About a month back I was informed by work that I needed to work Saturdays again. This would cut into my boxing Sparing so I signed up for my one last hurrah and was set up against a younger guy with greater experience and technique than me. The night before I manage to get food poisoning and stepped into the ring in less than fighting shape. A quick hook to the ribs followed by a head shot elicited a standing 8 count which had me questioning my life choices. The second round I settled down despite getting cracked on my nose and round three had another shot breaking my nose (Thank God I still wear masks in the clinic 😁) I ended the match and potentially my sparing career by vomiting all over the gyms bathroom that Bahn mi that gave me food poisoning the night before.
I slept the rest of my Saturday off before waking up on Sunday thinking my injuries weren’t that bad because they didn’t feel as bad as previous fractures to the nose and ribs respectively. I went to the clinic, adjusted 30 patients with moderate pain to myself yet haven’t missed a day of work. I took a week off of Boxing and the gym and have returned full time with slight moderation to the routine.
The nose has a small dent in it but who cares with my large honker, and not a lot of pain. Noticing recently now that the swelling is down and the pain, well over 80% better, is pin point over a “dip” in my rib Curiosity sent me to a medical clinic today for an X-ray (which are notorious for missing rib fractures) and an ultrasound where a fracture was clear as day.
While everyone is asking me if I’ll be OK I’m all “Fuck I’m 80-90% better already” 2 weeks into an injury that has a shelf life of about 6 weeks. I wonder if I only broke it “a little bit” as, again, the injuries I have sustained the past decade of my life are milder then when I was a kid and a young adult. Today the nose and the ribs, a few years back the three avulsion fractures in my ankle which “didn’t feel as bad” as the sprained ankle when I was a teenager.
This made me think of pain, a very nebulous concept, from a psychological perspective.
As a Chiropractor I’m certainly guilty of dumbing things down for education purposes in my patients: “Yes sir your low back pain is directly caused by this 4mm disc bulge at L4/L5” knowing full well that many people are blissfully walking around unaware of disc bulges that size and larger.
Pain is not just a mechanical concept, it’s a brain concept one that we know a fraction of what we should. Pain is not just damaged tissue, or even “all in your head” but involves a complex system where your brain is making constant predictions where incongruent information – a mismatch between intention, proprioception, and visual feedback or sensorimotor conflict may cause pain.
In English: Pain Generation is the bodies check engine light for not just tissue damage but to alert the individual to faulty information processing in the brain which is trying to make sense of the world and minimize risk.
And now you know why I tell laymen “yes ma’am this disc pinching on this here nerve…”
Bringing this all around… (I’m getting to the point here) … why do the injuries of a middle aged man: broken bones, torn meniscuses, missing ligaments pale in horror to those when I was younger?
Well I don’t want to jinx myself here but possible it’s because my brain has changed, for the better, I’m literally a different person with a stronger processing brain than I was when I was younger.
If this were to be true this has the potential to revolutionize the all too easily misunderstood concept of one of healthcares most difficult conundrums, the problem of pain.
We aren’t just treating tissue, we are treating the brain. Now all we have to do is convey this to the patients who have lived with the false “Body is a machine” paradigm, where damaged parts can be repaired and replaced… 😉
Chiropractic Rōnin 