In the last week I’ve gone on 2 runs. This is a big deal for me! I love running. Running has been one of the things I’ve missed most these last 7 years. I’ve given it a go a few times, and was quite successful last summer (read about it here!), but I started experiencing new pain in my left hip that made me stop.

It was that new left hip pain I was most worried about when Peter O’Sullivan asked me to tell him my story during my patient demo experience at his Cognitive Functional Therapy workshop. I hadn’t known I was so worried, so afraid of going back to all the trials and tribulations I went through with my right hip.

Through the workshop I realized how much I brace and tense my low back and hips. How I habitually hold myself up and out of my hips as much as possible, how my back is always extended no matter what position I’m in or what type of movement I’m doing.

Apparently I do it while I’m running, too. Actually, I think I brace and tense even more, really limiting the movement in my hips and low back. How do I know? Because I went for my first run since the end of last summer on April 1st (no foolin’!). It was really a slow jog, but run sounds way better ;)

Run number 1

A funny thing happened before the first run even started.  As I walked to the trail I was going to run on, a trail I had literally just walked on with my husband and dog with ZERO thoughts of pain, the pain in my left hip started to go up. I wasn’t even running yet. Hell, I wasn’t even to the trail yet.

But just the anticipation of running, and therefore the anticipation of my pain flaring up, had me tensing and bracing to protect that oh-so-sensitive hip. I was holding myself up and out of my hips again, breathing shallowly, guarding, all just thinking about running and expecting pain. And my pain did indeed go up.

I was actually thankful this happened. It was PROOF that my pain wasn’t going up because I overdid it or overloaded my tissues or injured myself in some way. I hadn’t even done anything yet! It was fear and worry. It was the anticipation of pain.

So I relaxed. I breathed deeply, trying to direct the breath into my hip. I could feel my back let go a bit, my hips loosen up a bit. My mantra was ‘loose, relaxed, floppy…loose, relaxed, floppy…loose, relaxed, floppy’.

I started to jog. Loose, relaxed, floppy.

Pain, but no worry

During that first run the pain kept creeping up as the tension kept creeping back in: the guarding, the limited hip movement, the motionless low back. It’s hard to let go, it feels vulnerable. I’ve been tense and braced for 7 years now. After being in protection mode for so long, it’s hard not to protect. It’s scary.

But I was confident in what I was doing. I am good with this path, this choice. I can live with a bit of pain, and live well at that. So the pain didn’t really matter all that much, it was nothing I needed to worry about. Hell, worrying about it was part of the reason why I was in pain in the first place!

So I stopped focusing on my hips and started focusing on my breathing, on relaxing, on the scenery. The pain started to ease. Then I’d think about writing this post and my pain would go up again – another fascinating thing. So I tried to stop overthinking everything ;)

Running while trying to relax is easier with this view

The trail :) Should be easier to relax with this view!

But I did have to think in order to concentrate on relaxing, letting go, breathing deeply (as deeply as I can whilst jogging at 8550′, anyway). It’s super easy for me to fall back into protection mode, to tense up, to brace, to guard. I especially had to concentrate at the end of the run, as I was walking home. When the anticipation of pain was palpable, the desire to look for the pain irresistible. (Is it there? Lemme check…)

I had to stretch, keep moving, breathe. I meditated when I got home. I worked REALLY REALLY HARD at relaxing.

And I felt awesome.

Run number 2

My second run was even better, just five days later. Two runs in a week! Awesome, right? And the second was nearly a mile longer than the first at 3.75 miles (aren’t you impressed? I sure as hell am).

Relaxing came a bit easier. Letting go wasn’t so damn hard (but still not easy). I focused on breathing deeply, letting my wiser, rounder Buddha belly go (vanity be damned!), and moving freely, everywhere, not just in my hips.

I channeled my Calm meditation practice, focusing my attention on the breath until I got into a bit of a rhythm. Long inhale in through the nose, slow exhale out through the mouth.

Relax already!

To relax, when I’d feel the guarding creeping into my hips and low back, I’d think ‘dump your guts into your hips’. I’d try to sink deeply into my hips rather than trying to lift myself out of them. I’d wiggle around to move my lumbar spine a bit and think ‘turtle’ to round forward.

At one point my shadow was alongside me. I fully expected to see the hunchback of Notre Dame in it’s image, but I was still upright. Our minds are curious things, aren’t they? Our mental images do not always match up with reality, eh?

