Understanding Pain

Understanding pain on a scientific and practical level is one of the key things that we must do as movement coaches. To do this most efficiently, it helps to understand the basic history of pain science. For hundreds of years, it was understood that the brain played a role in our pain. However, the problem was that people believed that there was a singular spot in the brain, think of it as the “pain center” that governed our experience of pain. Modern neuroscientific research has proven beyond a shadow of a doubt, that there is NOT a single pain center in the brain, but instead that many areas are involved in what is now termed a “pain experience.” This is actually great news for us as coaches, because it allows us many different avenues to help our athletes deal with their pain issues. To best understand pain, there are a few key concepts that you must remember:

CONCEPT #1 – Understand that pain is produced by the brain. Many people, physicians, therapists and trainers included, are still struggling with what is now an undisputable fact – that pain perception is produced by brain activity. Unfortunately, the cultural beliefs surrounding pain still tend to focus on pain as a reliable source of information about what is happening in the body. This is a false assumption and the leading cause of ongoing pain for most people. Remember to implant Dr. Lewit’s phrase, “He who treats the site of pain is lost!” into your memory and refer to it often.

CONCEPT #2 – Pain is produced when the brain perceives that danger to body tissues exists and ACTION is required. Pain should then be seen as an ACTION SIGNAL.

CONCEPT #3 – Because pain is a part of the survival system, ANY THREAT, can be interpreted as pain. One of the most powerful concepts to come out of our growing understanding of the pain networks in the brain is that virtually any stimulus can create pain if the brain interprets it as threatening. This is why we term our theoretical approach to understanding pain the Threat Neuromatrix. Your brain can produce a pain signal in response to any stimulus or event that threatens your survival. Whether that event is a cognitive, emotional or physical challenge, if your brain perceives a threat to your ongoing survival there is a possibility that you will experience pain or a noxious event of some kind.

CONCEPT #4 – Pain is individual. Life experience has shown each one of us that people respond very differently to what appears, from the outside, to be the exact same stimuli. In other words, two individuals struck with the same amount of force in the same place will often have two very different internal experiences of that event. Modern pain research points out the fact that there are many different factors that determine what and when stimuli are painful for each individual.

Here are just a few of these factors:

  • Context – In what situations does the athlete experience the pain? If the pain is always present when moving while seated, changing the context and performing the movement while standing and talking with a friend may alter the pain.
  • Posture – If the pain always accompanies standing movement, the same movement could possibly be performed pain-free while seated or lying.
  • Emotional State – An athlete may experience less pain while listening to his favorite music versus when he is angry.
  • Visualization – Imagining that the movement is pain-free prior to performing it can alter the pain event.

At a basic level, this is a beautiful, ongoing real-life example of how the Threat Neuromatrix actually works. It helps us understand that pain is an EVENT that is based on the athlete’s perception of that event.

As a result, altering this perception of the pain event can have long-term consequences in either improving or worsening their pain experience.

CONCEPT #5 – Pain is a multi-system output event. Because pain is an action signal that is specifically designed to deal with a survival threat, it is a multisystem output event. What this means in simple terms is that pain can and does induce body-wide changes in order to help you meet the threat. These changes in function can range all over the physiologic map – creating changes in your body at every level.