Pain moves both ways

I used to run a psychological therapy clinic for people suffering with long-term physical pain. There’s the obvious connection to spell out here – physical pain can be both stressful and depressing. But experts are now discovering this relationship isn’t as one-way as people used to think.

The way our body’s electrical wiring works when we’re anxious or depressed creates extremes – being super highly charged or really depleted. And physical pain can get stuck at certain points in our bodies when this happens.

A lot of people I saw in the pain clinic had symptoms of hypermobile joints, but barely any were diagnosed. The current and best quality research shows hypermobility is still pretty misunderstood, even by the specialists who diagnose it. Being diagnosed as hypermobile myself, my own physio from APPI has been crucial.

Stable vs moving

Almost everyone suffering with physical pain tends to overdo it a bit when they’re feeling alright again, then they inevitably crash when they can’t do anymore. It’s our own natural way to try and maximise our resources, but hypermobile joints can’t stand it.

I’m no physio, but a crucial bit of info here is the difference between two types of muscles – movers and stabilisers. The movers are all the big ones you can see – the stabilisers aren’t really visible and protect the joints.

When hypermobile people go for this boom-and-bust pattern of behaviour – our stabilisers keep shutting down until they’re almost in shut-off mode, then our big mover muscles take up the slack.

So people with hypermobile joints can know it’s not a case of fixing dodgy joints, like the way we’d fix a broken bone. It’s more about living with it effectively, by gradually sticking to bespoke exercises that work for each person.

Here are my new rules for living

• Regularity is key – little and often, avoid boom and bust
• Use recovery lots – cold water/compress, restorative yoga, deep-tissue/roller
• Prioritise mat work – isometric and pilates-based strengthening
• Only use low-load bearing cardio – freestyle swimming is the best!
• Avoid going beyond a joint’s range of movement
• Activate the stabilisers almost daily, before even thinking about the movers

Milestones

Using an evidence-based way of managing the condition myself has been the biggest achievement. Any health practitioner these days has to work in an ‘evidenced-based’ way. It’s not as dull as it sounds. It just means treating people with the most effective interventions – supported by the best research available at the time.

This is a problem when there’s not enough research, so guidelines don’t really exist – like with hypermobility. That’s why finding a practitioner who could bridge this theory-practice gap completely changed my game.

Before working with a physio and pilates-instructor who really knew about hypermobility, I was in and out of physio services a few times a year. Now, I manage it largely by myself, with the occasional top-up from my instructor – which is what’s recommended, rather than lots of clinic time.

• I can continuously swim again – just a few minutes wasn’t possible before
• I hike again for hours – this was really painful before, and I’d get stranded
• I can do push-ups again – before, just picking up iron pans was getting tricky

Also, talking about goals and how they’ve been reached is key. If people are buying something for their physical health, they want to be able to relate to it. This is where using people’s own success stories comes in handy.

Like most things, body work is a process and not an end point. Adapting it to fit my needs has been hugely rewarding – and writing about it has helped make it second nature.

Would you like a hand with your physio content?