Archive for the ‘General public’ Category

The Haunted House Effect, Fear and Chronic Pain

Friday, October 30th, 2020


Photos are the property of Nightmares Fear Factory
This is an update from a post originally shared October 2015

The most current science on pain, tells us pain is an experience and not a sensation. Yes, we use words to describe our pain in terms of sensation (stabbing, aching, dull, throbbing, nagging, etc.), but there are many factors that contribute to just exactly how each of us get to the point where this pain is demanding our attention. Associated with this pain event are the many biological, psychological, and social elements that were present before, during and after the “experience”.

Many of you will be familiar by now with the bio-psycho-social paradigm used to better understand the pain experience. This video interview I did will help explain if you are not familiar.

The “Haunted House Effect” is a brilliant metaphor to add insight into our own experience.

We have all heard the saying “frozen with fear”. It is that brief but profound period of time where something is so shocking or terrifying that one cannot move. The body does not respond because the brain is overwhelmed with the danger or threat of danger at hand.

Similarly, consider what happens to your body and you mind the moment you have the fright of your life in a haunted house. The image above is from the web site Nightmares Fear Factory. They are hugely popular images on the internet of visitors caught at a moment in time inside the Nightmares Fear Factory’s haunted house.

If we got a little “sciencey” here and thought about all the things that happen to the body as this photo is taken and for the short time after, we would observe:

 A huge dump of stress hormones entering the blood stream (adrenaline, cortisol)
 The heart rate and blood pressure spike
 Blood vessels dilate
 Pupils dilate
 Breathing gets rapid and shallow
 Muscles all around the joints contract and stiffen the body
 Posture instinctively goes into a flexed protection mode
 Ensuing movement is guarded and apprehensive
 Language to express the experience are dramatic and emotionally charged

I purposely used boxes in the list above because I want you to think of “ticking the boxes”. In the haunted house examples, these are boxes that are “ticked” when an extreme scare has occurred. Now let us imagine these events happened within the first 5 minutes of a scheduled 30-minute tour through the haunted house. They still have 25 more minutes to take part in an experience where the tone has been clearly established as frighteningly intense.

So, what happens when they approach that next corner that they cannot see past? Are they relaxed and at ease? Absolutely not! Their body will reproduce the identical events it did from the first scare. Except all those responses will happen before they even get to the corner.

As they cautiously approach the blind corner, and their body is in full anticipation mode-anticipation of the next blood curling scare-they turn the corner to see a unicorn and rainbows.

No threat exists at this corner. Yet their body and mind went through all the same events as if the next big scare actually took place. That pattern continues through the remainder of the tour with each anticipation of the scares almost as physically and mentally real as a scare itself.

The source (which we cannot see) that created those responses in the photos is not the only part of that scare experience. Although likely not as obvious to those in the photos, the entire experience includes the people they are with, the smell of the room, the temperature of the room, the sounds and even how their clothes fit. And as the remainder of the tour continues, they all become part of the biological, psychological, and social contribution to that experience.

Now consider this scenario. After the first scare event, the participants get to put on full body armor and carry a 4-foot taser wand that can keep anyone or anything at least 4 feet away. Do you think this would increase their confidence and decrease the threat as they approached the ensuing corners? I would suggest it does make them safer and more confident. Perhaps they will have some fear, but not nearly as intense now that they have these protective “tools”.

So, what has this got to do with someone dealing with chronic pain? The scenarios can be almost identical except replace “scare” with “pain”. Let us say for example that after a long flight you felt a pop in your back as you lowered your carryon from the overhead bin. You begin to feel your back tighten up and you experience the pain ramping up as you exit the plane. Beginning with the “pop” you felt, you would begin to experience those same 7 traits listed earlier. And whether you realized it or not, the physical pain itself is not the only part of the experience. The people you are with, the smell of the airplane and then the terminal, the temperature, the sounds and even how your clothes fit all become part of the biological, psychological and social contribution to that pain experience.

These combined elements begin to form a neuro signature or neuro representation in your brain. Over the next couple of days as you are recovering from this episode, you experience those 9 traits (boxes to tick) any time you anticipate potential threat to your back. This could be something as familiar as putting on your socks. Some movements may in fact provoke pain, but others may not. Yet the net result is remarkably similar in terms of your physiological and mental response.

