Podcast: Episode 160: The 3 Phases of Recovery: Getting Out Of Pain -> Transition -> Strengthening

This week, we’re diving into a brand-new miniseries that will cover the concepts and tools I use to help people reduce and get out of pain. The clients I see most often have persistent symptoms, have had them for a while, and have made some gains with what they have tried but the gains aren’t sustainable.

There are some key phases that I have seen over time when working with clientele. There is the initial helping them get out of pain, then there’s a transition, and then a period of strengthening.

Join me this week as I dive deeper into each of these phases to show you how I teach clients to hear the whispers and recognize the yellow lights. Discover what I find gets in the way of these phases for people and how to be successful in each one.

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What You'll Learn from this Episode:

  • What is involved with the getting out of pain, transition, and strengthening phases.
  • A big reason why my clients’ gains often are sustainable.
  • The importance of growing your awareness of what is happening beneath the surface.
  • How I help my clients nurture and acknowledge what is working and what is not.
  • The kind of client I tend to see most often.

Featured on the Show:

  • If you want to dig deeper into this work and would like to explore and connect to your body and being, I recommend you join me for the Therapeutic Yoga Intensive. It runs from Saturday April 15th, 2023 – Thursday April 20th 2023, 8:30am to 2pm MT. Click here to learn more and sign up.  

Full Episode Transcript:

Male Announcer: You’re listening to From Pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.

Welcome, and welcome back. With this episode I introduce you to a brand new mini-series, which is all about the concepts and the tools that I use for helping people reduce and get out of pain. It’s a lead-up to my therapeutic yoga intensive that I’m running this April for six days, from April 15th to the 20th. And it’s six and a half hours per day, so a total of 39 hours of you just hanging out with me online helping you to reduce and eradicate pain.

The training is really designed for health professionals who are integrating the concepts or wanting to integrate the concepts into their practices. And over the years that I’ve run this, and it’s crazy to think I’ve been running it since 2003, we’ve had a number of people who are non-professionals but really want to work in an intensive way with me. And I’ve just let them know that this is a professional teacher training, and that absolutely you can come and join me and help yourself with your own body.

And people have loved it because, ultimately, the way that I teach is one that focuses on embodiment. So we’re not just waxing on with a lecture and talking about science. You’re actually doing the movement. You’re doing this to yourself because I really strongly believe that as professionals we need to be eating our own cooking.

And so if we’re not working with our awareness and our bodies and improving and gaining function and demonstrating that what it is that we’re teaching is working, to me that’s the whole point, in a way. That if what I’m teaching doesn’t work for me, then why the heck am I teaching it, right? So we do a lot of work on each person so that each person can really feel the shift and the change so they can come from a really lived experience when they’re working with their clientele.

Okay, so that’s the therapeutic yoga intensive. If it interests you and it resonates with you, and you want to spend some time with me, have a look at learn.functionalsynergy.com/intensive. And I would love, love, love to see you there.

Just a note that this is not a program like my others where you can purchase it and then buy the recording later, like watch the recording later. This is a live, real-time experience where there is a recording but the recording is meant for review. And so you are required to be in attendance in order to take the training, okay?

So I just want to emphasize that because so much real cool magical stuff happens in the real-time online experience. It’s not in-person in-person, meaning like in your face in-person. But there’s an in-person real-time online experience that does make some real magic happen within the group.

All right, so the first episode today, what I want to dig into are the key phases that I’ve seen over time when I’m working with my clientele, where I’m initially helping them reduce and get out of pain. Then there’s a transition and then there’s a strengthening. And that strengthening phase is really when they’re back into daily life, doing more complex things, doing more than they’ve ever done in a long, long time.

I want to emphasize that the kind of client that I tend to see most often are people who have a persistency of symptoms. They’ve had them for a while and they’ve made some gains with the various things that they have tried, but the gains haven’t been sustainable. And so a big reason that I have seen that they aren’t sustainable is because they aren’t actually addressing the thing that’s the thing.

And that thing that’s the thing is often under their level of awareness. And you can’t change anything you aren’t aware of, so it’s really important to grow that awareness. And that awareness is one of these common themes throughout each of these phases. The rehabilitative phase, the getting out of pain phase, the transition phase and the strengthening phase.

So what I want to do is go a bit deeper into each of these phases to have you really get how I utilize awareness, how I teach and utilize the whispers or the yellow lights, what I tend to find gets in the way of people’s progress at each phase, and then things that you can do. And we get into all of this during the therapeutic intensive at a deeper level and really study it and experience it. And the things I’ll be teaching you today you can easily start applying for your own practices and with your clients if you’re a teacher, and you can start to get a feel of how this can all work.

