Pain can feel random sometimes, but very often it actually isn't. When we are in pain, we often rush to Google to find a) a diagnosis and b) a self-treatment. Often however, this is not relevant to ourselves at all. Things don't improve and we really start to worry (read about the effect of that here). So let's start logically: When did IT start?
Start with a timeline
Making a timeline can be an incredibly useful tool to start unravelling a movement or pain problem, which in fact I do with all of my clients. It helps us bring structure to the problem. Often however, we are so consumed with the actual problem that we disregard everything else.
When we draw a timeline I ask people to consider everything from birth until now, from physical to non-physical events:
Physical impacts/injuries
Write down everything. The things that you think aren't relevant, well they probably are. Like a broken big toe when you were 8. Go through your body step by step and write down if anything happened there, no matter how small. Left foot, right foot. Left ankle, left ankle. Left knee, right knee...work your way up like this but really think. The more detail you can gather here, the better. This includes minor car accidents as well, even if you shook it off.
Write this on your time line along with the date/year it happened.
Surgeries & Sickness
A surgery is an injury - they cut us open! :) Of
course, they are necessary and potentially life-saving, but the scar can often leave non-optimal patterns of guarding and avoidance behind. Appendix, tonsils, wisdom teeth. It all goes on your timeline. Sickness that lasted a long time which meant that had you stay in bed/hospital for a while - we want that on the timelines along with the date/year.
Change in life circumstances
Did you change your job or company? Did you leave home? Did you end or start a relationship? Did you lose someone close to you? How did these changes in your life go for you? These often neglected factors may play a huge role, especially if you identify those that didn't make you particularly happy.
Emotional stress/trauma
Related to a change in life circumstances, these are huge. Was there a period of bullying, abuse, a period of loneliness or depression. Were there periods in your life where you felt left behind, neglected, worthless or where you wanted to hide from the world around you? The impact on the nervous system, and therefore pain, cannot be underestimated as this is where a downward spiral of fight/flight could have started.
Change in hobbies and habits
Did you start a new hobby or sport? Did you stop playing a sport? Why was that? Could it be that some of the demands on your body were creating movement habits and patterns? E.g. racket sports biasing movement to one side?
Take your time for this. And then look at it... maybe it's long, maybe it's short. It doesn't matter...but what does matter is this: no matter what you have in front of you, you got through of all of this. Despite hardship, injuries, losses or traumas: you are still here. That is something worth celebrating for a moment. Look at how adaptable and resilient you are! Well done! What you're looking at is something to admire. It is also something that hopefully starts to unveil some potential:
When did it start?
Now move on to experiences of struggle and pain: When was the first time in my life when I first experienced a rather long period of pain? This does not necessarily have to be the pain that you are currently struggling with. You can think about any pain in your body. Has there been a time when something was bothering you, even if it's not a such a problem today?
Or were there other things that just didn't feel right. For example, was there (or is there) a period of digestive problems, of chronic fatigue, of migraines...When was the first time in your life when you felt like things are not okay? Write these period down onto your timeline. Of course, write down the start of your current problem as well :)
You should now have a really good and detailed timeline and you can start investigating:
Have I actually been experiencing other problems way before my current pain? Is there a time in my life when there were no problems and then all of a sudden it cascaded? Does it look like I have been jumping from one problem to the other? Or is it just this one big thing that I've always struggled with?
What happened before or during that time? You have it in front of you. Maybe you broke something a couple of years before things started go south for you. Maybe you had a surgery before the first physical symptom (note, this also includes those IBS and fatigue problems). Is it that since then you were jumping from one pain to another? Maybe an emotional event preceded all of that. Maybe there was an ankle sprain a few years before that neck started hurting? Maybe you dislocated a shoulder and that's the only real thing on your timeline...but that was before your current problem started?
Maybe you think "well, I only have this one real impact but that was after I was already in pain". That's okay. That impact may play a role in your movement today, but it's unlikely to be the cause of your struggle. Think back to other factors from the list above, or double check that you're not playing something down ("ah, I was fine after that, never any problems"...really? :) ). Start considering it...it all started somewhere!
Start investigating
Hopefully by this point you have some insights about your life and your timeline that you didn't have before. But at this point we still don't know whether those preceding events actually have an impact on your health, wellbeing and pain. So we need to check it out :) Here are just a few examples. As always, these are just examples from clients that I've worked with and your timeline will look different :)
Broken toe before onset of neck pain and headaches
How does that toe move now? Is it as mobile as the other? When you walk, do you actually put weight into it or do you stay away from it? When you start moving it, how does that make you feel? With feet it's always a biggie - a quarter of all of our bones are down in the feet (26 bones in each foot! that's 33 joints per foot). We want them to get their movement back, have the ability to pronate and supinate. If that's not the case on both feet, the body above will be adjusting accordingly. And a stubborn broken toe can in fact be in the way of everything.
Appendix surgery before a period of pain in A, followed by pain in B, followed by pain in C (over the course of a few years)
Scars are potentially a big deal for you. In the healing process, fibres don't move very much in order to grow back together. Which means that we don't move very much in that area. In case of appendix, that means hip and spine movement will be altered in order to avoid any healing, so that the scar can heal. It's helpful, but what if that movement just hasn't come back? Have you ever touched that scar? See what happens if you do. What happens to your breathing, to your weight distribution in your feet, to your ability to move your hips?
Period of stress before/during the onset of irritable bowel syndrome, chronic fatigue followed by back pain
This cannot be underestimated. When we are stressed (whether it's because of a relationship, a shitty boss or trauma of any kind), our whole system responds to that stress by going into fight or flight. Breathing is naturally altered - the diaphragm, which attaches to the spine, won't be functioning as well and our whole body starts to prepare for one thing: react to a threat. Have you dealt with whatever happened back then? Or are you still in the same situation (the same job, the same toxic relationship, the same burdens)?
What have you found? Where can you start to make connections? Get some help and advice if you're not sure, but just by doing this task - starting when it started - you will have taken a big step forwards towards your healing. You might also be able to explain why previous interventions didn't do much - because the initial stressors might still be there.
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