Authors – Katelyn Carpenter, PT, DPT & Jimmy Sliwa, PT, DPT, CMTPT

Introduction

  • What is mindfulness?
  • Can mindfulness affect pain?
  • 5 Strategies to Implement Mindfulness into

Practice

Remember how the supermoon lunar eclipse helped us start the new year with a sense of awe and amazement for just how expansive the universe is. In moments like these, it’s easy to allow time and awareness to change our mental outlook. Looking at life situations from a different mental perspective is a great way to welcome change.

Learning how to practice mindfulness helps us appreciate our space, our role and purpose in our lives. It offers a personal connection between our thoughts, emotions and experience. It’s often far too easy to become self consumed by painful problems in our lives. Whether it’s physical, emotional or social pain, it is important not to let these issues take the driver seat. We all approach pain at different points on a spectrum.

For instance, an athlete that sprains his ankle and can not play in Friday nights homecoming football game may view his ankle pain as completely debilitating. Compare this to a spinal cord injury patient who is grateful to take his first few steps after his car accident. The difference of pain levels from one person to another is not based upon character, injury or condition. Instead, pain levels are more related to wellness and mindfulness.

It’s how well we care for ourselves and how much we perceive pain as a threat vs an opportunity.

In physical therapy practice, we encourage clients to establish Wellness and practice Mindfulness. Our experience supports this approach to resolve pain through a willingness to make changes which lead to improved tissue health and tolerance for loading. Hurt does not equal harm, pain is an opportunity not a threat. Pain is a chance to make lifestyle changes, and an opportunity to learn new movements or motor patterns. The mind is a powerful tool and can be leveraged to promote healing.

Mindfulness is defined as an awareness to self that comes by being present and intentional with thoughts and actions. Often times we view mindfulness as something only a buddhist monk would find beneficial. The reality is that mindfulness has a number of health benefits. Regular participation in mindfulness can help lower blood pressure, reduce stress/anxiety, and aid in productivity. Furthermore, research observing mindfulness practice has shown changes in the brain that help attenuate chronic pain through psychological and neurological processes (Zeidan 2016).

It may sound cliche, but there is power in positive thinking. Mindfulness is nothing more than pausing, being present, and taking a positive perspective. With those that experience chronic pain, following the 3-P program (pause, present, and positive) can offer healing benefits. Knowing that chronic pain can be mitigated by mindfulness, it is now important to understand how to incorporate mindfulness into a daily routine. Integrating a new task into a daily routine can be daunting, especially with the busy lives we lead. To keep things simple, we have created 5 steps to begin practicing mindfulness.

Body

Five Steps

  • Breathe
  • Stop and “Smell the Roses” (smell, sight, touch, sound, taste)
  • Smile and Laugh more
  • It’s okay to say “No”
  • Consistency

Step 1: Breathe

Breathing is an automatic body function; nobody has to think about it. But take a moment to focus on breathing. What is happening? Are your lungs expanding fully or are your breaths shallow? Do you breathe through your mouth or nose? Bringing attention to breathing can lead to conscious changes in what is already an automatic action. Breathe has healing properties. The body requires oxygen to fuel muscles, the brain, and all vital organs. Taking a moment to be aware that breathing floods fresh oxygen throughout your body. Take time during the day, especially stressful times, to focus on your breath. Inhale through your nose for 7 seconds, followed by holding your breath for 4 seconds, then exhale completely through your mouth for 5 seconds. Perform this action 5 times and feel some of that stress float away.

Step 2: Stop and “smell the roses”

Pay attention to senses (smell, sight, touch, sound, taste)

Have you ever noticed a bruise on your arm or leg and wondered, where did this come from? Do you ever feel like your body is falling apart and you don’t know when the process started? Periodically stopping during the day to bring awareness to our five senses (smell, sight, touch, sound and taste) can tell you a lot about your body. Our bodies are powered by the ability to detect change and harmful stimuli which is often translated as pain. Pain is a message our body uses to tell us something needs to change to prevent further tissue overload. If we do not have body awareness, we are placing ourselves at a higher risk for injury.

So I challenge you to stop at a meal to really taste your food instead of inhaling it. Pay attention to how that computer mouse feels under your fingers. Take a moment to look around and enjoy your surroundings. Listen to your surroundings and walk into a bakery for free smells. Use all of your senses everyday and your body awareness will improve.

 

Step 3: Smile and Laugh More

Laughter really is the best medicine. Numerous studies have demonstrated that laughter increases our well-being by altering chemicals within the brain. It can boost immunity by increasing T-cells or provide an avenue of stress relief by releasing endogenous endorphins. This powerful release of chemical mediators has been shown to have analgesic effects as well. This means laughter can actually cause our pain to reduce. Laughter clearly has benefits but no one can laugh on command. Instead, try smiling when you feel the onset of pain.

Engaging the muscles in the face will actually provide similar benefits to laughter. When you feel pain begin take a moment to “grin and bear it.” Smile for a minimum of 30 seconds. If possible, look in the mirror while you smile and pay attention to your mood. Smiling and laughing more frequently is an excellent way to manage the stress and mood swings associated with chronic pain.

Step 4: It’s okay to say “No”

In our society, saying “no” often times comes across as rude or inconsiderate. Unfortunately this thought process has left many of us afraid to say it. The reality is that it is ok to say “no.” In fact, saying no is often the best option as it can free up time to focus on more important tasks. Many times we overcommit and overextend because of our difficulty telling others no. If “yes” is your knee jerk response, you may want to consider buying more time and responding later. One tool you can implement is the phrase “Thanks for asking, let me check my schedule and get back with you.” This buys you time to fully think if the demand being asked is the best option. Saying “no” avoids overcommitment which goes hand in hand with increased stress. It really is ok to say “no” more often.

Step 5: Consistency

Consistency compounds. Anything worthwhile takes practice, and practice without consistency is useless. You can not expect significant progress in pain management after a few sessions of mindfulness training. A more realistic approach would be to adopt mindfulness as a consistent routine before expecting any results. The best way to remain consistent is establish regular practice times. For myself, mindfulness is most easily performed first thing in the morning. This is when I have uninterrupted time. Distraction is the enemy of being mindful. When you first initiate mindfulness practice, aim to do it in a calm and distraction free environment. Another reason I enjoy morning mindfulness is that it gives me a sense of calm throughout the rest of the day. Just as breakfast is the most important meal of the day, mindfulness practiced in the morning sets the day towards success. A simple way to start the day off with mindfulness is to take several deep breaths and smile right before breakfast. Next, focus on how the food tastes, smells, and feels while you chew. Finally, think about the upcoming day and decide which tasks you can cut out (say “no” to).

Jimmy Sliwa

PT, DPT
Born and raised in the Mat-Su Valley, Jimmy Sliwa is excited for the opportunity to establish his career in the community he grew up in. Jimmy attended the University of Great Falls in Montana, where he graduated with honors with a bachelor’s degree in Biology and then continued his education and graduated with his Doctorate of Physical Therapy from Eastern Washington University in 2016.