The Pain Issue in Rehabilitation
Pain has been a rather constant companion and source of information for me since mid February. My reactions to pain have become habitual, just like most humans’ reactions to pain. I guard, stiffen, compensate, and generally pull myself down.
I could describe and differentiate the many nuances of pain resulting from a fractured patella and repair surgery, but that process would most likely contract me further. Pain is undeniable with a serious injury. The question is one’s conscious choice in response to pain.
Today, my skilled PT, Heather, gave me exercises, both passive and active, to increase the flexion of my injured knee. These exercises hurt, but I must do them to regain desired function of the knee. Heather advises, “Respect your pain”, meaning that on a scale of 1-10, don’t push myself beyond 4. I can go to the the edge of tolerable pain, but can I do it with good use of myself? Can I use myself elastically while I push my knee beyond where it seems safe to go? If my question becomes my entire use rather than my knee pain, I can actually bend my knee further! If I am not interfering in an overall response, the injured area has the room to move, even incrementally.
Heather also manually pushed my flexion to a degree of nearly fainting pain. The pain was balanced by the resulting increase in knee flexion. Meanwhile, I had to use every molecule of “big picture” thinking to dynamically allow her expert work.
What Heather identified most clearly is that I have indeed been moving as though I am still wearing a leg brace, and that my fear of pain is impeding progress more than actual pain. Faulty sensory awareness strikes again!
I see now that I have to endure pain with good use for my functioning to improve. I have to refuse to end-gain through pain also, and to respect tolerable limits, yet still explore the territory of pain with an overall elastic response. This is a constantly changing territory, and thus my dynamic response needs to be quietly attentive. Recovery as a process includes pain. I can view pain as an ingredient of my experience to which I can respond with conscious direction of the entire self. Not easy, but occasionally possible.