John E. Sarno on Physical Activity

Yup. I have to admit even though Dr. Sarno told me I had TMS, I still hesitated to do certain exercises because I was told by a doc years ago that my tailbone would never heal. Therefore I avoided any exercise that I feared would bother my tailbone. After I realized this fear, I said to Dr. Sarno "my doc told me I pushed my tailbone out of place while giving birth and that it would never heal." I will never forget his reaction and I smile thinking about it. "NONSENSE. The body heals." Next day I decided to face my fear and do a rowing exercise that had me leaning back on my tailbone. I remember thinking I AM DOING THIS since I am not hurt. And the pain has never come back. That was a very powerful moment for me. THE BODY HEALS. Love it. I'm so happy I faced that fear and moved on!

 

Lori you may just be a sexy foot in the ocean to us, but this is one of the most powerful posts I've ever read. It was concise, hit all the main points and the ending was a happy one.

It fits into that article I wrote for JenningsWire, "Are Doctors Making Us Worse?" When someone tells you that they can never do this or that again, they harm the person---the nocebo effect. I knew a woman who was having heal pain. Her doctor told her that she would need to "walk only on level surfaces the rest of her life." With those words of ignorance she began degrading until she ended up in a wheelchair, from pain. She found MPB and began to heal, and she now hikes and walks and does whatever she wants. I've met 1000s of people who have reacted the same way over the past 11 years. I also had a discussion on this yesterday with Dr. Miller. When a physician gives your disorder a name, they allow it tangibility. If the person believes what she is told, she becomes a citizen in that "nation of the partially disabled" Dr. Sarno wrote about. Thank goodness we have people like Dr. Zafirides who also see this and are trying to change things.

Lori I would like to use what you said here in the future, if it's ok with you. Do you have a right foot too?

It's not just the physical restrictions that keep people disabled. It's also the fear of the physical--the "physicophobia." One of the toughest things about helping people is that their doctors often stand in the way of their healing. But I can't responsibly say "don't listen to your doctor." That would be foolish. I'm not a clinician and I don't know the full reasons the doctor says something. So there's a delicate balance there. But some things are just dirt dumb, like "your tailbone will never heal."

If your doctor tries to limit you, find another doctor. I'm not anti-doctor, I'm anti-message. I'm pro-doctor. We need them, but we also need them to get onboard the healing train and to stop spreading fear from town to town. Hope is the most powerful of all healing tools. Dr. Sarno gave me hope, and from that light I healed. I'm now paying it forward.

Steve

 

I think one of the reasons that Dr Sarno advises his TMS patients not to start exercising until the pain is completely gone (or almost gone) is because the ischemia (oxygen debt) to nerves, muscles and tendons might still be present if the pain is still there. If this was the case, if you began too soon, you might actually tear those oxygen-deprived muscles when you started to stress them during exercise. I think this is how I tore my rotator cuff just as my TMS relapse began in 2007-2008. I'd fallen on my left shoulder (left side again!) and it didn't seem like much of an injury except it felt sort of "funny". Then, a week later while rock climbing in the gym, I did an iron cross type move and my superspinatis tendon partially tore. That hurts! I can see now that my TMS symptoms were returning at this same time due to a period of emotional stress both external and self-imposed. So, the superspinatis tear was not caused by the TMS, but happened because that area of my shoulder was not getting enough oxygen due to TMS. So getting back to full activity means that you have to be aware of how severe your TMS still is before stressing that area or you could develop real muscle or tendon tears. It's a fine line, and you have to be mindful of how you're progressing before launching into a really intense exercise program it seems to me. This is a real grey area in the TMS recovery process that varies a great deal from individual to individual.

 

Hi Steve. Yes you can use what I said; I hope it helps at least one person.
And yes, I have two feet. New photo!

 

lol, she has 2 feet! It looks like the back of a boat or the front of a TV. No matter where, it looks r e l a x i n g

Bruce I'm not sure why Dr. Sarno said to wait, I always assumed that it was so the confidence was built higher, so that any setbacks wouldn't create a rubicon of doubt. But you could be right. You're definitely right that the oxygen is very low creating microscopic physical problems, and that the grey areas in healing seem to be very individualistic. Great observation.

