Lesson Overview

This section provides overviews for each of the lessons.  These overviews are available to help you determine if the lesson is right for you or to review key concepts for lessons you have already taken.

Pain

Pain is complex and new neuroscience is constantly emerging to refine our knowledge.  Most of us do not have an accurate concept of pain or how best to manage it.

Pain is always an output from the brain to protect the body from perceived danger.  So how we perceive our situation is central to our pain.
Pain and tissue damage are not always related.  Horrific tissue damage can be painless if the brain feels survival is best served without pain. It is common to hear of incidences where victims get to safety with tissue injuries which would normally cause debilitating pain, feeling no or minimal pain.  Likewise, excessive pain from a mouth sore or paper cut can far exceed their actual danger to survival.

The brain considers many complex inputs to form a pain output and changes the pain threshold in response to  information from the body, environment, thoughts, beliefs, emotions, etc.  The pain output from these inputs is generally calculated to best insure the person's survival.

The complexity of pain makes all pain relative.  Similar minor tissue damage to a hand is likely to be perceived differently by a surgeon who needs great dexterity versus a construction worker.
The nervous system remodels its sensors every few days to better protect the body in the current environment. The body is excellent at adapting to survive.

 
A map of the body resides in the brain in a structure between the ear and crown of the head, about the size of your index finger, represented in images as a homunculus .  The skin map of the body is quite accurate and the location of skin pain can be precisely identified.  Locating pain in deeper structures becomes trickier, think of a heart attack causing pain in an arm or the "brain freeze" that happens when you eat ice cream too fast.  The pain and the danger are in two different places of the body, but the overall pain message is delivered loud and clear, if not inaccurately.  The brain map can be seen in action when we consider amputees who experience pain in the space their limbs formerly existed, when they point to a pain that is in empty space or refer to moving their missing limb.

Referred pain occurs when a problem in one part of the body causes pain in another.  One classic pain referral can occur when you press on the back of the scapula and feel pain in the front of the shoulder.  Research has constructed fairly predictable referred pain patterns that appear common to all humans.

The nervous system changes both hardware (sensor types and locations) and software (connections, thresholds, maps, stories, etc.) to adapt to new situations.  This can cause pain to increase or decrease in response to increased danger or safety.  The ability to change the nervous system is called neuroplascticity.
Pain can remain as an overly sensitive protection mechanism long after tissues have healed.

Research shows the two largest actions that can be taken to manage pain are education and appropriate or graded movement.

What about medications?  Most are only effective at managing pain for a short time, have undesirable side effects and ALL are ultimately less effective than the pain medications generated by your body in the long run.  The missing key is getting consistent access to the body's internal pharmacy.
 
 
Our brains contain mirror neurons that activate when we see or imagine movements, without our bodies moving.  This brain activity can cause a pain response when we see someone injured or do something we think may hurt, as an example a male witnessing a male groin injury will generally evoke such a strong response that a grimace or groan is emitted.  Mirror neurons may be the basis for empathy and imitation as we can experience and practice by observing others.

The phenomena of mirror neurons can be used to communicate safe movement or improve our ability to move through observing others move and visualization exercises.  This approach can be useful when our own movement is not possible, too painful or dysfunctional.
 
The overall goal of managing pain is to make changes that allow the brain to have a realistic understanding of the true danger and safety behind the pain, which generally incorporates education and movement.
  

Tension

Tension is complex and individual, but revolves around many of the same issues as pain, such as safety and danger.

The part of our nervous system that runs automatically is the autonomic nervous system or ANS.  It controls things like heart rate, blood pressure and muscle tension.

The ANS has two primary components.  The "rest & digest" or parasympathetic nervous system is responsible for maintaining the body and recovery (anabolic processes which bring in energy, building up the body).  The "fight or flight" or sympathetic nervous system is responsible for responding to threats through physical action (catabolic processes which use stored energy, tearing down the body). 
These systems developed over millions of years to address a much more primitive life than we currently lead, which is at the heart of many of our modern diseases.

  
The sympathetic nervous system evolved to respond to life threatening situations by preparing the body for physical conflict.  Running from a predator, hunting prey or fighting a scavenger to protect food.  These conflicts were generally short duration events, after which we returned to the more beneficial parasympathetic mode to recover.

