is a form of communication from within our bodies. Generally, when it comes to our movement, it means that something is not moving well.
Ignoring pain is kind of like sticking one’s fingers into their ears and yelling loudly. Except, the longer one ignores it, the louder it becomes–until it eventually gets their attention.
A big lesson in the Mobility Restoration program that I teach is to simply slow down, become a little more sensitive to the conversations within your body, listen to your physical pain, allow it to become a guide or a coach to help you move better. Below are the simple “rules of pain” that I follow to move better, even when I am feeling pain.
Moving when pain is present
Begin by acknowledging that pain is truly present. This surprisingly is one of the hardest things to learn for clients (as well as myself). My ego likes to go hard, and sometimes going hard is not what my body needs. When it comes to moving with physical pain, I don’t want to move my body from my ego’s point of view.
The Rules of Pain
Rule 1: Is it Painful?
This is a very important question to answer.
The answer is either Yes or No.
If you get anything other than Yes! or No!, then keep asking the question until you get either a “YES” or a “NO”.
If the answer is No, then great. I suggest you keep reading and save this email for the next time you are in pain.
If your answer is “Yes!” Stop moving! Read the Rules of Pain (read it over again each time you’re in pain).
Rule 2: Do not move into pain, but do keep moving.
How to move when pain is present
Rate your pain on The Pain Scale of 1 – nonpainful to 10 – excruciating. (I consider slight discomfort to be between 1-3 on the pain scale).
If the pain is less than 3, Slow Down!
Enter your movement slowly, cautiously, safely, and non-forcefully.
Don’t take movement beyond a level 3 on the pain scale.
If the pain is greater than 3, Slow down, even more.
No matter how slow you go, you can always go slower).
Make your movement smaller and less painful.
Keep it below a level 3, and move slowly, cautiously, safely, and non-forcefully.
Super Important: Don’t move beyond level 3 on the pain scale!
Going slow and exploring the edges of your painful range of movement is a wonderful space to explore the depths of your breath and heart. Be spacious, playful, open, and generous with yourself.
This is a guest post from Kimberly Culbertson, who just celebrated her one year moving better anniversary with The Art of Fitness!!
Today marks a full year of movement therapy with Jesse! I wasn’t sure what I was getting into when I began the journey, but I’m glad I did 🙂
I wasn’t exactly in the market for a new movement paradigm, but I overheard Jesse talking with a colleague at Orange Coworking, and I was curious enough to brave a conversation with a scary personal trainer. (Okay it turns out he’s not really scary at all. Quirky, maybe.)
The truth is that I’m not “the athletic type,” although, as I type that, I can almost hear Jesse sternly begin a little speech about how every human is meant for movement. After surviving middle school gym class, I had mostly kept my distance from fit people, and to a certain degree, from movement in general. I’ve been gifted in more intellectual pursuits, and movement in the physical world has always been a secondary activity, a necessary evil.
My whole life is marked by seasons of dieting and various spurts of exercise, but it wasn’t until my late 20’s that I started to see fitness and strength as markers of self-care and even self-love. Despite genuine effort though, I consistently began some workout program, injured myself within a couple of months, and then had long seasons of pain and recovery. I had bad knees, a reverse curve in my neck, foot pain, messed up shoulders, and a long line of people ready to tell me that losing weight was the only real solution. But losing weight requires exercise and exercise causes injury, so pursuing weight loss turned me into a depressed, she’s-a-little-bit-crazy person. And that person was in pain.
To make matters worse, about two years ago I injured my shoulder. It was some kind of swollen, tight, pinched nerve mess in my right shoulder blade, and it didn’t go away after a couple of weeks. The pain was severe and made it nearly impossible to lift my arms while seated. I know that’s very specific, but this was a big problem for driving and typing (and since I was working as a freelance writer, typing was pretty important). With pain meds and chiropractic and electro stim therapy andrest and ice, the pain lessened to about a 4 on a ten-point scale, a big improvement from the original 9-intensity, but still noticeable, chronic pain. After a year, I figured this pain was probably mine to keep.
