Marie-Claire Prettyman - MOVE Away from Pain: A Guide to a Pain Free Life

MOVE Away From Pain First published in 2020 by Panoma Press Ltd 48 St Vincent Drive, St Albans, Herts, AL1 5SJ, UK www.panomapress.com Book layout by Neil Coe. 978-1-784524-31-9 The right of Marie-Claire Prettyman to be identified as the author of this work has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. A CIP catalogue record for this book is available from the British Library. All rights reserved. No part of this book may be reproduced in any material form (including photocopying or storing in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright holder except in accordance with the provisions of the Copyright, Designs and Patents Act 1988. Applications for the copyright holders written permission to reproduce any part of this publication should be addressed to the publishers.

This book is available online and in bookstores. Copyright 2019 Marie-Claire Prettyman

Thank you! Huge thanks as always to the creative people in my life: Katey Fox for your brilliant photography as always
www.kateyfoxphotography.co.uk Clare Green for such cute illustrations
www.fromlens2canvas.co.uk and to Susannah Thompson for helping me write in less jargon and stopping my grammatical tick! (Parenthesis) Finally, thanks to my husband and son for making me tea and putting up with me when I shut myself away for days on end because Ive had a good idea. I love you loads xx After I hurt/broke some bits of my back and pelvis falling on to a tiled floor in a leisure centre I fully expected to be completely fine within a couple of days; but then it was weeks, then months and the pain didnt get better, it got worse. I owned a Pilates and Yoga studio, I ran Pilates and Yoga teacher training courses, I was (still am) a mum and really needed to be the strongest and most powerful version of myself to do it all, but I just couldnt. The pain kept me up at night, I worried about it, wondering what on earth I had done to myself to be suffering so badly. I became depressed and lost confidence in my abilities to do my job; eventually this all culminated in me having to sell my business and do something else for a while.

I went to work in a school as a teaching assistant, but I was so depleted in energy and confidence I couldnt even do that after a while. I suffered from anxiety, depression and fatigue. I did, however, find some excellent pain management medics, who through a number of nerve ablations and steroid injections prevented a proposed surgery and allowed me to get off all the pain medication, including morphine. The reduction of pain allowed me to start moving properly again, and as a result I got stronger and stronger and I moved away from my pain. All of this sparked an interest in working with others who were suffering from chronic pain, so I started to do more reading and attend courses on pain management and therapeutic interventions for pain, and it was here that I actually started to learn what I feel I should have known four years previously. I had understood that the pain medication was there to help me move more freely so that my body could heal, but the deep impact of stress and worry on my pain receptors was not fully explained (or if it was, I hadnt been able to process it).

The way that pain behaves as a separate entity to injury was not clear. Retraining PAIN as opposed to fixing musculoskeletal damage was not clear (at the time). It felt at times that people around me thought it was all in my head (it was) but not in a psychological made it all up kind of way, but the pain was being created by the brain, certainly. I know that if youre reading this, then youve experienced a similar issue. Youve felt not listened to or dismissed; that somehow people arent believing you with respect to how much you are suffering. I want this book to explain the things Ive learned over the last couple of years so that someone else doesnt have to spend years fighting the system and themselves in order to move forward.

Learning about pain can help you manage it and MOVE past it. The exercises are a combination of Pilates and Yoga inspired actions, designed to gently encourage your body to let go of its excitable pain signals and relax into comfortable pain-free movements. MOVING is the key so that:

Long-term pain isnt just about what is going on in your body, despite what it might feel like. There are many other factors involved as youll see working your way through this book. I remember being told years ago that pain is your bodys warning system, its telling you to stop doing what you are doing; well, sometimes this is true, sometimes its not! Many people still believe that ceasing activity is an appropriate management strategy for pain, for fear of further harming oneself. There are very rare cases where this might be true, but most often, rest and avoidance practices are the exact opposite of what is needed.

Dr Eyal Lederman divides recovery from pain/injury into three overlapping sections: repair, adaptation and alleviation of symptoms with recovery in the middle. For example, if a person sprains their ankle, their recovery would be expected to take place through a process of tissue repair (repair usually six to eight weeks); pain during this phase is definitely a message to cease or moderate activities until its feeling better. If the ankle was immobilised following an ankle fracture, multisystem adaptive changes would need to take place rather than just repairing tissues (adaptation). The most interesting section in the management of long-term, chronic pain conditions however is the last one. Take a person who experiences chronic back pain for several months and within a few weeks of an intervention treatment like osteopathy/chiropractic/physiotherapy or sports massage the person experiences a dramatic improvement in symptoms. If that individual had an MRI at the start of treatment and another at the end, the findings would very likely remain unchanged.

As Dr Lederman states, It can therefore be assumed that their recovery is related to reduction of the amplitude of their symptoms rather than by tissue repair or adaptation. As mentioned, these three processes do overlap, particularly between repair and alleviation of symptoms during the recovery from acute conditions e.g. following an ankle sprain. The ankle gets better due to the tissues healing and a subsequent reduction in symptoms. The recovery from chronic conditions like lower back pain however is represented by the overlap between alleviation of symptoms and adaptation.