1
00:00:00,000 --> 00:00:09,000
Hi, I'm Quinn Carmighi. Welcome to Manifestation, Motivation and Passion. If you're looking

2
00:00:09,000 --> 00:00:14,100
to transform by delving into brain science, sacred inner wisdom and want to heal and feel

3
00:00:14,100 --> 00:00:19,160
great about your life and live in your powerful loving centre, whilst bringing affluence into

4
00:00:19,160 --> 00:00:23,200
your world, then tune in and let's evolve together.

5
00:00:23,200 --> 00:00:29,200
Jen Ashold grew up in Western New York and has been a PT for over three decades. Has

6
00:00:29,200 --> 00:00:35,280
worked in multiple treatment environments including travel PT. Out of her love for PT

7
00:00:35,280 --> 00:00:40,200
and helping others to empower themselves, she was drawn to both pain science and health

8
00:00:40,200 --> 00:00:45,940
coaching. Jen has completed a fellowship in pain science with evidence in motion and

9
00:00:45,940 --> 00:00:52,480
is an eager learner and has also studied lifestyle medicine and positive intelligence. Jen loves

10
00:00:52,480 --> 00:01:00,080
and has been teaching since 1998 with companies in Chicago, Virginia, Colorado and internationally.

11
00:01:00,080 --> 00:01:08,240
Jen has owned a small private practice since 2007. Outside of PT and coaching, Jen is a

12
00:01:08,240 --> 00:01:13,800
passionate mum to three, mostly grown kids, I understand that one, while seeking laughter

13
00:01:13,800 --> 00:01:19,240
and connection with others. As the saying goes, laughter is good medicine and Jen wholeheartedly

14
00:01:19,240 --> 00:01:24,200
agrees. Let's connect and get ready for some learning, smiles and even laughter today.

15
00:01:24,200 --> 00:01:29,600
Hi Jen, thanks for joining us. Thank you so much for having me, Quinn. I'm excited. Thank

16
00:01:29,600 --> 00:01:34,600
you for joining me. Perhaps we can jump straight into it. We're going to discuss chronic pain

17
00:01:34,600 --> 00:01:42,640
today and how does that differ, please, from acute pain? What a very good question. Well,

18
00:01:42,640 --> 00:01:50,560
I'll start by saying that pain is a universal experience. All of us experience pain and

19
00:01:50,560 --> 00:01:57,040
there's a very, very small segment of people that are born with the inability to feel pain.

20
00:01:57,040 --> 00:02:03,800
Most of us do not like pain, however, it is protective and those who have this condition

21
00:02:03,800 --> 00:02:08,600
where they don't feel pain, they actually don't live very long and an easy way to understand

22
00:02:08,600 --> 00:02:14,240
that is if you put your hand on a hot stove and you don't feel it because you have this

23
00:02:14,240 --> 00:02:19,920
condition, then this is going to very quickly turn into a problem for you. That's usually

24
00:02:19,920 --> 00:02:24,480
an aha moment for my clients who would think not having pain would be the most wonderful

25
00:02:24,480 --> 00:02:31,560
experience ever. The reality is pain is protective and if we go to this difference between acute

26
00:02:31,560 --> 00:02:40,040
pain and chronic pain, acute pain is more closely related to when we've had an injury

27
00:02:40,040 --> 00:02:47,040
or a surgery and a sprained ankle is a great place to start. So if you're hiking on a trail

28
00:02:47,040 --> 00:02:52,480
and you sprain your ankle and you feel pain, we would put that in the category of acute

29
00:02:52,480 --> 00:02:58,280
pain. We know that the way tissues heal, our muscles, our ligaments, these are very, very

30
00:02:58,280 --> 00:03:03,280
well researched and documented and we know that the bulk of those tissues are going to

31
00:03:03,280 --> 00:03:09,800
heal in generally three to six months. And so when we have people that have pain for

32
00:03:09,800 --> 00:03:16,160
a prolonged period of time, this could be months, years and even decades, we have to

33
00:03:16,160 --> 00:03:24,360
get a little bit more curious about pain beyond the physical, musculoskeletal tissues. All

34
00:03:24,360 --> 00:03:32,320
pain also has a component of the tissue health and also psychology and sociology and the

35
00:03:32,320 --> 00:03:38,920
framework that we work from is something called a biopsychosocial model. And what that means

36
00:03:38,920 --> 00:03:46,480
is that all pain has some biology to it, some psychology to it and some sociology to it.