So the first phase that I sometimes call the rehab phase or the getting out of pain phase, where there’s an initial rehabilitative focus. And I’m really clear about this phase because I’m wanting someone to really understand how they’re moving and to learn to listen to their body. Because what I have found time and time and time and time again, is that when people learn to listen, and when they can be aware of their movement patterns and clean up their compensatory strategies, their pain goes away.

Their pain definitely goes down, and their pain starts to go away more and more and more consistently. And so it’s very important for me not to make someone stronger in this phase. I know that there’s a lot of talk out there that if you have pain, that suggests that you’re weak, so you should get stronger.

I hear that a lot of times. And then I don’t find that to be true because you can strengthen all you want, but you’re essentially strengthening on top of compensatory or inefficient movement patterns. Which, yes, you’ll get stronger and have a little more stamina, but the underlying patterning still hasn’t shifted, so it will come back at you again, right?

So this phase is one where I’m really looking at and teaching my client about their movement patterns, what’s working and what’s not working. And nurturing and acknowledging the thing that is working and really being clear about what they’re doing really, really well.

And in that context, letting them know where things that are extra, or tension, or just inadvertent patterns that aren’t necessary to make the movement happen, and then showing them what they are. And then helping them integrate that which is working really, really well with the quieting of the thing that’s not working. Because it’s often the thing that’s not working, meaning the compensatory patterns, that’s in the way of them getting to that next level.

In the process of this, they start to learn about their yellow lights. And I’ve had plenty of episodes where I’ve spoken about yellow lights, and you can go into the show notes and I’ve listed a few of the episodes that you can go to if you are new to this podcast and don’t quite understand what I mean by yellow lights. So do take a look at that and you can delve in deeper to what I mean by yellow lights.

But essentially, they are what I call the whispers, because when someone comes to see me, they are at a place where their life is feeling constricted, they’re a little annoyed, and they’re a little more than agitated. And they might be bordering on a cuss word or two in terms of how they feel. And they’re just fed up. They’re fed up with feeling the way that they’re feeling.

They’re in what I would call red. And so the aim is to help them recognize the movement patterns that are contributing to what it is that they’re experiencing. And when they start to recognize those compensatory strategies, whether it’s breath holding, or tension holding, or bracing, or having body parts move when they don’t need to move, those are all what I call orange or yellow lights. Those are the indicators to let the person know that something is going to get worse.

So then we start to teach them how to move inside of those lesser lights, those kind of like orange and yellow lights. And they start to learn kind of the bandwidth they have before the red comes. Because often after the first visit that I have with someone and we’ve had this conversation, and we’ve taken them through some movements and some breathing exercises and some stillness practices, they start to say, “Oh, yeah, I feel way better.”

And when they start to feel better, I say to them, okay, that feeling better feeling will fade. “And the reason it will fade is because you haven’t developed stamina around this new neuromuscular pattern. It’s a new pattern. So you only have a certain neuromuscular pattern, a certain bandwidth, and then you’re going to start to feel those darker oranges to reds show up.

Don’t be alarmed, it’s all good. It’s totally normal. What I’d love for you to do is to notice what else is contributing to those showing up. Is it when you went for a longer walk, or you were sitting for longer? Or is it whatever, it could be any number of things. And if you can start to notice what those things are, then we can start to see other contributing factors that before you weren’t aware of, now you’re becoming aware of, that are now, you can see, is a pattern towards the reds showing up.

So then what starts to happen through this rehab phase, through this getting out of pain phase, is that they become more and more and more aware of both what’s going on in their life that’s contributing to oranges and reds showing up and how they can stay longer in yellow, what contributes to them staying in yellow.

And then as their pain starts to have moments of being gone completely, then they start to notice what’s green. And they start to notice what contributes to green. And then they start to see this relationship between green and yellow, because the big thing is I don’t teach anyone to stay in green all the time. That’s impossible, right? Just think about the course of your day, you get hungry, you get thirsty, you get tired, right? And then you start to feel certain ways.

The aim is not to be static in green. The aim is to notice those yellows and then to recognize the yellows are there. And so then what do you do to support yourself, right? That’s really, really vital. I really want to emphasize that yellows aren’t bad. Yellows are the key whispers and they let us know just where we’re at in terms of our bandwidth and if we can push or if we need to stop, or if we need to rest.

And that’s everything that the person is learning in this rehab phase to really recognize and feel the sensations in their body, what these sensations are actually telling them. And then utilizing that information to support themselves.

Now, where people get tripped up in this part of the process is sometimes it feels very, very new. Not many people teach this way, paying attention to their body is relatively new, seeing the reality of their movement patterns can sometimes be a bit shocking, particularly when they thought they could move a lot further than they actually can.

And so of that awareness of where their movement actually is, can be a bit stunning. And there can be thoughts like, “Oh my God, if I’m moving this small, how am I ever going to get better?” Right, that often can happen. And that thought pattern can really get in the way of progress.

