Understanding Under a Heavy Load

After a disappointing lift on Thursday, one where I not only missed reps on my press but downright failed, my lift Saturday felt great.  Of course it is always a sweet feeling to be able to get all your sets and reps with a new, heavier weight on the bar, but I realized as I was driving home, that this was only a piece of why my Saturday lift left me feeling so happy.  The bigger piece of it came down to environment, to the supportive lifting community at Fivex3 Training.

Necessity dictated that I did my Thursday lift on my own at a nearby gym.  From the get go, things were out of whack: different environment, mirrors everywhere, work issues filtering into my consciousness, and critical people.  There are many different approaches to lifting weights and the approach one takes depends on one’s goals.  There ought to be room to accommodate different types of lifting in any commercial gym, but there are usually a few individuals who don’t understand and criticize heavy lifting and feel perfectly comfortable expressing their views.  Many people misperceive it as dangerous or possibly inappropriate for women or older trainees.  Just look through the comments on Beau Bryant’s post and follow-up article from Westminster Strength and Conditioning about 88-year old Mrs. Fox’s 88# deadlift to get an idea.  When I walked into the weightroom to lift that Thursday, one such outspoken individual was there, a woman who had stood next to me a few days prior, while one of my clients was doing weighted squats, and said loudly “Oh my God.  The cartilage in my knees is shredding just watching you do that!”  So when she started talking to me again that Thursday as I was warming up for my press, ideally I would have had the mental discipline to focus only on my lift and not on her follow-up commentary.  Apparently my mental discipline is still a work in progress.

fivex3community
Fivex3 Training: A Supportive and Encouraging Community of People Lifting Heavy S#!t

Conversely, when I went in for my Saturday lift at Fivex3, I was greeted by a much more encouraging environment.  No mirrors or work issues to distract me, but more importantly no opinionated and critical people.  Everyone was on the same page about lifting heavy weights as the most effective way to build strength and about its appropriateness for all people, regardless of age or gender.  The trainees at Fivex3 were working on different lifts and different programs, some building pure strength, some working on conditioning, some training for Strong Woman/Man competitions, but there there was no judgment or negativity.  The similarities in our lifts allow us to learn from each other, to spot each other, and to offer observations and suggestions when requested.  If someone misses a rep, you will never hear “well, that’s because you shouldn’t be lifting so much weight”.  Instead you might hear an empathetic, “Bar didn’t want to move.  That’s ok.  You’ll get it next time.”   When I missed a rep on my bench press, Christian coached me to keep my back tighter and puff my chest more, so then when I easily got all my reps on the subsequent sets Coach Bob (aka: “Silent Bob”) noticed the difference and responded with a “Fuck Yeah!” and a fist bump.

The starting perspective for any of the interactions between coaches or trainees at Fivex3 is that you can and should lift heavy weights and build strength.  It is an attitude of empowerment, an expectation that you can and will do amazing things.  That’s the beauty of a shared experience, of understanding what someone else is struggling with because you’ve struggled with it too.  Those shared experiences become the building blocks of a supportive community.  But that kind of support doesn’t need to be born just from shared experiences; it can also be forged from a desire to set judgement aside and attempt to understand another person’s perspective.  What if that woman in the gym had asked why I had my client doing weighted squats, had tried to learn about the benefits of the exercise instead of standing behind her preconceived ideas?  What if I hadn’t gotten rattled by her apparent criticism and instead tried to find out how she had formulated her opinion?  For me that is clearly easier said than done, especially under a heavy load.  In reality though we are all usually under some kind of heavy load, struggling with something that is far less obvious than a weighted barbell.  Maybe if we begin with that recognition, it becomes easier to be understanding of the critical and judgemental people we encounter.  And in reality, empathy and understanding offered to the difficult people in our lives is also pretty amazing.

