What I didn’t understand about pain

It’s Nicole writing today on the “other side” of a complex shoulder condition, which coincided with a perfect storm of involuntary change, including the recurrence of my autoimmune disease, the gateway into perimenopause, and a tumultuous personal time. It’s been tough!

That’s me on the far left in the photo below. Check out that shoulder action! If you look closely, you can see that my right shoulder doesn’t go as far into the overhead range as my left does – by no means is it “perfect”, but it’s so much better than it was. Progress!

In addition to physiotherapy and surgery, my shoulder recovery journey ended up including a 300-hour training program with Mindful Strength. Unrelated to my personal experiences, I wanted to learn more about pain and strength training as a teacher, so I enthusiastically signed up while unaware of how personally relevant these topics would become.

During the course, I learned that I was in fact dealing with a frozen shoulder and an anatomical joint impingement, both pretty painful experiences. This made the learning feel particularly timely and personally relevant. We examined the typical beliefs about pain that don’t actually stand up to scientific scrutiny, including these two potentially harmful ones:

  • Misconception No. 1: “Pain is well-correlated to tissue damage.” Contrary to this widespread belief, the science says that not only can you have tissue degeneration without any experience of pain (it’s actually very common, especially in active adults), but you can also have pain in the absence of injury or tissue degeneration.
  • Misconception No.2: “Any instance of pain has a single cause.” In fact, the science shows that pain is multifactorial — a fancy way of saying that it’s caused by a complex interplay of factors

The Bio-Psycho-Social Model

Central to my expanded understanding of persistent pain — defined as lasting for 6 months or longer — was the bio-psycho-social model. This framework situates pain in the context of one’s entire life, including factors both inside and outside your realm of control. Through this lens, pain has multiple influences beyond biology, with thoughts, behaviours, and social experiences holding equal weight.

It turns out that social connections and support (or lack thereof), along with your own beliefs about pain — and in addition to your biology — can directly impact your experience of it! 

Read that one more time to let that sink in!

This isn’t to say that pain is all in your head (it’s so real). Instead, when considering what influences our pain, we should also acknowledge our whole human experience and the rich stew of possible contributors.

From Frustration to Hope

As a yoga teacher, a participant in a 300-hour training, and a moderately active person, I was often gritting my teeth in frustration and discomfort. Outside of my professional identity, I was emotionally and physically drained by daily chores, errands, and activities — that were equal parts painful and fatiguing. I realized that I had to apply my expanded view of pain to my choices for treatment and recovery, including which activities to continue or restart. 

As I progressed through the formal diagnostics and treatment avenues, I identified an important truth that changed everything: strength training, done conscientiously, didn’t exacerbate my overall condition — in fact, I felt better mentally, physically, and emotionally following a workout, plus I got a sense of connection to my training group. Of course, my pain didn’t magically go away, but my perception of my capacity to cope with it shifted enormously, which led me to feel more hopeful.

Creating Confidence by Checking In

One of the most practical tools gained from my combined pain and strength training education is a collection of self-assessment techniques. When paired with the knowledge that pain acts as an alarm system, I’ve become empowered to assess my pain and rationally curb over-sensitized fear responses.

Checking in with myself during strength training and daily movements was sometimes as simple as noticing whether I was feeling capable, or whether doubt was creeping in. By self-monitoring, I regained confidence in my judgement, and in my ability to determine what activities were safe and beneficial.

Strength Is A Feeling – Beyond Lifting Dumbbells

The confidence I built through increased physical and emotional capacity spilled over into my interactions with healthcare providers. I trusted myself as my most-informed advocate, gathered multiple opinions, and I stayed committed despite inevitable wait-times and other systemic challenges.

If you can relate to the struggle of enduring persistent pain, know that you’re not alone! If you’re in this persistent pain boat or are simply interested in learning more from the standpoint of a movement teacher, check out an upcoming event this month from the primary trainer from my 300-hour course, Kathryn Bruni Young.

As a facilitator, Kathryn thinks deeply and then opens the floor for others to do the same. I really value her ability to clarify complexities, and her willingness to engage with differing perspectives within the learning environment.

Learn more about Kathryn’s upcoming session, Mindful Strength: Understanding Pain & Making Gains on Saturday, April 29th, 1:00-5:00pm.

Wishing you well on your pain and recovery journey,



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