At Physical Therapy the vast majority of our clients come to us in pain, either acute or chronic pain. Understanding your pain is a key area we focus on when helping clients to manage injury and pain.

The Fear Avoidance model above was introduced by Lethem et al. in 1983, explains how people can develop chronic pain from musculoskeletal injuries. What starts out as a minor injury e.g. Back pain, can develop into more chronic pain through fear and avoidance of activity. This fear and avoidance thought process can feed into pain, until a person becomes paranoid to move and the pain becomes all consuming everyday.

Obviously at the early stage of an injury it is important not to over stress an injured site while rehabbing the area and preparing the area for a return to work or sport.

The Fear Avoidance model talks about how a person, when injured starts to have anxiety about the cause of the injury, missing work or training, fear of re-injury or they go to a doctor or specialist who tells them their injury is very serious.

This fear and avoidance thought process can develop into a vicious cycle of doing less activity, visiting different doctors and therapist looking for different solutions to the pain. So in the example of a client with back pain, they might stop their weight training classes, stop picking up the kids or carrying shopping, for fear they might re injury their back. We always hear people say “I have a weak back” or an “I have an old back injury so I cant exercise much”, it is important to remember damaged tissues in the body heal within 6 – 8 weeks.

During the course of the injury the brain has been programmed to look for these pain signals from the back, in this case the nerves in the back can be hypersensitive and even thinking about a set of dumbbells can trigger these pain signals. These signals are not actually pain, they are warning signals sent to the brain. The brain then decides if it should transmit these signals into pain or not… so yes technically the pain is in your head.  In the case of chronic pain, the brain is programmed to transmit these signals into pain.

The process of understanding your pain and managing it, starts by trying to reduce these warning signals to the brain and change how the brain interprets these signals, at we see movement as the best way to do this.

At we educate clients on the importance of finding a baseline for your pain and movement, then starting at this base line and building on the simple movement that causes little or no pain. Then we build from this point by slowly introducing new ways to move e.g. starting movements on the ground, progressing onto the knees and then into standing.

As the body learns to move differently and warning signals lessen, the brain stops looking for these warning signals, so you may eventually get to a stage were movement is now pain free or modify your movement so as it is pain free.

This process can take some work and time, and we feel it is important to educate clients to understand their pain, do their research (not on Dr Google) and learn to control their thoughts around their pain.

If you would like to learn more about understanding your pain, please contact us for an appointment.