You can clearly see how patterns emerge that are counterproductive to your long-term goals. And the reality of this is that we can’t, and you can’t explain your way through process. Yes, you need an understanding, but your body and brain also need proof. This is where a strategic and structured corrective exercise plan can create the movement confidence you need to no longer anticipate a threat when the threat is not valid. The proper, strategic exercise program for you becomes your full body armor and 4-foot laser wand.

Pain is an extraordinarily complex experience for everyone. And many people will attempt to chase one aspect or another of their pain. The science now tells us that we must look at the entire bio-pyscho-social context from which chronic pain is experienced.

Don’t live your life waiting for the next ghost or goblin around the corner. Suit up, educate yourself and show your brain that you are not broken.

Happy Halloween!

The Problem is the Problem

Wednesday, April 29th, 2020

It’s amazing how a few simple concepts can completely change the way we process and approach challenges.

That’s why were so excited to share with you this brief conversation that I had with Kevin Murray, our Director of Education.

Kevin brings a dual perspective to our work with clients in pain that most other practitioners do not. After almost 10 years of learning and growing with the Function First Approach, Kevin went on to complete is graduate studies in Counseling Psychology.

Set aside 30:00 for some incredible insight and actionable items that we can all experience massive value from.

How and Why a Function First Virtual Appointment Works

Tuesday, March 31st, 2020

Did you know that we have been working with clients from around the world via video since the VHS days?! Today’s technology allows us to to communicate much faster AND you get a video record of your exercises!

The beauty of working this way is that you get to follow along a video, work at your own pace and keep a video archive of your exercises. Everything on the video is 100% personalized for you and recorded AFTER a face to face video consultation.

Many people have thought we would charge more for this appointment because of the extra time we put into filming your video. But we don’t. The price is the same as the in-person appointment.

You don’t require any special technical skills. We work via Skype, Facetime or Zoom.

Admittedly, there are advantages to in person appointments as well, but with the current distancing for our local clients, that is not an option. For our long distance clients, they have been working successfully through this medium for many years.

We are here to help!

Pain and the Guessing Game

Monday, December 23rd, 2019

As your 2019 wraps up, I’ve got a valuable message for you that will pay dividends for years to come, but it may be most relevant to you right now, as you welcome the holidays in full force.

There’s a great video that has made its way around social media about what occurred when 5 wolves were reintroduced to Yosemite. There are several versions of the video, but essentially the message is how introducing these wolves even changed the flow of the rivers and streams through the park. Watch on YouTube here if you’d like to see this video.

Now we would all be hard pressed to draw a direct line from a wolf to impacting the way millions of gallons of water flow. But what it does illustrate is the profound output that emerges from multiple inputs, especially with a biological ecosystem OR a biological human=YOU!

In the case of the changes to Yellowstone, it was the interaction of all the sub systems initiated by the introduction of a predator that had been eliminated from the ecosystem. Overgrazing was controlled, smaller animals for birds of prey returned, etc. and nature took over.

As humans, when we experience physical pain-especially chronic pain-there are always multiple contributing factors that are related to the bio-psycho-social paradigm around pain. You are more than a bulging disc, osteo arthritis, spinal stenosis or anything else you’ve been diagnosed with.

Which is why it is often so difficult to determine why you are having a “bad day”. But we search for answers and as humans, desperately strive to find a connection or relationship with something so that we can make sense of it. But how come we don’t do the same with “good days”? We welcome them but we don’t drive ourselves crazy trying to determine what led to that good day.

Let me help you. Lots of things lead to both good and bad days. And there are often patterns that we don’t look for or recognize. And it is almost never just one thing, unless the pain was felt immediately (within seconds or minutes) of a physically taxing or traumatic event.

The greatest gifts you can give yourself during challenging times of experiencing pain are these (in no particular order):

 Corrective or restorative exercise (ideally your Function First program)
 5-10 minutes of deep, diaphragmatic breathing in a restful position
 Non proactive aerobic exercise that elevates your heart rate for a sustained 20+ minutes
 Quality sleep
 Avoiding over processed and/or gut irritating foods
 Plenty of water
 Occupy your mind with social interaction or deep, meaningful work or projects

Happy Holidays from all of us at Function First!

