The chimp
“Shit! My fucking leg! What new hell is this?”
At least that’s how the chimp in my brain reacted when I experienced breath-robbing, limb-buckling pain in my right knee. En route home after school drop-off this morning, I was warily negotiating foot placements on the crisper, untrodden parts of the snow-covered path whilst striving to avoid the compacted snow and glossy patches. Sudden and intense — the sensation in my knee caused me to hold back from weight-bearing for a few steps. It really hurt. A different pain. New danger.
I’ve learned a lot about pain this last few years. Most importantly, I’ve learned to get a better handle on my catastrophe-predicting, over-dramatic, highly-strung critter brain. Where my being was once prone to pretty immediate limbic system hijack in the face of fear, I now find I have more of a choice.
The human
And so this being the case, the rational, logical human part of my brain took a moment to calculate her response.
“Yeah, that felt pretty intense, but hush, now. C’mon! You’ve read Explain Pain. You know about zings and zaps. This does not mean damage.”
Are you familiar with zings and zaps? Explain Pain, the must-have manual for the science-based pain sufferer, uses the term ‘zings and zaps’ to describe the phenomenon of sudden unpleasant sensations that one might experience due to an injured or irritated nerve, most likely provoked by stress, positioning or certain movements. It seems that these ‘zings and zaps’ can,
“…often lead to secondary postural changes as the person repeatedly tries to avoid the aggravating movement.”
Awareness and cognition
As I picked my way along the path, I became aware of the compensatory postural shift. I found myself reflexively bracing, my steps guarded — especially the right foot, and unconsciously holding my breath as I concentrated my efforts on staying upright, avoiding hazard and preventing a tumble.
I made efforts to purposefully relax my breathing, and the next time I placed the right foot down, I deliberately gave my full weight to my leg and foot, countering the involuntary compensation my brain was attempting to make. My chimp brain was still on red alert. The throb of pain continued with each step, intensifying even, and I lost my footing a little. Then the sensation began to fade. There was an unraveling and unwinding sensation in my left buttock, across the pelvis and down to the right knee. It eased off completely. The danger was over. My conscious breath and calculated gait had won out. The pain was gone and I was walking in comfort and with ease.
Rationalising the pain experience
What was all that about, then? I can’t be sure, but here’s my best guess:
I have added new some new, more vigorous elements to my workout recently. Maybe a little DOMs mixed with a little strain? I’ve also had a fair bit of disruption in my life in the last couple of weeks: being away from home; sleeping in an uncomfortable bed with resulting sleep deprivation; heightened stress; prolonged sitting;travel; poorer than usual diet. I know how these factors can contribute to the pain experience so I can rationalise why my body may have been feeling tighter and achier than usual. Oh, and on top of that I also appear to have what is known as central sensitization.
The clinician and blogger Barrett Dorko posits that we have a natural instinct to correct the vagaries of our bodies called ideomotion. He talks about it in his 2015 San Diego Pain Summit lecture and movement writer Todd Hargrove has written a number of blog posts related to this theme.
I believe that today I experienced this kind of spontaneous self-correction — which may or may not be the same as the aforementioned ‘zings and zaps’. Indeed, I have experienced it many times. Instead of that knee becoming a new impairment and yet another problem, I took the view that my body was following the adaptive action plan in response to threat — withdraw and protect — because that is what nervous systems do. This was defence, not defect. The pain in the knee was somehow related to the opposite hip. I could have treated it as a danger signal — continuing to ‘protect’ myself and guard against a tumble with braced posture and ginger gait — but instead I chose to let it be an opportunity to unwind. To allow a natural, surprising unraveling to take place through paying attention, taking conscious breaths, allowing softening. (Still bloody well HURT at the time, though!)
Education and exploration lead to self-regulation
It took me a while to get here. To this place of pause and presence. Lots of reading on pain science. Education. Experience. Exploration. Mindfulness. Movement, movement and more movement.
I wonder, what would it look like if more people in pain were aware of this phenomenon as an option, as a choice of action? If they began to find out more about the mechanisms that drive pain and started entertaining the possibility of a natural resolution to aches and pains?
Originally published at medium.com