The Path Is The Goal

A common link I have found between improving general fitness and decreasing physical pain is that both are process-oriented endeavors. This indicates that neither can be or should be expected to be dealt with in an acute manner. This is to say, there is no "top of the mountain", no "end game", no cure, but instead a constantly changing state of where you are. Often times a physical pain or realization that we can’t do something we used to take for granted, awakens us to the reality of this current “now”. This reality often seems undesirable due to fact that the symptom that awoke us was unpleasant, and our initial response is to seek a method for a quick eradication of the “danger” so that we can return to normalcy. However, if we are able to reflect on the path we took to get to this point, we will realize that our current state cannot be defined by an isolated diagnosis that can be remedied by a single intervention. Instead, our symptoms are the current expression of the causes and conditions of our experiences to this point. This awareness has the potential to be liberating, as without it, we do not truly have control over our circumstances. Instead, we are “riding the wave” of our habitual patterns until those patterns reach the point of noticeable discontent. Once we are able to enter into a path of awareness, we are able to be in the process of experiencing how our thoughts, emotions, and actions effect our consistently changing existence. This process is not one of metaphysical faith but instead a direct experience with how “what we do” creates “what we are”. This realization separates clearly what we can control versus what is beyond our control, and opens our eyes to the decision-making process of our potential. More simply put, we can choose to embark in the processes that allow us to progress, or we can choose not to; but we can no longer believe we do not have a choice in progress. Our awareness has laid out the path too clearly for that fallacy to be considered.

Pain Does Not Equal Damage

Pain and discomfort are often considered inherent realities of a structural abnormality or disorder. Although, this notion is common, it is hardly supported by any scientific or physiological evidence. Over and over again scientific studies have demonstrated minimal association between structural damage and the extent of one’s pain, discomfort, or state of disability. Moreover, although worthy of admiration, it is not uncommon for individuals with physical disabilities to optimize their physical function well beyond those with comparably able bodies. Although this information is widely available and often well accepted, the lessons that may be gained from it will often be disregarded when pain rears its head in our lives. Immediately, we will search for “the answer” to what it wrong with us, and seek out those individuals/groups promising cures and quick fixes. This desperate “search” is often led by fear. Fear that the pain indicates something unchangeable and beyond hope. These notions are often more overwhelming than the physical experience of pain itself. Contrary to the poor association demonstrated scientifically between pain and structural pathology, feelings of fear, a tendency towards activity avoidance, and a lack of self-efficacy regarding control over our progress are associated highly with increased levels of pain and disability.

For this reason, it is the opinion of this healthcare professional that we must explore those activities that we find uncomfortable or promote fear in us and approach them in a process-oriented manner that allow us to:

Improve our physiological tolerance to them
Change our relationship with them from that of being fear-based to one of curiosity and acceptance.

Common examples of fear producing activities:

Enduring cold or hot temperatures
Boredom (being still for longer periods without distraction - i.e. meditation)
Lifting heavy weights
Moving continuously for longer durations
Exploring greater joint ranges of motion
Moving at faster speeds
Eating bland or unpleasant tasting foods

Making change to any of the above examples, must be gradual enough that the body and mind to only register a slight discomfort so that the already fear-producing nature of the activities does not become so great that fear is increased after the stimulus is removed. Therefore, the addition of the discomfort should only be enough to provide the body with a gradual, progressive experience that disproves the fears initially imagined. Gradually as we can track progress via metrics such as time, load lifted, bodily positions attained, foods conquered, etc., we will prove to ourselves that we are capable of the change we feared impossible. Moreover, we will have gained confidence that we do indeed have control of our own change, as opposed to being slaves to the inevitable change of a cruel world.

References:

https://www.researchgate.net/…/8378790_Knee_Pain_and_Radiog…
https://link.springer.com/article/10.1007/s00256-006-0100-x
https://www.medscape.com/medline/abstract/20739918
https://www.sciencedirect.com/…/artic…/pii/S0304395904003173