Enter Jesse, The “Movement Therapy” Coach.
When I sat down with Jesse, my defenses were high. I had a speech ready, and it went something like this: “Look, I know I’m not thin, but I’m not trying to lose weight right now because I like my sanity. I don’t hate who I am, and I’m not trying to earn my right to exist by changing my shape. I do have a 4-year-old, though, and I want to be just as active as he wants to be. And I want to feel healthy. In the past, I’ve genuinely enjoyed working out, but I have an injury that causes me chronic pain, and at this point I’m a little bit afraid to move.”
I didn’t know it yet, but Jesse’s movement therapy approach was exactly what I needed. His philosophy is that fitness should help a person increase function and enjoy movement, and that any external changes are a side effect. Extra pounds don’t disqualify someone from movement in his book, and really shouldn’t be the focus. This was a relief, since my first experience with a personal trainer was a free session with “Tank” (no, really) during which he told me to ride the seated bike until I lost 25 lbs, at which time he might consider working with me more. Jesse, on the other hand, rails against a fitness industry that is primarily “designed to get you laid as quick as possible” and that often results in injury.
Jesse looks at how you’re moving and assesses where your body has “lost” movement. For me, he immediately focused into how little mobility I had in my lower back, and hypothesized that my neck and shoulder pain were related to this lack of mobility. I was skeptical. But I had been focusing on my shoulder for a year with minimal results, so I decided to play along anyway and see where this went.
At first the movements seemed silly to me, and I told him a couple of times, “This does not really seem like a workout.” He explained, and then explained again, that we are starting with movement restoration, and once we get there, we’ll add in skill and conditioning. In spite of my impatience, I did the silly things, and in about a month I realized I HAD NO PAIN IN MY SHOULDER. What was even happening?! Beyond that, my balance had improved, I had less neck pain, and, oh, turns out I actually could do squats! I was sold on this “movement therapy” stuff.
One Year Later
Jesse and I have been working together for a year now. Today is our training-iversary. It sounds a bit melodramatic to say that Jesse has changed my life, but it’s true anyway.
I’m not thinner, exactly, but my body’s shape has changed. Not only have I NOT injured myself in the process, but I have far less pain, and tools to address any pain that I encounter. I do squats like a boss. I climb things on playgrounds with my 5-year-old. I know how to move after I’ve been typing for a while, and since I actually do the movements(!), I don’t get headaches and lose neck mobility during high-stress times. I cannot even believe how strong my legs are. I don’t look at stairs with dread, because stairs are no big deal now. I can do an hour of heated yoga and not die. This is what it is like to feel strong.
But the way that working with Jesse has bled into my life outside the gym is perhaps even more interesting. At this time last year, there were so many things (in working out and in all aspects of life) that I assumed I could not do, and wouldn’t even try. My inner critic was loudest in the gym, but she was seldom quiet anywhere. My fear of failure kept me on the sidelines more than I’d like to admit. Jesse and I have had sessions where the coaching has centered more around my mindset than my muscles, and I am a braver person for it. Over the course of this year, it has become very clear to me that I actually can do a lot of “scary” things, even when I am sure I can’t. Not everything comes easily, but it’s a process, and it turns out that’s actually fine. Normal, even. Just when I am certain that Jesse will give up on me and that I am clearly a giant disappointment, he pulls out his seldom-utilized stern voice and lectures me about self-care, and listening to my body, and being patient with myself.
So I’m a work-in-progress. And I’m actually really enjoying the progress, for once. I’m focusing on becoming strong to be helpful. And to be playful. Because I want my kiddo to remember me in the fray with him and not on the sidelines. He deserves that. And you know what? So do I.
