We know how important understanding our environment is. Our brain is largely devoted to processing the world around us. We have the 5 senses we’ve been taught since grade school (sight, sound, taste, smell, touch) but we also possess a crucial input that we maybe have not heard of before: Proprioception. 

All of our joints are loaded with little sensors known as proprioceptors that sense where we are in space. The highest densities are our neck and and low back, but also our hips and ankles - all dedicated to knowing where we are in space. 

This learned sense of spatial awareness works to our advantage. Our bodies feel secure in familiar environments. It allows us to process many small pieces of information quickly, filing them away under “been there, seen that.” It’s in that way we can scan the environment to look for new, unsettling details. The salient pieces that will mean the difference between our safety or injury. 

The trouble is that pain and injury will change the way our brain recognizes these signals. If we have chronic back pain, our brain is going to get really tired of that loud, nagging feeling. So, to turn down the volume on your pain (though not make it go away entirely), your brain will blur the lines defining its perception of “your back”.

While this dims the pain, it also has an unfortunate effect of making us less aware of ourselves in space. Because pain is directly related to spacial awareness; you can’t have one without the other. Your body must know where you are in space to know if you are in any immediate danger. Then, your brain will provide pleasurable or painful sensations to encourage you stay put, or move out the way. Too much repeated pain, and your brain will stop paying close attention to the problem. In its own lazy way, your brain is perhaps assuming that you know there is a problem, but can’t do anything about it. So, to help you out, it dims the painful sensation.

It creates a bit of a vicious cycle. Injury creates pain, which leads to poor mental mapping to avoid the sensation of pain. The poor mental mapping leads to a sense of clumsiness which in turn can create more injury, and you guessed it, pain! Rinse and repeat. 

So how do we avoid slowly falling apart year after year, injury after injury? Aren’t our bodies meant to be resilient and powerful? Aren’t we meant to heal? Of course! The trick comes from leaning into the persistent work of reprogramming your brain’s uncertainty. It’s why passive treatments for pain have been shown to have minimal, long term, positive effects. They remove the sensation of pain, but they don’t teach your body to heal or that the trauma has passed. 

The only way to do that is to get moving again! Deliberately, and safely engaging your brain and body to understand its environment again. Essentially, reminding your brain of all it’s unique parts.

Yours in service,

Dr. Carly