Jonathan Kuttner - Best of .. Life After Pain

8/12/2019 Jonathan Kuttner - Best of .. Life After Pain

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You never stop searching or a solution to chronic pain- whether its or yoursel

or or your loved ones. Youre slowly becoming an expert in an area o health

that most people never hear o.

And I want you to know - you have more power than you think. Our bodies are ALWAYS

regenerating, healing growing, living. And were naturally geared to heal. Te keys to health

are different or everyone, but I know that people like you are the ones who find theirs.

So, starting today, walk tall, breathe deep and know that what you do in your daily liemakes a huge difference to all the people around you
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Alice in Wonderland

Where we revisit the most basic thing possible

I was spending some time with my grand daughter Alice the other day. We were conducting

some serious exploration o the orest next to my house. Alice is at the wonderul age o

nearly two, and everything (I mean Everything) is new and amazing to her.

She would get lost in contemplation o a lea, a tree trunk, her shoes....and just stop,entranced in wonder at a lea catching the sunlight. And afer hal an hour o this, I started

slow down and to see world in the same way.

And heres the thing - it really is a wonderul way to see the world. Te world becomes new

and rich again, beauty is everywhere, every sight is ascinating. And...I ound that my aches

and pains rom yesterdays tennis match disappeared completely.

Now theres a valuable lesson here.

When you take time to stop and slow down and just be - now - you give your body a chance

to restore its balance and rest. And we ofen dont take time to do this in our busy schedule.

Teres a simple way to do this right now. ake in a deep breath, hold it, count to 6 slowly,

then let it out - slowly.

Deep breathing can put you - instantly - into a restorative mode. Its like a magic switch that

sends a message right through all your muscles to relax. Troughout your day, whenever

you eel stressed, or hurried - or you just suddenly find yoursel in the moment - do this.

Youll be surprised at how youll gain a whole new awareness o the only moment that

matters - now.


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Nurse Kayla

(and why she was banned from the back garden)...

My dogs name is Kayla, but shes earned the name Nurse Kayla and Ill tell you why.

For quite some time now Ive been bringing her to my surgery every day. She usually lies

under the reception desk so you can see her two hairy eet poking out rom under the

bottom o the desk.

Whenever patients come in, she gets up, checks to see that they dont mind dogs, and i

theyre happy, she comes and sits up against their legs, practically sitting on their eet.

Tats why we call her nurse Kayla. Shes a vital part o the meet and greet at my clinic.

Ofen I can literally see peoples blood pressure drop and their shoulders relax as they give

her a pat.

Now, I used to put her in the back garden, where French doors open out rom my consulting

room.

But I had to stop that.

Te reason was that like all dogs, Kayla senses emotions very keenly. So or example, when

a patient in my room was telling their story to me, and getting upset and overcome with

emotion, she would sit right by the door and whine in sympathy.

Tis proved a bit too distracting or me and my patients.


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Te thing is, there is a lot o emotion bound up in pain, especially chronic pain.

One patient o mine described it like this - my back pain entered our home like a cuckoo-

pushing aside my husband and two children.

Chronic pain can be incredibly invasive and emotionally debilitating.

So to break out o chronic pain, you sometimes need to re-look at the emotions surrounding

it. Ofen, they are eeding and ampliying the pain.

Its vital to keep a watch on your emotional as well as your physical health. In my case, the

end o my 6 years back pain came when I noticed that I only elt pain when I woke up,

when I was relaxing, and when I was doing un activities like sport - never when I wasconcentrating at work.

Using this knowledge, i was able to determine that my original injury had healed - instead

what I had was a pain amplification problem. I didnt allow it to interere with my work, but

it became severe when I was trying to relax.

Within 8 weeks o this realisation, using mind body techniques, I was able to finish the

chronic lower back pain that had blighted my lie or 6 years.

And i what you have is a pain amplication problem, then it could be well worth looking

into the mind body connection or pain relie.


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Recovery

Your Bodys Natural Tendency

One o the most important questions I get is: I have this daily pain - how do I know that Ill

recover?

Tis is a really good question, and there are two things to keep in mind here:

1. Your bodys natural bent is towards health. Its like the natural world.

Afer every environmental disaster - drought, flood, oil spills, fire, even while the ashes are

cooling, nature is already making a comeback.

Your body is like that. Give it a air chance and itll start to heal.

2. Tereore you need to give your body a air chance. Tere may be some oods youreeating that dont help reduce inflammation, or perhaps there are some movements you are

doing throughout the day that cause your muscles to tense up.

Correct these, and like the orest afer a firestorm, your body will start to recover. It may

take some time, but it will happen.


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Primeval Instincts in the 9-5 Office

Taming the Lizard Brain

I think Im a pretty well unctioning human being.

In act, most o us believe were pretty together, got things airly sorted, and present a united

ront to the world.

So it might surprise you to know that when you look at the human brain, its anything but

united.

Teres the amygdala - the so called lizard brain. Tis has evolved and stayed with us - like a

piece o old but useul sofware that never got uninstalled or upgraded.

Te amygdala is continually asking is it sae now? Is it sae now?

And i it doesnt think youre sae, then it turns on a panic response.

Now this was fine back when we needed to be this alert otherwise we would have been ood

or saber tooth tigers.

But on a monday morning when you walk into the office, you start eeling stressed out and

this same stress (but without the outlet o running away) gets turned on.

What happens?

Well or most people, your body produces cortisol. Tis means that your heart rate speeds


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up, your breathing becomes a little aster, you eel hyped up. Tats fine i theres a precise

danger that you can do something about.

But many people spend hours every day in this state o low grade tension. And this is bad

or your system. In a state o emergency stand by your body doesnt prioritise restoring

cells, properly digesting ood, and many o the myriad processes required to maintainhealth.

Over time, this results in less than ideal health, and ofen causes muscle tension and trigger

points. A better plan?

When you notice a stress response in your body, stop. Ask yoursel: is there real danger

to mysel? I yes - what can I do about it? I no - take a deep breath in, hold it or six slow

seconds, and breathe out.

Feel you heart slow down, breathe deeply rom your diaphragm. Congratulations. Youve

just turned off your stress response, and you can carry on your day with a clear head - and a

relaxed body.