Habit, Change, and the Low Bar Back Squat

The change from high bar to low bar back squat was a difficult one for my left shoulder to adjust to. At some point years ago, it received a good bit of impact from a skiing injury, and since then I have piled ample other unknown insult and abuse to the area.  For a low bar back squat, the bar sits just below spine of the scapula; sometimes for me this feels like it’s on bone.  I’m luckier in this department than a lot of women because, as Emily says, I’ve already got “some meat back there”.  Nevertheless, Emily encourages most women to wear an extra t-shirt for back squat to provide a little more padding.  One of the cues that is given when setting up for this exercise is “elbows up.”  This is to create tightness in the upper back, a shelf of delt on which to trap the bar so it is secure.  Somehow in the process of trying to keep the bar off of bone and keeping my elbows up, I ended up turning the proper position into something else that my shoulder didn’t appreciate.

Louise has been working on this shoulder.  And as with anything related to the body, I have found the process to be fascinating.  Long story shorter, my humerus was being pulled further forward on the left side than on the right, the result of tight pecs and lengthened upper back and neck muscles.  Louise says the connective tissue on my left pecs was bound down all the way to the sternum.  The first day Louise worked on that shoulder, she released those bound tissues, and as my scap almost miraculously relaxed down far enough to touch the table under me, I took a deep breath that filled my entire lungs, bottom to top.  It was only then that I realized that the shallow breathing I had been experiencing and attributing to stress was actually also related to a physical cause.  In releasing that bound muscle, Louise allowed me to find increased range of motion in the joint, more space to move, the ability to breath deeper, and greater relaxation.

As my shoulder relearns its original position, the whole experience of lifting keeps changing. I imagine that Louise is like an archeologist digging through layers of bound connective tissue, excavating and sifting through years of assorted pains in the shoulder, unearthing them and clearing the area. As this happens I’m experiencing new sensations in my shoulder as my tendons find different ways of tracking and my body relearns some of its original ways of moving, rather than using the altered movement patterns that it discovered over the years to compensate for weakness and avoid pain.

Our brains work in a similar fashion to our bodies in this regard.  Just as our bodies compensate for weaknesses or injuries by recruiting muscles for jobs that are not their prime purposes, and just as our bodies often find the path of least resistance allowing our dominant muscles to hijack movement patterns, we develop intellectual and emotional coping mechanisms to help us get through our days and our difficulties.  We find shortcuts to help us save time and energy and compensations to make aspects of our lives less painful.  Sometimes these shortcuts are relatively harmless, like always taking the same route to work; potentially some are helpful, like establishing morning routines to ensure that nothing gets forgotten in our rush out the door.  Sometimes these shortcuts are in our thought processes, stereotypes or outdated views of ourselves and others that prevent us from recognizing change or potential or that keep us from truly seeing what’s before us because we are bound down by our views from the past.  Sometimes the compensations and habits we develop are detrimental to our health and well-being, causing more pain for us in the long run than the initial issue: addictions to food, work, substances, shopping, exercise, technology – the list is endless.  Often we irrationally hang onto these compensations long after they have outlived their usefulness and even though they cause discomfort or pain in other ways.

habit-change-650x425At one extreme these compensations can be destructive, but at the very least they limit us; they constrict our ability to fully experience individual moments or appreciate individual people, and they limit the degree to which we fully engage in our activities; they restrict our range of motion as we move through life.  It is important to be aware of our habits and our fallback patterns, of the ways in which we shortcut and compensate, and it is even more important to consciously decide if the trade off is worth it.  Sometimes the answer will be yes, sometimes no; either way it is a question that only we can answer for ourselves.  Then we must decide if we are willing to act upon our answer, to make a change for the better.

A conscious decision inspired by our own desire for change, not based on someone else’s need for us to be different, is the strongest motivator for establishing new habits.  Change is not always easy; it can be a messy and uncomfortable process of wrestling with the memory of old injuries.  But change will not happen by masking all that with compensations and habits that no longer serve us well. And just as with my shoulder, by releasing some what binds us down, we can find relief, a greater range of motion and a renewed ability to move through life more effectively.