37
00:03:46,480 --> 00:03:52,920
And when somebody has an ankle sprain or they just had a tooth removed, the piece of the

38
00:03:52,920 --> 00:03:58,320
biology pie is going to be much bigger and that's what we see with people who have acute

39
00:03:58,320 --> 00:04:04,760
pain. And then the longer people have pain, after we know the tissues are healed, then

40
00:04:04,760 --> 00:04:10,440
we have to get more curious about the psychology piece and the sociology piece. That might

41
00:04:10,440 --> 00:04:15,480
be a good overview and then I'm curious as to how I can dive deeper with you.

42
00:04:15,480 --> 00:04:22,240
Wow, that's a lot of information. So then how does I guess chronic pain impact a person's

43
00:04:22,240 --> 00:04:24,560
daily life and overall wellbeing?

44
00:04:24,560 --> 00:04:32,120
Wow, the answer is it is a unique experience for everyone and I have seen people who have

45
00:04:32,120 --> 00:04:41,200
been in pain for 30 plus years. Pain impacts all areas of your life and it impacts it differently

46
00:04:41,200 --> 00:04:47,840
for each of us. We have FMRI studies which are fancy brain scans that show us that there

47
00:04:47,840 --> 00:04:54,440
are nine different parts of the brain that are potentially involved in any pain experience

48
00:04:54,440 --> 00:05:00,160
and for each person that's going to be unique. And for somebody who it's the part of their

49
00:05:00,160 --> 00:05:04,920
brain that handles digestion, this may be somebody who shows up with more irritable

50
00:05:04,920 --> 00:05:10,120
bowel symptoms. And for somebody who's really having trouble remembering doctor's appointments,

51
00:05:10,120 --> 00:05:17,200
this might be affecting the memory and concentration part of their brain. And we can kind of go

52
00:05:17,200 --> 00:05:24,920
on and on in that area. And so the way I like to describe this is if you think about one

53
00:05:24,920 --> 00:05:28,920
of your favorite foods, so what's one of your favorite foods?

54
00:05:28,920 --> 00:05:30,960
Custard or chocolate.

55
00:05:30,960 --> 00:05:31,960
Custard?

56
00:05:31,960 --> 00:05:34,480
Yeah. I have a sweet tooth.

57
00:05:34,480 --> 00:05:35,480
Homemade custard?

58
00:05:35,480 --> 00:05:37,480
Pardon? Oh, I'm not fussy.

59
00:05:37,480 --> 00:05:38,480
Homemade custard?

60
00:05:38,480 --> 00:05:39,480
I don't mind.

61
00:05:39,480 --> 00:05:42,960
You're not fussy. Well, we're going to say homemade custard because it will make my metaphor

62
00:05:42,960 --> 00:05:43,960
be easier to understand.

63
00:05:43,960 --> 00:05:44,960
Okay.

64
00:05:44,960 --> 00:05:52,560
So there are many ingredients in custard. There are eggs, there's sugar, there's milk,

65
00:05:52,560 --> 00:05:58,240
there's vanilla, there's other spices. And what is it that makes custard amazing?

66
00:05:58,240 --> 00:06:07,520
Oh, it's warm liquid ooziness. It's sweetness. It's homely. It reminds me of my Nana.