Due to my uncanny ability to make even the most casual of therapeutic jogs into a competition, I ran almost a mile further on my second outing just so I could pass some people and show them how awesome I am. The people were walking, mind you, this was in no way a difficult or pride-worthy effort. It did mean going up a little higher in elevation and having to run through mud and snow, though, so I had that going for me.

But I did it, dammit! And I loved it. And I felt pretty damn good, too. I was feeling relaxed, like my strategies were working. And I was in a bit of a rhythm so I didn’t have to focus on them so much. As I turned back toward home, heading slightly downhill now, I was feeling like a champ. And because I wasn’t having to think so much, I could actually look around me and take in the scenery.

Spring is sproinging!

And how wonderful that was! I saw my first butterflies of the season and fresh moose tracks, so then I had to be on the lookout for moose, which meant scanning along the river, which meant noticing the fly fisherman in a cowboy hat with a yellow lab sitting on the riverbank behind him. Toward the end of my run I also saw a hawk circling above me. Just plain awesomeness.

I jogged almost 4 miles. Not too shabby, right? That’s about what I’d worked up to by the end of last summer! 

As I started to walk the rest of the way home I started to notice the ache in my hips. I wasn’t worried about it, but I could also sense the tension and guarding creeping back in, could feel myself going into protection mode in anticipation of pain.

So I came up with one more strategy.

Ache and shake

I made a concerted effort to stay loose, relaxed and mobile. I wiggled my hips, did some gentle back twists and dumped my guts into my pelvis rather than holding myself up and out of my hips. I breathed deeply. I exaggerated my movements and my looseness. I’m sure I looked a fool. I was sure grinning like one ;)

As I write this it’s ‘the day after’. My pain is up slightly but it’s no big deal. What is a big deal is that I feel friggin’ awesome.

Some revelations

I’ve finally made the connection between the tension and guarding in my hips and low back and the anticipation of pain. I am now more aware and have some strategies to let go, while also being compassionate with myself for it being hard to do. It sounds ridiculous to say that relaxing is hard, but it is. I’ve been in ‘protect mode’ for years. It feels scary and vulnerable to do something different.

But I also know I can do something different. I’m becoming more confident in doing so and in doing so I’m also becoming more confident in my hips. I have a healthy body. I can run. I can snowboard. I can hike. I can adapt. I am strong and resilient.

I’ve finally recognized the way I habitually hold myself and move (upright, out of my hips, back in extension, little to no movement in my hips and low back) through everything I do. I genuinely didn’t realize just how much I was bracing and guarding.

It was ALL THE TIME. 

I thought that by changing from sitting to standing to lying down I was changing up my position. Turns out I wasn’t! I was always holding my low back and hips in a protected state. Even while moving. Even while running (Not anymore!).
Before all this I also wasn’t aware of how much fear and anxiety plays a role in how much I protect, tense, guard and brace, even though I was well aware of the fear and anxiety. How much my worry, even worries I don’t admit to myself (like that pain has to mean damage, even though I *know* better), sit there in my hips preventing them from moving. And how much those fears and worries are because I’m constantly anticipating pain.

Connecting dots, putting the pieces together

I knew all the pieces, you see, I just didn’t connect them all in a meaningful way until now. Having a guide is so important to helping us see the bigger picture, to help us bring it all together.

In my post on my DNM experience with Rey Allen I talked about how guarded I felt in my hips, and how I was able to let some of that guard down over the course of the workshop.  It was like I went from wearing a steel girdle to a leather girdle to no girdle by the third day. That’s when I had an emotional breakdown because I didn’t feel like I was holding myself up anymore. I could actually feel my hips, not just pain in my hips.

But I slipped back into that steel girdle in the following weeks because I was still worried about the pain, what it meant, what the future held. Was I sliding back to square one? Was I going to have to go through it all again?

My fear/anxiety/worry/anticipation surrounding pain is FIERCE folks! That’s where my work needs to be done. That will allow me to relax more, let up my guard, loosen the protective girdle.

Relax already

I do feel there is one area of my life that I’m not a stiff, rigid penguin, and that’s snowboarding. In my volunteer work as an adaptive snowboard coach I’m constantly reminding my students to relax, to sink in, to just feel the snow and the board beneath their feet and not try to muscle it. To go with the flow.

