| T O P I C R E V I E W |
| robin |
Posted - 03/07/2006 : 19:42:37
I am so excited!! I just got my April issue of Runner's World. There is a two page article about Mind Body issues and the focus includes Sarno and Schecter.
I have not usually had a lot of respect for Runner's World because it often focuses too much on injuries. I have a whole new respect now and maybe finally many of my running colleagues will not think I am totally nuts for saying "Yea, I have pain in____________(any body part) but I really think it is because________________(any stressful event occurring in my life)." Most of my friends have thus far just looked at me like I had horns on my head, but now maybe they will start to question their own pain. |
| 20 L A T E S T R E P L I E S (Newest First) |
| wrldtrv |
Posted - 03/15/2006 : 22:32:59
Thanks for posting the RW article on TMS, Peter. I was struck by the paragraph where Dr Schecter says that some runners obsess over a "problem area", the site of a previous injury, the hypervigilance either creating the pain or making it worse. Reminds me of the hamstring tendonitis I have had for yrs that never seems to heal completely. It has been my problem area, one that I have put all my attention on, being careful with it, expecting it to be sore after a run or race, doing all the correct things --ice, ibuprofin, gentle stretching...all to little avail. The thing that has kept my focus on the physical is (as I said before) that I had a partial rupture there 20 yrs ago. The RW article gave me a different way to look at the matter. |
| Fox |
Posted - 03/15/2006 : 09:37:30
FlyByNight - Good point about helping to determine if pain associated with an activity is TMS or not - to visualize the activity and see if you get tightening or some pain in the problem area....It's amazing that this often works. I have convinced myself that my pain is due to conditioning by this simple mental exercise several times in the past and this knowledge gave me the confidence to push through the pain with the particular activity until pain no longer was evoked.....Now I just need to push myself to do this with running, since I do get the pain response when visualizing this activity. |
| n/a |
Posted - 03/14/2006 : 15:32:30
Here is the full text of the Runner's World article:
Mind Over Matter
Ice and meds don't always work. Sometimes you need to out-think your pain
by: Marc Bloom - Runner's World (April 2006)
http://www.runnersworld.com/article/0,5033,s6-78-0-0-9463,00.html
About a decade ago, my running was brought to a halt by lower-back pain. I went to numerous doctors, received an array of treatments, and spent months in physical therapy. But the pain wouldn't go away. Fearing that any physical activity would make my back worse, I spiraled into a depression, thinking that I'd never run again.
Then I read the book Healing Back Pain: The Mind-Body Connection, by John E. Sarno, M.D., professor of clinical rehabilitation medicine at New York University Medical Center. Dr. Sarno's theory of Tension Myositis Syndrome (TMS) claims that ongoing physical pain can sometimes be caused by psychological reasons. Something must've clicked, because just reading the book made my back feel better.
Dr. Sarno believes (and somewhere in my unconscious, I agreed) that physical pain is easier to take than emotional turmoil, and that in order to end the pain, you need to confront your feelings (on your own or with help from a therapist), ignore the pain, and resume normal activities. The ache in your back (or foot or knee) can be a coping mechanism-a way to distract your mind from its own suffering. Once you are able to resolve the true source of the pain, it will disappear.
Of course runners get injured and have pain for identifiable physical reasons, but there are some cases (like mine) when underlying emotional issues are to blame. After months of hopelessness, I was ready for an alternative, even if it sounded radical to others. Over the course of a few months, I used several TMS treatment strategies (see "Get Over It," page 50), which helped me resume running and ultimately defeat the pain.
Ask your family doctor about TMS, and it's likely you'll get a clueless look or a dismissive response. There are thousands of success stories, but without randomized, controlled trials supporting TMS, it's a hard sell to the medical community.
David Schechter, M.D., hopes to change that. The Beverly Hills physician is doing research and collaborating with researchers at UCLA to conduct studies that will lend credence to the theory of TMS, or what he calls Distraction Pain Syndrome. Dr. Schechter's decision to specialize in sports medicine and mind-body medicine was no accident. He suffered from nagging knee pain while in med school, and standard treatments were of little comfort. "Running was my stress relief and when I couldn't do it, that stressed me out more, which only made my knee feel worse," he says. Learning about TMS helped him break that cycle. "Once I understood that the pain was my body's way of distracting me from the pressures of school, I could let it go and run again," he says.
Too Good to Be True?
Hard evidence for TMS might be slim, but the interplay between mind and body is indisputable. Scores of studies have linked feelings of stress, tension, and anger with the increased risk of various ailments, from migraines to heart disease. And it works both ways: Having a positive outlook has been shown to bolster the immune system and speed healing and recovery.
