A primer on persistent pain, Pt.1: Why you won’t stretch your pain away

Physical pain is a funny thing. Sometimes pain makes sense, like if we fall or get a slap of a hurl across the shins. Other times it doesn’t make sense, at least not in the conventional sense that we think about it. We intuitively understand acute pain, but less so persistent pain or chronic pain as it is commonly known. The two can be differentiated by the time scale involved. A common marker of persistent pain is that which still remains 3 to 6 months since the onset, while some clinicians will extend that somewhat arbitrary point to a year. Either way, we are dealing with pain that hangs around for longer than it should. Here is a good definition of persistent pain: Pain that is often (but not always) elicited by an injury but worsened by factors removed from the original cause, usually lasts a long time, interferes with daily function, and is not explained by underlying pathology. Biomedical intervention is frequently sought and rarely effective (Turk & Okifuji, 2010) The burden of persistent pain is wide-scale, estimated to affect 1.5 billion people worldwide, with studies putting the prevalence point in Ireland and the UK Ireland at one third to one half of the population. Low back pain is so ubiquitous that everyone will have either suffered personally from it or will know someone close who has. It is not, however, exclusive to the low back and can present itself anywhere in the body. Pain is a complex topic, with a myriad of potentially contributing factors. In order to resolve persistent pain, it is important to understand what...

Moving towards a better normal

As we edge our way with a certain trepidation out of lockdown, we are facing into a ‘new normal’ of hand sanitizer, facemasks, and social distancing. What about beyond that, when we are out of the Covid-19 woods? Are we going to shake it off like a bad dream and keep going the way we have been? Our record as inhabitants on this planet would suggest that we will continue our onwards march towards total annihilation, but the global response to Coranvirus is cause for hope. If anything is to be taken from this pandemic, it is an awakening to the fact that we urgently need to change our ways to avoid an even greater crisis next time. Charles Eisenstein, in his essay, The Coronation, describes the current situation as humanity at a crossroads, with a hundred paths radiating out in front of us. Some lead us in the direction we were already headed, and others lead to a more healed and flourishing world. In many ways, Covid has given us a glimpse into what life will look like just down the path we are already on. Covid-19 is like a rehab intervention that breaks the addictive hold of normality. To interrupt a habit is to make it visible; it is to turn it from a compulsion to a choice. When the crisis subsides, we might have occasion to ask whether we want to return to normal, or whether there might be something we’ve seen during this break in the routines that we want to bring into the future. Charles Eisenstein, The Coronation What better time to reflect on...

Have yourself a better breakfast

It’s not easy giving up your favourite cereal. That is no accident of course, as breakfast cereals are designed to be addictive. These sugar-laden processed foods are designed to be hyper palatable, triggering the a surge of hormones that make you feel good, and leave you wanting more. As I discussed in my previous post, cereals are far from harmless, and I make the case for dropping them from your diet altogether. I can attest, as a past three-bowl-a-day cereal eater, when you kick the cravings, they eventually lose their appeal altogether. So what should we eat for breakfast? There are loads of quick and easy options to swap in for your soggy Cornflakes. There are three questions I would ask to help choose a better breakfast for yourself: 1) Are you using single ingredient foods to prepare your breakfast? Each food on your plate should contain one ingredient only, the food you are looking at. Let’s do a dummy test run..Banana. Ingredients? Banana. Nice, okay..Egg. Ingredient? Egg. Excellent. How about..Kellogg’s All Bran. Ingredients? Wheat Bran (87%), Sugar, Barley Malt Flavouring, Salt. Oh, no. But it says on the box here ‘Heart Healthy’, and ‘Fibre’? Sorry, doesn’t pass the test. (Incidentally, did anybody put their bowl of All-Bran with milk in the microwave, or was that just me and my Granny?) 2) Do you want your breakfast to consist of carbohydrates, protein, or fat? The macronutrient content of your breakfast will depend in part on your energy requirements for the day. Especially for athletes. If you are going to be taking part in an intensive training session a few hours after...

Breakfast cereals are highly-processed, junk-food, crap

Getting up in the morning during my school days was never easy, but I knew that if I could roll out of the bed and into my school uniform, a great prize awaited downstairs. A big bowl of cereal. Weetabix, or Wheat Biscs as the case may be. Cornflakes. If we had both in stock, a Weetabix-Cornflakes combo. On the weekends, we would raid my Granny’s cupboards for the serious stuff. Rice Krispies, Coco-Pops, plenty of milk of course, so that we could guzzle that chocolatey liquid-gold down at the end. During my college days, it was a free for all. Cereal for breakfast, cereal for lunch, and cereal before bed. And the best thing about it? This stuff is good for you! Heart healthy, whole wheat, part of a balanced diet, fortified with vitamins. A win-win situation. Or is it? To get to the truth about cereals we need to dive into the dark and murky world of Big Food. Nestlé is the world’s largest food company, which in 2018, spent €6.7 billion on marketing worldwide, with a net profit of around €13 billion. Kellogg’s marketing spend in 2019 was €625 million, with a profit margin of €1.3 billion. The bottom line for these giants multinational companies is financial profit, and they spend billions to make us believe that their products are good for us. They are not. They are highly-processed, junk-food, crap.The marketing strategies of companies such as Nestlé and Kellogg’s are so effective (and well they should be for the money poured into it) that their brand and products are universally accepted as part of a...

Finding the motivation for training

The world has effectively ground to a halt in a bid to contain the spread of Covid-19, disrupting our usual way of life. We are all getting used to a different way of living, and in light of the closure of all gyms and restrictions on group gatherings, this includes our exercise behaviours. This poses not only a logistical challenge to our training routines and habits, but also a psychological one. For many, exercise is a social activity, and is rarely a solely individual pursuit. We go to gyms and fitness classes, we meet up with walking groups, or are members of athletic or sports teams. And for good reason. Relatedness, or perception of personal connection with others, is a highly motivating factor to sustaining behaviour. For those in sport, the health benefits are often more of a by-product of training rather than a goal in and of itself. And there-in lies the challenge. What happens when we remove that this supportive environment that many rely on? The answer in part, will depend on what motivates people to exercise in the first place. Motivation can be defined as the degree of determination, drive, or desire with which an individual approaches or avoids behaviour (1), and it is an extensively researched topic in the field of sport and exercise psychology. We can explore what motivates people to exercise engagement by looking at the goals on which individuals focus their efforts. Self-determination theory, a framework which helps us understand the elements of human motivation, distinguishes goals based on their intrinsic or extrinsic content. Intrinsic motivation refers to taking part in activity...