March 12, 2025 • 28 mins
In this episode, we delve into the intricacies of pain perception and management, discussing how our brain interprets and modulates pain signals. We explore the importance of focusing on how pain or discomfort changes over time, and how this shift in perspective can aid in the healing process. Real-life examples from the author's experience with patients and personal insights highlight the resilience and healing potential of the human body. Introduction
Case Study: Ankylosing Spondylitis
The Brain's Perception of Pain
Real-Life Experiences and Patient Stories
The Science Behind Pain and Noceptors
Focusing on How It's Different
Practical Advice and Techniques
Conclusion and Final Thoughts
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:06):
Watch for how it's different.
This is something I tell people who cometo me who have an injury, or have pain.
You know, whether it be acute, fresh,or chronic, or anything in between.
(00:29):
Or if they have a certain littleniggle, we call them, in running.
Which is like, something that'sirritating, but it's not stopping
them from doing what they love.
It's also something Itake on in my moan mind.
So when somebody has a problem, evenif it's been going on for a little
(00:53):
while or a long while, the brain hasthis interesting way of, you know, if
there's pain in an area of the body,even though it is shifting, the brain
kind of makes it seem the same, you know?
And this was really evident,uh, early in my career.
(01:16):
I remember I was working with aperson who had ankylosing spondylitis.
An incredible amount ofpain in the anterior chest.
And we were working on this andworking on this and making headway.
This person was seeing me liketwice a week for quite some time.
(01:39):
And after, after a while, we weregetting better down to once a
week and once every two weeks.
And they came in one day, I guess I hada cancellation on an emergency call.
And they were like, they camein there white as a ghost.
And they're like, it'sback, the pain's back.
Okay, okay, where do you feel it?
(02:00):
And they pointed to theirback, to the rhomboids.
And I was like Don't you remember thepain was right, uh, pointed on their body?
Right there, right in your pectorals,right on your chest, and it's jaw dropped.
And he's like, Oh yeah,and he calmed down.
(02:26):
It's just interesting how the brain works.
Like they say a few things, right?
Um, and maybe it's because welive in our body every day.
And the brain actually has theability to forget pain, right?
It just keeps on forgetting, soyou don't remember how bad it was.
(02:46):
But you're still getting feedback from anarea, so your brain thinks it's the same.
So it's kind of like it'smulling over your head.
It's still happening.
It's still happening.
It's still happening.
Like one of my patients, uh, she talksabout, yeah, and I started, I started
my descent down the rabbit hole.
Uh, love that commentbecause it's literally you're
spiraling down, going down.
(03:09):
Um, and I'm not.
Laughing at her.
I'm like, I'm understanding her andI do the damn same thing all my life.
I've done the thing if itwasn't like mental and emotional
at one point in my life.
Now I have some of this physicalstuff going on too because like
I've been taking on some runningand I'm really enjoying it.
(03:30):
But it's funny how the body is andthe brain is So it's literally like
what I, I notice with people isthings are constantly improving and
changing, but like they don't seemto register into the consciousness.
A lot of times.
Um, I remember I had a patient andthe debilitating shoulder pain and
(03:51):
we were working on it for a while.
I didn't see him for two weeksand they walk in and they sit
down and like, how's the shoulder?
And they're like, I haven't thoughtabout that since last time I saw you.
And I'm like, yes.
And it's a high five time.
You know, they also say so.
Yeah.
You know, when somebody's getting intoshape, it takes, um, like there's be
physical, physical changes in yourbody that people outside you can
(04:16):
see within three weeks of a change.
And like, it might take you 11weeks to register a change in your
own body because the brain has thisinteresting way of looking at you.
And it's really hard for like, it's almostlike the ego, the sense of identity.
It actually has a vision of who you are.
(04:36):
It takes a very long time for your brainto register changes because it keeps
on thinking you're the same, you'rethe same, you're the same, you're the
same, and in 11 weeks, ooh, you changed.
Although the change hasbeen going on all along.
It's like when people are going throughan injury, the injury is probably
getting better every day, but it'sso minuscule and you're there 24 7.
(04:58):
It happens so slowly that you don'trealize it's happening until one
day you suddenly realize there'ssomething you can do that you couldn't
do before and you're like, Wow!
And it's like super interesting.
I mean, I've talked about painscience before now because I really
think it's fascinating and I knowthere's lots of work to be done to
(05:21):
really understand what's going on.
But the basics of pain science isthere's no, um, there's no like
specific pain sensors in your body.
And this is differentthan they used to think.
So there's no specific pain sensors,but what we do have is there are no
(05:43):
scepters and there are free nerve endings.
So, there are nerve, the end of thenerve is, there's no myelination,
there's no insulation around it.
So it can pick up, like, it canpick up from sensation, mediators
of inflammation, from tissue damage,pressure, stretch, other mediators.
Heat, like, really likeextreme heat or extreme cold.
(06:08):
All these can trigger this nerveending, which sends a non specific,
like, it doesn't tell you whathappened, it just sends this, like,
danger, danger, danger from this area.
And then your brain takes a look atthat, um, that danger message, and
it modulates it.
(06:29):
So, like I said, even, so the pain isn'thappening, necessarily in the body.
There's a danger message comingfrom the body and the brain looks
at, okay, so that's that right hip.
And you know what, for the lastsix years that's been bothering
me and there's been pain there.
So the brain goes, Ooh, maybe we mightneed to send a pain message back.
(06:52):
This happens.