67
00:06:07,520 --> 00:06:15,000
Oh, I love how you just brought in your Nana. So you have a very emotional connection to

68
00:06:15,000 --> 00:06:23,360
custard and people have an emotional connection to their pain experience. Someone who sprains

69
00:06:23,360 --> 00:06:29,600
their ankle on a job that they hate and they're poorly treated is going to have a different

70
00:06:29,600 --> 00:06:36,040
pain experience than someone who sprains their ankle on their honeymoon and they're having

71
00:06:36,040 --> 00:06:40,600
the time of their life and they happen to sprain their ankle. So that is a great thing

72
00:06:40,600 --> 00:06:41,600
that you highlighted.

73
00:06:41,600 --> 00:06:47,520
The other piece of our custard example is that the custard isn't amazing because of

74
00:06:47,520 --> 00:06:55,360
one ingredient. We need all of those ingredients to create that custard. And for you, we need

75
00:06:55,360 --> 00:07:02,600
the emotional connection and the love of your Nana. And so pain is no different. Everyone's

76
00:07:02,600 --> 00:07:08,440
pain experience is unique. How it shows up in their brain will be in these different

77
00:07:08,440 --> 00:07:14,840
parts, but how it shows up is going to be different to them because all of us have had

78
00:07:14,840 --> 00:07:23,160
different experiences and exposures and beliefs and education that got us to this point. And

79
00:07:23,160 --> 00:07:28,240
that can be helpful because sometimes it's really frustrating for people to say have

80
00:07:28,240 --> 00:07:33,800
had a back surgery and really struggle and wonder, well, my sister had back surgery and

81
00:07:33,800 --> 00:07:38,920
she's fine, my neighbor had back surgery. And that's because it's much more complicated

82
00:07:38,920 --> 00:07:42,160
than merely the health of the musculoskeletal tissues.

83
00:07:42,160 --> 00:07:49,640
I really like that you've said that it is different for everyone and it depends on your

84
00:07:49,640 --> 00:07:57,820
psychosocial status at the time. So my question is how, given that you can't, pain is something

85
00:07:57,820 --> 00:08:06,160
that you feel. So how do you study that? How do neuroimaging techniques help researchers

86
00:08:06,160 --> 00:08:11,520
study and visualize chronic pain in the brain because we can't see it? Do you know what

87
00:08:11,520 --> 00:08:17,120
I mean? Like we can't, like, well, you might be able to because, I don't know, like neuroscientists

88
00:08:17,120 --> 00:08:21,960
and that might be able to, but how do they see it? How do they research it? Because it's

89
00:08:21,960 --> 00:08:25,000
not something that is seen. Well, to my knowledge.

90
00:08:25,000 --> 00:08:33,080
It can be seen and the reason we know so much more about the way pain works now since the

91
00:08:33,080 --> 00:08:42,320
nineties then before is because of fMRI scans and spec scans and all of these fancy scanners.

92
00:08:42,320 --> 00:08:47,640
Prior to this, we've been working on a model that goes back literally three and a half

93
00:08:47,640 --> 00:08:53,920
centuries. Rene Descartes told us pain is either physical or psychological. We now know

94
00:08:53,920 --> 00:09:03,600
from these fMRI studies that pain always has a physical and an emotional component. And

95
00:09:03,600 --> 00:09:10,120
we know that pain is not derived from the tissues. We require the tissues to feel it.

96
00:09:10,120 --> 00:09:15,520
However, it's actually an output of the brain. So I'm going to slow down a little bit with

97
00:09:15,520 --> 00:09:22,200
this because this can be hard for people to kind of grasp. Never are we saying people

98
00:09:22,200 --> 00:09:29,480
are making up pain. All pain is real. That's the most important bottom line. And the way

99
00:09:29,480 --> 00:09:34,760
we get to pain is I often use a story of stepping on a nail. Do you want to go through this

100
00:09:34,760 --> 00:09:40,280
story with me? Oh, absolutely. All right. So let's just say that you're walking and

101
00:09:40,280 --> 00:09:49,440
you step on a rusty nail. Do you want to know that you've stepped on a rusty nail? It would