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Stubborn Soccer Player Changes the

Medical ProfessionAccepted Wisdom vs. a Determined Sportsman

I really like this story because it shows how challenging the accepted wisdom o the day can

be done by anyone - at any time - and with amazing results.

Also, while I grew up in South Arica, I was originally born in Manchester - so any stories

with Manchester United soccer players in them are fine by me:)

How you use your body when youre recovering rom surgery will have a big effect on how

your scar turns out. Its known as relative rest and runs counter to the old lie in bed and

dont move orm o recovery.

It appears slightly counter intuitive but once you think this principle through it makes

perect sense. Using relative rest, your scars heal in a way that makes them smaller, more

flexible and stronger:

http://lieaferpain.com/ino/muscles/healing-scar-tissue/


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Why Worrying about the Small Stuff Helps

Widsom from my Father

I was talking the other day with my ather. Hes 86, and one o the most active 86 year olds I

know.

3-4 times a week he plays gol. 2 times a week he plays bridge with some riends. He

gardens, makes antastic ruit salads, and when hes not doing that, he spends time reading

the New Scientist, playing bridge and solving chess problems.

I was asking him how the country is going (he lives in South Arica.) And he was recounting

all sorts o problems - political, social, etc.

But then he said - But you know my biggest problem is my gol swing. I just cant seem to

keep my head down and get the rotation right. We both laughed. My dads a wise guy. You

see, its an old secret. I you worry about big stuff that you cant change, youre on your way

to stress, headaches and more stress.

Youre giving all your energy to things that will make your lie harder. But i you can keep

your worries small, and about things you have some control over, then lie becomes much

easier.

Likewise, when youre in pain, everything seems harder. But i you can take small steps

towards health, just little steps can help you regain your confidence. Little steps, thencelebrate the small victories.

Ive seen mysel how small steps - like correcting your posture, or breathing correctly can

give people back their confidence in lie - and help them eliminate pain.


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The Vineyard and the Bend in the Road

(On the virtues of Serendipity and Skinny Legs)

When I was a young man (many years ago :) I took a hiking holiday with my wie-to-be

down to the Cape.

Its beautiul country there - vineyards and old Cape-Dutch homesteads. We were resting by

the roadside one afernoon when an old Arikaner armer spotted us.

He seemed to take a shine to us both because he offered us a bed and board i we could help

him with a ew chores on his arm.

We agreed, and spent the next ew days happily working on this beautiul old vineyard.

When it came time to go, he eyed me with a mischievious glint in his eye.

Young man, he said what are you doing walking all this way with such a big pack and suchskinny legs? Come with me.

He beckoned us down into his cellar, where bottles and bottles o amazing hundred year old

wine were gently aging.

Whatever you can fit in your backpack and carry out, you can take, he told me.

So we filled out backpacks as much as we could, and staggered out onto the road. We made

it as ar as the next bend beore we had to rest under a tree (and set about lightening the

load with a vintage red sundowner.)


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Which just goes to show - you never know, when you agree to something, what riches may

be in store you - just a little down the road.

It was like this when I first cracked open my aged copy o the original trigger point manual.

I had no idea how ofen I was going to use this knowledge - both to help others and to help

mysel.

Since then, Ive refined the techniques with my own experience and experimentation.

Ive ound new ways o helping people treat themselves - in pain ree, sae and even more

effective ways.

And at www.LieAferPain.com Im offering you a chance to take as much as you can carry

away rom my own personal store o wisdom.


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The Mystery of the 11 oclock pain

(One of the Many Things I did not Learn at Medical School)

I once treated a guy who used to have a severe back pain arrive at 11 oclock every Monday

morning.

And heres the amazing thing he told me in our first consultation.

It was a long weekend last weekend, and the pain arrived at 11 oclock on uesday.

Hmmm. I thought. Ive never heard o a physical condition that was able to tell the

difference between the days o the week. I told him. Tis could be mind-body related.

What? You mean, like, not real? he asked. But it hurts!

What do you mean by not real? I asked.

Well, i its in my mind, does that mean Im making it up? Is there really nothing wrong

with my back?

Tis is a really good question.

Te answer is that all pain is elt in your brain. Its possible to eel massive pain in your

back - with nothing physically wrong. But the pain is just as real as i there was something

wrong with your back.


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o your brain, all pain messages are equal and real.

So how can you tell i the pain messages youre getting are rom not rom physical damage?

Here are a ew possible indicators:

You have had pain or months and there is no underlying disease (like lupus,

arthritis or cancer)

Tere was an injury, but it has had time to heal (even broken bones will heal in

2-3 months) but the pain continues

Te pain is set off by situations - ie when you are stressed, or at work, or trying

to relax - but absent at other times.

Tis type o pain could well be part o what we now know as the Mind Body Connection.Tere are some ascinating studies coming out now on how this works, and some even more

interesting treatments - like Mindulness Stress Reduction.

Here are some resources on the Lie Afer Pain Site: http://lieaferpain.com/ino/category/

mindbody-interaction/


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But the subconscious reflexes developed as a child that normally protect us rom spills and

alls were switched off on that day, and she always ended up injuring hersel.

Afer some sessions talking things over, she was able to break this cycle.

I tell this story to illustrate that our minds are incredibly complex instruments and have a

tremendous influence over our health and well being.

Sometimes the problems we assume are purely physical actually have their origins in the

subconscious, or in our emotions. And at these times looking careully at the wider picture -

with an open mind - can bring about lie changing results.


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The Power of Definitions

(In which we discover that the force will always be with you)...

One o my avourite movies ...Im slightly embarrassed to admit....is Star Wars.

I remember being completely blown away when I first saw it. My wie and I went to a special

sense-around cinema. Te whole cinema rumbled, the chairs shook, the star ships blazed...

and my wie ell asleep!`

Well, theres an important message in these films or all pain sufferers. It comes rom Yoda,

the grammatically challenged but wise little green guy.

Here it is:

Named must be your ear beore ace it you can.

Now,this is true, but these days people are throwing around diagnoses and names without

really even knowing what they really mean.

Names like arthritis, rheumatism, spondylosis. Tese are all names that carry a lot o ear

attached, but that mainly happens when we dont know exactly what these conditions mean

or us, and more importantly, what we can do about them.

Ill be sharing some more inormation on these soon, but right now I just want to set the

record straight.

Arthritis is not a lie sentence.


