Practical Science on Movement and Pain
Practical Science on Movement and Pain
In a previous post I introduced the concept of ideomotion, which is a non voluntary movement prompted by mental activity. In this post I’ll discuss Barrett Dorko’s interesting theory that ideomotion may play a role in reducing and preventing some common sources of chronic pain. Here is my (hopefully accurate) interpretation of Dorko’s theory in a nutshell.
Thought requires movement
Mental activity and physical movement are more intertwined than you would probably imagine. Here is a barrage of neuroscience factoids to illustrate.
If you imagine moving your hand, the muscle tone in your hand will change slightly. If you botox your face as much as Nicole Kidman and start to lose range of motion in some of your facial movements, you will lessen your ability feel the emotions associated with those movements. If you engage in certain hand gestures while learning math skills, you will learn them quicker. If you wash your hands, you will feel less guilt about your sins. If you enter a nationally televised political debate, you will gesture more with your dominant hand when making positive points, and more with your non dominant hand when going negative. (This is also why the Italian word for left is sinistra, the French word for left is gauche, and the English and romance language words for right are synonyms for “correct.”)
The takeaway message from this neuro montage is that the brain is a very complex system whose apparently separate outputs are actually incredibly entangled. This is why Moshe Feldenkrais claimed there is no such thing as an isolated emotion, thought, movement or sensation. Each mental output will always involve elements of the other three, so that every thought has an associated movement, sensation and emotion, every emotion has a related movement, sensation and thought, and so on. With these relationships in mind, let’s look closer at the connection between movement and one sensation in particular: pain.
Ideomotor movement can be corrective
Given that all mental representations tend to be coupled with a motor command, what kind of motor command would we expect to be associated with the sensation (or some might say emotion) of pain? Given that the brain has evolved over billions of years to protect the physical health of the body, we would expect that the motor response accompanying pain is one that is well calculated to make it better. Indeed, the neuromatrix theory of painstates that any painful sensation is accompanied by a simultaneous motor output to reduce the pain. For example, if your neck is feeling a little stiff as you look at a computer screen, the motor output simultaneously and unconsciously produced with that sensation will be a movement designed to resolve the discomfort – perhaps moving the head two or three degrees to the right. In fact, you make these movements all day without thinking about them, just as you walk and drive a car without thinking about the necessary muscle contractions. Given the brain’s amazing ability to unconsciously coordinate the muscular contractions of the body, we might also assume that it has a similarly impressive ability to unconsciously identify and perform movements that can reduce pain.
Dorko calls the ideomotor movements that accompany pain “corrective.” He further claims that such movements probably work by reducing mechanical deformation of nervous tissue that restricts blood flow. The details of how nerves become deformed and how movements could restore their blood flow requires a post of its own, but a good background on this topic is provided by a three part series of posts I did on nerve mechanics here. For now, the important points are that corrective movements are necessary to prevent certain types of pain, and that the brain is capable of making such movements intelligently and unconsciously.
Corrective movement can be inhibited
So we have a great built in automatic system to prevent chronic pain caused by bad mechanics. What could go wrong? Dorko hypothesizes that this system can become inhibited. How would this occur? One possibility was suggested long ago by the extraordinarily prescient philosopher and psychologist William James, who speculated that mental representations will not fully express themselves in physical movements if they are simultaneously met by another representation seeking a competing movement.
This idea makes sense. Our devious little brains usually have more than mental event going on at one time. If we have two different thoughts that seek to express two antagonistic movements, only one movement can prevail because there is only one body to express them. So, a sensation of pain will not result in a corrective movement if some other more dominant thought or emotion requires a different movement or maybe no movement at all. Acording to Dorko, the most likely source for such inhibition is mental energy devoted to social concerns. Here is an unimaginative dramatic example to illustrate.
Picture a rather cliche social scene that you have probably seen at numerous movies. The protagonist hero is at a tense formal dinner with an overbearing and critical boss. The boss is powerful, arrogant, and hypermasculine. Our hero is intelligent and sensitive, but neurotic, submissive and weak. He hates his boss and would like to tell him to go to hell, but at the same time desperately needs his approval for financial and emotional reasons. You get the picture.
As a matter of common sense, we all know how our hero’s body will move and feel during dinner and afterwards. He will be stiff, uptight, ill at ease, awkward and perhaps will even suffer a recurrence of his chronic back pain. But why would that be? Why would a social context cause pain? Here is an explanation on the ideomotoric level.
Ten minutes into dinner, our hero senses for the first time that his low back is becoming a little stiff. This sensation is unconsciously and spontaneously coupled with an appropriate ideomotor output – a command to move the body into a more comfortable position – in this case perhaps a little slump of the shoulders and head to the left will relieve a little pressure.
However, his mental activity at this point is dominated by thoughts of social positioning, not body positioning. His social brain wants to project respect, readiness, strength, and dutiful attentiveness. His emotional need to please is spontaneously and unconsciously coupled with motor commands that will display the proper body language – sit up straight and sit still. The corrective movement of slumping to the left is inhibited. His brain has competing mental representations, and this manifests as isometric tension in the body. His movements are stiff, stilted, and awkward. By the end of dinner his back is killing him. Does this ring true for anyone? It is one of many examples of how movements necessary to protect our health take a back seat to movements necessary to achieve social ends.
So it’s all society’s fault! I knew it! In the next post I’ll discuss Dorko’s ideas about how to resolve pain by sticking it to the man, and removing the inhibition that prevents expression of corrective movements.
To read part three, click here.