So when I hear that, I say to them, I get it. I totally get that there’s this expectation here that you had movement that was what it was. Now I’m showing you what your movement actually is. It can feel like the gap is really far, like if this is your movement now then how in the heck are you going to get to the movement you thought you had? And so it’s totally normal to be frustrated and to be sort of feeling a bit downtrodden.

And it’s all good, because we think that the distance is really, really far. But in fact, it doesn’t take long, when you follow the yellow lights it will not take you long to get to a range of motion that’s actually a better quality range of motion and a movement pattern that’s better quality. And that will actually bring you more strength and stability quite organically.

So I often will provide that kind of conversation with people in that phase to let them know they’re on the right track. The other thing that I’ll do, too, which is also very helpful is I will let them know when they have gains like reduction of pain or improved movement, I make sure to let them know so that their brain can focus on the small glimpses that they’re experiencing.

Because, again, just because they’re small, doesn’t mean they’re tiny. Small is mighty, right? It’s mighty. And when our brain can see, oh, look, I created that, meaning the person created it, not me, then they can repeat it. And then they can repeat it. And then they have more and more evidence that this is possible to change. And that is so fundamental for improving one’s internal locus of control and just a fundamental confidence in knowing that they can do it. So that’s that first phase.

Now, lots of times, when people get to the, they’ve gotten out of pain, whether it’s with me or whether it’s with any other modality that’s out there, what can happen is there’s this like euphoria feeling of like, “Yes! I feel so good.” And then they want to jump right into whatever activity they were doing before.

So whether it’s cross country skiing, or downhill skiing, or running, or cycling, or CrossFit, or weight training, or Pilates, or even like getting into their favorite chair and watching Netflix, or getting down to the floor with their grandkids or their kids. They want to get like right into it, meaning golf, walking, I mean, you name it, like the activity because they feel good. And there’s a switch that can sometimes happen in their brain of like, all right, let’s go, let’s go, I feel so good.

And in that phase, I actually have to say to them, “I know you feel really, really good. I need you to wait a week. I know, I know you want to go. But right now the neuromuscular patterns you have are a fit for where you are now. And those things that you want to do require a little bit more complexity of movement, and there’s a likelihood that your doing them might then create or be correlated to an increase of pain.”

Now, having said that, you can still go off and do them, I just want you to be clear on what might happen. And then they recognize it. And that’s why I have built in this transitionary phase and I named the transitionary phase as exactly that, a transitionary phase, from moving from this getting out of pain phase to a real strengthening phase.

It’s also an important phase because there are a lot of people out there who have gotten out of pain and then they start into some strengthening or some more activity, and they hurt themselves. And then they’re scared when they get out of pain. So they don’t have feelings of euphoria at all, then they say like, “Oh no, I’m here. I feel really good, but I’m nervous about even getting back to activity, because the last time I did that I hurt myself and I don’t want to repeat that.”

So then there’s almost this frozenness of fear that can kind of come over them. And then they kind of keep cycling around in the getting out of pain phase and they don’t really ever graduate out of that. So in those scenarios, what I say to them is I say, “I totally get it. It makes sense, right? Because there’s been times in the past where you’ve moved ahead with other activity and then you’ve hurt yourself and you get really mad and frustrated and just like, oh, my body’s broken and I feel my body is betraying me and all the things that can arise.”

And so I say to them, this is why we have a transitionary phase. Because in this transitionary phase, it moves you from the getting out of pain phase, moving you out of some of those fundamental rehabilitative type of movement patterns where we’re building out motor control and coordination, recognizing what a coordinated strength and a really quality range of motion actually is, easy breath and really feeling one’s body.

We want to take that into this transitionary phase and start adding a little bit more complexity. Just a little bit. And then that helps to bring about more confidence, again, of like, “Oh, I can do this,” right? I don’t want to rush someone into the strengthening phase when they’re feeling a lack of confidence. I recognize that there are trainers out there who do that and do it quite successfully, but generally speaking with my clientele, that’s not what I have found as being successful.

So I tend to go at it what might appear to be a little bit slower. But in fact, what happens is the progress, compared to other folks out there, is really quite quick. Really quick. We consistently receive feedback from the surgeons that clients of ours have seen, whether it’s for knee or hip replacements or recovery from cancer surgery, that they’re so shocked at the gains they’ve made.

Even if it’s not a surgical recovery, that there’s a recovery from any other persistency of symptoms, people around them are surprised at how well they’re doing. So even though it appears somewhat slower, it’s actually faster. That’s why I like to say that my process is one of the turtle, always. Dangerous word, always, right? But the turtle always wins, right? Slow, steady, deliberate.

And so in this phase, what can sometimes happen is that some people can get really overly ambitious and then they override their patience and they want to jump to the next phase too fast. Or they forget about all the awareness that they gained early on in the rehab phase and they just kind of get going, and they forget and stop feeling and stop being aware.

