Exercise for Chronic Pain Relief – with Anthony Carey of Function First

Anthony Carey holds a masters degree in biomechanics, is a fitness trainer with 21 years experience whose work has been featured in New York Times, Time Magazine and Oprah’s “O” Magazine. He is the founder of Function First, a clinic in San Diego where Anthony and his team treat chronic pain and musculoskeletal imbalances without drugs or manipulation. Anthony is also the author of – The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulder, and Joint Pain.

In this interview we’re going to discover how the corrective exercise programs Anthony has developed help people get their lives back and get active again.

Neuroscience & Strategic Exercise

The first and most important thing to learn about the neuroscience for chronic pain is that it is not specific to any physical region. The next fundamental thing is to be aware that there is no pain until the brain says there is pain. For a lot of people this is an uneasy piece of information to digest.

In terms of exercise, Anthony and his team have discovered that no matter how much the brain is involved and how much the nervous system has increased its sensitivity, regular exercise and movement can “re-teach” the brain and the nervous system. By doing regular exercising you provide a reliable and consistent reference to the brain that the back or knee or neck etc, is capable of moving in certain ways and is not as fragile as initially interpreted.

The first step to building those new evidences for your nervous system and brain is to start looking strategically at you exercise. Start with observing your posture, the way you walk, the way you sit. As long as you continue operating on the same patterns you will keep sending the same signals to your brain.

To change these patterns you need to start introducing corrective exercises to your body. Be careful not to “overwhelm” your nervous system with too complicated or perfected movements. This will create a defensive reaction and compromise the ultimate results. It is much better to start slow and gradually build up to more complex exercises. Remember that each starting point is very individual, based on current situation and past medical history.

The most important thing when re-educating your nervous system with movement and exercise is to be able to relax and fade out the anxiety of getting pain after a specific movement.

Tricking The Nervous System

There are a lot of ways to introduce new motion to the nervous system. One that is particularly interesting is to trick the nervous system that a new movement is performed while the actual motion of the body is the same one producing the pain earlier.

For example, one of Anthony’s patients with chronic neck pain had a long history of not being able to rotate his head to the right. Instead, he was now asked to keep his head still and rotate his right shoulder to the left. Ultimately this is the very same motion in terms of what your eyes see and interpret. The muscles being involved however are different and this new combination confuses the nervous system which until now was used to associate this motion with neck pain.

What Else Is In The Mix?

A very common misconception among people suffering from chronic pain when performing certain movements is that the movement itself causes the pain. Therefore they should never do that movement again. In reality there are a lot of factors contributing to the brain’s decision whether you will experience pain or not. The first step for people with this false belief is to learn to acknowledge what else was in the mix at the moment of experiencing the pain – were they stressed out, dehydrated, lacked sleep etc.

An extreme and very powerful example for the variety of reasons causing chronic pain is the following case Anthony had in his practice. A woman came to him after she was pushed down her bicycle in a very crowded place and felt down on her shoulder.

Conventional examination didn’t show any serious bones trauma or tissue damage, however, she was feeling a persistent pain and limitations in moving her shoulder. After a 20 min conversation Anthony learnt that the woman have had other troubling experiences in a short period prior to the bicycle accident.

At the moment of the accident she was experiencing great anxiety for the safety of her husband and herself which the brain added to the mix of factors in deciding on the level of pain.

She was able to experience relief and freedom in her shoulder movement after a short and simple relaxation practice, combined with focused breathing.

One Size Does Not Fit All

The 3 most important questions to ask when evaluating an exercise are: For whom, For What and When? 

Most of the time exercises prescribed in conventional environments are not based on a deeper look into the individual case and needs. For example a common advice for people with lower back pain would be to strengthen their core.

While the core training might be a great idea for some, for others it only means increasing stiffness in an area they already feel stiff and try to protect from movement.

Chronic pain exercises generally are coming from purely bio-mechanical standpoint. We need to add to that the recent discoveries of neuroscience to be able to create a comprehensive and effective exercise for each individual case.

Learn more about Anthony and his work here: http://www.functionfirst.com/

You can read Anthony’s Book – The Pain Free Program


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