Action Overrides Emotion

“Act the way you’d like to be and soon you’ll be the way you’d like to act.”― Bob Dylan

“You are what you do, not what you say you’ll do.”― C.G. Jung

Today after listening to me explain her next set of exercises, one of my clients stared at me pointedly and said, “You know,… I really don’t want to do this.”  “That’s OK” I replied and shrugged.  She chuckled and said, “You’re going to make me do it anyway, aren’t you?”   “Yup!  That’s why I’m here.  You decided you want to be stronger, so this is what we do.  You don’t have to want to do the exercises; you just have to do them.”

you-cannot-command-an-emotion-but-you-can-command-an-action-emotion-quoteMy client is not alone in this feeling of wanting to avoid certain exercises.  This summer, my friend Dan wrote to me to request a post on this type of situation.  He commented that while there were plenty of exercises that he loved, there were some he really disliked: “Turkish Get-up, Bulgarian split squat, almost any variety of lunges, hang-cleans, wall ball work: but they are all par to functional strength and conditioning and so I know I should do them.”  Getting stronger and maintaining our health is not easy work.  And it’s definitely not something that people always want to do.  Even people who love exercise have off days, days when the work of psyching themselves up for the job is harder than other days.  Sometimes people resist exercise categorically and sometimes they just resist certain exercises.  The reasons that we love or hate particular exercises, or exercise in general, are multiple and varied, but well worth investigating.

Sometimes the exercises we dislike are ones that challenge our weaker areas and seem to prevent us from using our usual compensation patterns.  Our bodies find the most efficient way to do things, the path of least resistance.  So when certain muscles are weak, our bodies recruit neighboring muscles to take over.  Exercises that target the weaker areas are often on the list of those most hated, because no one likes to be reminded of their weaknesses.  Dan observed that many of the exercises he hated are ones that address the posterior chain, the back of the body, the muscles that we sit on and ignore for large portions of the day, the ones that typically become weaker from our modern sedentary lifestyle.  Many of us neglect to train the back side, preferring instead to work on the muscles we can see easily in the mirror.  This error in exercise programming is so common that aspiring personal trainers are taught the postural deviations that result from tight pecs and a relatively weak upper back so they can help people address and correct this sort of imbalance in training.  Often the exercises we’d rather not do are the ones that help further our progress.  For many of us the exercises we know we should do but hate include the mobility and stability work that form the basic building blocks of health, the non-glamorous work of getting down on the floor with the foam roller or training stabilizing endurance muscles at light weights.  Stuff you wouldn’t write home about.

I suspect that the exercises we love are most often the ones that we are good at, the exercises that allow us to feel a sense of mastery.  Sometimes they are exercises we were not especially good at initially, but they become favorites because they are the ones where we see the most improvement.  This too allows us to experience a sense of accomplishment, of inching closer to perfection through practice.  This feeling is its own reward and provides ample motivation.  The exercises we usually dislike though are the ones that provide the least in terms of short-term gratification or sense of mastery; often they are the ones that force us out of our comfort zone.  And as with many things in life, working outside of our comfort zones offers the potential for even more profound rewards, benefits that exceed the physical ones of improved mobility and stability, benefits that also allow us to grow our character.

Doing things we love is easy.  Doing things we know we need to do but don’t want to do requires discipline and mental toughness.  Our actions override our feelings about our actions.  So regardless of whether or not we want to be doing something, when we act on what we believe to be right, when we do the work even though we don’t want to, we shape the way we see ourselves.   Whatever our feeling about it, just showing up for each training session and determining to do our best for that day becomes an essential piece in building a habit of excellence and in shaping our perception of ourselves.  Little things like that matter.  There is a poem hanging by my kitchen sink, a portion of which speaks to this: “Watch your actions, they become your habit.  Watch your habits, they become your character.  Watch your character, it becomes your destiny.”  mental-toughAt the same time that we build our character, we also build our mental toughness, something that is essential to lifting.  We build mental toughness and self-esteem by rising to the challenges that face us, by doing what we believe is right regardless of how we feel about it.  In his article “4 Ways to Build Mental Toughness”, Dan Blewett defines toughness as “the internal discipline to not quit.”  Showing up and doing our best even when we don’t feel like it, especially when we don’t feel like it, defines us as dedicated, disciplined, persistent, dependable, mentally tough.