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Ive know plenty o people with incredible wear and tear on their spinal vertebrae.

Te x-rays o the neck looks like a catastrophe, but they have a great range o movement,

and pain ree lives.

What does this mean?

It means that i you have pain in your joints and your x-rays show wear and tear, its not as

large a concern as you may think. And its certainly not a sure sign youre in or a painul old

age.

Wear and tear on joints is like a gnarled tree you may see down by the river. Its grown that

way through a lietime o adapting to external orces. And while it may not look so pretty,

its perectly natural, healthy and strong.

So once you get the joint pain settled - by anti-inflammatory medicine, injections, and

rigger point releases or the surrounding muscles or whatever treatment you choose -

theres no reason why you cant resume a healthy, active, pain ree lie. Even i your x-rays

show wear and tear on your joints.

Te relationship between wear and tear and pain in your joints is just not that strong. So

theres no reason to accept pain and deterioration as part and parcel o aging. And anyone

who tries to sell you on arthritic pain is just part o getting old - dont buy it!.

Your body is amazing at adapting to change, and aging is just that - a change. And its a

change that can be weathered graceully.


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Once Upon a Time

A Story Healing & Transformation - Your Story

I was reading some airy stories the other day - more entertainment or my grand daughter.

And I was struck by just how violent they all are. Almost without exception someones head

gets cut off, or they get eaten by a wol, or a dragon.

aken out o context, its odd what we read to our kids. Children seem quite calm and

accepting o airy tales though - Im not sure why.

Tere was, however, one airy story I particularly liked. Te Ugly Duckling.

You may know it. Its the story o a giant grey ugly duckling who gets harrassed and

bothered by his small yellow fluffy duckling riends, until....one day... he grows into a

beautiul white swan.

Its a powerul story o tranormation.

And the message or me was this - not all the things that appear to be bad or a struggle at

the outset are in act as they seem. I hated having back pain or six years, but it gave me

a valuable lesson in empathy and prompted me to specialise in musculo-skeletal pain -

helping people like you and I to navigate their way out o chronic pain.

Id be interested to hear - has their been any silver lining to your challenges?

Go here to join the conversation:

http://lieaferpain.com/ino/general/once-upon-a-time/


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Wax on, Wax off

Mr Miyage Teaches Trigger Points

I was watching the Karate Kid movie the other day. I know its not a serious movie, but it

does have some important lessons that can you can use.

You probably know the story - this kid learns karate rom the master Mr Miyage so he can

stand up to the neighbourhood bullies.

When he first starts his lessons, Mr Miyage puts him to work waxing all the cars in his car

yard with the same hand motion:

Wax on, wax off.

Te kids urious because he eels like hes just working or ree and not learning karate.

But then Mr Miyage shows him how the wax on, wax off hand movement is actually a

crucial movement in karate. With this sweeping hand motion, he can block any punch.

So, how does this apply to you? Well, there are two types o learning - technique based and

principle based.

I you understand the undamental principles behind a technique, you can apply it -

anywhere.


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I would like you to have principle based learning. I want you to be able solve the problems

o trigger points, and understand how and why you can do this.

Ten you can switch them off - anywhere in your body. Te first step, though, is that you

need to understand how trigger points work.

And or that purpose - heres a short video I made explaining trigger points:

http://lieaferpain.com/ino/muscles/trigger-points/


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Pain Vampires

Garlic and Holy Water for Pain Relief

Have you noticed the number o vampire books/movies/V series around at the moment?

Its hard not to. Its like the worlds suddenly become obsessed with vampires.

Why? Its hard to say. But heres a ew olklore legends about vampires.

1. Tey cant enter your house unless you invite them in

2. Once they come in, its game over. Tey suck you dry.

Now, this is just olklore stuff, but I would bet that everyone has some kind o vampire in

their lie.

It could be a work colleague who is always taking your time and energy. Or the daily

commute in a traffic jam that gets your blood pressure up and stresses you out.

Or or many o my subscribers its a daily pain that keeps coming back, leaving you tired and

sore.

So, remember rule number 1.= dont invite the vampire in.

When you start eeling the pain, turn your attention to something else.


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I can already hear you saying yes but....

But it hurts!

I didnt say it was easy. Te thing is, just as you can ampliy your pain by giving it your ullattention, you can turn it down by directing your attention away rom the pain.

Having access to a good range o trigger point and myoascial release techniques helps. But

the most important thing is the this:

Bottom line: dont let pain vampires rule your lie and suck you dry.


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Youer than You

(On the Secret to Life and Other Such Matters)

My grandaughters avourite film at the moment is Kung Fu Panda. Its probably a bit old or

her, and we ast orwards through the fight scenes, but she really loves watching that panda.

I was watching it with her the other day (any excuse to chill out and enjoy childrens films)

when I had a startling realization.

In the film, theres the legend o the great Dragon Warrior, who can overcome any challenge.

And the secret to being this warrior is written on the Dragon scroll.

Now, i you havent watched the movie, then maybe you should stop here, because Im going

to give the plot away. (I you have, or you dont mind plot spoilers, then read on.)

When the panda opens the Dragon scroll, its blank.

Or rather, its beautiul shiny gold mirror that reflects back whomever is looking at it.

Tats the secret!

o overcome any challenge, you have to be you. You cant be anyone else.


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o quote another great childrens author (Dr. Seuss):

oday you are You, that is truer than true. Tere is no one alive who is Youer than You.

You have within you all the resources you need to over come any challenge. Whether it iswith your health, your lies goals, or your past.

And do that, you have to be Youer than You.

I have every confidence that you can do it - whatever it is - when you commit to being true

to yoursel.

Tat means letting go o the past, orgetting about the uture, and ocusing on whatever is inront o you - right now.

Go to it - amazing you!


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oday you are You, that is truer than true. Tere is noone alive who is Youer than You.

- Dr Seuss


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The Tipping Point

(the Value of Keeping On Keeping On)

Ive been watching my grand daughter Alice learn to walk.

She hasnt quite got the hang o the lean orward until youre almost alling, then as youre

alling, put one oot orward, then the next and...Voila! Youre walking.

Watching her trying to walk, alling down, getting up, alling down again - that made me

think.

Probably, Alice doesnt eel like shes making any progress. At the moment, she just eels like

shes alling down a lot. But in act, shes very very close to walking. When I take her hands

and give her just a little help, she can walk just fine.