And then also on top of that, likeit starts looking at your beliefs.
What's, what's my beliefs about that area?
And I was like, Oh myGod, that hip is screwed.
I'm going to need a hipreplacement someday.
I saw that commercial where theywere like stabbing needles into
the hip and the electric coming.
Oh man.
(07:12):
So your brain sends back a pain signal.
And then of course, as this happensover and over and over again, those
noceptors, those free nerve endings, theyget more and more and more sensitive.
So.
Next to nothing will cause noception,and your brain really believes
there's a problem there, so it'sgoing to shoot back a pain signal.
And this is, this is why I was,like, a long time ago, if you've,
(07:37):
uh, listened to my first officialepisode called Crack the Door.
And it was Crack the Door thatthere's a possibility that
pain won't be there someday.
And that was specificallyto give, kind of, break.
Like, reframe and kind of break this 100percent belief like somebody would be in
pain forever who'd been in chronic pain.
Like, create a little tiny bit of doubt.
(07:59):
Like, and then, of course, throughgetting people moving and stretching
and treatment and like, um, movinginto the pain free zone, uh,
eventually those noceptors reset.
And
You're not getting noception, there'sno pain message being sent back again.
(08:24):
So this is why I also created, payattention to how it's different.
So if you came and saw me in my clinic,and you'd had an issue that we'd been
working on, I would like, on your wayout the door, I'm like, okay, so there's
something I really want you to do for me.
And I was like, people will reallytake a look at what's going on in their
(08:44):
body, like that annoyed space, they'llbe paying attention to it a lot, right?
Um, and, The brain will try to makeeverything all the feedback coming from
that area be the same thing like there'sstill a problem There's still a problem.
There's still a problem.
There's still a problem What Iwant you to pay attention to is
how is it different and like whatdo you mean by how it's like?
(09:07):
How is it different?
It's like, you know, it doesn't matterif it's more painful or less painful
Or the pain moved down Or moved overhere, or now something over here hurts.
How's it different?
I want you to keep on focusingon how's it different.
How's it different?
How's it different?
(09:27):
So there's a, there's afew good reasons for that.
Like, one of course is the factthat if you're looking at how
something's different, that meansyou believe it's not the same.
So the brain's probably gettingsome messaging around that.
And maybe the belief that there'salways a problem going to be a
(09:48):
problem there is broken down.
But it's also true, like I said, you'rehealing every single, your body is
built and designed to heal itself.
Like you've got fibroblasts, you'vegot like lymphatics, you've got
all this stuff going on inside you.
That's just focusing and like, you've,you've got like basal cells and you've
(10:13):
got like, if it's bone injuries,you've got osteoblasts and osteoclasts,
your body is completely designed.
It's incredible.
It is designed to heal.
Now, you know, I've heard somebodysay, well, my ACL was torn and
they couldn't put it back together.
And yeah, that's true.
Maybe you need to get thatsurgically put back together.
But once it is, your bodytakes over and it heals it.
(10:36):
The body is resilient, strong.
It's able to do incredible things.
I believe that.
Always have.
And, well, maybe not always have,but I've learned it over the years.
Let's put it that way.
That it's true.
And working with people, I've seenpeople come back from incredible things.
I've seen, yeah, like,miracles, basically.
(11:02):
Even the structure of your body isincredibly strong like people think oh
my back's weak like if you took a lookat the Back if you took a look if you
went to a cadaver lab And you lookedat how strong the muscles and ligaments
are around the spine you being you'd beinspired It's so strong and yet we have
advertised in the background tellingus all this other stuff So like my my
(11:23):
point is when you're leaving this place.
I'm gonna say watch for how it's different
And it's crazy like sometimes it almostseems like this is another thing like
it's not always coming from where you'refeeling it It's usually like I'm a I'm
a big proponent of working with the deephip flesher ileo So as when it seems to
(11:46):
be in a contraction it inhibits your glutemax your hamstrings are overworking on
hip extension because your, your glutemax is inhibited by the prime mover
of hip flexion being in a contraction.
So your high hamstring gets tender.
And then in the front, like your, if yourdeep hip flexors stuck in a contraction,
(12:07):
then your sartorius, your, uh, TFLand your rectus femoris, the three
secondary hip flexors are overworking.
And so like your TFL, if it getsreally tight, it'll pull the IT band
off track a bit and you get a littlebit of pain on the lateral knee
from a little bit of friction there.
(12:27):
The sartorius will, will get reallyaggravated if it's doing too much hip
flexion and then if it's your rec fem, rexfemoris, you're either going to feel some
pain above the knee or below the knee.
And, so, but all those littlepains you got aren't coming
from where they're showing up.
(12:48):
They're coming from A tight hipflexor, which is, at some points,
inhibiting or is so weak that otherthings have to take over the body.
So intelligent.
It's got secondary systemsall over the place.
So,
not only is the body resilient,built into the design to heal
itself, it can and it will.
(13:09):
Um, it's strong, it's incredible.
Um, it's, yeah.
The issue that you're probablyfacing, unless it's like, uh,
acute injury where you got smackedwith something, it's probably not
exactly where you're feeling it.
So that's one of thethings I look at, right?
(13:29):
And then, of course, with noception, like,noception is based, like, is modulated
by beliefs and, like, history in an area.
And if it keeps on happening over and overagain, it takes less and less and less.
Uh, feedback to cause a response ofyour brain to that, uh, pain message or
that danger message to send back pain.