For me the irony in all of this is that the two people who expressed concern about not wanting to do certain exercises are people who, from where I stand, regularly exhibit resoluteness of character.  When I work with this particular client, what I see in her eyes is determination, a willingness to work hard, a desire to rise above her previous status quo and to exceed her own expectations.  I see her through the actions she performs; she sees herself through her feeling about those actions, and so we come to different conclusions.  When I think of my friend Dan, a distinguished high school English teacher and principal, I know that he spends a good portion of his day patiently and graciously putting other people’s needs before his own, being reliable, dependable, and trustworthy.   And after all of the mental energy that his job requires, he still shows up for training.  His feelings about wanting to do the exercises or not inform only his view of himself; for the rest of us, his actions speak volumes about dedication and discipline.  It’s easy to get caught up in our own thoughts and feelings about the task at hand.  Ultimately though, it is the decision to show up and do our best regardless of how we feel about it that most vividly defines us and provides the greatest potential for us to grow in meaningful and sometimes unexpected ways.

The Blessing of Rest

Sometimes in conversation, you see a version of yourself reflected back to you.  The other night I saw in some friends the same struggle to understand the importance of rest in my current pure strength program that I wrestled with at the beginning.  We were talking about our training for that day and describing our usual programs.  Both of my friends described circuit style work, moving quickly from one exercise to another without a conscious focus on rest between sets; the rest seemed more the accidental by-product of the amount of time it took to move from one station to the next.  I described my lift that day, a heavy lift that actually involved moving for reps and sets more weight on some lifts than I had previously ever moved.  Rest was essential in order for me to get each rep; my rest between sets on the really heavy lifts was a minimum of five minutes.  My friends looked at me with something akin to horror and said, “Yeah… See… I could never do that.  I need to keep moving.”

I know exactly how they feel, because that’s the same mindset I had when I started training pure strength, and it’s something I struggle with too.  “I know!”  I told them.  “When I first started training this way, I had a hard time waiting.  I have to set the timer on my phone to make sure I don’t try working again too soon.”  I told them the story of one of the first Saturdays I trained that both Diego and Emily were there.  Emily had been stressing the importance of rest between sets with me over several weeks and apparently had mentioned it to Diego.  He noticed that I was sitting down on an empty bench waiting for my next set, as opposed to pacing around, and he pointed this out to Emily as though describing a victory.  Emily laughed and said, “Yup, I’ve trained her to sit.  It’s obedience school around here.”

Being still and just sitting is difficult for me, and as my conversation with my friends indicates, this is a challenge for many of us.  I think this resistance to being still is not isolated to our experiences in the gym.  I go through a lot of my day in a state of fairly constant motion.  I believe a lot of us are like this; this is the pace at which our culture encourages us to move.  The state of constant motion in which we live was the starting point of one of Pastor Earl’s sermons, aptly delivered at the start of the school year as our more spacious summer schedules started to get jammed up and on a Sunday when two of the readings addressed the idea of Sabbath.  The Gospel lesson was one in which Jesus was criticized for having worked on the Sabbath, and the reading from Isaiah contained God’s announcement that honoring the Sabbath leads to blessings.  Pastor Earl helped us break down what “honoring the Sabbath” meant historically; Sabbath was originally a gift of rest for the Hebrew people following their enslavement in Egypt when they were forced to work 24/7.  He explained that many of the rules of keeping the Sabbath that might seem silly or extreme to us originated out of a desire to protect that blessing of rest, and that to a certain degree they are necessary:  “In reality, these rules are not silly. Why, just look at how we’ve filled our days and weeks to the brim so that pausing, resting, and focusing on our relationship with God gets shoved aside. We are modern slaves to our work, our way of life, our pursuit of financial comfort, and our accomplishments used to define ourselves.”