Sometimes, thats all we need - just a little help. You may eel like youre a mile away rombeing pain ree because every day youre in pain.

But in act you may be much close than you think - and you may just need a little help to

turn the corner and begin your journey back to health.

I dont think its ever occurred to Alice that she wont eventually get the hang o walking. Te

thought that youll never be pain ree may have occurred to you.

But please - dont let it be more than a passing thought - quickly dismissed. Focus on the

things you can do - 5 minutes daily exercise, core breathing, good posture.

You could be at the tipping point - right now.


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Heres how to do that:

1. Look or moments in your day that you eel your heart racing, or your eel anxious and

overwhelmed.

2. In that moment - stop. Ask yoursel - what is the exact cause o this eeling? You may have

to ask yoursel this a ew times beore you get down to the real cause.

For example: Im anxious because I have so much to do. Why do I have so much to do?

Because I have 10 things on my list or this morning. Why do I have to do all these things

this morning? Because I dont know which o them is the most important, so Ill just try to

do them all as quickly as possible.

Aha. So the real problem is not having too much to do, the problem is clarity about what isthe most important thing.

For a sore back, it might go like this: Im anxious because my back hurts. Why does this

make you eel anxious? Because Im araid that i it gets worse I may not be able to keep

doing my work? Ok - how do I know that it will get worse? I dont - Im just worried that it

will, and I have no other way o supporting mysel i it does.

So - the underlying problem is that this person doesnt have an alternate means o financial

support. Now - this is not a quick fix problem.


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However - talking yoursel out o worry is not the answer. o put persistent worries to rest,

you need to act your way out. In this case, the best way to move orwards is to investigate

what options there are or disability support, or what kind o work can be done i youre not

physically active due to a sore back.

Ofen once you have mapped what you can do in the worst case scenario the nagging

anxiety the comes up whenever you think about the uture disappears.

And usually the worst case scenario will not happen. But knowing what you would do i it

did happen helps.


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The Ski Coaches Secret

( that might just help you stay pain free)...

Awareness is sel correcting.

Tis is a principle used in learning many skills.

For example, some skiing coaches, instead o loading their students heads ull ocomplicated instructions, just get them to become aware o the angle o their skis

edging into the snow.

Te idea is that awareness o this will allow your body to do all the complex adjustments

that it does naturally. You just need to set up awareness eedback loops.

Tese eedback loops are an essential part o listening to and understanding your body and

moving better.

Its the same with posture. Once you have the awareness o what good posture eels like, and

keep that awareness in mind, you will naturally sel correct your posture.

Afer all, you had perect posture as a child - you just need to remember what it elt like.


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Is Cognitive Dissonance

Keeping You in Pain?

( Posture, Pain and Payoffs)...

Te wikipedia definition o Cognitive dissonance goes as ollows:

Coginitive Dissonance is discomort caused by holding two or more conflicting ideas

simultaneously.

Te theory goes that people have a motivational drive to reduce inner conflict. Tey do thisby changing their attitudes, belies, and actions.

So or instance, you go out to dinner and you didnt like the meal much. But because you

spent time getting ready to go out, and spent money on the meal, you justiy it and kid

yoursel it was quite nice, really. Tis relieves the tension within yoursel.

Because o cognitive dissonance its hard to cancel subscriptions, change bad decisions and

reverse habits that arent helpul to your health.

Its ofen the same i you have had a type o pain or a long time. In a way, it has become part

o your lie.

You are invested in having this pain because youve suffered or it and it has cost you a lot

o time and energy. Sometimes there may even be so-called secondary gain - where people

around you give you sympathy or you dont need to do certain tasks.


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Deep down you know it could be different, however...trying a new treatment that might

work would be like admitting that you have spent all that time in pain when you didnt need

to.

Tats why its sometimes easier to continue down the same path, even when the resultsyouve been getting arent that good.

On that subject, one area thats very easy to overlook is your posture. Its hard to change

because youve moved that way or years.

But, or all you know, bad posture could be causing you a world o pain. And just because

youve had the same posture or years doesnt mean you shouldnt reassess it rom time to

time.


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Hammer and Nail Treatments


o a man with a hammer, every problem looks like a nail.

Tis ofen happens without conscious effort. People cant really help it.

Tats why when a surgeon looks at your MRI scan, he sees possibilities or operating. Aphysio will see ways to treat you with exercises & stretches.

A massage therapist will see how you can benefit rom massage.

Tere is nothing wrong with all this. Its just that you need to understand all your options -

and get second opinions.

And dont rush into treatment that are irreversible - ie. using your vertebrae - until youveexplored other treatments.

rigger points are a powerul and surprising cause o pain thats ofen diagnosed as

something else.

Te symptoms can be close to arthritis, tendonitis and sciatica. And trigger point treatment

is sae and non-invasive.

Tats why - in addition to investigating all the possible causes and symptoms o a chronic

pain condition - its ofen well worth looking or active trigger points - and turning them off.


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Health and Happiness


Tere was a study a while ago where researchers tried to find a predictor o happiness.

Tey looked at everything - how wealthy they were, whether they were healthy, where they

lived, age, i they had children, as well as their race and gender.

Te single actor they ound in common was the number o times people ate together

with riends and amily.

A simple truth - eat together 1-3 times a week with your riends, amily or loved ones, and

youre more likely to be happy.


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Heres how it works.

Every day you do just one thing to improve your body health.

Maybe on Monday you adjust your workstation to an optimum position. (I youre reading

this at your computer, take 2 minutes to do this now.)

Ten or that week you practice keeping tabs on how youre sitting. Every time you eel

tension building up you stop, relax, stretch, breathe, and assess your posture. Ten carry on.

Once you eel like this sel checking has become a habit, you move onto the next thing.

Afer doing this or a couple o months youll be amazed at how ar youve come.

Tats the magic o Kaizen.


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The Meaning of Life

Wisdom from the Psychologist of Auschwitz

oday Id like to share with you the insights o an extraordinary man - Victor Frankl.

Survivor o Auschwitz, psychiatrist and ounder o Logotherapy, Frankl was able to find

meaning in the most difficult o circumstances.

In Auschwitz, everyone suffered terribly. Many inmates began to eel that - with all they hadborne and witnessed - there was nothing more lie had to offer them.

