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  • Dr. Ryan Albert

Fear Avoidance: When Pain Obstructs Progress


When injury strikes, pain always enters the room in a VERY uninvited manner.

The body goes into protection mode and rightfully so, it doesn’t want you to damage anything further.


Here’s where the problems start. 


We move a certain way or perform a certain task…. OWW! Your internal monologue goes, "Ok, my body doesn’t like that, I’m not doing that again” Well, duh, that makes sense because who enjoys feeling pain?!

Left unchecked though, we continue down the classical conditioning pathway of avoiding, avoiding, avoiding. Soon enough some of us develop what we call, fear avoidance behaviours


We start becoming stressed and anxious about performing those pain provoking movements and activities and then we completely avoid them altogether! Behaviours like these can have a HUGE impact on recovery as well as your mental health.



After an injury, I’ve seen people let weeks, months go by without any proper guidance, assessment or reassurance, or to be completely frank, they’ve received some archaic advice (aside: if your professional’s only piece of advice is rest or to avoid something altogether with no plan to return, you may want to get a second opinion)


By now we’ve let those fears of movement really sink their teeth in, and though it still may feel like you SHOULD be avoiding these movements, I can tell you with some confidence that you may be falling victim to one of the many tricks the pain monster plays!


The body wants to protect you but it doesn’t always have your best interests at heart. After most neuromusculoskeletal injuries I see in practice, it is vital to create a gradual plan to return swiftly to those activities or movements that were originally pain provoking. Through research, we know that patients are more likely to extend their recovery or enter chronic stages when solely resting an injury. 




“So what are the take-homes, Ryan?”


- If a pain/injury is new for you and it’s getting in the way of activities or daily routines, GET IT CHECKED, PEOPLE! I’m not telling you because I want to drive business, go see someone else, just see some one (with a good track record that incorporates movement into their treatment plan and doesn’t just tell you to rest)!

- Know that fear avoidance behaviours are a thing and can be impactful for your recovery down the road if left unchecked. - Just because you hurt something performing a certain task and now it hurts to do that task, doesn’t mean you're never going to be able to do it again. - The body is powerful, it knows how to heal and get you back to doing awesome stuff. Pain is not always a good measure of how healed something is or, conversely, how damaging something is.



Ryan Albert

www.drryanalbert.com

@dr.ryanalbert

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Foundation Physiotherapy & Wellness

123 Edward Street, Suite 100

Toronto, ON

M5G 1E2

p. 416.979.3022

f. 416.979.3023

ryan@foundationphysio.com

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PHOTOGRAPHY: MISHELLE RABKIN      ©2018 BY DR. RYAN ALBERT