In August I attended the NOI Groups\u2019 two day Explain Pain course,\nfollowed by the one-day Graded Motor Imagery course. While there is a plethora\nof fantastically interesting knowledge that I gained of the current science and\nunderstanding of pain and stress biology that I would love to go on and on\nabout, I am choosing to spend some additional time sharing my reflections on\nthe biopsychosocial treatment approach that is Graded Motor Imager (GMI).<\/p>\n\n\n\n
So, firstly, what is GMI? For those of you who haven\u2019t heard of it, GMI\nis a series of progressive cognitive activities that are all about virtual\nmovement and accessing your body\u2019s representation in the brain, to assist in\nimproving your pain state, especially when movement itself is very limited by\nthe pain experience. The three main techniques are Implicit Motor Imagery,\nExplicit Motor Imagery, and Mirror Therapy. In brief (VERY brief):<\/p>\n\n\n\n
The idea is that by rehearsing movement and activities that might be too\npainful for the individual to physically do, in a way that is completely safe\nand unable to cause further physical damage, we can begin to adapt and retrain\nthe neuroimmune system and change the experience.<\/p>\n\n\n\n
Sound a bit hokey? Well, without integrating modern pain science and a\nbaseline level of understanding of the neuroimmune system with the GMI\ntechniques, it will definitely seem hokey to anyone you ask to imagine\nthemselves doing something with the expectation that it will resolve their\npain. Which brings us back The Explain Pain intervention and my biggest\npersonal take away from the weekend. <\/p>\n\n\n\n
During my University Basketball career in Canada (Go VReds!), we used\nimplicit and explicit motor imagery all the time in the form of watching film\nof professionals, watching film of ourselves performing both small aspects of\nthe game (i.e. shooting mechanics) or short clips of the game itself, and\nlastly through visualisation (until attending this course, my least favourite\ntechnique). At that time, I used to moan about watching film, cringe when I saw\nmyself make a mistake, and frequently fall asleep when I was meant to be visualising\nmyself achieving success on the basketball court. I didn\u2019t appreciate that\nthese techniques were what pushes good athletes to become great athletes. By\naccessing your body\u2019s representation in the brain between practice sessions and\ngames, you can maximise your potential beyond what you can achieve through\nphysical practice alone. <\/p>\n\n\n\n
The fact that I didn\u2019t get to fully take advantage of these tools that\nwere put in front of me to improve my performance falls right in line with what\nI believe happens for a lot of people experiencing pain, and is what The\nExplain Pain intervention is built upon: Knowledge = Power.<\/strong> I didn\u2019t\nfully understand howmy brain worked when it came to motor learning and\nhowthose mumbo jumbo visualisation and video sessions would be\neffective in improving my performance, so I didn\u2019t properly master the\ntechniques and I didn\u2019t reach the level of success in sport that I hoped I\nwould (my abysmal free throw shooting percentage is evidence of that!). I went\nthrough the motions and completed all of the visualisation and imagery tasks\nthat my coaches put in front of me (I wasn\u2019t risking any extra running), but I\nwasn\u2019t making the gains I likely could have made if I understood at that time,\nwhat I understand now about the brain and neuroimmune system. <\/p>\n\n\n\n Similarly, I see many clients diligently complete all of the treatment\nprotocols and physiotherapy exercises that are the best practice interventions,\nbecause their treatment provider told them to. But for some reason, at the end\nof it, they haven\u2019t experienced the improvements in function or in their pain\nexperience that they were expecting and hoping to make. Can we, as health\npractitioners, improve their outcomes by helping clients to understand what is\ngoing on in their body when experiencing pain? The answer is YES. <\/strong>But\nfirst, we need to truly understand it ourselves, and understand that we can\nplay a pivotal role in giving our clients the key to unlocking the mystery\nbehind their pain and debunking some of the unhelpful beliefs and ideas they\nmay have picked up along the way. <\/p>\n\n\n\n So for any health practitioners out there, who play any form of role in\nsomeone\u2019s recovery after an injury or illness, I encourage you to look into\nExplain Pain. I promise you, it is not your average research article or\ntextbook. It is engaging, humorous, and approachable, and will hopefully help\nyou to feel better equipped to answer those tricky questions from clients\nlooking to learn more about \u201cwhy this<\/em> hurts more when I do that, <\/em>or\nam feeling this, <\/em>or am even thinking about going back to (insert\nactivity<\/em>)!\u201d<\/p>\n\n\n\n