(13:52):
So if you can start like lowering,lowering the amount of like the load,
so you don't get noception, like findinga way that you can, because movement
is medicine, you got to move, butyou got to move in a pain free zone.
So the noceptors, uh, reset.
So this is all my thought, like I'mjust spitting out all my thought process
(14:16):
and working with people with injury.
And if you honestly do believeand look and watching for how it's
different, then what you'll notice islike, um, I was talking to a runner
recently and they've been through alot of stuff and it's understandable
that they're hypersensitive and thatthe rabbit hole is very accessible.
(14:39):
Uh, they're getting really great atfiguring out that they're going down
the rabbit hole and stopping themselves,which is like, what a skill, like that
skill was going to take them furtherthan any other skill they have in this
lifetime because anxiety and worry andfear do not help with the healing process.
Like if, if you're under too muchheightened stress, it inhibits your.
(15:04):
Your, um, your, your lymphaticsystem, which is your healing system.
So you want to do what youcan to keep yourself calm.
You want to watch your thoughts.
You want to correct them when you can.
But they were telling me that like,okay, they're having a few little things
go on, and they're pretty concerned.
But what they're learning is, andthis is another thing I tell people, I
(15:25):
really define pain as sharp shooting.
Like if you have sharpshooting pain, stop.
Now if you have a dull ache that'sbothering you a little bit, Then, modify.
Uh, change the way you're moving.
Like, uh, speed up your cadence.
(15:46):
Slow it down.
See, is there something there that can,that can help it, like, be relieved a bit?
Like, get externally focused.
Like, really, like, experience,if it's raining, feel the rain.
Feel, if it's sunny, feel the warmth.
If you're in a race, hear the crowd.
(16:06):
And see, does it reset?
Because sometimes these things reset.
If you, if you think of it thisway, that, that, Muscle tone is
governed by the cerebral cortex andconscious thoughts there too, right?
So, if the cerebral cortex is decidinghow tight to make your muscles,
and there's some some feedbackcoming from one muscle and you're
(16:31):
focusing all your energy on that.
The body's got this incrediblething called muscle guarding
or muscle splitting.
If it's worried there's an injury,it's going to tighten it up.
So if you're focusing all your energyon that, then it's going to tighten
up and it's going to feel worse.
And it could become aproblem because of that.
Or at least the thought processwill create it as a problem.
(16:54):
This is why I say get externally focused.
Just feel the thing.
The heat, the wind, um, if you're runningwith somebody, talk, laugh, uh, I put on
music so I'm not listening to my brain toomuch, uh, feel the sunshine, if you're in
a race, hear the crowd, although I reallywant to clarify, if it's sharpshooting,
(17:17):
you always respect sharpshooting pain,sharpshooting pain is, is something you
want to be really careful with, okay?
And then, so this athlete was telling methat So they realize that this thing is
bothering them, but it's, it's interestingbecause it's not like the problems
(17:38):
that became big problems because thebig problems they started off terrible
for a few steps and this one is not.
So that's how it's different.
And it does kind of like bother thema little bit later in a run and it
bothers them after the run, but itrecovers overnight and they're fine.
So they're not as worried about this.
(18:00):
And this runner is really, really, reallysmart because if they, if they're at
all really worried, they'll just shift,they'll just shift, uh, to a cross
training session, which doesn't aggravate.
So I was sharing them, uh,with them the other day.
So back in November, I ran a 10Krace and a couple of weeks before
(18:23):
I developed this left hip pain,kind of like as a lower hip pain.
And it's kind of quadratus femoris,which is the lowest down lateral rotator,
which has been, had been bothering me.
Typically what happens is I go toolong, too hard, and it gets aggravated
and it's aggravated for a few days.
(18:44):
But it was bothering me two weeksbefore the race, and I kind of limped
my way to the race, and I got outthere and I'm like, first thing in
the morning I felt pretty good, Ithought it was going to be great.
And the first kilometer it startedgetting aggravated, and I was like,
but this is my goal so I'm going.
And it was aggravated the whole time.
And I found that if I ran too, ifI could change my cadence, I could
(19:09):
like shorten my stride and it wasmanageable, but it was still painful.
And then there was some peoplewho are just so amazing.
Like I I'm always blown awaywhen somebody shows up for me.
Okay.
Like that's who I am.
That's like, I could not notshow up for human beings.
Um, 100 percent all the time.
(19:30):
But I am so grateful and touched,and I think you know who you are.
Um, yeah, it was special tosee you out there that day.
It really, it meant a lot, and Idon't know if I've been really clear
about that, but it really meant a lot.
Because I don't, I don't expectpeople to show up for me.
I know everybody's got a life,and they've got stuff to do,
(19:51):
and they've got their circles.
And yet, I am just so, so grateful.
It just means so much to mewhen somebody shows up for me.
And like I said, I don't, I don't,I'm, I'm not concerned if you don't,
like, that's okay because like,I know you had a busy life, but I
never would expect that from anybody.
(20:11):
It's just, I want tosay how grateful I was.
But of course, that person was at thetop of the hill, so I had to rush there.
And by the end, I was in a lot of pain.
And then for the next few weeks,just sitting down, I could feel it.
It took a while to recover.
I think I took about a month off ofrunning, and I was cross training,
(20:33):
and then I slowly started getting backinto running, and I started a walk
run program for a number of weeks, andthen I moved up, and I'm getting into
the last week of kind of a I wantedto do a zone 2 training, which is like
a lower heart rate, but it turns outthat zone 2 for me is like a fast walk,
so I had to do zone 3, and it's hardto keep your heart rate down, but it
(20:56):
forces me to run slow, and when I'mrunning slow, um, it doesn't hurt, so
dropping your load will really help.