102
00:09:49,440 --> 00:09:56,080
be painful. Let's go there. It would be painful and you'd look at it and this would provide

103
00:09:56,080 --> 00:10:00,920
valuable information. Oh, I've stepped on a rusty nail. I need to check for nails in

104
00:10:00,920 --> 00:10:07,280
the area. I need to make sure my tetanus is up to date. I need to clean the wound and

105
00:10:07,280 --> 00:10:12,800
maybe put a band-aid on it. Now, if you hadn't felt that pain, you wouldn't have known. You

106
00:10:12,800 --> 00:10:16,960
wouldn't have received that information to do those other things. So when you look at

107
00:10:16,960 --> 00:10:25,120
it that way, can you see how pain is valuable and protective? Absolutely. Absolutely. And

108
00:10:25,120 --> 00:10:33,880
have a friend that works in the disability sector and has someone that can't feel heat.

109
00:10:33,880 --> 00:10:38,160
They don't have that sensation so they need someone with them to make sure they don't

110
00:10:38,160 --> 00:10:47,280
burn themselves. So I understand from that perspective that the pain is a very needed

111
00:10:47,280 --> 00:10:54,760
sensation to alert us to danger. Exactly. So let's keep going. So now you've received

112
00:10:54,760 --> 00:11:01,240
that information. How do we get to the experience of pain? People know what pain feels like

113
00:11:01,240 --> 00:11:08,120
but it's very hard for people to define pain. We do not have pain nerves and we do not have

114
00:11:08,120 --> 00:11:15,280
pain sensors. What we have and to use your word is we have danger sensors and the fancy

115
00:11:15,280 --> 00:11:22,080
science name is a nociceptor. This takes the information to the spinal cord and then it

116
00:11:22,080 --> 00:11:27,640
takes it up to the brain and then the brain will decide, yes, this is important. Quinn

117
00:11:27,640 --> 00:11:34,520
needs to know what's going on and then you will feel pain. So does it make sense? Oh

118
00:11:34,520 --> 00:11:39,400
sorry. Are there specific areas of the brain then that are associated with chronic pain?

119
00:11:39,400 --> 00:11:45,320
No, there are nine different parts of the brain that have the potential to participate

120
00:11:45,320 --> 00:11:52,040
in any particular pain experience. And the challenge we have is when someone shifts from

121
00:11:52,040 --> 00:11:59,360
more that acute pain into the chronic pain, then those parts of their brain are busy,

122
00:11:59,360 --> 00:12:05,040
we call that being in a pain meeting. So instead of taking care of digestion, that part of

123
00:12:05,040 --> 00:12:11,320
your brain is busy in pain and so this shows up as somebody with irritable bowel symptoms.

124
00:12:11,320 --> 00:12:18,120
If the musculoskeletal part of your brain is busy in the pain meeting, then this shows

125
00:12:18,120 --> 00:12:25,720
up as sore muscles, tired muscles, fatigued muscles. It's similar to when we are in meetings

126
00:12:25,720 --> 00:12:31,080
all day, people aren't getting things done in the meeting because they are not able to

127
00:12:31,080 --> 00:12:38,200
focus on their regular job. And so with chronic pain, we want to get those parts of the brain

128
00:12:38,200 --> 00:12:43,160
out of the pain meeting so to speak so that they can get back to their regular job. How

129
00:12:43,160 --> 00:12:48,680
does one go about doing that? Ah, great question. Can we go back to our nail story because that

130
00:12:48,680 --> 00:12:55,920
would make more sense. Absolutely. Okay, great. So now we know that the information travels

131
00:12:55,920 --> 00:13:01,440
on a danger sensor up to the brain and the brain says, Quinn, you stepped on a nail.