In Frankls observation, this was a very dangerous state, because humans, beref o hope,

quickly became sick and ofen died o the many illnesses in the camp.

He determined that there is nothing worse than to suffer or no reason - to eel like your

suffering is meaningless.

So he aced his suffering straight on, and endeavoured to find a meaning or it.

In the end, Frankl saw that he could choose a meaning. Tough he could not prevent his

difficulties, he could place a meaning on them that helped him as a human.

Te meaning he chose was spiritual advancement. o plumb the depths o his soul through

suffering and see i he could come out o it a wiser, truer, more compassionate human being.

He envisioned himsel, afer the war was over, giving a lecture at his university on the

insights he had gained as a psychiatrist and inmage o the Nazi concentration camps.


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Courage

(the most likely improvement anyone can do)...

oday I want you to take a minute and remember an instance - one time - that you showed

real courage.

It could have been helping someone in a dangerous situation, or starting a new job, or

asking out someone that you really ancied.

I you had the moment o heart stopping adrenaline, and then went ahead and did the brave

thing anyway, then you showed real courage.

Id like you to think back on the moment, and recognise that you have that same courage

within you, now.

Because living with chronic pain requires huge courage. It takes courage to get up in themorning and go or a walk outside in your street.

It takes courage to do a set o core exercises when youre worried about causing more pain.

And it takes courage to have aith in your bodys innate ability to heal.

So today, take ten minutes to remember every time you proved yoursel courageous, write it

down, and put it somewhere youll see it - ofen.

And with your courage, begin the path back to health.


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If You Dont Do This, No One Will

(Frodo Steps Up)...

I was watching the Lord o the Rings the other day the last movie in the trilogy. Teres

this part near the end when Frodo the main hero is battling against tremendous odds to

accomplish his task. Hes exhausted, araid, hungry and close to despair.

Its at this point that you hear a voice rom his past saying this task was appointed to youFrodoI you do not find a way, no one will.

Tis got me thinking. In lie there are many tasks appointed to us by ourselves or by

others. And we seldom think o our own health and well being as a task. But it is a vital

one.

And i you do not find a way to own and take control o your health, no one else will.

Im not saying that you shouldnt seek help rom every quarter when you have a health issue.

But healing is always a two way process. On one side theres the medic, or physician, or

healer and then on the other side theres you.

And what you bring to the table is crucial to getting better.

You bring: your understanding: do you understand what the problem is and what you can

do to accelerate your healing?

Your attitude: do you eel positive towards your body and encourage its healing?


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~

Your action: do you do the things you need to in order to give your body the best shot at

getting better whether its good nutrition, exercise, relaxation practice or taking your

medication regularly?

In the end, expecting to be fixed just doesnt work. Teres always some part that you need

to do. And no one else can do this or you. Its once you realise and take responsibility or

this that things get not easier exactly. But clearer.

When I had back pain or years, I medicated mysel (haphazardly) and generally tried to

ignore or berate my body when it gave me pain. But one day I decided that really, this task

was mine, and i I didnt find a way to fix it, no one would.

Tis started me on a quest. I tried a variety o approaches until one finally worked. And

it was the clarity that came rom truly owning the problem o my back pain that gave

me the crucial insight. In my case it was the mind body connection that was the key to

understanding and then ending my chronic back pain.

Te key or everyone is different, and or some people there may be no one thing but a

variety o actors that combine to give a better quality o lie and in time some degree o

control over chronic pain. But the first step is realising that you are the one in charge the

final arbiter, the captain and CEO o your own health.

o your continued wellbeing,

JK


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Subway Virtuosos

Coming Awake to the Wonder of Life Around You

One afernoon in a busy New York subway a violinist played to a typical commuter crowd.

People bustled by, barely sparing him a glance. One or two kids stopped, transfixed, beore

being pulled away by their harried parents.

Little did they know that this particular violinist had not taken the subway to get to his

busking spot.

Instead, he had caught a taxi in order to protect his 4 million dollar Stradivarius violin. In

act, the violinist was none other than world amous virtuoso Joshua Bell.

And he was playing one o the most technically challenging pieces in the violin lexicon. A

week previous, Joshua had perormed at Carnegie Hall, with tickets a minimum o $100 aseat.

So - how did he do with the rush hour crowd? Afer hal an hours playing, Joshua had made

the princely sum o $32. And only 7 people had stopped to listen or more than a minute.

How does this happen?

Well, our brains are constantly filtering reality or us - according to expectation. Tat means,

i were not expecting to see a world class violinist busking in the subway - we dont see him.

Even i hes smack bang in the middle o our daily commute.


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~

And i were not expecting to find a simple solution to a problem thats plagued us or years,

we may not recognise it. Even when its with us every day.

Tats why when it comes time to reassess our posture, we ofen overlook the obvious.

Tings like the chair we sit on, or the shoes we wear.

But changing these these can sometimes be the key to ending chronic muscle pain.


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Spirits in the desert

(the most likely improvement anyone can do)...

My wies ather ought in World War II. He was posted in the North Arican desert, fighting

against General Rommel - the desert ox.

Now, when a war lasts years, as this one did, there were brie periods o conflict and

adrenaline, ollowed by long months o what could have been utter, mind numbing

boredom.

But, my ather in law was a man o many talents. As an engineer, he organised maths

competitions and chess championships to keep his comrades morale up.

Amongst the soldiers were university proessors whom he encouraged to give lectures on

their field o study. ogether, they put on theatre productions and studied greek philosophy.

Tey ound ways to keep their minds occupied and spirits up as they waited or months inthe harsh Arican desert or news o the enemy.

Chronic pain is a desert where good people can be stranded or months, or even years.

And keeping good morale is key to winning this battle.

So you need to keep engaged in lie - any way you can. Even i youre not well enough to

exercise as you used to, do something - even i its a small walk around the block.

Watch a sports game and visualise yoursel playing too. Read, listen to music, keep your

mind active. And, as part o keeping your mind active, I would highly recommend learning

more about the mind body connection.


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80-20 Thinking

(An Italian Economists and his Pea Garden)...

I want to introduce you to a concept today: its called the 80/20 rule.

It was originally discovered by Pareto, an Italian economist several hundred years ago.

Pareto noticed that 20% o the pea plants in his garden produced 80% o the peas.

