How Do You Interpret Pain?

We are often asked by our students (especially now following all of this talk of injury in yoga) how to discern “good” pain from “bad” pain. The first thing is to realize that pain is neither good nor bad, it is simply information. The important thing is how we relate to (listen to) and integrate this information. A chiropractor we know in NYC, Robert Davidowitz, has said, “Pain means: pay attention inside now.”  Pain comes in several varieties and one could literally write volumes on the subject. In this post, we will touch lightly upon distinguishing certain types of pain that pertain to movement, but more importantly, how to relate to that pain in such a way that you decrease your potential for injury.

Painful sensations in movement are generally caused when our brain receives signals from nocireceptors, which respond to stimuli that reach a harmful intensity. This means too much mechanical stretch or pressure. Even within mechanical pain, there are different categories. Different institutions categorize pain differently. One useful method is to segment pain into: visceral (organ related) which can often be referred to places far from the origin of that pain (for example, pain from gall stones can be felt behind the right shoulderblade), superficial (on the skin), neuropathic (nervous system related) which is often perceived as burning, tingling, electrical or stabbing pain, and deep somatic (pain in the ligaments, tendons, bones, blood vessels, etc) which is sometimes perceived as dull, aching and localized pain. Pain can also be psychogenic, which is a category of pain that seems to have no physical cause and often is mental, emotional or behavioral in origin. This is a place where yoga can be a powerful tool. If you start to feel a pain during a new movement, instead of abandoning ship, see if the pain will go away once you calm your breath. If so, it may not have had an actual physical origin. This relationship between the mental/emotional body and the physical body is a main focus in yoga.

Often we feel fear or anxiety when pain comes into the picture. For some people, this can lead to hypersensitivity to pain, or even the feeling of pain before anything has actually happened. The anticipation of pain can cause anxiety to the point of interrupting natural processes, like the breath, and cause unnecessary tension. Others feel pride in having a “high pain tolerance”, attributing strength to how well they can ignore pain.  Having a high pain tolerance may be useful for certain scenarios and may even make certain situations more tolerable, but being able to ignore the messages your body is sending you, or push past it can sometimes cause real problems later. Even if the pain you are experiencing seems to be “tolerable” or “not so bad”, this is your body’s way of communicating with you that something is going on.  It’s really up to you how you interpret that message.

If pain is acute it is more often less likely to be ignored. For instance, a stubbed toe or back spasm is an acute pain that most will pay attention to and begin immediately assessing the extent of any potential damage done.  But many of us, especially those of us with high tolerances will ignore the little aches, pains or discomforts that don’t indicate real damage…in that moment.  Over time, that little pain signal will become louder and louder until one day it is no longer a whisper of sensation, but a full on scream.  That’s usually when someone will no longer be able to push past it (not that we like that idea anyway) and will realize that something is really wrong.  Think of it like this: You continuously practice forward bends and push past discomfort to keep stretching and opening the back of the legs.  In the moment you get better flexibility, but begin to notice some soreness or achiness or some “feeling” in the back of your leg near the top of your thigh bone.  You push past it or ignore it.  Then that feeling becomes more persistent as you keep up your forward bends with the goal of straightening your legs.  One day while in the bend you feel a pop or tear in that same one place near the top of the thigh bone and there isREALLOUDPAIN!  Well, turns out you’ve pulled your hamstring (which can take months to years to heal), which was something your body was trying to warn you against all those weeks and even possibly months before.  Oops.

For the most part, as practitioners, we can do a better job of noticing and assessing our own pain. If you’re feeling consistent pain, start collecting information.  Notice when it is happening and how often. Is it only at certain times a day, like when you wake up?  Is it during a certain movement? Bearing weight or not? Is it in a specific location? Does it travel? Can you identify what precedes it?  The more specific the information you collect, the easier it’ll be for your doctor, physical therapist or other movement specialist to help you assess what is going on and how to address it.  This practice will also improve your ability to discriminate more accurately your bodily sensations.  Just as some of us are able to ignore pain (to a fault) there are some who are fearful and crippled by it.  Amy Matthews, one of our more influential teachers, helps her students to discriminate and manage pain as part of her work. She often will ask, “Is it pain you are feeling?  Or is it unfamiliar?”  when teaching a new movement. Often, if we are getting in touch with a part of our bodies that we are not familiar with we will feel new sensations and some may have a difficult time identifying it and will categorize it as pain.  If you begin paying attention to your body’s sensations and signals you will have an easier time with self-assessment, which is a necessary tool for keeping whatever movement practice you participate in a safe one.

Here is an example of gauging sensations during a stretch. When you start to feel sensation, ask yourself: is the pain is the belly of muscle or in a joint?  If it is in a joint, you probably need to back out or modify. This can make a huge difference in a stretching practice and help you avoid injury like the one described above.  Other questions to ask yourself:

How long does it last for?
If you’re stretching does it abate and disappear in 15 to 30 seconds?
Does it ease if I take a breath or two?
Does it persist throughout my entire day?

The better you get at this self-assessment process, the less fear you will feel when pain comes about.  You will know for yourself if it is a stretch sensation that you can work through respectfully or you will know if it is sharp and that you need to immediately back off and avoid that movement/position.  We advise that if your pain persists for 2-3 weeks that you should seek out guidance from a professional.  Pain is not something to be afraid of, but is something to be respected.  If you learn to interpret it appropriately then it can also be a valuable tool in keeping your body and mind healthy.