132
00:13:01,440 --> 00:13:08,520
Now does it make sense that it's going to take longer for our foot to heal and for that

133
00:13:08,520 --> 00:13:14,280
messaging to calm down than to ramp up? I'm not sure I understand what you mean. Are you

134
00:13:14,280 --> 00:13:18,840
going to use me? Sorry about that. Your foot might be sore for a couple of days. Can we

135
00:13:18,840 --> 00:13:22,800
agree on that? Oh yeah, absolutely. Sorry, did you want to grab a drink? Yeah, I'm good.

136
00:13:22,800 --> 00:13:25,920
I have a drink right here so I apologize. Oh, okay. All right. So it will take longer

137
00:13:25,920 --> 00:13:31,800
to calm down than to ramp up and that's just the way the nervous system works. So that's

138
00:13:31,800 --> 00:13:37,440
good. We know that it's going to take longer to reach its baseline. And if your foot feels

139
00:13:37,440 --> 00:13:43,320
sore in the few days afterwards, you're not damaging the foot anymore. It's just that

140
00:13:43,320 --> 00:13:50,040
the sensitivity is still a little bit elevated. So in our nervous system, we have 400 nerves

141
00:13:50,040 --> 00:13:55,360
and they're all connected like a big crazy highway and it's about 45 miles in length.

142
00:13:55,360 --> 00:14:00,680
All of these nerves have a little bit of a low buzz all the time and it lets us know

143
00:14:00,680 --> 00:14:07,880
we're alive. So maybe your listeners can just imagine a scale of one to 10 or zero to 10

144
00:14:07,880 --> 00:14:12,920
and the nerves are buzzing along at a one all the time. When we step on the nail, we've

145
00:14:12,920 --> 00:14:20,440
crossed the threshold at 10 and then we expect it to come back down. The problem about one

146
00:14:20,440 --> 00:14:25,800
in four people, not only in the United States, but it's a similar statistics worldwide. The

147
00:14:25,800 --> 00:14:33,560
alarm never gets back to baseline. Really? So maybe it's staying at a seven or an eight.

148
00:14:33,560 --> 00:14:39,240
Right. So how does this impact us? This was your question. How does this impact us day

149
00:14:39,240 --> 00:14:46,840
to day? So if our nerves are buzzing at a one and we have from one to nine or 10 before

150
00:14:46,840 --> 00:14:52,840
we cross that threshold, that gives us so much room to do what we want to do and need

151
00:14:52,840 --> 00:14:59,400
to do every day. If someone has their nerves buzzing at seven or eight, the image, mental

152
00:14:59,400 --> 00:15:06,520
image, we have so little room to play and do and be before we cross that threshold.

153
00:15:06,520 --> 00:15:13,400
Sometimes it's easier to understand it with the example of an alarm on your house. If

154
00:15:13,400 --> 00:15:19,160
you have your alarm set and the alarm goes off, if a brick goes through the window, this

155
00:15:19,160 --> 00:15:24,200
is good, right? We want to know. We want the alarm to go off. Does that make sense? Yeah,

156
00:15:24,200 --> 00:15:31,080
sure. Okay, great. Now, if the sensitivity of the alarm is elevated or changed and a

157
00:15:31,080 --> 00:15:36,760
leaf hits the window and your alarm goes off, is that helpful? That would scare the bejesus out of me.

158
00:15:36,760 --> 00:15:45,000
No. I'm like that. So you know what? Pain does scare the bejesus out of people. And so

159
00:15:45,640 --> 00:15:53,320
oftentimes it's not the state of the body. It is the state of the alarm. And so I'll tell

160
00:15:53,320 --> 00:15:59,960
my clients, I'm like, so if your alarm goes off, when a leaf hits the window, is your house okay?