David Rakel, M.D., director of the University of Wisconsin Integrative Medicine and assistant professor of family medicine, believes the mind and body are so intertwined that saying there is a "connection" between the two is misleading. "That implies that they are two separate things, but they aren't," he says. "The mind is in your body and your body is in your mind." Dr. Rakel takes a holistic approach in treating all his patients. He considers if there could be an emotional root to the problem. If not, he focuses on conventional treatments. "When a muscle cries out in pain, it's assumed its cause is physical," he says. "It's an oversight to not appreciate the mind's influence on the physical."
Mind Power
Emotional turmoil-be it dissatisfaction with your job or running performance-can cause the autonomic nervous system to reduce blood flow to nerves. This can result in mild oxygen deprivation, which can cause achiness in muscles, Dr. Rakel says. "A massage won't resolve it," he says. "You need to explore what's going on in your life that's causing your body to react this way."
Dr. Schechter says he has seen cases of plantar fasciitis, iliotibial band syndrome, and patellar tendinitis-all common running ailments-that were triggered by the brain. "The first time a runner comes to me with a problem," he says, "I ask, 'Did you recently change your training? Are your shoes worn out?' If there is no problem, then I start considering psychological causes."
Dr. Schechter says that some runners can experience pain by obsessing over "a problem area," a spot where they have a predisposition to tenderness or discomfort. "There could be a slight physical pain, but the stress and anxiety they feel over it amplifies it," he says. Runners coming back from an injury are especially prone to this, says sports psychologist John Heil, author of Psychology of Sports Injury. Pain from an injury can linger even after the body has healed because of "hypervigilance," says Heil. "When you experience pain over time, there can be a resetting of the pain threshold," he says. "It may take less stimulation to send pain signals to the brain." So what you perceive as an ongoing injury could be ordinary muscle soreness. If your doctor has assured you that your injury has healed, and you've done the proper rehab, ignoring the pain should make it go away, he says.
Even the stress of racing can provoke pain. If you come into a race feeling anxious, your mind can trigger certain body processes that result in pain, says Heil. "Fear can set off a fight-or-flight system. Your muscles tighten and you burn up resources like adrenaline and energy reserves. This can lead to premature fatigue and inefficient running, resulting in muscle pain."
Being open to the possibility that pain could be rooted in emotion isn't easy. But if it can bring peace to your mind and your muscles, it's worth the effort. At least it was for me. Now I'm running to my heart's-and my back's-content
Get Over It
If you're plagued by an ongoing, nagging injury that isn't responding to traditional therapies, there could be a psychological link. If so, "there are a lot of roads to relief," says David Rakel, M.D., of the University of Wisconsin. One of these might work for you.
Journaling:
"Writing about a stressful event helps you feel a sense of control over it," says Dr. Rakel. Gaining a better understanding of your feelings often reduces the severity of the pain instantly, he says. Writing about a disappointing race performance, for example, could help free you of pain.
Distract yourself:
Some of John Sarno, M.D.'s patients find relief by repeating "reject the physical, embrace the psychological," to distract their minds from their pain. Develop your own mantra ("I'm fast, I'm strong") and use it in a race when your mind needs to convince your body to keep going.
Coping rehearsal strategy:
Sports psychologist John Heil suggests anticipating the feared aspects of a race and how you'll get through them to eliminate surprises. "Plan to change your form in order to relax the body and use positive self-talk in conjunction with relaxed breathing," he says.
Mindfulness-based stress reduction:
This treatment encourages people to live in the moment. "Most of us are either stuck in the past or focused on our desires for the future," says Dr. Rakel. "Being in the 'now,' and focusing on the things you can control can help you more fully enjoy life." |
| Dave |
Posted - 03/14/2006 : 14:19:04
hsb,
I see where you are coming from but it seems you don't fully understand the finer points of TMS, and that is necessary for recovery. Have you read Dr. Sarno's books, multiple times?
For example, the ortho tells you that running will make your neck more painful. You say "you cannot dispute it" because you run and you get pain. This implies you don't understand the conditioning aspect of TMS which is an essential concept. You have been conditioned to get more neck pain when you run. The pain produces the desired effect: it makes you believe you have an injury. Thus, the pain will continue, and it will present itself in exactly the way you expect -- in a manner designed to convince you that it has a structural origin.
I suggest you re-read Healing Back Pain and The Mindbody Prescription and allow the concepts to sink in. You are obsessing about your neck pain and that plays right into the hands of TMS.