And when he looked into other spheres o lie - economics, nature, lie, the rule held true.

In essence the 80 rule states that 80% o the good results you get come rom 20% o what

you do.

And 80% o the problems you get come rom 20% o what you do.

So when it comes to chronic pain, its very likely that theres an important just 20% you needto change to get a vast improvement in your quality o lie.

And or a lot o people, discovering that 20% involves looking at your daily habits.

What do you do every day? What do you eat? How do you sit when you work? What do you

do or recreation?

When you really start to analyse your daily lie, you can ofen see some surprising patterns.

Tere may be a relationship between your work habits and muscle pain. Or between your

emotions and how sensitised your pain system is.


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~

O all the connections, the tie between emotions and how you eel is the one that intrigues

me most.

Its what helped me end my years o severe back pain and get back into my normal lie.

And while its easier to look or a cure outside o you, Ive had many patients who were able

to use the Mind Body Connection to get back their normal lives.


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The Ant Puzzle

(Finding the Problem Underneath the Problem)...

Heres something that happened to me a while back.

In our kitchen, there was an invasion o ants. It was summer - so not too surprising. But

these guys were everywhere - a true armageddon style invasion.

I tried all the usual things to contain them. Im not a big an o poisonous chemicals

(especially at home) but I ended up spraying some pest control chemicals around the

kitchen. It did nothing.

I set up a honey trap or the ants - they werent interested.

I tried looking or a hole where they might be getting in - still no luck.

Finally, I looked in the very bottom back o the pantry. And nestled down there was a

broken jam jar with a veritable ant-heaven o jam ull o busy little ants.

Problem solved.

So - the moral o the story is: what simple problem are you trying to solve with band-aids

like ant spray, honey traps and hole plugging - that would go away i you just threw out the

broken jam jar?


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~

For some people its a toxic work environment. For others its an activity they do every day

(like typing) that theyre doing in such a way that it sets o triggers in their neck, arms and

shoulders. Still other people need to change their diet (sometimes only a little) to get rid o

oods that amp up the bodys inflammation response.

Id like to invite you all to sit back and have a think - whats the simple (though sometimes

hidden) solution to a problem thats had you stumped or a long time.

For many people I know with chronic pain, its rigger Points. But thats not everybody.

So have a think on it, and you may come to some unusual conclusions.


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The Stop Doing List

(Good news...Bad News?)...

Heres an interesting assignment.

It goes like this: Suppose you woke up tomorrow and received two phone calls. Te first

phone call tells you that you have inherited $20 million, no strings attached.

Te second tells you that you have an incurable and terminal disease, and you have no more

than 10 years to live. What would you do differently, and, in particular, what would you stop

doing?

A lot o the time, the headaches and strie in our lives come rom things we need to stop

doing, rather than things we arent doing.

And once you stop doing things that cause you stress and muscle pain, that gives you roomto start doing the things that keep you healthy and well.

So - what would your stop doing list be?


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~

A lot o twenty year olds would struggle to keep up with these olks.

But I also see people who, or whatever reason, decide that their best physical years are over,

and theres no reason to stay active.

So, please - i theres anything you love doing, that gives you joy and challenges you - keep

doing this!

Even more importantly - i there is something new you wish to learn - do it.

Tis is because it has now been shown that learning a new skill lays down new neural

pathways in your brain.

Itll keep you young, happy and healthy, no matter what your age.

And treating trigger points can also help you stay flexible. Its a little known act that latent

as well as active triggers can cause stiffness, so keeping them treated can prevent stiffness

and injury - especially i youre active.


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Too Stiff to Stretch

(Quite likely youre doing this too - somewhere)...

Te other day, I was spending time with my gorgeous grand daughter Alice. She was getting

tired, and a bit grumpy, but reused to go to sleep.

Shes too tired to sleep her mother inormed me.

Huh? I thought. Ten I realised theres something very human in that logic. Ive had people

tell me they were too old to start eating healthily. Or too at to diet.

Or too stiff to stretch. Or too unfit to exercise.

I know that being stiff or unfit makes stretching and exercising difficult, but thats precisely

the time when you need it more.

Like my grand daughter Alice, she wasnt going to eel better until she had a sleep.

Doing stretches and having core strength can be the missing link or getting rid o muscle

pain.

Te key is to start small - and gradually work upwards. Start with the smallest possible

action - like a 2 minute walk, do that or a week, then slowly increase it - just 30 seconds

more a day.

Tats the best and astest way to create new habits - using miniscule baby steps. But over

time, added together, these baby steps transorm your lie.


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Move aside the Fascia

(1970s Med School)...

I remember in 2nd year medical school we spent the entire year dissecting one person

who had donated their body to science.

Te first session was quite eerie - in a hushed and ormal kind o way. We were 4 people

to one cadaver. Everyone was very quiet and we started dissecting at the lef oot.

We had a surgical specialist conducting the dissection.

He was a small guy with a slightly dry voice. As wed look or a particular muscle or organ

wed ofen find a silvery glistening substance in the way.

I cant find the psoas someone would say.

Just move aside the ascia our surgeon would direct.

You see, in those days the ascia wasnt seen as important at all. It was just something you

moved aside to get to the important parts.

Tat was then.

Now, we know that the ascia is responsible or our smooth movement. It binds all the

musclestogether in a glistening silver second skin. Without it wed move like jerky robots.

It also plays a big part in how we age, our flexibility, coordination - and staying pain ree.

And thats why knowing how to release trigger points is a vital health maintenance skill.


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When its time to call it quits

(The Answer to a Tricky Question)...

What is the definition of madness? Doing the same thing twice

and expecting a different result. - Einstein.

I youve been trying a certain treatment and it isnt working, when is it time to call it quits?

Te answer to this is both difficult and easy.

Quit as soon as you are sure that you have a negative result.

And this timeline varies rom treatment to treatment. For anti-biotics its about 6-7 days.

For dietary changes, its a matter o weeks. For postural changes, again, timelines vary rom

a ew days to a ew weeks.

For surgery, sometimes you have to wait months until your scars have healed to be sure that

youre eeling better than beore the treatment.

And you cant undo surgery. (Tats why I usually advocate some types o surgery - ie. using

vertebrae, as a last resort.)

Te good news is, or trigger point releases, you can get a result in about 2 minutes.