But I, I realized I, I like to watchmy thoughts and I was running the
other day and I was like thinking, Ohmy God, what if this keeps on going?
Like I'm going to do ahalf marathon in June.
What if my whole, what if my whole, it'slike starting to dig a rabbit hole here.
(21:20):
What if my whole training blockis with me feeling this pain?
Or this, this niggle or this feedbackfrom my hip and, uh, yeah, what if
it gets worse and I can't run and Idon't get to do my half marathon, which
means like I'm going to have to bump mymarathon for next year and what, like
(21:40):
I want to go back on the track and doa five, like just running down like,
and this is even with my music on.
So you gotta, you gotta know thatthis is when my brain's loudest.
You can, you can, you canaccept that inner dialogue.
See, I want you to understand isthat inner dialogue is not you.
(22:03):
If it's spouting off at high speed andyou're not actually intentionally creating
it, it's just happening, it's not you.
You're like, what do you mean it's not me?
Yeah, that voice there.
That's the one I'm talking about.
That's the ego, the sense of identity.
The internal dialogue.
(22:25):
It's pretty much, prettymuch on autopilot.
It's the one that's always going.
And sometimes we don'trealize that that's not us.
And sometimes we actually listen to it.
And we, we spiral down with it.
If you really want to come past, ifyou really want to see how things are
different, and change the way it'sgoing, you gotta break in intentionally
(22:50):
and go, and that's what I do now.
It's like, I'm going down that rabbithole, I'm going to go, wait a minute,
you know, a month ago, when I ran,I'd be in pain for three days,
sitting down, I'd feel it, thewhole bit, so on and so forth.
But now,
(23:12):
when I go out and run, yes, it, itfeels, I feel discomfort, um, but I
only feel discomfort for the first,say, kilometer or two, and then it calms
down, and maybe I feel a little bit.
When I, when I'm, I'm doing an outbackon my way back, but it's not the same
discomfort and then that one calms down.
And then I might feel it for a littlebit like the morning of that, that
(23:34):
run, but by the evening it's gone andtomorrow, then tomorrow will be gone too.
So, that's how it's different.
It's not the same.
It's improving it.
Maybe it's not perfect yet, butit's improving and the more it
improves, the more I calm down, themore I relax, the less it tightens
up, the less I'm worried about.
So think about that.
(23:54):
If you've got things that are goingon like this, how is it different?
Like, has it moved?
Has the pain moved to another place?
Cause like a lot of times in, in myclinic, we're playing whack a mole.
It hurts here, then that sorted out.
And then it hurts overhere and that sort of that.
And we're back and forth andback and forth until it's gone
(24:15):
because things jump around.
But they're, they're, Oh,I'm always saying, see that.
Remember last time it was this and nowit's over here and they're like, Oh yeah.
Okay.
And that calms people down and like,so you can do that for yourself.
And I know this athlete does.
They're like, okay, well, you know,yeah, it feels better the next day.
The next run is great.
(24:36):
How's it different.
And you can actually intentionallybreak in on the, that internal dialogue
that just blah, blah, blah, blah, blah,blah, blah, blah, blah, blah, blah,
and taking it down that rabbit hole.
And you can intentionally break inon that and say, uh, wait a minute.
No, it's like literally when it wasbad, it was like this bad and I couldn't
(24:56):
do this or maybe I couldn't run.
I was just cross training and it wasjust like that, that, that, that, that.
And now it's like, Oh, you know,maybe I feel at the beginning around
or maybe it starts up in somewherein the middle of the run, but then
it goes away after it warms up a bit.
Maybe it comes back after the run,but then later on the day it goes
away and the next day I feel fine.
(25:18):
So, if you don't hang your hat on thefact that there's feedback from the area.
If you just say, Oh, feedback,feedback means a problem.
There's something wrong.
There's something wrong.
There's something wrong.
And that's like the same thing.
And maybe it's getting worse.
Or you can look at, Oh, I doget feedback, but it improves.
So I'm actually improving.
And if you really take a look at it, I seethis with athletes so often, that they're
(25:41):
working, Training harder, harder, harder,work out, work out, work out, work out.
But that issue is not getting better.
There's still a little bit of feedback,but it's not, it's not getting worse.
And if you think of it, if you'reincreasing load, but the pain is
either staying the same or gettingless, that's a huge improvement.
Because like when, when you're increasingload, if it's a real problem, it's going
(26:04):
to, it's going to increase the problem.
Like if you're increasingload and the problem's getting
better, That's a good sign.
And think about your whole life, right?
All the things you learn throughsport and through this, think about,
(26:27):
you know, if you start looking atanxiety around different things, and
as you learn to see how it's differentin your body with feedback and pain
and injury, as you shift that, youmight also see Whoa, it's different.
I don't get as anxious.
(26:48):
And maybe I'm not as worried about things.
And maybe I trust.
And maybe I believe that mybody is resilient, strong,
and able to do amazing things.
Maybe I believe it's able to heal.
So, if I gave you one piece of advice,
(27:09):
don't pay attention to how it's the same.
Always, always look.
for how it's changed, how it'sdifferent, not only physically, but
mentally, emotionally, and spiritually.
Thanks again.
(27:31):
Thank you for listening to thisepisode of conversation with Kimen.