It's easy to relax in this kind of scenery

My happy place – on my board in some pow under bluebird skies

I even model relaxation. I demonstrate how hard it is to ride when we’re stiff and rigid and how much easier it is when we’re relaxed. I *get* this concept! So it’s exasperating at times to see how in my day-to-day life, particularly if my pain is up, I resort back to rigidity, guardedness, tension.

*sigh*

But I’m working on it! I’m trying to bring my snowboarding zen into my daily living, into my running, into the other activities I enjoy. Loose and relaxed. Breathe deeply. Sink into those hips.

I think the movement and postures can only change, though, can only become more easeful and natural if I work on the other things, too. My thoughts, beliefs, fears, worries, anxiety and reactions. After all, my movement changed because of the confluence of a whole lot of stuff in my life that changed as a result of pain.

The whole story matters. The big picture. I’m finally starting to get it. 

 

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6 Responses to "Relax! Running, pain and my CFT experience"

  1. Love it! It’s always so invaluable to read how you convey the cognitions/emotions/patterns/other factors influence your lived experience of pain.

    Your posts are so rich!

    Very happy things are clicking for you.

    • I’m so happy you love it and very much appreciate your kind words. I’m so excited to be out running again! And hope that my trying to figure it out on the blog will help others.

      What a great message to wake up to this morning, thank you kindly!

  2. Jo this is very interesting. I am a runner and physical therapist. In the tough last miles I often incorporate focusing on breathing and self talk. It is amazing the difference in feeling and how it helps you finish stronger.

    I saw that you started the EPIC program so congratulations. In my clinic we a lot of chronic pain. However, I want to help more people beyond the clinic. I am certified running coach. I thought about combining my running experience, physical therapy and pain science background to create a goal-oriented program for people with chronic pain who want to get into running or distance walking. The program would include a structural and functional exam, questionnaires, pain education, CBT (coaching) in the spirit of helping that person achieve their goals. You probably know there is some similarity in pushing your limits and dealing with exhaustion in sport and people in chronic pain coping with their day to day life when they want to simply go grocery shopping.

    • Thanks for taking the time to read it and to reply, Cody! Much appreciated. And thank you for the congrats on EPIc! We are excited and hoping that we can help a lot of people. I think a new way of providing pain science education and evidence-based living well strategies is much needed, there are so many people living with pain who need help and aren’t getting good information.

      I love your idea for a running/distance walking program for people living pain! So many people want to do these things but they are unsure of how to get started or how to progress, so having a trusted, knowledgeable guide is so valuable. And all too often traditional coaches or fitness pros don’t want anything to do with people in pain, so they often have nowhere to turn! Or those fitness pros have terrible information about pain that doesn’t serve the client well. So yes! Do this! It gets my vote :)

      I can be a guinea pig if you need one!

      One thing I know I had to get over is starting over again. I’ve made that shift in perspective now but it took me awhile to get there. I wanted to be like ‘I was’ before pain when I averaged 7 minute miles over good distances and ran half-marathons. Not that that was ever fast, but it wasn’t slow, either. Now I’m slow! Oh so slow. So that was a bit of an ego punch. Now I’m just grateful I can be doing it all. I love running and I’ve missed it these last 7 years!

      And yes, I agree that many of the same strategies athletes use can be used in people with chronic pain, too. That’s part of why we have an adventure component to the EPIc retreats, too. We want to help people safely push themselves a little bit, to see that they are stronger, more capable, resistant and robust than they think they are. That they are adaptable and that there are things within their control they can do to change their experience. Breathing techniques, visualization, mantras, meditation, empowering self-talk – these are all things I use for pain that I once used for performance (I was an athlete my whole life).

      I’m so glad you reached out, I hope we can stay connected. I’d love to hear how the running program goes!

  3. Just started watching Peter O’Sullivans stuff today. Powerful! I havent got my head fully around all yet. The biggest take away so far was that all this forcing stuff to fix it with therapy and to strenghten muscles that are already over active might just be insane at least in certain cases.
    Ta

    • That is great to hear! His stuff is powerful in part because of it’s common sense, I think. I think we’ve largely just overcomplicated things with all the different modalities and techniques.

      I’m glad you’ve gotten something out of his work, though! It’s helped me immensely.

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