161
00:15:59,960 --> 00:16:06,120
I would say it depends on how bad the damage is. If a leaf hits the window. Oh, sorry. If a leaf

162
00:16:06,120 --> 00:16:11,320
hits the window. Sorry. No, I would say the house is fine. Right. And so then I also ask my clients,

163
00:16:11,320 --> 00:16:18,120
I'm like, is it possible that your body, your house is okay? And we need to address the

164
00:16:18,120 --> 00:16:23,720
sensitivity of your alarm. And this is where we start to have differentiation. The longer

165
00:16:23,720 --> 00:16:30,920
people have had pain, our treatment strategies are different because it is still about the body

166
00:16:30,920 --> 00:16:38,840
and the brain. However, the way we go about it is different. And we have four main very well

167
00:16:38,840 --> 00:16:47,480
researched pillars and they are the power of education. We have amazing fMRI scans of showing

168
00:16:47,480 --> 00:16:53,880
people and the way the brain is responding. For those who don't know, what is the fMRI?

169
00:16:53,880 --> 00:17:02,600
FMRI stands for functional MRI. And it is a scan that people have. And in this case, it's of the

170
00:17:02,600 --> 00:17:09,240
brain. So people are able, the scientists are able to see in real time what's going on in the brain.

171
00:17:09,240 --> 00:17:14,600
Perfect. Sorry, keep going. Yes. Sorry about that. Yes. That's all right. And so they have scans of

172
00:17:14,600 --> 00:17:23,480
people and before the education, you can see the brain's response to the painful motion. And then

173
00:17:23,480 --> 00:17:31,160
they do the education and you can see how beautifully the brain calms down after a small

174
00:17:31,160 --> 00:17:38,360
amount of education. So the power here is that one of our key treatments is helping people

175
00:17:38,360 --> 00:17:46,600
understand pain. And it is very, very powerful. Our other three main pillars are sleep. Sleep is

176
00:17:46,600 --> 00:17:54,280
essential because sleep is when we heal and many other amazing necessary things happen in sleep.

177
00:17:54,280 --> 00:17:59,720
I'm kind of a sleep geek. That's really difficult though. Oh, sorry. That's really difficult though

178
00:17:59,720 --> 00:18:05,640
when you're in pain to try and get to sleep. Yes. And that is a topic that I talk with my clients

179
00:18:05,640 --> 00:18:14,040
about. Many people think that because of their pain, it's impacting their sleep. And it's true,

180
00:18:14,760 --> 00:18:20,200
it's a two-way street. Pain impacts sleep, but the research actually shows that the quality of our

181
00:18:20,200 --> 00:18:27,160
sleep impacts pain a little bit more. And there are many different things we can do to address sleep.

182
00:18:27,160 --> 00:18:34,440
The three main areas that I address with my clients is looking at sleep hygiene, sometimes some very

183
00:18:34,440 --> 00:18:40,680
simple hygiene changes can make a world of difference. Looking at their airway, how efficient is

184
00:18:40,680 --> 00:18:46,360
their airway? Because if we're not breathing through our nose at night, we are impacting the

185
00:18:46,360 --> 00:18:53,960
quality of our sleep. And then the third area is nutrition and supplementation. Vitamin D is very

186
00:18:53,960 --> 00:19:01,400
important for sleep. We know that the microbiome or the environment of our gut, gut health is

187
00:19:01,400 --> 00:19:08,360
really important for sleep, as well as things like magnesium. So these are all areas that I address

188
00:19:08,360 --> 00:19:13,880
with my clients to help improve their sleep. Gosh, you're just a wealth of information. Sorry, keep

189
00:19:13,880 --> 00:19:19,960
going. Oh, say that again? I said you're a wealth of information. Yes, absolutely. And then the final

190
00:19:19,960 --> 00:19:25,320
area is having goals. So we know that for our clients, this is no different than any coaching

191
00:19:25,320 --> 00:19:32,840
scenario. Having goals helps us get to our final destination with little goals along the way.

192
00:19:33,880 --> 00:19:43,720
And in addition to those four, we also have 22 other areas. We call this PNE plus. PNE stands for

193
00:19:43,720 --> 00:19:50,280
pain, neuroscience, education, using these stories like we just talked about to help people understand

194
00:19:50,280 --> 00:19:58,520
the complexities of pain. The 22 plus are other areas that are evidence-based reading. We have

195
00:19:58,520 --> 00:20:05,720
research to support them to help reduce pain. This really puts the client in the driver's seat.

