The Importance of a Multi-Layered Approach
We don’t come into the world with an unlimited amount of energy or resources to adapt to the stressors that we encounter on a daily basis. This finite amount of resources serves as a protective mechanism, so that when you are reaching your threshold, the nervous system may determine that it’s necessary to generate a protective response. That response could perhaps be discomfort in a certain body part, excessive tension, increasing sensitivity, or pain. This is important to understand, especially for our clients suffering with pain. Understanding that many times, the expression of pain reflects your body’s need to protect itself. Increasing sensitivity in the feedback from the body is a great way for the nervous system to do that because now it can be hyper-aware of what’s going on. Unfortunately, it may not feel so great for the individual as they are now aware of those troublesome areas a bit more. They may feel pain sooner than they had before. The pain that was only present for a short period of time now tends to linger for much longer. It doesn’t mean there’s a problem there, it’s just the overprotective nervous system wanting to keep you safe at all costs.
This resource capacity that we all possess is an incredibly important concept, because when our clients are experiencing persistent pain, they may feel like they need a special stretch or a special strengthening exercise to “fix” it. As many of us therapists know by now, it’s never that easy. Humans have evolved over millions of years, and so if you think that you know what special stretch or strengthening exercise is needed to “fix” any pain, then you deserve a Nobel prize. Some of the smartest neuroscientists in the world are still trying to work out why the brain behaves the way it does. From an IKN perspective, we understand that humans are multisensory in nature, and require more than just the feedback from muscles and joints to develop a resource capacity that enables us to respond well to stressors. While we spend a great deal of time on our courses working with muscles and joints, we do want our clients to understand that there are other structures and systems outside of the muscles and joints that play a large role in determining their resource capacity.
We take an approach that aims to identify loading discrepancies through many layers. How well can the muscles in a certain body part feedback information to the brain? How well do the peripheral nerves accept load and feedback information to the brain? How well do the muscles and joints of an extremity couple and cooperate to coordinate movement? How well does the vestibular system accept load to modulate the level of tone held around the spine? What are the individual’s beliefs about their pain experience? What have they been told by other practitioners? Essentially, these are all sources of LOAD to the nervous system, and we want to ensure that:
- These systems are able to tolerate load well in a manner that proves to the nervous system it’s safe using simple assessments.
- The type of load they are experiencing is encouraging positive adaptation
For example, if the muscles are able to accept load well on their own but they are not able to cooperate with the other peripheral tissues to dampen and share stress over a greater surface area, then that may influence our resource/movement capacity. As well as that, If we believe that our experience of pain is due to damage of a certain structure despite good quality evidence to support that, then that’s not a quality source of load to the nervous system. Your words LOAD the nervous system. Having negative beliefs about your pain does not encourage positive adaptation.
Take a look at the attached paper, and we can see how employing strategies that focus on behavioural change instead of focusing on changing symptoms can positively influence an individual’s function in the presence of pain. Instead of focusing on the problems, focus on what we can change as you move forward to promote resilience and adaptability. If we allow an individual to take advantage of the multisensory nature of their body, and improve the load tolerance of many systems, then we may be able to have more of a positive impact on their adaptability. We’re not looking for problems, but more so layers that can be positively changed to promote resilience.
Spend less time on symptom modification and more time identifying those other layers that we can positively influence. If we can help the individual understand that very often pain is all about sensitivity, we can target layers of their movement system that can help to reduce this sensitivity by providing more options to adapt. More options to adapt helps us share stress and load over a greater area, reducing the need for excessive protection in the form of pain, excessive tension, and increased sensitivity. A multi-layered approach is key because it respects the complex nature of human movement and behaviour.