By applying neuroscience to traditional physical therapy, you might be able to retrain your brain to feel better.
I HAVE HAD a few injuries over the years. I have learned how to support my body to heal, and I am happy to say most injuries had no lingering side effects.
Then there is my groin; I wrote about it years ago. While my body is strong and functions well, my groin nags at me. My hips pop when I rotate my leg to the right during a squat or while walking. My massage therapist, chiropractor and acupuncturist all work on it. I roll it out. It still pops daily.
Enter Orit Hickman. I reached out to Hickman, who owns Lake Burien Physical Therapy and specializes in chronic pain.
Lake Burien Physical Therapy
Hickman’s own pain story started with nerve symptoms in her sacroiliac joint. Despite being a PT and living a healthy lifestyle, she felt numbness and tingling. An MRI showed nothing. Then she discovered research on phantom limb pain for amputees who felt debilitating pain for a limb that was gone. Since applying the neuroscience she learned about the brain, her pain disappeared years ago. She now applies it to traditional PT.
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Your brain produces pain in response to a perceived threat, Hickman says. We think pain equals tissue damage, but you can experience pain — or no pain — regardless. Have you ever had a bruise and didn’t know where it came from? Pain is your brain’s warning system, and the system can overcompensate or learn to be less acute. Construction workers have told Hickman they don’t feel anything when they step on a nail. They’ve programmed their brains to know feeling a nail is part of the job.
Let’s be clear — you need pain. It’s how you know you’ve broken your leg or are having a heart attack. But tissue heals in three to six months, she says; if you experience pain afterward, your system might be malfunctioning.
“It’s not just a tissue problem, not just a movement problem; it’s also your brain impacting what’s happening,” she says.
I realized my hip popping might be in my mind. Seriously. I went to see Hickman.
She tested my balance. I didn’t balance as well on the right, previously injured side. When I did a mini-squat, my knee rolled in, which meant my glutes weren’t firing properly. An Olympic lifting coach had noticed I was crooked in a deep squat with a bar overhead. My body sees my left hip, not my right, Hickman says. It would behoove me to get my right side firing properly, especially when lifting weight.
She showed me a map of how your brain identifies body parts. Your hands, face and tongue, for example, take up a big chunk. If you don’t use a certain part or experience an injury, parts of the map can fade, Hickman says.
She handed me her phone to scroll through a series of foot photos on an app called “Recognise Foot.” I visualized balancing on my right leg. It felt wobbly. I went through the feet. I visualized it again. It still felt wobbly, but less so.
Studies show that when you look at feet (or hands, depending on your injury), and identify left and right, your brain remembers body parts without firing a pain response; people with chronic pain remember their bodies working without pain.
The app is one component of a full plan her patients receive. She sent me home to work daily on visualizing a squat or balance before and after using the app.
After two days, my balance remained wobbly, and my right hip still popped. Yet I could tell my brain was paying fresh attention to my right hip. I used the app before and after lifting and could sense my body trying to rely more on my right side.
It was enough for me to say yes to visualizing, and looking at feet every day.