The sympathetic nervous system suppresses the parasympathetic system because it is unnecessary in short duration conflicts.  It readies the body for action by increasing heart rate, blood pressure, tensing large movement muscles and inhibiting smaller postural muscles not contributing to short term action.  The sympathetic system also generates excess hormones such as adrenaline and cortisol, which have longer lasting effects.

Unfortunately, modern stressors are more frequent and longer term than past encounters with a predator. Our bodies respond the same to being stalked in the forest or the office, however, in the office action never comes, only the preparation.  Have you ever been in a meeting where you catch yourself in a flexed, ready to go posture, heart racing, fists clenched, but there is no opportunity for a physical release?  The sympathetic nervous system primed your body for action, but there was no "fight or flight', no opportunity for physical action.

Under enough stress, and these stresses sum up, your sympathetic nervous system is constantly revved up and your parasympathetic nervous system is constantly suppressed.  This situation implies your body is tearing itself down faster than it can repair itself.  A side effect of this condition is that when the parasympathetic nervous system is active, the body recognizes it is constantly under attack and chooses to alter the metabolism to store as much energy as possible as body fat.

So where does that leave us?  Increased heart rate, increased blood pressure, increased body fat, increased muscle tension in large muscles , poor posture from inhibited posture muscles and ultimately a reduced ability to move well.  Years of living under these conditions leaves us with metabolic changes such as diabetes and fascial and skeleton changes such as humped backs and osteoporosis.


  
The overall goal of managing tension is to calm the sympathetic nervous system and activate the parasympathetic nervous system.  Again, education is key and understanding the true nature of safety and danger.  While this approach is simple, move and understand more, the implementation can be quite complex and difficult, as it reaches all the way back to our personal and societal value systems.  

Body Changes with Movement

The body's ability to adapt, bioplasticity, is at the heart of managing pain and tension.  It is also at the heart of the problem.  Our society has evolved rapidly in the last two hundred years and our bodies adapt slowly.
 
So a key question to better understanding is,

"How quickly can I change each part of my body that supports movement?"
 
Hopefully, you recognize that the quickest thing to change is your mind, or nervous system.  There are several ways to do this rapidly, including education, touch, movement, visualization and breathing.
 
Our nervous system controls the tension in our muscles, so that change can be near immediate also.  Muscle is the next most adaptable tissue, as we can change strength and size in the order of weeks.  It should be noted the most immediate strength gains are actually neurological adaptations of recruiting more and different muscle fibers in a better coordinated manner, essentially "learning" the move.  Later changes, such as increasing the cross sectional area of muscle fibers, take more time to occur.

It is important to understand that muscle is delicate tissue housed inside much more resilient material called fascia.  Also critical to consider is that what we call a muscle, say the biceps brachii in the arm, is only a separate thing because that is where someone applied the scalpel and a name to a section of fascia containing muscle cells.  The reality is that the entire fascial system is contiguous, surrounding the bones and essentially housing the muscle fibers, nerves and blood vessels.  Another example of why the pain and the problem could be in two different places, an problem in your feet can cause a pain in your neck.

Although there are many definitions of fascia, we'll consider most anything which is not nervous system, circulatory system, organs, muscle or bone to be fascia.  That would include muscle sheaths, tendons, ligaments, cartilage, tissue containing fat cells, tissue connecting from skin through our deepest organs.  Some definitions would consider bones as calcified fascia, but that is unnecessary for our current purposes.
 
Fascia provides resilience and bounce to the body.  It adapts and responds to stresses, but does so much slower than the muscle fibers it often surrounds.  Whereas muscle adapts on the order of weeks to months, fascia adapts on the scale of months to years.  The classic example of maladapted fascia is the dowager's hump or hump back that often emerges as a result of poor posture and age.  Fascia can be trained and worked, with large scale body shape and function restored to some degree over time. 

Besides defining shape, fascia also glides across itself to support smooth movement.  Severe dehydration, injury, surgery and other factors can cause distinct fascial sheets to adhere to each other, causing what is commonly referred to as an adhesion.  These range from very minor which resolve themselves with movement or massage to permanent.  Clearly, fascial adhesions can have far reaching effects in the body and are another potential explanation for some pains that are experienced at a different location than the problem.  A key feature of fascia is to provide temporary kinetic energy transfer and storage, it literally puts the spring in our step.