As you do the trigger point release, you should be able to eel the trigger point melting away

under your fingers.


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~

O course, or ull effect you may need to spend some time - days or weeks -finding all the

trigger points.

Some trigger points may only become apparent afer youve deactivated the the most

obvious ones.

But to get a first, positive result, even i its small, takes about two minutes to test.


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~

Tis is what happens with trigger points. You get a spasm in the muscle, and through

convergence, the pain can be perceived as coming rom a completely different part o your

body.

Te perceived pain rom a trigger is called the pain reerall pattern, and it can at times be

quite puzzling.

riggers in your neck can cause an aching pain radiating down your arm, points in your

abdomen can cause pain in your back, points in your buttock can cause pain shooting down

your leg, triggers in your orearm can cause pain in your wrist and hand.

And most commonly, active trigger points in your shoulders can cause pain that goes up

your neck and settles behind your eyes - the classic office workers tension headache.

Tats why Ive ound the skill o treating trigger points so valuable. rigger point pain is

airly common, it can come up in the most unlikely places - and its ofen missed entirely.


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The Fascinating Link between Good

Intentions and Muscle Pain

(The Great Grandmother Food Test)...

Teres an old saying that the road to hell is paved with good intentions.

Teres a lot o truth in this. When I look around, its strange that the rise o health oods

and varied and complex diets - the South Beach, Liver Cleansing et al has coincided with

the highest incidents in recorded history o weight problems and diet related illnesses.

How did this happen?

Teres many reasons. Our change to office work. Our busyness and how easy it is now to

not cook and eat at home. Te ease and availability o processed and packaged oods.

It comes down a airly simple equation though. Teres what I call real ood - the stuff

that your grandma would have had when she was a kid, and the not quite real ood whichcomes in packets in the supermarket.

Tis psuedo ood is sometimes known and energy bars or health supplements but more

commonly comes under the heading o quick instant or 0% at ood.

Buyer beware - this stuff will not help reduce muscle pain in your body - quite the opposite.

When you eat ood that your body is not used to processing, you raise the amount o

inflammatory chemicals in your body. And this can cause muscle pain - and trigger points.

Te bottom line: eat real ood. I your great grandmother wouldnt recognise it, chances are

your digestive system wont either.


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The Big Problem

(the one most people dont know about)...

Heres a big problem almost everyone gets - but we dont know it. Its this: we have whats

called the internal monologue going 24/7 in our heads.

Have you ever had the experience o - just beore you all asleep - hearing the constant

chatter o thoughts in your head that wont stop?

Tats the internal monologue. It doesnt ever stop. Its the part o your brain thats always

busy, weighing, worrying, judging, retting - nonstop.

Its always telling you about whats happening in your world - and putting meanings onto

events that - rom the outside viewpoint - just happen.

Te problem comes in when this part o your brain puts meanings on events that make itharder or you to live in relative peace and comort.

For instance - a twinge in your back can be labelled as the onset o arthritis, or a serious

problem that may need surgery when in act you just need a hot shower, a stretch, and some

gentle exercise.

You may even stop exercising out o concern or your back - and this may indeed make your

back eel much worse - a true sel ulfilling prophecy.

Now - Im not saying you should ignore all warning signs o pain in your body. By all

means, have them checked out by a medical proessional i they are not clearing up.


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~

However, i medical science cant find anything wrong with you, and youre still in pain,

then sometimes you have to look in a slightly unusual place or the solution.

In some cases, the cause o your problem is in your mind - specifically in the mind body

connection.

And in the internal monologue which is putting meanings on the messages your mind is

receiving rom your body. Tis effect is powerul - its now been shown that your mind can

ampliy pain messages - turning a twinge into a major source o pain - even when there isnt

damage in your body.


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The Wish for Healing

(the half of health)...

Te wish for healing has always been half of health.

Lucius Annaeus Seneca

Tis has always been true. Many years ago, when I lived in South Arica, I remember

we had a mobile clinic once a week in Soweto - one o the poorest parts o Johannesburg.

Te people who came there would have waited or hours, and possibly walked or miles to

get their 2 minutes o medical care.

I wouldnt be surprised though, to find out that the success rate o their treatment was very

high.

You see, their healing had begun rom the moment they lef, early in the morning, to get tothe clinic and wait in line.

Likewise, I sometimes get people booked in to see me. Unortunately I have a long waiting

list - sometimes up to two months.

Tis is usually not a problem, as I dont see people who need urgent medical attention.

Its interesting, though, how many people report that they eel much better by the time they

come to see me.

Almost as i the decision that they made to see a specialist has helped them to start the

healing process themselves.


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~

Te confidence they have that help is on its way helps their body rally its own natural

resources.

Because - medication and physical treatments aside - you have your own powerul toolkit o

healing.

And once you learn to unlock and use those tools, the effects can be dramatic.


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Unreasonable Bosses and Hidden Tensions

(How much tension are you secretly holding?)...

rue story - I once had to ring up the boss o one o my patients to get him time off work so

I give him an injection treatment.

Tis guy (well call him Derek) came to me with a very stiff neck. I ended up needing to give

him trigger point injections, and we were discussing when I could book him in to do theinjections.

He looked worried. I cant really take time off work. My boss wont like it.

Derek, I said. Tats what sick days are or. How many have you taken this year?

Just one, he said. Tis one now.

Well, you need to take one more.

He looked worried again. I cant.

So I ended up ringing his boss. Derek was right - his boss wasnt happy. He tried to reuse,

saying that he couldnt give Derek any time off work.

But I explained that this was non-negotiable. He needed the treatment, and he had a legal

right to a sick day to get it.


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Strange Tales from the Clinic

(The Mind Body Effect)...

Charlotte came to see me with a terrible pain that would wake her up in the night.

It was a very odd kind o pain: two bands across her wrists and her lower legs. Shed had it

or several months, and it was excruciating.

I listened to her. Tis is the strangest pain Ive ever heard o. Can you think about anything

in your lie - anything at all - that youve had in the past that may have been similar?

Charlotte sat and thought or a couple o minutes.

You know, I dont know i this has anything do with it, but in my twenties, I had terrible

depression, and to treat it I had electro-convulsive therapy.

How did they do that? I asked.

Well, she said I would get strapped down to a bed - with straps around my ankles

and wrists. She stopped.

