Do you know why you hurt? There are several factors that contribute to our pain. We have nerve pathways that provide information to our brain including pressure, temperature, and tissue (muscle, ligament, tendon) stretch. The brain interprets all of this information and sounds the “pain alarm” if it perceives danger or possible damage to our tissues. For example, if we step on a nail, nerve pathways send information to the brain to tell us we stepped on a nail. The brain then processes this information and sounds the pain alarm so we appropriately treat our injured tissues.
After we heal from our injuries, pain can persist even though we are no longer in danger or experiencing tissue damage. This can happen because our nerve pathways and brain have become more sensitive, and they trigger the pain alarm more easily. Many factors contribute to this increased sensitivity of our alarm system including stress, fatigue, anxiety, uncertainty, and history of pain or injury.
Thankfully, there are many tools that can help us dial down our pain alarm system. One effective tool is visualization. Have you ever heard of an athlete practicing visualization in order to improve at their sport? Visualizing the touchdown pass or the sprint to the finish line enhances the same nerve pathways that are activated when physically playing the sport. The more an athlete can enhance these nerve pathways, the better his or her performance will be.
So how can this type of visualization help dial down our pain? Visualization allows us to activate the nerve pathways involved in movement without triggering our pain alarm. We must visualize ourselves feeling great during the activity because it allows the nerve pathways to activate without the brain perceiving danger or damage. Activating these nerve pathways facilitates physical changes in the nervous system that help dial down our pain response.
For example, if a runner sprained her ankle 3 months ago and still feels pain every time she runs, we need to consider 2 things. First, we need to consider how muscle weakness, tightness, or scar tissue may be contributing to the ankle pain. Second, we need to think about how changes in the alarm system are contributing to the ankle pain. The alarm system is perceiving damage or danger while running, even though the tissues are fully healed. To dial down the sensitive alarm system, the runner should visualize herself vividly running without pain. By doing so, the nerve pathways utilized in running are activating and physically changing to become less sensitive.
While visualization alone may not make your pain go away, it is can be important part of your recovery process.
Dr. Katie Hall is a physical therapist at Colorado In Motion