Key to all successful changes, but especially fascial changes, is maintaining correct hydration.  A guideline is to consume daily about half your body weight (in pounds), as ounces of clean, fresh, mineralized water.  Your activity levels and climate may increase this amount significantly.
The final element we consider in any depth are the bones, which are suspended in the fascia to give our bodies form.  The bones are the rigid structures that meet inside joints constructed of fascia to allow us to move when muscles are contracted and relaxed.  Bones also adapt to the stresses and strains to which they are subjected.  They are continuously breaking down and rebuilding to both provide and store calcium for the body to function.  Bones also adapt on the order of months to years, with weightlessness in space and inactivity contributing to reduced bone density.  Bone density can generally be improved with appropriate weight bearing stresses and adequate nutrition.

 
While we don't consider the other body systems in depth, their correct functioning is key to any successful approach to improving movement or managing pain or tension.  However, a discussion of the respiratory, circulatory, digestive, endocrine, urinary, reproductive and skin are beyond the scope of this short overview.  It is worth consulting with a physician to insure that your body is functioning well and is free of disease, harmful fungi and parasites before making other changes to insure the best results and safe guard your overall health.   Working with a functional medicine doctor is a great way to move towards a more optimal overall state of health.  A key component to overall health and change in all the body's systems is the food you consume, which is not addressed in this overview.

Next we consider what tools we have available to help us manage pain, tension and the health of our movement systems.

Breathing

Breathing is possibly the most effective self care tool we possess for pain and tension.  While breathing is partly controlled by the autonomic nervous system, it is the one autonomic function most of us can consciously control to suppress the sympathetic nervous system and engage the parasympathetic nervous system.  Your parent's advice, "take a deep breath", may be the key to reclaiming your life.

Let's keep this simple. Breathing in deeply through your nose communicates to your brain that you are safe.  Breathing shallow and through your mouth communicates danger and fear, like you are struggling to outrun a predator.

While there are many suggestions on how to breath available, it comes down to a few simple things. Probably the most important is to breathe naturally for your current structure, but aim for an " ideal" such as that described below.

Breath in deeply through your nose.
The first 2/3 of the breath should come from your belly expanding.
The last 1/3 should fill the upper part of your chest.
Exhale in reverse for about the same amount of time, through your nose or pursed lips.

You don't have to breath like this all the time, but when you want to calm down, grab control of your breath and breath with awareness through your nose to activate your parasympathetic nervous system.

More involved breathing plays with the speed of inhalation and exhalation, focus on breathing into specific locations of the body, alternates nostrils, incorporate chants or other additions.  But for now, just remember to breathe.  Initially, you may want to set alarms to remind yourself to take a breathing break.  Very similar to a smoking break, but with  health benefits!

Movement 

How long can you live without movement?
Trick question, life is defined by movement, so without it, you'd already be dead.

If your cells are not moving, you are dead. If your blood is not moving, you are close to dead, if not there. If you are not moving to breath, it won't be long. The point is that movement is the basis for life and health.

Air is important, but without movement, your body cannot take advantage of it. Breathing has multiple layers of movement. The diaphragm and accessory breathing muscles moving to inhale and exhale air. The air crossing into your body and the wastes leaving your body, through the alveoli. The oxygen moving into the hemoglobin for transport around the body via the movement of your circulation. The wastes, primarily carbon dioxide, leaving the blood stream for exhalation. We cannot do without air for more than a few minutes.

Breathing is a beautiful ballet of movement at multiple levels!

Much of this ballet is a water ballet, as the fluids in our body are the medium of movement and critical to survival. Movement is optimal with lubrication. Hence, water is our third essential element, which must be replenished regularly. Our bodies shut down without water in one or two days. However, this water ballet must be fueled by energy.

Food is the primary resource to provide the energy to sustain life. Fortunately, our bodies store a fair amount of energy that they can reclaim if required, so most of us can go weeks without food.