Mobility Matters: Flexibility vs. Mobility

Sunday, September 29th, 2019

via Gfycat
The terms flexibility and mobility are often used interchangeably. Although from the same “family” they are two different things. The fundamental difference is that flexibility relates to the ability of a muscle to lengthen. Mobility refers to the ability of the muscles to lengthen with control.

For example, if you can lay on your back on table and someone can push your straight leg back toward you with your knee straight so that your hip is flexed past 90 degrees, that would be your hamstring flexibility.

Then if you stood up from the table and tried to kick your leg to the same range, it is doubtful you get more than 60-80% of the range you had on the table.

That’s the difference between mobility and flexibility in its most simplified way.

Is one better than the other?

Both are important and we use both with our clientele at various times in their journey and for different objectives. But ultimately, mobility is more transferable to activities of life, work and sport. This is because mobility is a much more integrated “hardware” and “software” process. Hardware referring to the soft tissue and software referring to the nervous system.

Conversely, someone pushing on your leg (or you pulling with a strap or belt) is more of a hardware process and less of a software process then the more movement-based mobility approach.

At the end of the day, flexibility is a means to an end and not the end itself. The results of stretching can feel good and help with the compliance of our tissue.

Improvements in our range of motion (ROM) from flexibility practices can be acute (immediate but short term) and chronic (sustained improvements).

Some of the most up to date research on flexibility has shown that the most effective strategy for acute changes in ROM is self-myofascial release followed by either static or dynamic stretching. This would include foam rolling, lacrosse or tennis balls, massage sticks and other implements.

The following guide can help compare and contrast the techniques you use to feel like you have more range of motion and feel “looser”.

Self-Myofascial Release

What it is: The use of foam rollers, lacrosse or tennis balls, massage sticks and other implements in soft tissue areas of the body to produce a form of self-massage.

What it does:
Effects both the mechanical properties of the soft tissue (skin, fascia, muscles, tendons, nerves, blood vessels) and the nervous system. It reduces the resting tone of the effected muscles, leading to healthier, more compliant soft tissue.

What it doesn’t do:
Lengthen muscles or fascia

Senior woman using a foam roller for self myofascial release


Static Stretching

What it does:
Increases range of motion at a joint by lengthening the elastic component of the muscle, causing some changes in the visco-elastic properties of the muscles. Some improvements in stretching are actually attributed to the individual’s increased tolerance to the discomfort of stretching.

What it doesn’t do:
1. No clear evidence that is reduces the risk of injury prior to activity
2. May decrease force production when done prior to explosive and/or maximal effort (such as jumping, maximal lifting, etc.).

Dynamic/Active Stretching

What it does:
Increases heat and fluid exchange to the tissue. This helps with elasticity to the soft tissue. Stimulates the nervous system and thereby prepares the body for activity.

What it doesn’t do:
Provide huge gains in range of motion

Some of the most up to date research on flexibility has shown that the most effective strategy for acute changes in ROM is self-myofascial release followed by either static or dynamic stretching. The research include using foam rollers, lacrosse or tennis balls, massage sticks and other implements.

How Accurate Are Your MRI Findings?

Monday, July 15th, 2019

We all want the best, most accurate information we can get regarding our health. And when the doctors and therapists are not getting the results everybody wants, they will typically order imaging studies to gather more information and an “accurate” look at what is going on.

Many in the general public consider the MRI as the gold standard or best possible diagnostic available. What we must realize, however is that an MRI (magnetic resonance imaging) is an image or picture. And as such, its interpretation relies on the individual reading the image. This is generally a radiologist but may also be another medical doctor that is treating you.

The technology behind an MRI is quite amazing and is not in question. What is of concern is the accuracy of the conclusions reached and therefore the ensuing treatment plan, costs and expected outcome(s)that follow.
lumbar mri
A 2017 study in The Spine Journal, wanted to look at just how accurate and consistent MRI findings would be across 10 different MRI centers. A 63-year-old women with a history of lower back pain and nerve pain down her leg received 10 MRI’s at 10 different locations over the course of 3 weeks.

What they found were very large differences in what was reported as the findings on the MRI in both false positives and false negatives (see chart from study below). Using disc herniation for example, 47.5% had a false negative or miss rate. Meaning the herniated disc was there but missed by the radiologist.