It is true that acceptance is a battle. But it is a necessary first step. Until you get there, you can't get anywhere. Many struggle with symptoms for a long time even after they accept the diagnosis. That is when it is essential to take a long-term view and accept the process of recovery. But first you must repudiate the structural diagnosis. |
| FlyByNight |
Posted - 03/14/2006 : 12:36:00
HSB
I am having exactly the same battle as you do my friend and I agree 100% with what you just wrote. Fighting your TMS is a process, not an end. I had multiple TMS symtoms in my life and I must say that the neck ones are the most scary becaue of the complexity of the structures affected by oxygen depletion in this area (there is a lot of nerves, 6 layers of muscles , etc) and the variety of symtoms that are resulting from it (also the fear coming from the fact that the neck it is very close to the brain). To my modest opinion, it is normal that you have a hard time to 100% accept TMS . But AS I am starting to do it now , I am sure you will if you do your homework properly.
By the way HSB, I am also running with my neck pain since 3 weeks now . sometimes the neck pain is reaching higher peaks during the cool down process, sometimes it does not change at all.... you need to find 1) if your pain while running is a conditionned response. To do that, just vizualize you running, do you feel some pain or muscle tightning ? If so, there is probably a conditionning response involved here... and 2) if so, try the Rewarding system proposed by fred amir in his book to help you decondition yourself.
good luck dude !
P. |
| hsb |
Posted - 03/14/2006 : 11:54:56
Dave-
I would say I am more confused than non-receptive.
The physical stuff is very very powerful and persuasive. From the messages I have read, many TMSers struggle with the acceptance and are going through the same battle as I. The pull to look for a cure or a treatment is very strong especially when the pain doesn't get better. Look how many people write multiple posts about their continuing battle and look for acceptance here.
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| Dave |
Posted - 03/14/2006 : 11:23:41
hsb,
You keep posting here and honestly, I'm not sure why. You don't seem to have any desire to consider treating your neck pain as TMS. You are clearly convinced it is an injury, so you might as well treat it as such. |
| hsb |
Posted - 03/14/2006 : 11:17:31
well I ran 6 miles on Saturday, 10 miles on sunday and an hour this morning. The neck pain was tolerable Sunday and Monday but this morning, the pain is very bad. I am fighting within myself about going back to Ortho. (he dxed DDD). I know he will want an MRI but I am afraid that it will show herniations. He did tell me not to run through this as the jarring would make my neck painful and not heal. I guess so far I cannot dispute it. I honestly do not want to stop running. I am at a standstill now. I have not stopped running since the neck pain started.
I wonder if I should experiment and stop running for a few weeks, but that goes against my grain.
Thanks all.
HSB |
| hsb |
Posted - 03/10/2006 : 14:50:10
robin-
thanks. believe it or not my "injury" this time is not affecting my legs or butt or calf!!! WHAT A CHANGE. it is my neck and trapezius muscle. some of thoughts that are put into my head by the ortho and the PT are -- running, i.e. the weight bearing will hurt the neck (DDD) and it will never get better.
my TMS beliefs are: (1) a slight crick in the neck gets better - doesn't last 6 months; (2) a slight crick in the neck would get better with NSAIDS, (3) a slight crick in the neck doesn't turn into DDD. last year i didn't run very much because of groin/adductor issues and i had surgery. that pain is completely gone now - guess what - the little crick in the neck is so bad now and is making me think of the usual stuff - go to doctors, find a treatment, running will prevent it from getting better. the neck pain is the next version that TMS is using now. NOW WHY CAN'T I FULLY BELIEVE IT!!!!!
hsb |
| robin |
Posted - 03/10/2006 : 14:39:13
my tms disallowed me to run. so, as soon as i came to realize it was tms I went with it and then i tried to run. the pain initially went away totally (I didn't have a hard time- at all- believing in tms), crept back and still keeps creeping back. This is where the work comes into play- i do continue to journal, etc. To keep it away you need to work at it- not necessarily changing your personality but realizing what the triggers are and ignoring the pain. I think this is what will help keep the pain away forever. But you are not looking at forever at this point. All you want to do is be able to run tomorrow... So go do it! My point is that you have to stop with the physical crapola and trust that it IS TMS and your pain will go away. |
| hsb |
Posted - 03/10/2006 : 13:28:10
oh by goodness - the work!!!!!!!
isn't that the crux of how to get pain free? i think i once read awhile back that if "i could go out and run all i want, and not do the work, the pain won't go away."
this is a very difficult concept for me and i suppose others. from your previous posts robin, you seem to be a high mileage runner who is fairly obsessed with it (LOL) like me. you also were given a dx of DDD - didn't you think all that by running, the pain would not go away?
i will be going out tomorrow to run 6 miles and sunday 10 miles.
hsb
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| robin |
Posted - 03/10/2006 : 12:15:22
hsb said:
that it is a way to continue to run w/o taking that time off. BUT this won't work unless i do the TMS work -- correct?