Maybe our desire to have more, be more, and do more requires each of us to establish some of our own rules of Sabbath in order to honor it.  Pastor Earl explained that Martin Luther detailed the two main purposes of Sabbath in his Large Catechism as being “first for our health and second for making sure that we gather and worship God.”  Pastor Earl invited us to find the method that worked for us.  In the gym, many of us use the timers on our phones to ensure that we don’t attempt our next set before our minds and bodies are ready; some read articles on the internet; sometimes we talk; one girl reads Harry Potter.  The method we use to protect that rest is less important than the fact that we do.  Find your own way, but take up the invitation:  “Carve out a little time each day to sanctify, to make the day holy for you. Carve out a day every week to sanctify, to make the day holy for you. We don’t have to get legalistic about it … that eventually leads to more work and stress. But make that part of that day and that day of that week something where you pause and remember God.”  Find the blessing of rest that is both needed and promised.

Body Weight: It’s Just a Number

Body weight is a funny, shifty thing.  There are so many factors (food and water intake, type of food consumed, hormones, bathroom usage) causing our weight to slide up or down during the course of any given day, that it really makes more sense to talk about our body weight in terms of a weight range, yet most of us have a single number in mind as our perfect weight.  Often that ideal weight is based on some chart we’ve seen at a doctor’s office or in a magazine.  Sometimes that ideal is based in our own experience, a weight at which we felt happy and satisfied with our lives.  For some of us, the number the we designate as our perfect weight is a lower number, one that we’re trying to regain.  For some of us it’s a higher number, one that we believe will reflect desired muscle growth.  For a handful of us, that number is the one we see reflected back to us on our scales.  Whatever the number, for many of us body weight is a number to which we become emotionally attached, and whether or not we achieve or maintain that number becomes another way for us to judge ourselves.

scale5In reality, our weight is just an indication of the force with which gravity holds us to the earth; and there are very few instances where the number on the scale actually matters outside of our own ideas of what that number says about us.  Like many, I have kept an eye on the number on my scale, but as I become more involved in strength training, my relationship with this number is changing.  During my teen years, I was overly and unhealthfully concerned about body weight; the number on the scale in the morning largely determined what I ate or did throughout the day and also how I felt about my body and myself.  I spent most of my twenties intentionally avoiding scales, refusing to purchase one or even keep one in the house.  I realized that knowledge of this number had informed my opinion of myself too much, so I looked for other ways to shape those views.  Early on those measures were external, the number of miles I logged on a long run or during a week or the size on the clothes I bought.  As I got older, I learned to use more elusive, internal measures, like how much energy I had throughout the day or how comfortable I felt in my own skin.

When I started strength training, my interest in knowing my body weight more exactly increased, but my attitude toward that number has shifted.  Rather than body weight serving as a straight-up measure of self-worth, as it did when I was younger, I want to know how much I weigh so I can calculate percent body weight on my lifts.  One way of understanding an individual’s strength is to look at the total amount of weight on her bar, but to understand that more accurately in relation to the strength of another individual, you need to account for body weight.  Mass moves mass.  So if two lifters both squat 200#, but one weighs 200# and the other weighs 120#, that’s not an equivalent lift.  The 200# individual has squatted her body weight, but the 120# individual has squatted 1.67 times her body weight.  This is why the frequent follow up question to a report of how much an individual has lifted is how much the individual weighs.

Percent body weight calculations are interesting and help us to understand lifts in a different way; they provide a way to compare apples and oranges.  Just as with actual body weight though, it is easy to get emotionally attached to percent body weight of a lift or to use that number to judge our value.  When we get right down to it, in most cases our attitude towards ourselves matters more than any body weight related measurement.  More than any number or percentage, what we allow ourselves to believe about ourselves, our ability, and our worth ultimately is far more important.

Faith, Focus, and Movement

Most people recognize that it is through our hard-fought struggles that we learn the greatest lessons; the easy lessons of success often have much less impact and are more quickly forgotten.  With encouragement from Louise and Emily, I learned a couple of significant lessons from my recent back pain.  Louise encouraged me to pay attention to the way my own body processed the pain, to focus inwardly to find my own specific answers to what brought relief or further discomfort, before putting my faith in the generalized answers I might find by googling something like WebMD.  Emily introduced me to the concept that movement is medicine, a necessary part of the healing process that allowed me to reframe the painful mind-body conversation that my injury had begun.

