"If you don't like something ,change it. If you can't change it, change your attitude." - Maya Angelou
We often hear, “If it hurts, don’t do it”. We are most likely to hear this when recovering from episodes of acute pain or when rehabbing an injury. Using pain as a guide is essential not only for recovery but to keep us free from future injury. Tapping into pain enhances awareness of our body and prevents us from going on autopilot when we move. Whereas pain is a messenger that serves to protect, it is not a foolproof reference point. Rather, its value as a guide is dependent on how well we understand our limits and how closely attuned we are to body sensations.
Pain is a complex and multilayered experience. A sensation that is perceived by one person as “hurting” might be described by another as “uncomfortable”. People new to exercise frequently confuse a burning sensation in the muscle as a sign of potential injury whereas athletes are trained to ignore pain in pursuit of performance goals. Research has shown that our experience of pain is influenced by how accurately we describe it. Using vague terms such as “hurt” can, for some, increase the sensation of pain as it heightens anxiety. Using broad terms also fails to provide specific information that can help us to make good decisions about future behavior. Using pain as our only measuring stick can cause us to overlook more subtle sensations, such as tingling and numbness, that may eventually lead to tissue damage. On the flip side, broad descriptions of pain may unnecessarily restrict our movements. Burning or stretching in a muscle are uncomfortable sensations that hurt but are not necessarily dangerous. In fact, body tissues need to experience some level of stress, so that type of pain is a necessary component of building strength.
We tend to think of pain as a sensation that travels along a one-way street to the brain, which receives the message and then alerts us to take action. Over the years, specialists have concluded that pain is more complicated than is represented in this “stimulus-response” paradigm. The Gate Control Theory, developed in the 1960’s, provides a more detailed description of how we experience pain. Although this theory is somewhat controversial as it has yet to be validated in controlled settings, it offers a way of conceptualizing the connection between the brain and our experience of pain.
The Gate Control Theory is based on the relationship between sensation and the perception of pain, known as nociception, and the sensation and perception of pressure, distortion, and movement, known as mechanoreception. When we experience pain, messages about the event travel along two separate pathways. The larger pathway is mechanoreceptive, which transports messages about many different sensations other than pain: movement, touch, muscle tension, posture, etc. We can think of this pathway as the “495 Beltway” of the nervous system—wide, congested, and fast moving with lots of on and off ramps. Messages traveling on this highway tend to reach the spinal cord before pain messages. Pain travels along the nociceptive pathway, which is much smaller and tends to happen outside of our awareness. When pain is acute, these signals get prioritized because of intensity and, like an ambulance, travel with priority on the larger highway, stopping traffic so that it gets to the spinal cord quickly. Chronic pain, however, has a harder time getting through the traffic. When the larger pathway is congested with non-pain sensations, the smaller, chronic pain messages get crowded out, stuck on the on ramp, unable to merge into the congested traffic on the beltway of nerve signals.
To make this journey more complicated, pain messages that flow from peripheral nerves to the spinal cord on their way to the brain encounter “nerve gates” that can open to give the pain priority status to move ahead or close to inhibit them. Jelly fish stings hurt so much because their toxins force all the gates open, allowing pain signals to flow unimpeded to the brain. However, the opposite happens when the gates close and the intensity of pain is reduced. This is what happens when, upon stubbing your toe, you shout a few choice words, walk around a bit, and, realizing nothing is broken, feel less pain and move on.
Even with all the nervous system’s traffic, congestion, and gates, when the pain does finally reach the brain, parts of the brain stem can still inhibit it by producing endorphins. This is why exercise helps reduce chronic pain, and why pain is perceived differently when we are under stress or in an excited state.
Regardless of its experimental validity, the Gate Control Theory provides a framework to understand why pain and tissue damage do not always correlate. Many people have significant damage in their joints and spine but experience very little pain. Likewise, people can experience high levels of pain without any associated injury or damage. The Gate Control Theory helps to recognize that pain is both a subjective and objective experience, influenced not only by our nervous system, but our brain as well.
This approach underscores the value of learning how to describe pain signals, emphasizing how the vocabulary we use to articulate physical sensations can help in pain management. Studies on chronic pain show that, as people’s descriptions of pain became more precise, their subjective experience of pain was either downgraded or localized. For example, rather than report that “my knee hurts”, they described the sensations with more detail, such as “feeling a sharp tug on the inside of my knee”. These detailed descriptions were correlated with healthier movement patterns that helped mitigate pain and promote healing. Greater attunement to body sensations has also been shown to increase a person’s endurance as well as the overall tolerance of movement, regardless of the presence of tissue damage or injury.
Every yoga pose creates some level of stress that provides a good amount of body sensations. Many of us can identify what our body parts are doing in a pose—i.e., my foot is turned in, my forearms are on the floor-- but can we also describe what we feel? Refining our ability to describe body sensations can deepen our practice by informing us when it's safe to move further into a pose and when we need to back off. We can’t avoid pain—injuries happen in yoga just as they do when running a marathon—but with skillful observations we can make better decisions about the direction in which we move in our practice. Small tweaks in body position can make for big changes in our experience but they require listening deeply to sensations to know how to make adjustments within safe limits.
We can safely explore our edges through twists and, when possible, binding. The action of binding occurs when one part of the body holds onto another part, with the intention of creating stability that allows us to deepen the pose. Clasping the hands behind our backs in a Forward Bend is an example of a simple bind that accentuates the engagement of back muscles while expanding the front of the shoulders. Moving into binds requires patience and mindful movement, using sensations as a guide to find our edge. As such, they require deep listening and attunement to the body.
I invite you to approach your practice not only as an opportunity to feel the satisfying sensations of release that come with twists, but also to enhance your awareness of what is happening in your body throughout your practice. Rather than focusing only on the mechanics of a pose, notice what happens when you turn your attention to the subtle sensations that bubble up throughout your practice. We never want to ignore pain, but we can use our practice to explore the vast range of sensations that exist between a warning sign and healthy effort. Allow your body to skillfully guide you, bringing you closer to your edge, wherever that may be.
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