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Qualified as an occupational therapist in Malaysia, registered in the UK. Former Lecturer and Head of Occupational Therapy in a Malaysian private higher education institute. I take a social justice informed approach and apply an intersectional lens to my work.

Monday, February 2, 2015

Sometimes, DON'T "listen to your body"

In response to my previous post about observing pain I had quite a few interesting responses from my colleagues. My brother, also an occupational therapist, asked, "Observe, what for?"

Observe, then choose how you want to respond to it. The response to pain that is the best for your well-being may not necessarily be what your body automatically wants you to do.

Typically when people respond to pain, it's a reactive kind of response, i.e. when a Taekwondo athlete injures the top of his / her foot while fighting in a tournament by accidentally kicking their opponent in the elbow (a very common injury by the way), what would be the instinctive response?

The instinctive response is to take the injured foot off the ground and put the weight on your uninjured foot. The immediate response is to let the injured foot rest.

However, what if I told you that the best response is actually to put your body weight on the injured foot instead? Press on it, and keep pressing as the match goes on. That's the only way you could use it to support your uninjured foot (which should be used for kicking, since I don't think you would still want to use your injured one for kicking - at least for the time being).

Something important to be aware of particularly if you're in the ring with an opponent who's aiming to kick you in the head at any given point in time and you've got a match to continue with.

That's an example very specific to Taekwondo. Now let's look at another example closer to the day to day experience of a person living with chronic pain.

Last year in December, I had an impinged nerve in my spine. I immediately texted my good friend Dr Dansen Wong from Bangsar Chiropractic to set up an appointment when I realised something was not right, only to find out that he had gone on holiday so I had to wait a few days for him to get back.

I already had tons of appointments lined up - my typical work day either involves working on the computer (doing my writing work, development work, promotion work), working on the mobile phone (communicating with clients), or actually driving around to see clients, to events, etc. The pain was really really bad (I'm Malaysian, we avoid going to doctors for every tiny little thing that's not right with us ... So no way I would contact Dansen for an appointment unless I really needed it, and I know I did!) but I couldn't afford to let it get in the way of my work so I had to be my own occupational therapist - come up with some adaptations (see my makeshift standing-sitting work station below) so I could make my way through the day, keep doing what I needed to go etc.



When I finally got round to seeing Dansen, I was in pretty serious pain, BUT the pain could have gotten worse if I had done what (Malaysian - not sure if people in other cultures react the same way) people instinctively do, which is:

(1) drop everything until they manage to get that appointment in order for the chiropractor (or some other health worker who does manual manipulation) to see to them.

OR

(2) take painkillers then just ignore and go on as usual (or just go plugging on even when in pain until they can't stand it anymore).

By OBSERVING AND ACKNOWLEDGING pain OBJECTIVELY first, then only looking at what CHOICES are available, it allows us the time and mental space to think about what actions to take next in order to deal with the pain. Sometimes the best choices to preserve your well-being are not necessarily what you might expect. I'll write a blog post reviewing the lifestyle modifications I did for my nerve impingement episode another time (actually, this entire blog is about the CHOICES that are available), but hey - I was *so grateful* to get my spine sorted. Thanks Dansen!

Occupational therapy may not be able to "cure" a person from chronic pain, but it can sure help in terms of preventing deterioration and also encouraging a faster recovery (when you're not continuously damaging your body - that gives it time to rest and heal, right?)

Note: Dansen discharged me after only two sessions, the earlier expectation was that I would need about four sessions to get the impingement properly fixed. No repeat injuries since. :)