It was while I was in the process of writing about these lessons, that I heard two separate sermons on a difficult passage in Luke where Jesus says he brings division, not peace, to this world.  (Luke 12:49-56).  Not an easy passage, and not one that many people like to focus on.  Both pastors, Pastor Glenn Schoenberger from Our Savior Lutheran Church and Pastor Earl Janssen of Our Shepherd Lutheran Church, recognized that this is not the way we usually like to think of the message of Christianity.  As Pastor Glenn says, we prefer the Jesus of Christmas, the Prince of Peace; “the Jesus who invites us to come to him and he will give us rest, because his yoke is easy and his burden light.”  We are far less interested in the Jesus who promises to turn family members against each other.  Yikes.

Instead of giving us what we want, Jesus offers us some “edgy” stuff, as Pastor Glenn said.  Pastor Glenn acknowledged that the early history of Christianity was one of near constant confrontation with authority and established structures, and that to follow Jesus at that time required “all of the passion and commitment and courage [His followers] could muster” because it was likely that they would “be divided from loved ones who [didn’t] understand or believe in [their] choice.”  While this was the situation during the early days of Christianity, “the practice of our faith holds far less danger and challenge for us in American society today than in Jesus’ time.”  While he recognized that this isn’t the case everywhere, Pastor Glenn suggested that perhaps we lose something of the original intent when we become comfortable in a certain place in our faith where nothing is risked and nothing is challenged.

For another take on this reading (along with a warning that paraphrasing Jesus is dangerous), Pastor Earl summed the passage up like this:  Jesus says to those who were following him, “Really? What did you expect when you started to follow me? Did you really anticipate that I’d make your life easier? I’m proclaiming justice, I’m proclaiming selflessness, I’m showing you what being a child of God means. The powers of this world don’t accept that without a fight.”  From either sermon, it’s clear that this text offers us something challenging, something potentially painful, something we might rather avoid.

conversation-bubbles-2Like the lessons I learned from my painful back, Pastor Earl suggested that the way to engage with this challenging and divisive passage is to turn our focus inward and then to move.  First we need to find our answer to the question, “How does my faith inform my decisions?”  This is not always an easy question to answer, and we can’t expect our answers to square up neatly with those around us.  These differences in response might seem odd, since we “would think that the teachings of Jesus would lead us all toward a single definitive decision”, but instead often we find potentially painful division.  But just as I learned from my back, that pain is not necessarily something we should shy away from; it is something we should move through: “… the reality is that faith informs each of us differently. That’s why … conversations are so important. Faith isn’t some kind of static thing. It is living, breathing, dynamic and so deeply influenced by the witnesses who have surrounded us.”  So we first look inward, and then we put our answer into motion by engaging others in conversation: “How does my faith inform my decisions? Ask yourself the question often. Share your process with others. You will learn about yourself, deepen your faith, and serve as a witness to life in the faith for others.”  And just as movement helped me reframe a painful mind-body conversation during my back episode, having respectful and open conversations about faith allows us to gain a greater range of motion in our relationships and an expanded ability to engage in life effectively, maybe especially when those conversations are “edgy” or challenging.

Movement as Medicine

In the first few days after my recent back spasm, I instinctively minimized my movements, but after the acute pain had subsided, movement became my therapy.  The initial role of pain in this case was to cause me to restrict motion, to protect the area, and to remind me to use caution.  Once that pain diminished and the aggravated tissue healed, I was left with something more like a nagging ache, a feeling akin to that sore, tired back feeling many people have at the end of the day, only for me it began upon rising.  Emily insisted no lifting whatsoever until the pain was gone, but she encouraged walking and gentle yoga.  The first day I was feeling well enough to be back in the gym, she told me that the purpose of my lifts that day was strictly to reassure my brain that my body could still move safely.  This was important, she explained, because often our brains hold on to a memory of pain and experience it as though it is real for a longer time than the pain serves the purpose of protecting the body. The point of my lifts that day was not to work up to a certain weight on the bar, but rather movement for the specific purpose of retraining my brain after an experience with acute pain; in other words, medicinal lifting.