Kimberly Culbertson is a Team Dynamics and Leadership Coach and Speaker, and she co-hosts the Creation Curve Leadership podcast. She is a recovering approval addict, a paint brush loving workaholic, and a walking billboard for hope in all its many manifestations. She is not afraid to admit that latte art lifts her spirits, and she gets a little melancholy when she doesn’t make it into a coffee shop for a few days.
All of us need to sit down and assess what we want out of our workout.
If you want sore muscles, you can fall down the stairs. You’ll be sore and hurt. Is that a workout?
You completed the 15 mile run, but you hobbled out of bed the next day. Did you build fitness on a dysfunctional platform?
I assumed the workout was in place to make one healthier. There is nothing healthy about beating oneself up.
Eustress – positive micro stresses – can have huge medicinal benefits. We are adaptive beings. But the workout making us hobble is not eustress.
If your goal is to deadlift 500 pounds, then earn it – safely. Put the time in. Get a good coach. Or get a new goal.
If your goal is to be “healthy,” I’m here to tell you that no one knows what that means but you. What does health mean to YOU?
Seriously, sit down and contemplate what you want from your workout.
Time is valuable. You can spend it beating yourself up, or you can spend it BUILDING yourself up.
As always, it’s your call.”
Falling Down Stairs
I reposted it onto my facebook page and it garnered some great discussion. There is one line in this post that has really resonated with me.
“If you want sore muscles, falling down the stairs will work. You’ll be sore and hurt. Is that a workout?”
This quote sums up really well why so many people get caught up in the cycle of injury. They are essentially throwing their bodies down the stairs through every set and repetition of their workouts, whether it’s running, weight training, sports, or even Yoga.
Running, squatting, and lunging are controlled falls. If you lack the ability to stabilize your feet, hips, low back, and/or core, then you have movement dysfunction. Your body lacks the ability to absorb, stabilize, and respond safely to your environment. In this circumstance, every step is the equivalent of falling down stairs. Your joints, connective tissue, and other supportive structures do not know the difference. How many flights of stairs can you fall down before something breaks down?
Rest and recovery are important for your tissues to heal. But once they are healed, if you return to an exercise program without addressing an underlying movement dysfunction, you will be once again throwing your body down the stairs.
When your workouts hurt you, it’s time to take a hard look inside at how you value yourself, your body; and your life. It is not fitness or a workout when it hurts you. It is self destruction. As Dr. Dooley said, “Time is valuable. You can spend it beating yourself up, or you can spend it BUILDING yourself up.”
If you are tired of falling down stairs and are ready to break the injury cycle I strongly encourage you to reach out to an experienced Movement Therapist in your area. I highly recommend someone certified in NeuroKinetic Therapy™, gait assessment, and natural movement. If you’re in the Austin, TX area, then click here to schedule a free consultation.
I frequently get questions about specific injuries. Many of these are about plantar fasciitis. Here is a breakdown of one of the more common causes of plantar fasciitis.
Plantar fasciitis is a pain symptom located at the heel or plantar fascia of the foot–the thick connective tissue which supports the arch of the foot. It is often most painful in the morning with the first steps out of bed, and may be aggravated by standing, walking, or running.
Here’s the deal about plantar fasciitis
It is the diagnosis of symptoms. It is not the diagnosis of the problem. The pain may be in your foot–but the problem is not. What you will not often find in definitions or explanations of plantar fasciitis on the web is that there is a deeper issue at play. The pain in your foot diagnosed as plantar fasciitis can often be traced back up to your gluteus maximus–your butt. These days, we sit too much and our butts muscles wind up not doing much. So they basically shut down or go to sleep–they become inhibited. This is not a good thing.
Your gluteal muscles have some very important functions. They are some of the most powerful muscles in the body and are the primary reason we stand upright. The gluteus maximus is a pelvic stabilizer and powerful hip extensor. The gluteus maximus provides power when we are going upstairs, rising from a sitting position, and climbing or running.