Please follow me on Instagramat conversations with Kimen
and feel free to direct message me.
Also, please share my podcast withanyone you may feel would benefit
(27:52):
from its content and let them know.
And you can find me atconversations with Kimen on Apple
podcasts, Spotify, and Podbean.
Have an amazing day.
Watch for how it's different.
This is something I tell people who cometo me who have an injury, or have pain.
You know, whether it be acute, fresh,or chronic, or anything in between.
(00:29):
Or if they have a certain littleniggle, we call them, in running.
Which is like, something that'sirritating, but it's not stopping
them from doing what they love.
It's also something Itake on in my moan mind.
So when somebody has a problem, evenif it's been going on for a little
(00:53):
while or a long while, the brain hasthis interesting way of, you know, if
there's pain in an area of the body,even though it is shifting, the brain
kind of makes it seem the same, you know?
And this was really evident,uh, early in my career.
(01:16):
I remember I was working with aperson who had ankylosing spondylitis.
An incredible amount ofpain in the anterior chest.
And we were working on this andworking on this and making headway.
This person was seeing me liketwice a week for quite some time.
(01:39):
And after, after a while, we weregetting better down to once a
week and once every two weeks.
And they came in one day, I guess I hada cancellation on an emergency call.
And they were like, they camein there white as a ghost.
And they're like, it'sback, the pain's back.
Okay, okay, where do you feel it?
(02:00):
And they pointed to theirback, to the rhomboids.
And I was like Don't you remember thepain was right, uh, pointed on their body?
Right there, right in your pectorals,right on your chest, and it's jaw dropped.
And he's like, Oh yeah,and he calmed down.
(02:26):
It's just interesting how the brain works.
Like they say a few things, right?
Um, and maybe it's because welive in our body every day.
And the brain actually has theability to forget pain, right?
It just keeps on forgetting, soyou don't remember how bad it was.
(02:46):
But you're still getting feedback from anarea, so your brain thinks it's the same.
So it's kind of like it'smulling over your head.
It's still happening.
It's still happening.
It's still happening.
Like one of my patients, uh, she talksabout, yeah, and I started, I started
my descent down the rabbit hole.
Uh, love that commentbecause it's literally you're
spiraling down, going down.
(03:09):
Um, and I'm not.
Laughing at her.
I'm like, I'm understanding her andI do the damn same thing all my life.
I've done the thing if itwasn't like mental and emotional
at one point in my life.
Now I have some of this physicalstuff going on too because like
I've been taking on some runningand I'm really enjoying it.
(03:30):
But it's funny how the body is andthe brain is So it's literally like
what I, I notice with people isthings are constantly improving and
changing, but like they don't seemto register into the consciousness.
A lot of times.
Um, I remember I had a patient andthe debilitating shoulder pain and
(03:51):
we were working on it for a while.
I didn't see him for two weeksand they walk in and they sit
down and like, how's the shoulder?
And they're like, I haven't thoughtabout that since last time I saw you.
And I'm like, yes.
And it's a high five time.
You know, they also say so.
Yeah.
You know, when somebody's getting intoshape, it takes, um, like there's be
physical, physical changes in yourbody that people outside you can
(04:16):
see within three weeks of a change.
And like, it might take you 11weeks to register a change in your
own body because the brain has thisinteresting way of looking at you.
And it's really hard for like, it's almostlike the ego, the sense of identity.
It actually has a vision of who you are.
(04:36):
It takes a very long time for your brainto register changes because it keeps
on thinking you're the same, you'rethe same, you're the same, you're the
same, and in 11 weeks, ooh, you changed.
Although the change hasbeen going on all along.
It's like when people are going throughan injury, the injury is probably
getting better every day, but it'sso minuscule and you're there 24 7.
(04:58):
It happens so slowly that you don'trealize it's happening until one
day you suddenly realize there'ssomething you can do that you couldn't
do before and you're like, Wow!
And it's like super interesting.
I mean, I've talked about painscience before now because I really
think it's fascinating and I knowthere's lots of work to be done to
(05:21):
really understand what's going on.
But the basics of pain science isthere's no, um, there's no like
specific pain sensors in your body.
And this is differentthan they used to think.
So there's no specific pain sensors,but what we do have is there are no
(05:43):
scepters and there are free nerve endings.
So, there are nerve, the end of thenerve is, there's no myelination,
there's no insulation around it.
So it can pick up, like, it canpick up from sensation, mediators
of inflammation, from tissue damage,pressure, stretch, other mediators.
Heat, like, really likeextreme heat or extreme cold.
(06:08):
All these can trigger this nerveending, which sends a non specific,
like, it doesn't tell you whathappened, it just sends this, like,
danger, danger, danger from this area.
And then your brain takes a look atthat, um, that danger message, and
it modulates it.
(06:29):
So, like I said, even, so the pain isn'thappening, necessarily in the body.
There's a danger message comingfrom the body and the brain looks
at, okay, so that's that right hip.
And you know what, for the lastsix years that's been bothering
me and there's been pain there.
So the brain goes, Ooh, maybe we mightneed to send a pain message back.
(06:52):
This happens.
And then also on top of that, likeit starts looking at your beliefs.
What's, what's my beliefs about that area?
And I was like, Oh myGod, that hip is screwed.
I'm going to need a hipreplacement someday.
I saw that commercial where theywere like stabbing needles into
the hip and the electric coming.
Oh man.
(07:12):
So your brain sends back a pain signal.