From my own past experience, this made complete sense.  I had twisted my knee up badly in a skiing injury in my 20s.  Sometimes it still bothers me, but these days I can fully bend it.  That was not always the case.  I remember yoga classes in my 30s where everyone else was sitting on their heels “ohmm-ing” and I was practically bolt upright with my knees at nearly a 90 degree angle.  A yoga instructor had said something similar to me, that my knees had been so well trained to function in protective mode that they would not let me bend them, and she suggested that perhaps my pain had outlived its usefulness.  Carefully and slowly, over several weeks, I worked on inching further down onto my heels and was surprised in the process that it was my memory of the pain which had been more real than any physical pain.  The result is that now I sit on my heels regularly and easily.

My experience with my knee suggested to me that pain does not always result from an outward cause, but is often the very real manifestation of something going on internally.  Perhaps you’ve had a similar experience with pain.  Emily sent me a link to a great article called “Aches and Pains” by Austin Baraki, MD and Starting Strength Coach, which gets at this point.  Baraki discusses the inadequacy of the traditional theory of pain, the “‘bottom-up’ theory, [in which pain] start[s] at the tips of your peripheral nerves … and then converg[es] along a one-way street towards your brain” (1). He points out that this model is insufficient to explain the discrepancy between a patient’s experience of pain and clinical indications that a patient should or should not be experiencing pain, beyond the six week window during which injuries generally heal:

“There are countless patients with debilitating symptoms from fibromyalgia, chronic pelvic pain, chronic back pain, or prior sexual/physical abuse who have undergone numerous examinations, MRIs, and laparoscopies with no evidence of structural pathology or tissue injury.  There are many more walking around with objective radiographic evidence of severe osteoarthritis and herniated discs who have no symptoms whatsoever.” (2)

The confusion that these patients and their health care providers feel as a result is attributable to the inadequacy of the “bottom-up” explanation of pain.  Instead Bakari suggests that the biopsychosocial model of pain is more accurate.  This model recognizes the complexity of our systems and the fact that “the brain uses multiple additional inputs to modulate our sensory experience” – inputs such as environment, emotional state, duration of pain (2).  The biopsychosocial model recognizes both objective and subjective causes of our experiences of pain.

Based on this model, Bakari makes some excellent recommendations in dealing with pain, which in his example diagnosis was most helpful to me at the time, since he chose to discuss back pain:

“1.  Managing stress, anxiety, and depression (much easier said than done)

2.  Education about back pain to reduce the fear that your pain is reflective of constant ‘danger’

3.  Getting adequate sleep

4.  Avoiding use of opiate pain medications and ‘muscle relaxants’ (although acetaminophen / NSAIDs may be helpful)

5.  Exercising – or, even better, training – to move through previously ‘threatening’ ranges of motion

6.  Continuing to participate in normal activities (ie, avoiding immobility!)” (8-9)

Something similar might be said of pain that is purely emotional in its origins.  Often we hang on to the memory of a wrong done to us or a traumatic event longer than necessary, causing us to avoid certain people or similar situations or to mask our emotional pain with distractions and destructive behaviors.  Certainly the biopsychosocial model of pain suggests that physical pain can be the result of our emotional state, the manifestation of stress, anxiety, and depression. Perhaps we’d benefit from following these guidelines in situations of emotional pain too: take care of our physical health, learn what we can about the situation, and move through the pain rather than stuff it down or avoid it.

Medicinal Deadlifts
Medicinal Deadlifts

However that plays out in terms of emotionally generated pain, I know that going through the motions of my lifts on that first day back at the gym allowed the slight, lingering, achy feeling to dissipate further.  Movement helped me change the painful mind-body conversation that my injury had initiated; it was a necessary part of my healing process.  Those lightweight “medicinal deadlifts” were among the first steps in re-training my brain and in building a different kind of strength.