What we're all looking for is our personal placebo, that thing that we believe deeply enough to alter bio-chemo-neuro-physiolology. It's different for every person, but the most important thing is belief, in healing. If we believe something, our systems will begin to match that belief. This is why guided imagery works so well. You have to see yourself as healed before you can heal, it must be somewhere in the mind's eye, or in its periphery. When hope comes along it shines light on the healed image.

Steve

 

Steve, my observation about how ischemia can lead to muscle tears comes from the chapter, "The Physiology of Chronic Pain" in James Alexander's new book, The Hidden Psychology of Pain (2012):

"In addition to ischemia, a painful problem can occur when muscles that are already suffering from an insufficient supply of oxygen become more vulnerable to tears in the muscle fiber due to exertion. The pain that results may be due to muscle fiber tear on top of ischemic pain which has resulted from a decrease in blood supply. As such, an acute pain (from a muscle strain or tear) can occur in addition to a longer term chronic pain (caused buy psychologically induced ischemia)." p. 83

Dr Alexander's remark made me wonder whether my torn rotator cuff had occurred because that was at the beginning of my TMS relapse in 2007, exactly the time I would have been starting to experience a psychologically induced ischemia to my extremities? It certainly does seem possible that you could injure yourself more easily because of poor blood circulation that would be caused by psychological factors like TMS. I would bet a dollar-to-a-donut that TMS and "real" muscle and tendon tears often occur at the same time and operate in a complimentary self-reinforcing vicious cycle. This must occur frequently when a TMS patient tries to push through the pain at work doing heavy lifting or other forms of manual labor, don't you think? This is where perfectionist and goodist personality traits must add to the problem by forcing the patient to just keeping pushing on doing his job no matter how much it hurts.

In any case, it does sound like Dr Sarno's admonition not to start exercising before the pain has disappeared or almost disappeared completely is, as usual, good advice based on his many years of clinical experience with TMS.

 

what's interesting is that my physical therapist has been working on and off on my tailbone for the last six months. he says it is dysfunctional, curled under and pointed to the left. This is really the only treatment that has given me relief, but it hasn't sustained. I was curious one day about it and read that tailbone treatment often brings up emotional issues because it is at the root (pun intended) and brings up deeply repressed feelings. This experience gives me faith that the repressed anger is what is causing this pain. I read the book on Sunday so it's early days, but i'm very hopeful.

 

Thank you for posting this! I have been getting back to exercising VERY gradually. Going all out after months of inactivity just didn't feel right to me--also it scared me. I've been wondering if I need to fight that fear and just do it, but this info bears out my decision. Slow and steady is the more conservative approach and it just seems to be working for me, as much as I want to do EVERYTHING RIGHT NOW!

 

Hmmm, our own personal placebo! I like that idea!

 

I have fallen foul of the all out approach, there's nothing wrong with me. I failed, and actually hurt myself in trying. You are right, take it easy and gently. But keep going, and keep building every day. I started swimming recently, and have really begun to enjoy it. After getting over the initial fear. I felt support and comfort from the water, and that helped me build my confidence again. I am now getting stronger, and more supple each week that passes. Eventually, I know the pain will leave in time. Good luck in your journey to recovery. You will get there.

 

I am one of those people who was healed rather quickly a few years ago by reading the book Healing Back Pain, and buying the DVD of the same name. I went from nearly bed-riddin from lower back pain, to surfing again within a couple months. It was miraculous, as I am sure many of you can relate. I was pain free, aside from a twinge here and there, for 3 years. Now I find myself battling nearly 2 years of persistent back pain and cannot seem to shake it this time. I did what another guy did and did everything right expecting it to go away like it did the first time around, but months and months later and it hasn't budged. I am 95% sure it is TMS, but once in a while I have a doubt for one reason or another, but I am fairly confident it is. My problem is, while I can still surf with minimal limitations, trying to pick up a weight bar from the ground, or my baby boy for that fact, is next to impossible without excruciating pain in the lower back. Oddly, when I shift my hips to one side, I am able to do it with slightly less pain (same goes for sitting up from the toilet, dare I say). I can squat just fine, lunges, lift heavy weights, etc. but the act of the torso bending is too painful. I've even tried doing a hand stand that brought about horrible pain from the compression weight of my lower body being above my upper body. Things like that give me pause and make me wonder if there is not something else going on, but there was not major trauma, it has not healed in two years now, and I am at a point where it is literally driving me insane. Its like nails on a chalk board that I cannot stop thinking about because it hurts in nearly every daily activity. I am truly at my wit's end. Bending to change the baby's diaper, unloading the dishwasher, picking up a weight, standing up from sitting... GETTING OUT OF BED OR TURNING OVER IN BED IN THE MIDDLE OF THE NIGHT KILLS ME! I am completely lost at this point. I've done it all right. Journaling, reading, meditation, exercise, un-restricted movement and even stopped paying attention to is, as much as it is possible when it hurts all the time. But now, I am lost, in pain and feeling quite hopeless. As many people as I read about having recurring pain, I can't help but to wonder if my 3 years of pain free was not a placebo. (I am probably in the wrong section writing about this, but I was reading about the restrictions we place on our own movements and it struck a cord with me not being able to pick up my weights even though I do not restrict myself from doing so) - Thanks, Shane.