196
00:20:05,720 --> 00:20:12,840
They get to choose, oh, this sounds great. Oh, I already like doing arts and crafts and this can

197
00:20:12,840 --> 00:20:20,280
help my pain. Amazing. I already love to do yoga. I already love to do journaling. And so we're then

198
00:20:20,280 --> 00:20:28,120
taking these additional strategies to create the best plan for each client. So can chronic pain be

199
00:20:28,120 --> 00:20:35,960
overcome to a point where it reaches sort of that acute pain or you do eventually get over it? Are

200
00:20:35,960 --> 00:20:46,840
there ways to rewire the brain so that you're no longer in pain? We are able to rewire the brain.

201
00:20:47,800 --> 00:20:57,480
It takes understanding of pain, the willingness to get curious about their pain, the willingness

202
00:20:57,480 --> 00:21:04,840
to get curious about things in the environment that may influence their pain and what can we do

203
00:21:04,840 --> 00:21:12,920
to reduce the pain experience? Pain management is a very common term. However, we pain science geeks,

204
00:21:12,920 --> 00:21:20,520
we like to say that we are treating pain rather than managing pain. We don't want to get rid of

205
00:21:20,520 --> 00:21:27,800
pain. We want to get their pain to a place where it is helpful and protective. Absolutely. And

206
00:21:27,800 --> 00:21:36,520
Adrian Lowe is one of my pain science mentors and he says pain is normal. Living in pain is not.

207
00:21:37,080 --> 00:21:43,080
And so that's what we're trying to get people back to. I have one client as you asked that question,

208
00:21:43,080 --> 00:21:52,120
she came to mind. I saw her a few years ago. I was her 27th provider in 10 months. That is a lot of

209
00:21:52,120 --> 00:21:58,520
physical therapy and other interventions. And she and I worked together for a while and she did have

210
00:21:58,520 --> 00:22:05,560
this goal of going on a trip to Budapest. When we started, she was only walking one to two minutes

211
00:22:05,560 --> 00:22:12,520
and just this past summer or spring, she sent me a picture of her in Budapest. And it was amazing

212
00:22:12,520 --> 00:22:18,280
because I didn't work with her for the whole time, but she had the tools and the strategies and she

213
00:22:18,280 --> 00:22:26,280
kept working at it even after we finished our work together. And I think that mental aspect is

214
00:22:26,280 --> 00:22:31,800
really important, having those tools to then be able to continue on, which it sounds like what

215
00:22:31,800 --> 00:22:39,560
you're providing. Right. Yes, it is about empowering the client for sure. And at the same time,

216
00:22:39,560 --> 00:22:48,600
if we have these, we know that the gold standard is combining education and exercise. So if someone

217
00:22:48,600 --> 00:22:56,120
is only going to do or willing to do two things, it is those two that are an amazing combination.

218
00:22:56,760 --> 00:23:02,680
And so I don't know if your listeners are familiar. Okay. Oh, sorry. From that PT perspective,

219
00:23:02,680 --> 00:23:10,120
how do you go about getting that motivation up so people not only do it with you, but then

220
00:23:10,120 --> 00:23:15,720
continue to do it at home? Because I think that's really one of the key factors is helping people to

221
00:23:16,520 --> 00:23:21,960
empower themselves. But I think when you're in chronic pain, you might not always see those

222
00:23:22,840 --> 00:23:28,360
benefits straight away. So how do you keep that motivation up? You are absolutely right. That's

223
00:23:28,360 --> 00:23:34,040
part of the reason why we use the stories to help people understand the complexity of pain.