Hip extension is your ability to stand upright. If you look at our primate cousins who still use their hands to walk, you’ll notice they have tiny butts. They also lack the ability to extend their hips into a fully upright standing position. Pelvic stability is hugely important. It provides the ability to stabilize the pelvis to our upper body, support the low back, and provide a solid powerful core. This point where your pelvis stabilizes with your upper body is where most coordinated movement is generated. If you lack pelvic stability, your entire movement system will be negatively affected. Your body demands stability. Without it, your body will find compensation elsewhere, by utilizing other muscles to do the job of those that are “sleeping,” i.e. inhibited. With plantar fasciitis, the calves are recruited to help stabilize the pelvis. This is not the work the calves are functioned to do. They don’t like it. Move like this long enough, and your calves will turn into The Incredible Hulk–they will get very angry and start to smash, i.e. tighten up and cause big hurt.
How this translates into pain in the foot
The two muscles that we call the calves (Gastrocnemius and Soleus) attach to the heel via the Achilles Tendon. The Achilles Tendon wraps over the heel bone where it then becomes the Plantar Fascia. The Plantar fascia stretches across the bottom of the foot to the base of your toes. While we may think of these muscles and tendons as separate tissue structures, you can see by the picture that these structures are not separate. They are one continuous fascial tissue structure. So you can imagine that tension in one will affect each of the others. If your calves are working overtime–doing not only their job but also the job of your glutes–they may get distressed. With this distress, inflammation and pain will eventually set in. That pain can then show up anywhere in this continuous tissue chain. When the pain appears at the heel or plantar fascia, we call it plantar fasciitis. If it happens above the heel, it is called Achilles Tendonitis or tendonosis. The irony of all this is that the calves are not the issue! If anything, they are the most functional muscle in the group–they’re working overtime, after all. It’s their relationship with the asleep at the wheel Gluteals which need to be addressed. This is where the pain in your foot is literally a pain in the butt.
Now once the pain is gone, this does not mean you are fixed. Pain is a communicator–it alerts us to an underlying problem. But it is not the problem itself. This is why the “treatments” often found online (such as this one) will only provide temporary relief; they target the symptom (pain) rather than the core underlying issue.
There is still movement dysfunction that needs to be assessed and addressed, and as detailed above, it likely originates in the hips. Strengthening and balancing movement patterns associated with the glutes is the next step in treating plantar fasciitis, and can best be done by making an appointment with a qualified movement specialist. To ignore this step places you at risk of an even more painful and serious injury at some point in the future. Finding help is hugely important in the long run for continued recovery and pain free movement.
This is a topic that has been on my mind as well. In the runner’s groups and forums, I see the advice, “pushing through the pain is what you have to do.” Usually it’s offered haphazardly by “experienced” barefoot runners to novice barefoot runners. This kind of thinking comes from a particular couple of ideas. First, that when transitioning to barefoot/minimalist running you will experience pain, and second, that the only way to get beyond the pain is to push through it. “No pain, No gain.”
I consider this advice to be not only irresponsible, but dangerous for most people. Doubly dangerous since the majority of those who offer the advice have very little experience in coaching much less in working directly with people with injury. Triply dangerous because they’re often strangers on the internet, where trustworthiness and background info are superficial at best.
I agree with everything Jason says. But I think he is speaking to a very specific segment of the running population. For the most part, his audience is made up of people who are already in good to excellent physical condition and injury free. However, many of the people transitioning to a barefoot/minimalist lifestyle are doing so because they have been dealing with chronic issues of pain and injury. And they are searching for the cure to their woes.
I grew up as a competitive athlete and I am all too familiar with the sayings. “No Pain, No Gain!” and “pushing through the pain is good.” One of my favorites comes from my best friend, an ex-Navy SEAL, “Pain is just weakness leaving the body.” My guess is that the last one would resonate well with Jason Robillard, being an ultra marathoner.