 

Forest, I sure do notice how doubts about the psychological origins of my TMS have a disturbing way of reasserting themselves whenever I experience a relapse of my TMS symptoms or even a slight rise in pain following vigorous exercise. It's as if my mind just doesn't want to give up the psychological strategy behind TMS, clinging to it like a security blanket whenever there is the slightest reason to have a doubt. You can see how a real solid belief in TMS as a psychologically induced disorder is absolutely essential to a complete recovery.

 

Well, I suppose that is the problem, as it has now started to show up during surfing. Bending down at the end of a wave to sit back on the board is beginning to be painful as well. My lower back weakens after a long session and fatigues. I know it is TMS. I have plenty in my life to cause it and a perfect personality curse to match. But, nothing seems to improve. Two years is a long time to battle a relapse. I've engaged in the journaling, reading, etc. a few times during that period, for extensive lengths of time. So, when do I quit and say I am getting no where with the typical TMS treatment? I am not sure a TMS therapist would help, as I am keenly aware of what is eating me, how it affects me and why I will always have it with me. So, when do I stop trying, accept the pain as part of my life and move on? Because if I hear another person talk about their "epiphany" when the pain stopped immediately, I will be forced to punch myself in the neck. ;-)

THanks, Shane.

 

Sure seems as though TMS has an independent life of its own, doesn't it, Shane? It's going to stop when it's darn good and ready to stop, especially if you're willfully trying to control or change it. That's why I think being mindful (i.e. accepting without judging and letting go) are so essentially to the TMS recovery process. Alan Gordon calls it, "Outcome independence". So easy to speculate about in theory, but so hard to achieve in practice while you're suffering TMS pain symptoms.

 

Shane, It takes time and believing 100 percent that your pain is caused by one or more repressed emotions.
And yes, it isn't easy, but try not to think about the pain or wonder when it will end.
It ends faster by accepting it and its cause(s). Dr. Sarno says we don't even have to solve the repressed emotion,
just recognize it and our unconscious gets that message and stops giving us pain. It may move somewhere else,
but eventually it goes away. Stick with being mindful and working toward Outcome Independence. It'll come.

 

I appreciate the kinds words, fellas. Honestly, I do. But I'm sure you're all aware of how hollow those words can be when you are in the pit-pain of despair. I feel like I have been mindful, focused on the mental when pain strikes (its always there, just sometimes MUCH worse than others) and doing my best to let my mind know that I know what it is doing. Outcome independence is probably the only thing I have not tried, though I must admit that is seems like more of a way to try and trick the mind than anything else, because ultimately, if there isn't an end goal of physical and mental peace, then why try at all? I know I am being a donnie downer. Just glad y'all are out there doing this for the broken, like myself. Cheers!
S

 

Dear Kshane,
I hear your discouragement and desperation. Two years of pain after being pain free for three must be very hard, especially when you are using all the usual TMS techniques. I must say I admire the fact that you have kept at them all this time. I think the key may be in your initial post when you said you are 95% sure your relapse is due to TMS. That 5% of doubt may be what is holding you back. I suggest focusing your energy there. I find that Alan Gordon's evidence sheet is a very useful tool for helping remove doubt. Have you tried that? I still have this habitual response to new symptoms where I first think, "this one is really, truly physical". But I'm developing the awareness to question those habitual responses, and looking at my evidence sheet helps get me back on track.