And then of course, as this happensover and over and over again, those
noceptors, those free nerve endings, theyget more and more and more sensitive.
So.
Next to nothing will cause noception,and your brain really believes
there's a problem there, so it'sgoing to shoot back a pain signal.
And this is, this is why I was,like, a long time ago, if you've,
(07:37):
uh, listened to my first officialepisode called Crack the Door.
And it was Crack the Door thatthere's a possibility that
pain won't be there someday.
And that was specificallyto give, kind of, break.
Like, reframe and kind of break this 100percent belief like somebody would be in
pain forever who'd been in chronic pain.
Like, create a little tiny bit of doubt.
(07:59):
Like, and then, of course, throughgetting people moving and stretching
and treatment and like, um, movinginto the pain free zone, uh,
eventually those noceptors reset.
And
You're not getting noception, there'sno pain message being sent back again.
(08:24):
So this is why I also created, payattention to how it's different.
So if you came and saw me in my clinic,and you'd had an issue that we'd been
working on, I would like, on your wayout the door, I'm like, okay, so there's
something I really want you to do for me.
And I was like, people will reallytake a look at what's going on in their
(08:44):
body, like that annoyed space, they'llbe paying attention to it a lot, right?
Um, and, The brain will try to makeeverything all the feedback coming from
that area be the same thing like there'sstill a problem There's still a problem.
There's still a problem.
There's still a problem What Iwant you to pay attention to is
how is it different and like whatdo you mean by how it's like?
(09:07):
How is it different?
It's like, you know, it doesn't matterif it's more painful or less painful
Or the pain moved down Or moved overhere, or now something over here hurts.
How's it different?
I want you to keep on focusingon how's it different.
How's it different?
How's it different?
(09:27):
So there's a, there's afew good reasons for that.
Like, one of course is the factthat if you're looking at how
something's different, that meansyou believe it's not the same.
So the brain's probably gettingsome messaging around that.
And maybe the belief that there'salways a problem going to be a
(09:48):
problem there is broken down.
But it's also true, like I said, you'rehealing every single, your body is
built and designed to heal itself.
Like you've got fibroblasts, you'vegot like lymphatics, you've got
all this stuff going on inside you.
That's just focusing and like, you've,you've got like basal cells and you've
(10:13):
got like, if it's bone injuries,you've got osteoblasts and osteoclasts,
your body is completely designed.
It's incredible.
It is designed to heal.
Now, you know, I've heard somebodysay, well, my ACL was torn and
they couldn't put it back together.
And yeah, that's true.
Maybe you need to get thatsurgically put back together.
But once it is, your bodytakes over and it heals it.
(10:36):
The body is resilient, strong.
It's able to do incredible things.
I believe that.
Always have.
And, well, maybe not always have,but I've learned it over the years.
Let's put it that way.
That it's true.
And working with people, I've seenpeople come back from incredible things.
I've seen, yeah, like,miracles, basically.
(11:02):
Even the structure of your body isincredibly strong like people think oh
my back's weak like if you took a lookat the Back if you took a look if you
went to a cadaver lab And you lookedat how strong the muscles and ligaments
are around the spine you being you'd beinspired It's so strong and yet we have
advertised in the background tellingus all this other stuff So like my my
(11:23):
point is when you're leaving this place.
I'm gonna say watch for how it's different
And it's crazy like sometimes it almostseems like this is another thing like
it's not always coming from where you'refeeling it It's usually like I'm a I'm
a big proponent of working with the deephip flesher ileo So as when it seems to
(11:46):
be in a contraction it inhibits your glutemax your hamstrings are overworking on
hip extension because your, your glutemax is inhibited by the prime mover
of hip flexion being in a contraction.
So your high hamstring gets tender.
And then in the front, like your, if yourdeep hip flexors stuck in a contraction,
(12:07):
then your sartorius, your, uh, TFLand your rectus femoris, the three
secondary hip flexors are overworking.
And so like your TFL, if it getsreally tight, it'll pull the IT band
off track a bit and you get a littlebit of pain on the lateral knee
from a little bit of friction there.
(12:27):
The sartorius will, will get reallyaggravated if it's doing too much hip
flexion and then if it's your rec fem, rexfemoris, you're either going to feel some
pain above the knee or below the knee.
And, so, but all those littlepains you got aren't coming
from where they're showing up.
(12:48):
They're coming from A tight hipflexor, which is, at some points,
inhibiting or is so weak that otherthings have to take over the body.
So intelligent.
It's got secondary systemsall over the place.
So,
not only is the body resilient,built into the design to heal
itself, it can and it will.
(13:09):
Um, it's strong, it's incredible.
Um, it's, yeah.
The issue that you're probablyfacing, unless it's like, uh,
acute injury where you got smackedwith something, it's probably not
exactly where you're feeling it.
So that's one of thethings I look at, right?
(13:29):
And then, of course, with noception, like,noception is based, like, is modulated
by beliefs and, like, history in an area.
And if it keeps on happening over and overagain, it takes less and less and less.
Uh, feedback to cause a response ofyour brain to that, uh, pain message or
that danger message to send back pain.
(13:52):
So if you can start like lowering,lowering the amount of like the load,
so you don't get noception, like findinga way that you can, because movement
is medicine, you got to move, butyou got to move in a pain free zone.
So the noceptors, uh, reset.
So this is all my thought, like I'mjust spitting out all my thought process
(14:16):
and working with people with injury.