So, how important is movement to the brain? Brains evolved to coordinate movement that optimizes the chances for life to survive. Any other brain functions that emerged are a bonus.
 
Movement is another area we humans love to complicate with machines, special places, formal systems and complicated rules & rituals.  We go out of our way and even spend money to avoid authentic natural movement, typically in attempts to find short cuts.  Like so many things in life, for movement, "the journey is the reward", so take the time to enjoy it.

If you want to understand the basics of healthy movement, watch animals and children move, then imitate them.  Their movement requires none of the baggage most adult humans seem determined to add.  They don't need books, they don't need machines, they don't need special places or detailed instructions and the universe has put all the required rules in place.  Animals and children appear to only need a few things to learn to move well:  their genetics, their body, good nutrition, a goal, time and AWARENESS.  They derive pleasure from simple movement and accomplishment.  Catch the prey, reach the toy, climb to play in the sink!
 

Our brains are optimized for movement.  Movement, especially bi-pedal movement, was critical in obtaining the high calorie nutrition necessary for all the other aspects of our large brain to develop.  Remember the "mirror neurons" from the pain lesson section which are so critical when we watch others move?  We are programmed at the lowest level to learn movement through observation, "monkey see, monkey do", literally.  We are also programmed to try, fail, adjust and retry based on our own limitations.  This pattern of observation and persistent self correction is the fruit of awareness.
We evolved to do the following fundamental movements and many more:  roll, creep, kneel, crawl, squat, stand, bend, twist, push, pull, lunge, walk, climb, jump, jog, run, sprint and swim.  None of these movements require special equipment.  However, all of them require one thing from you to be done well: awareness.  Our movement skills are constantly changing as we develop and decline.  The key to managing these changes well is again awareness.  Expanding, maintaining and adapting our movement is driven by awareness, but you must MOVE for awareness to work.
 
So how do you decide the best movements for YOU?  Again, the answer is complex, but here is a short list to ponder.

Movements you like and will do.
Movements that challenge you (which you may not like, contradiction #1).
Movements that are safe.
Movements that are new.
Old movements you haven't done in a long time.
Random movements.
Repetitive or cyclic movements.
Movements with meaning, like dance.
Movements with friends.
Movements that are part of your daily life or functional.
Movements defined by others like "fill-in-blank" yoga, tai chi, Pilates, Feldenkrais, Alexander technique or others
Martial movements like boxing, wrestling, judo, aikido, karate, kung fu, etc.
Expressive movements like ballet, tap, rhythmic gymnastics, eurhythmy, etc.
Athletic movements like gymnastics, diving, track & field, strength training, running, etc.
Movements that are original and inspired
"Your answer here"

 
But are you really ready for those movements?  Movement should progress as follows with these priorities:
 
Mobility
Stability
Balance
Strength
Endurance
Power

  

 

As you might imagine, this order is not arbitrary, but defined by nature.  If you follow the focus of infant development you'll notice that first they explore their mobility, "Hey, look, I can put my toes in my mouth!".  Then they explore stability, especially when it comes to head control, which prepares them to steady their vision while moving. Once they learn to control their appendages a bit, they explore balance, typically first by rolling over and back.   As infants progress through rolling, creeping, kneeling, crawling, standing and walking, they are continually exploring mobility, stability, balance, strength, endurance and speed.   
 
These explorations develop the proprioception, or sense of where their bodies are in space, that they will use for the rest of their lives.  The process is largely one of trial and error, which is highly served by awareness, consistency and perseverence.   There are also large doses of imitation, social interaction and goal setting.  
 
As you gain mobility, it is important to integrate stability and then balance.  Once a movement has acceptable quality, we can start training performance  through strength, then endurance and finally speed or power.  During this stage the integration of each element is typically targeted at an activity we are training to perform.  There is no need to develop a 300 lb bench press if your goal is to hike the Pacific Crest trail. During this process we might isolate small portions of movements, but we ultimately need to integrate new found strength with functional movements to make them useful to us.   
 
A bench press is an isolated movement that research has shown does not translate well to functional performance.  How often in your life do you find yourself trapped under a 300 lb weight you must press with strict form to escape?  A more functional movement might train the standing pushing pattern which you could use to push your car when it is out of gas or manhandle a lineman in a football game.  
 