What TMS work? I wouldn't call it work. I would call it just simply believing! Start by truly believing that all the pain is a bunch of b.s. and you refuse to take it any longer. Start swimming, lifting, and spinning again. Do ALL the things that you know previously have triggered pain. When the pain comes tell it- Thanks, but I don't need you anymore. Do this and your belief will inevitably become stronger once you have more proof.
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| Dave |
Posted - 03/10/2006 : 10:40:08
quote:
Originally posted by hsb
i don't mean to be negative, but in the past, all my attempts at therapies, meds, have never worked and again this might be considered "predicting the future" but it has never worked before in all of my millions of other "injuries".
Then why haven't you made the leap already and decided it was TMS? |
| hsb |
Posted - 03/10/2006 : 09:41:54
robin-
well said. i think my fear is that let's say i take off 6 weeks from running and treat the neck isses - do PT, meds, rest, etc. the fear stems from the "what if" --- what if i'm not better after the 6 weeks, then i wasted the 6 weeks and gotten completely out of shape, have to start all over again, with 30 min. runs, etc. there is no doubt i am obsessive with the running and exercising - because of this neck pain, i have stopped swimming, stopped lifting weights, stopped spinning classes and just have been running.
i don't mean to be negative, but in the past, all my attempts at therapies, meds, have never worked and again this might be considered "predicting the future" but it has never worked before in all of my millions of other "injuries".
i suppose deep down inside i don't want to gain weight and lose fitness and have to always start over and not be able to run with my friends.
when i said previously about using the tms theories as permission to run, i think i meant - that it is a way to continue to run w/o taking that time off. BUT this won't work unless i do the TMS work -- correct?
Thanks Robin.
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| robin |
Posted - 03/10/2006 : 09:04:48
hsb said:
perhaps i want to use the TMS belief system to give me permission to
run and not take time off from running and lose fitness, etc.? you compulsive runners out there - do you concur?
I wanted to reply to this message, but I can't figure it out. It seems weird to equate the tms system as a permission to run. It just occurred to me that maybe part of your issues involve the fear that comes from not being able to run. What would happen if you lost your level of fitness? Would that cause you to not be able to compete with others? Does that fear cause you anxiety? I definitely fear not being able to run and it (the fear) totally involves not being able to keep up with my runner friends. Does that make any sense? |
| FlyByNight |
Posted - 03/10/2006 : 08:44:43
Fox.
I do experience the exact same rash with chlorine ... is targets some specific soft skin part in my case hehe ..
interesting to see a potential link with TMS
P. |
| Fox |
Posted - 03/10/2006 : 08:40:40
I have no problem pain-wise with swimming laps in a pool or swimming/body surfing/body boarding in the ocean....I did swim laps for 3 months several years ago - 6 months after the surgery - and it was just as effective mentally as running, but I starting having a problem with itching and attributed it to chlorine in the pool so I stopped - but I bet the problem was really TMS. (I never actually saw a rash. I just had the sensation of itching.) |
| FlyByNight |
Posted - 03/10/2006 : 08:33:41
the key to me is to do it progressively ... you could start with swimming also... its very soft on the body and maybe more suitable for you to get more confidence at the moment considering your amount of present fear. |
| Fox |
Posted - 03/10/2006 : 08:26:04
Thanks for the encouragement, FlyByNight. I know that I need to push on this. Running for me used to be like a "Pepto Bismol" coating for the brain. I'd run an hour each morning and I'd feel relaxed and joyful all day....And it used not to increase my leg pain....But then I saw an orthopedist who told me to stop running or I'd tear up more discs, I had a spinal fusion (which didn't help at all), and I turned chicken....Without running, I tend to get upset and obsess over inconsequential things and I don't like that. |
| FlyByNight |
Posted - 03/10/2006 : 08:18:35
Fox,
I experience the same 'delayed' pain after running . actually its coming as soon as my neck is cooling down (15-30 minutes after the run) . To help me not focus too much on the pain, I decided to run to go the office in the morning. I am so busy at work that I dont have much time to obsess on the pain. It works almost fine.... almost .. hehe .
In my modest opinin, you should start running again ASAP
P. |
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