And if you honestly do believeand look and watching for how it's
different, then what you'll notice islike, um, I was talking to a runner
recently and they've been through alot of stuff and it's understandable
that they're hypersensitive and thatthe rabbit hole is very accessible.
(14:39):
Uh, they're getting really great atfiguring out that they're going down
the rabbit hole and stopping themselves,which is like, what a skill, like that
skill was going to take them furtherthan any other skill they have in this
lifetime because anxiety and worry andfear do not help with the healing process.
Like if, if you're under too muchheightened stress, it inhibits your.
(15:04):
Your, um, your, your lymphaticsystem, which is your healing system.
So you want to do what youcan to keep yourself calm.
You want to watch your thoughts.
You want to correct them when you can.
But they were telling me that like,okay, they're having a few little things
go on, and they're pretty concerned.
But what they're learning is, andthis is another thing I tell people, I
(15:25):
really define pain as sharp shooting.
Like if you have sharpshooting pain, stop.
Now if you have a dull ache that'sbothering you a little bit, Then, modify.
Uh, change the way you're moving.
Like, uh, speed up your cadence.
(15:46):
Slow it down.
See, is there something there that can,that can help it, like, be relieved a bit?
Like, get externally focused.
Like, really, like, experience,if it's raining, feel the rain.
Feel, if it's sunny, feel the warmth.
If you're in a race, hear the crowd.
(16:06):
And see, does it reset?
Because sometimes these things reset.
If you, if you think of it thisway, that, that, Muscle tone is
governed by the cerebral cortex andconscious thoughts there too, right?
So, if the cerebral cortex is decidinghow tight to make your muscles,
and there's some some feedbackcoming from one muscle and you're
(16:31):
focusing all your energy on that.
The body's got this incrediblething called muscle guarding
or muscle splitting.
If it's worried there's an injury,it's going to tighten it up.
So if you're focusing all your energyon that, then it's going to tighten
up and it's going to feel worse.
And it could become aproblem because of that.
Or at least the thought processwill create it as a problem.
(16:54):
This is why I say get externally focused.
Just feel the thing.
The heat, the wind, um, if you're runningwith somebody, talk, laugh, uh, I put on
music so I'm not listening to my brain toomuch, uh, feel the sunshine, if you're in
a race, hear the crowd, although I reallywant to clarify, if it's sharpshooting,
(17:17):
you always respect sharpshooting pain,sharpshooting pain is, is something you
want to be really careful with, okay?
And then, so this athlete was telling methat So they realize that this thing is
bothering them, but it's, it's interestingbecause it's not like the problems
(17:38):
that became big problems because thebig problems they started off terrible
for a few steps and this one is not.
So that's how it's different.
And it does kind of like bother thema little bit later in a run and it
bothers them after the run, but itrecovers overnight and they're fine.
So they're not as worried about this.
(18:00):
And this runner is really, really, reallysmart because if they, if they're at
all really worried, they'll just shift,they'll just shift, uh, to a cross
training session, which doesn't aggravate.
So I was sharing them, uh,with them the other day.
So back in November, I ran a 10Krace and a couple of weeks before
(18:23):
I developed this left hip pain,kind of like as a lower hip pain.
And it's kind of quadratus femoris,which is the lowest down lateral rotator,
which has been, had been bothering me.
Typically what happens is I go toolong, too hard, and it gets aggravated
and it's aggravated for a few days.
(18:44):
But it was bothering me two weeksbefore the race, and I kind of limped
my way to the race, and I got outthere and I'm like, first thing in
the morning I felt pretty good, Ithought it was going to be great.
And the first kilometer it startedgetting aggravated, and I was like,
but this is my goal so I'm going.
And it was aggravated the whole time.
And I found that if I ran too, ifI could change my cadence, I could
(19:09):
like shorten my stride and it wasmanageable, but it was still painful.
And then there was some peoplewho are just so amazing.
Like I I'm always blown awaywhen somebody shows up for me.
Okay.
Like that's who I am.
That's like, I could not notshow up for human beings.
Um, 100 percent all the time.
(19:30):
But I am so grateful and touched,and I think you know who you are.
Um, yeah, it was special tosee you out there that day.
It really, it meant a lot, and Idon't know if I've been really clear
about that, but it really meant a lot.
Because I don't, I don't expectpeople to show up for me.
I know everybody's got a life,and they've got stuff to do,
(19:51):
and they've got their circles.
And yet, I am just so, so grateful.
It just means so much to mewhen somebody shows up for me.
And like I said, I don't, I don't,I'm, I'm not concerned if you don't,
like, that's okay because like,I know you had a busy life, but I
never would expect that from anybody.
(20:11):
It's just, I want tosay how grateful I was.
But of course, that person was at thetop of the hill, so I had to rush there.
And by the end, I was in a lot of pain.
And then for the next few weeks,just sitting down, I could feel it.
It took a while to recover.
I think I took about a month off ofrunning, and I was cross training,
(20:33):
and then I slowly started getting backinto running, and I started a walk
run program for a number of weeks, andthen I moved up, and I'm getting into
the last week of kind of a I wantedto do a zone 2 training, which is like
a lower heart rate, but it turns outthat zone 2 for me is like a fast walk,
so I had to do zone 3, and it's hardto keep your heart rate down, but it
(20:56):
forces me to run slow, and when I'mrunning slow, um, it doesn't hurt, so
dropping your load will really help.
But I, I realized I, I like to watchmy thoughts and I was running the
other day and I was like thinking, Ohmy God, what if this keeps on going?
