Creative Movement for Pain Relief

Barrett L. Dorko, P.T. 

There can be no knowledge without emotion. We may be aware of a truth, yet until we have felt its force, it is not ours. To the cognition of the brain must be added the experience of the soul.

  Arnold Bennett (1867-1931)

The story goes that Thomas Edison (an Ohio boy, by the way) met one day with the team of workers he had working on the filament for his yet to be invented light bulb. “We’ve got nothing,” they said, “after all this time and trial, we have failed.” “Oh no," said Edison “don’t feel bad. Now we know a thousand ways it doesn’t work.” 

This essay is about the nature of creativity and its relation to movement, specifically, movement that relieves pain. Strange as it may sound, a lot of people don’t seem to know that simply moving is a remarkably effective way of relieving pain in a prolonged and profound way. And I’m not talking about repetitive or forceful movement full of effort and boredom and resistance. I’m talking about graceful, effortless, spontaneous and, often, very simple movement.  

Let’s back up a bit. The origins of pain are two: mechanical deformation and chemical irritation. (I am conveniently setting aside the central processes that may contribute to the persistence of pain for the moment) I deal primarily with the former and so movement that reduces mechanical deformation is my primary concern. The direction of the corrective-and thus pain relieving-movement will vary according to the specific deformation present. This is not rocket science, but there’s a catch. The catch is this; exactly which structures are deformed and in what direction and to what degree they are bent, twisted, compressed or pulled tautly (or some combination of these) cannot be easily seen, if sensed at all. Even the most sophisticated imaging will not reveal all the relevant deformation in a number of tissues, and those it can see might not be involved in the patients complaint in any case. Often, only by observing the patient’s response to care can we accurately speculate on the system formerly responsible for the problem. 

So we are left with the problem of knowing that movement is essential for correction i.e. a reduction in mechanical deformation, but not knowing what that direction might be. If it were a single gesture with no impediment to its expression, the patients would do it themselves. For instance, no one in police custody needs to be told how to untwist their arm from a hammerlock once the policeman lets go of their wrist. Unfortunately, the deformation our patients have acquired is subtler, more deeply imbedded and insidious than that. In addition, the movement necessary to resolve it often requires far more patience and courage to perform.  

The direction of correction is as big a mystery to me as it is to anyone else in this business, though I know that many feel that letting the patient’s symptoms lead them is the best way go about discovering it. McKenzie’s repetitive movement in an effort to “centralize” the complaint of spinal pain comes to mind. The literature on the reliability and validity of this treatment strongly supports several different views about this. 

My problem with only allowing the patient’s symptoms dictate what movements I might promote lies in the fact that correction of painful structures is not universally relieving at first, though eventually it should prove to be. Ever see anybody come out of a hammerlock? They typically groan on the way out, demonstrating the fact that the best movement for relief of symptoms is not necessarily painless. Neither should it necessarily hurt. This fact eliminates pain or its relief as an essential aspect of corrective movement. I have detailed the four characteristics of correction in an essay of the same name on my web site <http://barrettdorko.com>. What I want to emphasize here is the nature of corrective (read pain relieving) movement. 

Creative Movement

For a long time I've had the impression that movement that relieves pain is creative in nature, as opposed to that which strengthens or lengthens us. Movement of that sort I refer to as productive. In David Whyte's lecture, The Inner Necessities of Leadership, he makes the point that the workplace has always in the past asked for more production. Production can be coerced, measured and legislated if need be, and any management strategy must employ those methods if it hopes to succeed.  

The problem of managing creativity can only be resolved by understanding the origins of the creative process itself, and Whyte reminds us that creativity arises from an internal conversation. This is the kind of self-examination and soul searching that virtually every artist engages in for prolonged periods. Without an invitation from the manager toward the worker to engage in that, creativity cannot be expected, only production.   

Think of the modern therapy department. Designed to hold numerous stations for the application of modalities and exercise protocols, there is precious little space for any patient to engage in the internal dialogue creative movement requires. Of course, if strength and range are all that is required for recovery, there is nothing lost here. But the vast majority of painful problems will not respond to repetitive movement choreographed by another. If that works particularly well for non-pathologic problems, it's news to me. Regimens like this are productive, to be sure, but individually acquired problems of deformation would have no reason to improve like this, unless by luck.  

When your patient needs to create a movement, they will need an invitation that promotes unique expression, instinct, and, to some extent, courage. I say courage because the creative process invites failure into their life. This is why so many avoid it. Consider the story about Edison above. In my opinion, when someone says they are "left brained" and therefore unable to see a certain concept or develop an idea in a certain way, what is actually happening is that they are avoiding the internal conversation that the "right brained" are willing to risk. The manual technique I employ in order to promote creative movement is Simple Contact. It begins with the premise that within the unconscious processes of the person in pain (or those without pain, for that matter) exists a strategy for expression and correction and new patterns of use that will prove effective for pain relief. It is simply a matter of moving in a certain, creative way.