224
00:23:34,760 --> 00:23:41,640
For a lot of people who really think the main source of pain is in their shoulder or their knee

225
00:23:41,640 --> 00:23:49,640
or their back, understanding that story of how the sensitive alarm can be responsible for a bulk of

226
00:23:49,640 --> 00:23:58,280
their pain experiences helps them to be willing to try something different. And we also use a lot of

227
00:23:58,280 --> 00:24:04,600
coaching and motivational interviewing when working with chronic pain clients, because you're right,

228
00:24:04,600 --> 00:24:11,880
it really doesn't matter how much knowledge I have, unless they are willing to learn these

229
00:24:11,880 --> 00:24:17,640
learn these concepts and then apply them themselves, we're not going to get anywhere. And so the

230
00:24:17,640 --> 00:24:24,200
importance of coaching and meeting the client where they are is so very important because if I

231
00:24:24,200 --> 00:24:29,800
tell them they need to walk 20 minutes a day, because that's what research says, that doesn't

232
00:24:29,800 --> 00:24:36,600
matter if they're not going to do it. And I had one client once and she was very well aware that

233
00:24:36,600 --> 00:24:43,000
exercising 30 minutes a day was the recommendation. And we started talking and I said, Are you willing

234
00:24:43,000 --> 00:24:49,560
to exercise 15 minutes a day? And she said, No. I said, Okay, 10 minutes. No, we got all the way

235
00:24:49,560 --> 00:24:54,200
down. I said, Are you willing to exercise one minute a day? And she's like, Yeah, of course I am.

236
00:24:54,200 --> 00:25:01,560
And I was like, Okay, that's where we start. And that's exactly where she started. And this idea of

237
00:25:01,560 --> 00:25:08,760
working with the client, utilizing the tools and skills of motivational interviewing helps them

238
00:25:09,880 --> 00:25:15,160
shift and show up for themselves. Because that's really what's important is them showing up for

239
00:25:15,160 --> 00:25:21,880
themselves. Well, you just packaged that so well. That's been absolutely amazing. Thank you for all

240
00:25:21,880 --> 00:25:26,120
your information. We are going to have to wrap it up because we've got to that point already. It

241
00:25:26,120 --> 00:25:31,160
seems to come around too quick. And I have all these questions I haven't had the chance to ask

242
00:25:31,160 --> 00:25:37,800
you. But for anyone else that is wanting to perhaps get in contact with you, what's the best way for

243
00:25:37,800 --> 00:25:44,760
someone to find you? For information on the physical therapy and the pain science, my website is

244
00:25:44,760 --> 00:25:53,880
180therapyandwellness.com therapy and wellness is spelled out. Another compliment that we haven't

245
00:25:53,880 --> 00:26:05,320
talked about is mental fitness. And that website is iriseforeme.com I R I S E F O R M E.com.

246
00:26:06,280 --> 00:26:11,960
And anyone that's interested in emailing me, I would love to hear from you and answer questions.

247
00:26:11,960 --> 00:26:20,520
And my email is Jen at iriseforeme.com. Wow, perfect. Thank you again. That has been

248
00:26:20,520 --> 00:26:24,920
an absolute pleasure. And like I said earlier, you're an absolute wealth of knowledge. I just

249
00:26:24,920 --> 00:26:30,120
wish we had more time. So perhaps we can schedule another one down the track. I would love to

250
00:26:30,120 --> 00:26:35,160
schedule another one because there's so many other concepts that we can help people understand.

251
00:26:35,160 --> 00:26:39,960
Because the more people understand, the less pain they will have. And we will treat each other

252
00:26:39,960 --> 00:26:46,280
better. Absolutely. Absolutely. Thank you again for talking to you again.

253
00:26:49,560 --> 00:26:55,400
I'm Quinn Carnegie and I hope you enjoyed this week's episode of Manifestation, Motivation and

254
00:26:55,400 --> 00:27:02,120
Passion. I'm so thrilled you chose to spend time listening and would be even more grateful if you

255
00:27:02,120 --> 00:27:08,360
left a positive review. And if you found value, no doubt your family and friends will too. I'd

256
00:27:08,360 --> 00:27:17,720
love it if you share it with them. Thanks again.