Good pain, bad pain

We all know the difference between ‘good’ pain and ‘bad’ pain. Good pain goes away after a few hours or a night’s rest. Bad pain lingers and colours everything.

In exercise or physiotherapy, good pain means that something (usually a muscle or tendon) is being stretched beyond what may be presently comfortable, but not beyond its capacity; bad pain means that it is being pushed beyond what it is capable of, muscle fibres are being torn and will need to be re-knit and healed before we can make full use of the muscle or tendon again.

Pain is highly personal. Continuing, unresponsive pain can be perceived as failure, frustrating both for the sufferer and the doctor. It is often suppressed with painkillers and anti-inflammatories. The symptoms get treatment, not the cause.

Pain is a great motivator. It is often the reason that people come to the Alexander Technique: they’ve tried everything else, they say. The Alexander Technique is what’s left.

Good pain

In her essay on childbirth, Ilana Machover says that she has come to think that pain during labour ‘does not indicate that something is wrong, but…is functional rather than pathological.’[i] The process of childbirth produces pain but also releases endorphins. The hours after giving birth can be euphoric, even ecstatic.

In Alexander Technique lessons, I would also argue that ‘good’ pain is possible. By this I mean the aches and pains that signal that change is taking place: some muscles are giving up jobs that weren’t theirs to do; others, after perhaps years or decades of inertia, are taking up the reins again.

And there is the ‘good’ pain of a job well-done, whether it’s clearing up the garden, extending what we can do after surgery or illness via a good physiotherapy session, or the satisfaction of achieving a ‘personal best’ in exercise.

Bad pain

Chronic pain is bad pain: it often serves no useful purpose, medically speaking, but it’s still there, wearing you out.

Wear and tear on the joints has an impressive name: osteoarthritis. Repetitive Stress Injury, Carpal Tunnel Syndrome, sacroilliac, lumbar and sciatic pain can be added to the list. It goes on and on. The common elements: the result is chronic pain; and habits of tension and patterns of muscle use have significant effects on the problem, both negative and positive.

Me and my pain

If you are in pain, you know that there’s no holiday from it. Chronic pain is debilitating, exhausting, depressing and can dominate every aspect of life. You develop a long-term relationship with it: it becomes ‘my pain’. I remember when my shoulders were very painful (I ended up having rotator cuff surgery when we lived in the United States). How I responded to the constant, wearing pain depended on the day: sometimes it was a wry recognition (I know you, you’re back); sometimes resentment and anger that what I could do was defined by the pain, which made me try to ‘push through’; sometimes depression that ‘my’ pain would define the rest of my life.

Tension and pain

Anxiety intensifies pain. Not being sure, not being in control, feeling like the passive recipient of someone else’s decisions make you insecure, tense, rigid – and much less likely to be aware of, let alone receptive to, different options.

Research has confirmed what makes intuitive sense: feeling that you are in control reduces the response to pain and raises threshold of tolerable pain.

Lessons in the Alexander Technique are about choosing not to rely on instinct alone. AT encourages you to pause long enough to be consciously aware of the fact that we are making a choice every time we act.

One thing that makes pain ‘good’ is the knowledge that it will pass. Second best is knowing that you have a way to cope with it. It is tempting and natural when you are in pain to try to avoid it. An instinctive response is to pull away, to distort yourself to avoid it. A better long term strategy is to inhibit that reaction, to carry on consciously choosing to stop doing the wrong thing to allow the right thing to do itself. To keep out of your own way, in other words. It no good denying the pain: acknowledge it, don’t get entrapped by it. Don’t let it ‘get you down’, literally or metaphorically.