In the past, as a personal trainer and coach, I’ve even used these same phrases to motivate clients to push themselves just a little harder. But now that my work has shifted into movement therapy, my practice has deepened and grown, and I see more and more clients with issues of chronic pain and injury. Many of my clients come to me over-trained and in pain because they spend the majority of their training time “pushing through the pain.” In light of this, the “idea” that I have makes me think of this in an entirely different way.
What is “good” vs “bad” pain?
… is general in feeling, meaning it does not have a specific origin (i.e. muscle soreness vs. “my knee hurts”).
… happens when you try a new exercise or workout after a long break.
… comes from pushing yourself to your limits of speed, strength, endurance, power.
… goes away once you slow down or stop exercising.
… in the case of Delayed Onset Muscle Soreness (DOMS), the soreness you get a couple days after intense exercise. This pain should reduce within 72 hours, and be gone completely within 5-7 days.
… does not interrupt your sleep.
Most well-coached athletes spend less than 10% of their total training time pushing themselves into this level of pain. It is the extra kick at the end of a workout, or a planned high intensity day. The majority of their training volume is at a lower level of intensity. However, it is not uncommon for uncoached athletes to spend the majority of their training time at this level. Every workout is a hard workout. There are no rest days. They run as hard and fast as they can every run, lift as hard as they can every workout. Their idea of a rest day is.. well, the only easy day was yesterday. Spend too much time training at this level of “good” pain and you will eventually feel the “bad” pain.
“Bad” pain… … is when, in other words, you have done damage to your body.
… tends to be very specific (i.e. “my foot, heel, knee, hip, shoulder, elbow hurts right here.”)
… doesn’t necessarily go away once you stop exercising.
… lingers around for weeks or months.
… interrupts your sleep.
… affects performance.
… leaves you moody – frustrated, angry, or anxious.
… leaves you overly fatigued.
… makes your joints, bones, or limbs hurt.
… leads you to the point that your immune system is compromised.
… makes you question whether you should continue exercising.
Do you feel this? Well, if you do… You are injured. To continue pushing through the pain, your body will make the injury worse, it will increase the amount of time needed to heal, and will prevent you from doing what you love to do so much. When you have this pain, you need to stop immediately and seek help from a movement specialist who specialized in walking and running gait assessment, movement assessment, hands on massage therapy, and developing a personalized exercise program for you. It would also be highly advisable to seek the advice of a health care professional. What you want is a solid health care team!
What is Pain?
Pain is not good or bad. Pain is a vital piece of a complex communications system that tells you something is going on within your body. Pain is there for a reason, and it should be listened to, respected, and understood. Listening to, and participating in this conversation is incredibly important. If you listen to the ideas of “pushing through the pain” or “no pain, no gain,” you are consciously disconnecting or ignoring the body’s natural warning signals.
Let’s get specific for a second. If you are training for an ultramarathon (of 50 to 100 miles or more), then pushing through some pain is what you will need to do to be successful. There is a level in which you have to disconnect and ignore pain to achieve
your goals. However, doing so is not necessarily in the best interest of your long term health and wellness. This, I believe, is the grey area in which Jason is addressing in his article. Most high level athletes understand that they may be sacrificing some level of health to achieve a specific goal.
However, if you are learning a new skill, perhaps you are learning how to barefoot run, now is precisely and absolutely the WRONG time to shut off or ignore the vital conversation that is taking place within your body. Keep in mind that you have spent the majority of your life cut off from the communication taking place at your feet at every step. To your body, the change from walking and running in a shoe with an arch support, cushion, and heel drop, to walking and running barefoot/minimalist is like training for the Kentucky Derby by riding a merry-go-round. It’s not the same thing. It’s not even in the same ballpark.
Now is the time for you to be extra vigilant and hypersensitive. Listen carefully to every signal coming from your body. Right now pain is the best coach you could have on the planet. It will tell you when you have done enough, and when you have done too much. It will say when you need to rest and, ultimately, when you can push it a little harder. Appreciate it, respect it, love it. Listen to it, and don’t ignore it until you better understand exactly what it is telling you. Happy training.