And then when that happens, they lose touch with their body and lose connection, and they lose the feedback mechanisms. And then they can slide back a little bit. But even if that happens, it’s not a big deal. It’s more like, oh, look, look what happened. It’s bringing the awareness to what worked and what didn’t work, and then helping to refine the process for them so that they can tune more effectively into what’s going on through their body.

And usually it takes one or maybe two little hiccups for them to say, oh yeah, I forgot. I forgot that, I was feeling good and I forgot that I had to stay aware, I had to continue to be aware. And not being aware from like a place of fear, of like waiting for the thing to come back and bite them in a sense, but rather to be aware for the simple fact of being aware, of tuning in and being present to what’s going on in their body.

And then as they grow that ability and that capacity, their whole nervous system really starts to settle down and there’s just such a greater clarity of what works and what doesn’t for them. And they get that much more understanding of exactly that, what works and what doesn’t. And they get more and more stamina and longer periods of time without the symptoms that they had been experiencing prior.

What’s so interesting in this phase is, this typically happens with a lot of my male clients, is that they’ll be so surprised that they get more tone through their body, because we’re still not doing a lot of big movements and they wonder why they’re getting more toned. And my response is because now you’re getting more efficient in which myofascial tissue is actually doing the work, that now you’re getting better tone is what I’ve noticed.

Because when people compensate I’ve seen a correlation in tonality of tissue that changes when they stop compensating as much, which becomes really cool, right? Because the force loads are being dissipated and absorbed and transferred in a different way, which then leads to the strengthening phase.

And for some people, this might sound really weird that I’ve got strengthening at the end. I mean, I did speak about it in a previous podcast around relax, move, strengthen. But still out there in the world, and I’ve mentioned this before, that a lot of people believe that if there’s pain present, there’s weakness present, so we must strengthen. And that, in my mind, puts the cart before the horse.

We need to get the movement patterns sorted, have the awareness of what works and what doesn’t for our system, and then start to add strength. So whether that strength is the bigger activities like skiing, or CrossFitting, or getting on a bike, or just doing any other bigger type of movement, really. And then we can start to build that out because of all the awareness that is present.

And I was having a conversation with a client earlier today and I said, does it feel overwhelming, now that you’re in this phase, of all that you need to be aware of? And she said, no, I feel so clear and peaceful in my body. I so know what my body needs, and it’s great. And that was brilliant, a brilliant response because sometimes that can be a response that people have around growing awareness. It’s like, oh my God, what more do I have to be aware of?

But the reality is, now you have a reality of what your body can and can’t do. And so now you can be that much more specific about what you’re choosing in terms of helping it become more stable, stronger, and more mobile. And then really, the sky’s the limit. The possibility is endless in terms of what you can do when you have that level of awareness.

And when you go to a trainer of whatever stripe, and then they’re suggesting that you do something that you’re like, “I don’t think so, that’s not going to work for my body,” you can say with confidence, “That’s not going to work this time.” And even if they pressure you, you can say, “I totally get why you’re pressuring me, I’m not going to do it.” And you can just be really clear and confident in that decision. And then that just opens the gates more and more and more and more and more. All right?

So those are the three phases, the three buckets also is what I sometimes call them. Getting out of pain, the rehab phase, the transitional phase, and the strengthening phase, and just things that can get in the way for people and how to really be successful in each one. And as you do that, how that just picks up the pace and the tempo for your recovery.

And the speed at which you can recover can be very, very, very quick. It’s why my private one on one series are three months, because so much benefit can happen in three months, which is really not that long of a period of time, right? And a lot of times, when people come to those three month contracts with me, at the end of the three months they’re like, I want to do this again. If we could make this amount of gain in three months, then holy smokes, we can make this amount of gain in the next three, right?

And so I get a lot of people returning to get to that next level of function for what it is that they want to do. So if that’s something that you would like to experience and you would like to have an intensive six day experience of really exploring and connecting to your body and your being, or you’re someone who is a professional who wants to do that for yourself and learn how to do this for another person, it would be such an honor to teach you.

Truly, I’ve been doing this program since 2003 and it’s gone through its various iterations. And it’s one of my most favorite things to teach because we’re just there together, six and a half hours a day, just going for it, of really showing people how to make the transition from pain to possibility. And that just lights me up.

So if you’d like to join me, do have a read at learn.functionalsynergy.com/intensive. If you want to reach us by email, by all means send us a note, [email protected]. I would be delighted to answer any questions that you have. We’ll see you next time. Have a great, great time exploring your body and have a great day.

If this episode has resonated and you’re looking to deepen this idea of getting your body back on board, of listening deeply to your symptoms, of listening to the whispers, so you don’t have to hear the screams, and you’re looking for one to one support or professional training, then reach out to us at [email protected] where we can customize your learning path. That’s [email protected]. Looking forward to hearing from you.

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