For those of us that work with a population determined to overcome their pain, the MRI is a double-edged sword. Because, as you may know from some of my past posts, the findings on an MRI do not have a one-to-one correlation with pain. There are people who have MRI’s that looked like they have been hit by a bus and have no pain. And there are people who have no clear findings on an MRI and may have significant pain. The bio-psycho-social factors that contribute to the pain experience are numerous.

What Can We Do?

Most importantly be informed and question everything. Even if you are sure the MRI findings are accurate, they don’t equate to surgery. In the absence of any medical emergency (significant muscle weakness, bowel or bladder problems), conservative treatment has shown to be as good as surgery and in several studies having even better outcomes.

At Function First, we are not doctors or physical therapists. We are exercise and movement professionals who understand the pain experience and how important it is to provide exercises that remove mechanical stress from the body and restore movement confidence through a very systematic process of program design and coaching.

When you seek help from a practitioner, you always want to be the head coach. And appreciate that passive treatments (hands on therapy, modalities) and medications may be necessary to progress you to the next step. But a comprehensive exercise program is ultimately what translates to the real-life functions you seek to participate in and enjoy.
mri variability study

How does a client achieve success with Function First?

Monday, May 20th, 2019

In this part of the interview, Anthony shares several client success stories and what the transpires during the process. Exercise is the vehicle, but there are plenty of other elements that must be in alignment as well.

The Four Seasons of Chronic Pain

Tuesday, January 22nd, 2019

Written By:
Kevin Murray M.A.(pending), CAFS
Movement Masterminds – CEO
Function First – Director of Education
2012 CSEP CPT of the Year

For individuals’ living with chronic pain, the long-range forecast is often filled with metaphorical rain storms, treacherous winds and long, dark nights. When pain is present, the most noticeable characteristic of a client’s changing climate often revolves around biomechanical restrictions and movement limitations. Perhaps not so obvious (yet often just as burdensome) are the emotional and psychological factors involved with experiencing pain on a regular basis.

As such, in order to create a truly unique, multidimensional strategy for individuals’ in pain, expanding beyond the optics of biomechanics and connective tissue principles alone a becomes imperative. Let’s take a walk through the four seasons of chronic pain and examine how you can help your clients transition smoothly through each one.

The First Season – Winter (fear)
Winter is the first season of chronic pain, where the radical change in climate significantly impacts an individual’s emotional and psychological well-being. The narrative chaperoning this season is generally one of fear; fear of movement, fear of pain worsening, fear of the unknown. This fear can reach such heightened states that just the anticipation of pain is enough to steer an individual away from doing the things that matter most to them. Imagine avoiding an activity altogether because of the anticipation of pain, rather than in response to it!
Screen Shot 2018-11-09 at 8.30.54 AM

When such avoidance behaviors manifest, it’s clear that approaching the chronic pain demographic solely from a biomechanical perspective is an incomplete approach. The neuromatrix theory of pain proposes that the output of pain is regulated by afferent sensory mechanisms in conjunction with cognitive inputs (Melzack, 2001). These cognitive inputs have the capacity to upregulate and exacerbate states of anxiety, apprehension, depression, self-doubt; all of which fall into the category of psychological/emotional stressors.

It’s these stressors which contribute significantly to winters burdensome climate. To clients in pain, winter’s dark and onerous atmosphere can sometimes seem like it’s going to endure indefinitely. Successfully helping clients’ transition out of winter requires an understanding of one critical distinction; the difference between a clients ‘external’ and ‘internal’ problem.

The Second Season – Spring (awareness)
The melting of snow, dissipating precipitation and the alchemy of animals awakening from hibernation are all welcomed signs that winter’s season is changing. To the health and exercise professional, guiding clients’ towards these more desirable climates lies in understanding each client’s internal problem.
Screen Shot 2018-11-09 at 8.37.58 AM

All clients in pain have two global problems. The ‘external problem’ is the biomechanical or anatomical concerns each client reveals during their initial consultation. Consider the client who has been experiencing knee pain for years. That’s the external problem – the knee pain. The ‘internal problem(s)’ however are the area’s in life which hold the most meaning to individuals negatively impacted by chronic pain. The internal problems are the emotional, psychological and social/environmental stressors that are 100% unique to the individual.

For example, consider a husband and wife who spend meaningful time together each day walking their dog. However, in recent months the husband’s knee pain (external problem) has become so problematic that it’s preventing him from participating in the most meaningful aspect of his day, which is connecting with his wife via their evening walk (internal problem).