Now for the real good news, we probably only need to train quality for a few minutes every day and performance one to three times per week.  Check out the following page for more on the science behind strength training as an example.  Here's the teaser, "This article thoroughly summarizes scientific research on the question of strength training frequency and volume, and it is a rare example of near-consensus in exercise science. There is actually minimal controversy here, believe it or not: 20+ years of research has made it quite clear that most people train more often than they need to, because strength training can be a more efficient form of exercise than you thought. (And now cardio, too. Exercise in general, really!)" 
 
A favorite movement training video series is Paul Chek's Movement as Medicine .  There is a lot here and it takes time to abosorb, but is a great approach to movement from breathing on up. (Be careful and go through 1 through 7 in order, they don't always play that way automatically.)
 
The overall goal of training movement is to first improve quality to an acceptable level and then add in work to improve performance for your chosen activities. This goal can be accomplished in a way that is efficient, pleasurable and effective without consuming your life. 
 

Massage

Massage is a great way to address pain and tension issues.  The primary effect of massage is a reduction of tension and anxiety, as described in this article, Does Massage Work? .  Our lessons focus primarily on self-massage as a tool for managing pain and tension.  
 
The primary approaches we investigate are trigger point release , myofascial work , dermoneuromodulation and accupressure .  As discussed in the above article, the results are almost independent of the techniques, so it is best to explore and understand what works for you.  Below is an example of foam rolling for self-care.
 
Massage does not need to be painful, as the dermoneruromodulation (DNM) demo below shows how just slight skin stretching can reduce muscular tension and pain.   DNM can be difficult to use on yourself, but is safe enough to be attempted with a trusted friend or partner.
 
A professional massage is great for relaxation and therapy, but for long term effectiveness and daily care it is tough to beat self massage.  No matter how skilled the therapist, they cannot fully understand how you feel. You are the best judge of where to massage and how to adjust pressure and techniques.  Additionally, the most effective massage occurs in short periods throughout the day, which most people simply cannot accomplish with a professional for time and money issues. Fortunately, there are many tools available to help, including rollers (foam, pipe, etc.), balls (golf, tennis, lacrosse, tiger ball , etc.) and tools to get hard to reach places ( knobs , theracane , etc.).
 
Massage is very beneficial with mobility by reducing muscle tension and can help with stability and balance by awakening inhibited muscles and improving proprioception.  Massage is also useful in other movement stages for recovery and maintenance.
 
 
Learning the basics and being aware of how your body responds can go a long way towards delivering effective massage self-care to ward off tension and relieve pain.

Guided Visualization and Imagery

As should be apparent, much of what we are attempting to accomplish to manage pain and tension is to affect the nervous system.  Previous lessons have taught us the the power of "mirror neurons" for training our movements through watching others and visualizing ourselves.   Our sense of "vision", which extends beyond our eyes, is a very powerful management tool.   Likewise, listening to others can provide a means for calming the nervous system.   We all have different needs and capabilities when it comes to how best soothe our nervous system to relieve pain and tension.
 
Guided visualizations and imagery can have a profound effect for some.  A short example is provided below.
 
These guided approaches help us to focus our attention and become more aware.  Like crutches, eventually they may not be needed, but they are a great way to begin.
 

Happiness & Summary

The best piece of advise for using this material, is to find what makes you happier.  Avoiding tension and pain could be as simple as learning a new movement or massage technique, or as involved as changing careers.  It is important that no matter what you are doing, that your values and your actions are aligned.  Much unhappiness can follow when you mindlessly do something that does not align with your values and beliefs.  Amazing results can occur when you find a valid approach that aligns with your values and increase your happiness, for one thing, you'll stick to it!
 
This overview provided a brief understanding of pain and tension, emphasizing that modern research indicates education and movement are the best approaches to managing them.  It then provided an overview of the major body systems involved with movement, demonstrating the power of the nervous system, brain and mind when it comes to movement.
 
Finally, we looked at several ways to move better:  breathing, physical movement, self-massage, guided visualization and imagery.  The entire purpose of this site is to provide the reader resources to investigate their own needs and blaze their own path.
 
Invest in the process, not in the outcome.  Happy hunting!