With straps holding you down exactly where youre eeling pain now. I said. Which you

only get when youre lying down. Could it be that the pain is connected with this traumatic

experience rom twenty years ago?

We talked though the concepts o mind body - and how her pain could be a recreation

by her mind o a remembered pain.


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Nocebos

(On the Dangers of Misdiagnosis)...

Youve may already have heard o the placebo effect.

It occurs when a patient is given a ake medicine, but believes that it is a legitimate

treatment that will cure him or her.

Te placebo effect is when patients get better rom this ake medicine. It is actual proo

positive o the power o belie and our bodies ability to heal. Tis effect has at times been

powerul enough to get cancer to go into remission.

It is, I believe, the main reason that any health proessional stays in business!

Tere is another effect though - the opposite o the placebo effect.

Its called the nocebo effect.

It occurs when a patient is given a ake drug that they believe will have a harmul effect on

them.

Patients sometimes get sick rom taking sugar pills - but ones that they believe will give

them bad side effects. Tis effect can also occur when someone is given an incorrect

diagnosis.

So they may believe either that they have a disease that they dont have, or that the problem

they have is much worse than it really is.


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~

Te results can be extreme. At the ar end o nocebos, people have died rom diseases that

they never had.

So its incredibly important to understand exactly whats going on in your body.

But when you have unexplained pain, keeping tabs on what to think and ocus on becomes

very difficult. Especially when the pain messages youre getting may be incorrect - that is,

coming rom a sensitised pain system.

Tis is what can happen.

You get unrelenting pain. You go to a doctor, get all the tests possible - nothing comes up as

an explanation.

Tere are no simple, easy fixes or this. But i you do have a malunctioning pain system, the

first step is understanding.

You need to understand how your pain system works, and why some pain messages can (in

act need to be) be saely ignored to downgrade their importance in your pain system - and

thus gradually down grade the strength o the message.

And this helps to combat the nocebo effect - where believing that you have a potentially lie

threatening or non-curable condition can actually make the pain worse.


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How to Get Better

(Also Known as - You Experience What You Focus On)...

Yes, but......

Tis may seem strange, but I see people every day who are more concerned with their illness

than with finding a cure.

Teyre usually easy to pick.

As Im explaining treatment options, they are always looking or reasons why - in their case,

nothing will work. Even beore theyve tried the treatment.

Te commonest statement they make is: Yes, but....

When I take a medical history, theyre describing their affliction as i its part o them -

central to their lie. As different rom a necessary evil to be endured until they can get rid o

it.

Heres something true o lie - nature abhors a vacuum.

Its easier to replace something with another thing than to just get rid o it. Its also easier to

get better i you have a strong sense o purpose.

Whatever that purpose is - to pursue your career, look afer your kids, get back to work,

resume your normal healthy liestyle.

When youre in pain its important to remember who you were beore the pain happened. So

you can ocus on finding your way back.


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(the moment before the movement)...

One o my avourite books o all time is Winnie the Pooh.

For those who dont know the books, theres this great moment in them that could really

help you correct your posture.

Winnie the Pooh and his best riend Piglet are talking about the best things in lie.

Well, said Pooh, what I like best, and then he had to stop and think. Because although

Eating Honey was a very good thing to do, there was a moment just before you began to eat it

which was better than when you were, but he didnt know what it was called.

Tis is the moment where everything is potential, and youre ully there - in anticipation.

Youre ully present.

And this is the moment you need to capture i you want to correct your posture. (And stop

trigger points coming back.)

Its the moment beore you move, beore you sit up, beore you sit down. Its also the

moment beore you tense and let old habits bring your muscle tension (and ofen trigger

points) back in ull orce.

So today, practice experiencing ully that moment beforeyou move. See what it eels like,

relax, and then move in as natural and effortless way as possible.

The Winnie the Pooh Guide to

Correcting Posture


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Well, said Pooh, what I like best, and then he hadto stop and think. Because although Eating Honeywas a very good thing to do, there was a momentjust beore you began to eat it which was betterthan when you were, but he didnt know what it wascalled.

- A A Milne


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(Using Logic to Combat Chronic Pain)...

Tis kind o logic is so ingrained in us humans - its almost invisible.

I I get this, then this will happen, or I this happens, then this will be the result.

Its easy to see why we do this, because cause and effect are part o lie. But sometimes, this

logic is alse.

I my back stops hurting, then Ill walk in a relaxed way.

Sometimes, you have to break out o the i....then cycle and act as i you already had what

you wanted.

Studies have shown that people who smile (even when theyre not happy) end up eeling

happier. Its a response thats built in. You do something physical, and that affects how you

eel.

Tis response can work in other ways too.

Having relaxed posture will help your muscles relax - thus reducing pain. Good posture

shows you how to walk in an effortless way.

It also helps you breathe properly - helping your muscles to relax even i they dont want to

so that you can stop and rest without pain

You move as i you had relaxed muscles, and this creates a response so that your muscles

will in act relax. ry this or a day and eel the result!

If....Then Logic


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A Pound of Lard

(Genetic Lotteries & healthy eating)...

For many years beore I specialised, I used to look afer the old age hospital in my town. It

was a lovely place - red brick and tile, next to the gol course, with great staff and a caring

ethos.

And I met some antastic people there over the years.

wo memorable old guys were Harold and Ray. Harold was quite plump, while Ray was thin

as a rake, and theyd been riends since kindergarten.

Tey used to sit in their avourite sunny spot and tell jokes and stories to each other rom

the many years theyd shared.

Ten...

Nurse Harold would yell bring me a pound o lard to oil me joints.

Harold would always have a tot o rum hidden in his soa, (medicinal) and hed swig on

it throughout the day. Ray smoked or years, only stopping when he went to this old age

hospital.

And they both lived to a ripe old age, in relatively good health.

Which just goes to show - some olks are born lucky. Its like they win the genetic lottery.

Teyve ended up with rolls royce bodies, while the rest o us have lucked out on a beat up

old subaru.


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~

You probably all know people like this - they can eat what they like, when they like, with

zero problems.

Te rest o us - not quite so lucky.

And some o us absolutely have to watch what we eat. Its a big deal because what we eat can

have a huge effect on muscle pain.

I thats you (

Jonathan Kuttner - Best of .. Life After Pain

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