Persistent pain and returning to what you love

Return to what you love?

Even with pain? Yes, go for it!

It may sound either intimidating or exhilarating but, returning to what you love is absolutely possible.



Pain interrupts how you experience yourself in your own environment. Quite often it limits your possibilities. As pain persists your world feels smaller and smaller as capability wanes. One of the statements I hear often from clients, “I want to do a specific activity but I’m afraid I will hurt myself more.”

Fear of further injury is completely normal and can be useful at times. Fear of pain is also normal and useful at times. Pain is occasionally a warning sign as in cases like fractures, burns, or cancer. However when it comes to pain that persists there are many many more influential factors to consider beyond damage to the body. Persistent pain is more of about sensitivity and what drives that sensitivity is unique to you and your environment.   Evidence points to pain being a relational and emergent process of sense-making through a lived body that is inseparable from the world that we shape and that shapes us.


Give it Meaning

Pain is felt in your body and occurs in your environment. You seek information to make sense of the pain. From this you ask yourself, “Why is this meaningful to me?”.  This question evokes emotions like fear, worry, and concern, or relief and hope. 

We answer this self imposed question through stories. Sometimes those stories are self limiting. Sometimes those stories are mis-informed or flat out false. Sometimes the stories are placed upon us by friends, family, or clinicians. Too often physical therapists and the medical community have fed into the fearful stories making people feel fragile rather than resilient. Feeling this way can make returning to meaningful activity feel nearly impossible.


Reframe it

Here are five questions to ask yourself as a way of understanding your beliefs around pain and your potential for change.

  1. What would you be doing if pain weren’t an issue?
  2. How much support with you like along the way?

  3. How confident are you in engaging in the plan to return to this activity ?

  4. What would it take for you to feel safe starting it now?

  5. Can you see your potential for meaningful change?


The approach for returning to what you love (i.e. meaningful activity) is person dependent and not an exact protocol. When you are in pain and want to return to exercise it is difficult to know exactly how much to restrict and how much to push forward, especially if the pain has lasted for quite some time.

My personal approach with my clients is to rule out red flags, to discuss their goals and desires for activity, and to create a plan together to help them reach those goals. Evidence shows that gradually exposing yourself to meaningful activity, opens up new possibilities for action.  


Experience movement

Returning to what you love is important for people in persistent pain. Movement affords you the quality of life that has been missed due to pain. Moving in ways you enjoy helps you see your potential and possibility for change. Knowing you can move without damage opens up possibilities for goals. The steps to achieve your goals is where you can form an alliance with a physical therapist who helps you feel safe to move and fosters your autonomy to create change. This safety and autonomy helps make pain less of a protective alarm.

My desire is to see people in pain have less fear and gain greater confidence in movement. It’s time to think bigger and broader than pain reduction. You are worth more than that.  

When the value of a life goal outweighs the value of pain, then fear related protective behaviors are inhibited and pain is seen as less of a threat.  No evidence supports that specific exercises for persistent pain are more superior than general exercise. Therefore, choose exercises that align with your personal preference. Return to what you love. Go for it!


If you need personal help with this approach contact Melanie.

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