Like I'm going to do ahalf marathon in June.
What if my whole, what if my whole, it'slike starting to dig a rabbit hole here.
(21:20):
What if my whole training blockis with me feeling this pain?
Or this, this niggle or this feedbackfrom my hip and, uh, yeah, what if
it gets worse and I can't run and Idon't get to do my half marathon, which
means like I'm going to have to bump mymarathon for next year and what, like
(21:40):
I want to go back on the track and doa five, like just running down like,
and this is even with my music on.
So you gotta, you gotta know thatthis is when my brain's loudest.
You can, you can, you canaccept that inner dialogue.
See, I want you to understand isthat inner dialogue is not you.
(22:03):
If it's spouting off at high speed andyou're not actually intentionally creating
it, it's just happening, it's not you.
You're like, what do you mean it's not me?
Yeah, that voice there.
That's the one I'm talking about.
That's the ego, the sense of identity.
The internal dialogue.
(22:25):
It's pretty much, prettymuch on autopilot.
It's the one that's always going.
And sometimes we don'trealize that that's not us.
And sometimes we actually listen to it.
And we, we spiral down with it.
If you really want to come past, ifyou really want to see how things are
different, and change the way it'sgoing, you gotta break in intentionally
(22:50):
and go, and that's what I do now.
It's like, I'm going down that rabbithole, I'm going to go, wait a minute,
you know, a month ago, when I ran,I'd be in pain for three days,
sitting down, I'd feel it, thewhole bit, so on and so forth.
But now,
(23:12):
when I go out and run, yes, it, itfeels, I feel discomfort, um, but I
only feel discomfort for the first,say, kilometer or two, and then it calms
down, and maybe I feel a little bit.
When I, when I'm, I'm doing an outbackon my way back, but it's not the same
discomfort and then that one calms down.
And then I might feel it for a littlebit like the morning of that, that
(23:34):
run, but by the evening it's gone andtomorrow, then tomorrow will be gone too.
So, that's how it's different.
It's not the same.
It's improving it.
Maybe it's not perfect yet, butit's improving and the more it
improves, the more I calm down, themore I relax, the less it tightens
up, the less I'm worried about.
So think about that.
(23:54):
If you've got things that are goingon like this, how is it different?
Like, has it moved?
Has the pain moved to another place?
Cause like a lot of times in, in myclinic, we're playing whack a mole.
It hurts here, then that sorted out.
And then it hurts overhere and that sort of that.
And we're back and forth andback and forth until it's gone
(24:15):
because things jump around.
But they're, they're, Oh,I'm always saying, see that.
Remember last time it was this and nowit's over here and they're like, Oh yeah.
Okay.
And that calms people down and like,so you can do that for yourself.
And I know this athlete does.
They're like, okay, well, you know,yeah, it feels better the next day.
The next run is great.
(24:36):
How's it different.
And you can actually intentionallybreak in on the, that internal dialogue
that just blah, blah, blah, blah, blah,blah, blah, blah, blah, blah, blah,
and taking it down that rabbit hole.
And you can intentionally break inon that and say, uh, wait a minute.
No, it's like literally when it wasbad, it was like this bad and I couldn't
(24:56):
do this or maybe I couldn't run.
I was just cross training and it wasjust like that, that, that, that, that.
And now it's like, Oh, you know,maybe I feel at the beginning around
or maybe it starts up in somewherein the middle of the run, but then
it goes away after it warms up a bit.
Maybe it comes back after the run,but then later on the day it goes
away and the next day I feel fine.
(25:18):
So, if you don't hang your hat on thefact that there's feedback from the area.
If you just say, Oh, feedback,feedback means a problem.
There's something wrong.
There's something wrong.
There's something wrong.
And that's like the same thing.
And maybe it's getting worse.
Or you can look at, Oh, I doget feedback, but it improves.
So I'm actually improving.
And if you really take a look at it, I seethis with athletes so often, that they're
(25:41):
working, Training harder, harder, harder,work out, work out, work out, work out.
But that issue is not getting better.
There's still a little bit of feedback,but it's not, it's not getting worse.
And if you think of it, if you'reincreasing load, but the pain is
either staying the same or gettingless, that's a huge improvement.
Because like when, when you're increasingload, if it's a real problem, it's going
(26:04):
to, it's going to increase the problem.
Like if you're increasingload and the problem's getting
better, That's a good sign.
And think about your whole life, right?
All the things you learn throughsport and through this, think about,
(26:27):
you know, if you start looking atanxiety around different things, and
as you learn to see how it's differentin your body with feedback and pain
and injury, as you shift that, youmight also see Whoa, it's different.
I don't get as anxious.
(26:48):
And maybe I'm not as worried about things.
And maybe I trust.
And maybe I believe that mybody is resilient, strong,
and able to do amazing things.
Maybe I believe it's able to heal.
So, if I gave you one piece of advice,
(27:09):
don't pay attention to how it's the same.
Always, always look.
for how it's changed, how it'sdifferent, not only physically, but
mentally, emotionally, and spiritually.
Thanks again.
(27:31):
Thank you for listening to thisepisode of conversation with Kimen.
Please follow me on Instagramat conversations with Kimen
and feel free to direct message me.
Also, please share my podcast withanyone you may feel would benefit
(27:52):
from its content and let them know.
And you can find me atconversations with Kimen on Apple
podcasts, Spotify, and Podbean.
Have an amazing day.
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