A clients’ emotional transition from winter into spring begins with his or her health and exercise professionals’ gaining awareness into the clients’ internal problem(s). This awareness then provides an opportunity for both the coach and the client to begin scripting a new, more desirable narrative based on what the individual client values most.

The Third Season – Summer (possibility)
For any seed to blossom and reach its full potential, a conducive climate is required. To clients in pain – fear, anxiety, feelings of hopelessness and negative self-talk are the metaphorical weeds of cognition. If these weeds are ignored, they can uproot any forward progress. During the summer months, the seeds of possibility must be nurtured, and the cognitive weeds must be pulled on a regular basis.
Screen Shot 2018-11-09 at 8.45.38 AM

As with any journey, minor setbacks and moments of self-doubt are to be expected (particularly when chronic pain is present). Because of this, granting clients permission to steep themselves in the process of constructing future-oriented, growth-focused possibilities becomes essential.

The Yellow Brick Road refers to this process as a ‘Possibilities Paradigm’ and involves 4-chapters, each designed to amplify and reinforce a clients’ emotional and psychological resiliency & well-being. When successful, these 4-chapters begin to stir hope & optimism back into each clients’ current and future script.

The Forth Season – Fall (self-regulation)
The fourth and final season bears witness to clients’ returning to pain-free living. And while there are a host of ingredients chaperoning any given pain-free transformation (biomechanics included), a clients’ capacity to accurately assess and regulate their emotional states (self-regulation) is a primary contributor in overcoming his or her internal problem(s).
Screen Shot 2018-11-09 at 8.49.33 AM

Contrast the experiential difference in self-regulation between a client stating, “oh no, I just threw my back out again!” vs. “my back tightened up, but I know it’s just my body trying to protecting me.” These are two completely different emotional reactions, the former reverberating sentiments of fear and the latter signifying the perception of safety and protection.

Preventing clients from experiencing negative emotions is, of course, not possible. However, as health and exercise professionals, we can strive to cultivate a climate that enhances each client’s self-regulation competence and help them identify and overcome the emotional and psychological stressors that contribute to their pain. Importantly, you can begin this process with your client even before you have conducted his or her biomechanical evaluation.

Reference:
Melzack, R. (2001). Pain and the neuromatrix in the brain. Journal of Dental Education. Vol. 65. 12, pp. 1378-1382.

Health pros interested in learning more about the Yellow Brick Road curriculum through the American Council on Exercise can click on the image
Screen Shot 2019-01-10 at 2.50.11 PM

An Overview of a Function First Initial Visit

Sunday, June 3rd, 2018

We are regularly asked, “what does a visit at Function First look like?”.

Function First founder Anthony Carey takes you through an overview of what that first 2 hour appointment is all about and why it is so pivotal for so many.

Be sure to take note of the differences of how we approach our process compared to what you might experience elsewhere. Even if you are an existing Function First client, this video will be great to share with friends who you know can be helped by what we do.

Please pass along to those that are ready to take a powerful step forward with a movement based program that is backed by science.

Event: Age 50 Plus Training for the Life You Want to Live

Monday, October 30th, 2017


Saturday, November 11th at 10:30 am Brainstorm Fitness opens its doors for the workshop: The Importance of Training for the Life You Want to Live: the tools, the why & how.

Learn about the state of the art equipment at Brainstorm Fitness that helps individuals like you move better during their sessions and in everyday life. Hear about the specific physical benefits of moving certain ways and be able to ask questions of fitness professionals that understand the scientific reasoning behind them.

Understand how these different ways of exercising translate to improving the way you enjoy your life and how exercise makes you stronger and more efficient when going about your everyday activities that you have to do.

This will be an interactive workshop where you will be able to grasp more than the “exercise is good for you” idea but instead, understand why moving better is so important to maintaining your health and well being.

The speakers will be Anthony Carey and Damien A. Joyner

Anthony holds a Master’s degree in biomechanics and athletic training and is the inventor of the Core-Tex™. Anthony is recognized internationally as a leading expert in biomechanics, corrective exercise, functional anatomy, and motor control.

Damien is a Functional Aging Specialist that works with individuals 40 years and up so they can continue to do what they like and want to do in life easier and with less discomfort.