Mindfulness and Movement: When pain interrupts mindfulness

Point 3 Well-being – An Interview Kieran Lowe

Kieran Lowe head shot Just one body

We recently caught up with Kieran Lowe, an osteopath and sports rehabilitator to discuss when movement interrupts mindfulness. Kieran has been working within healthcare for over 14 years supporting elite and amateur level athletes in the UK and abroad. More recently Kieran has been working with ergonomic specialists based within a range of office based locations across London. With this Kieran treats a range of people, sporty or not, with the aim of managing pain in the short term, but ensuring his patients know how to prevent the problem from returning. 

ONLY GOT 30 SECONDS? HERE ARE THE 3 TAKE-AWAYS FROM KIERAN TO ENCOURAGE YOU TO MOVE MORE, PAIN FREE:

  1. Movement is important. If we don’t use our bodies to move in the way they were engineered then the body will take that functionality away, and it will become more difficult, and painful to move.
  2. Taking the time to be mindful of yourself and your surroundings is always important. It’s far too easy to just keep pedaling and before you know it you’re not where you want to be. You’ve got to look up for direction from time to time and if necessary get the help you need. Talk to a friend, family member or professional.
  3. We all know the benefits of movement and exercise. But when pain gets in the way, don’t worry, you’ve probably only just been bitten by a brown snake (read the full interview for the full story!)! Think about the various routes available to help resolve pain. Osteopathy is one of them. I’m not trying to hard sell osteopathy as the answer to all pains and issues, but it can help. As much as physio can help, as much climbing can help…

OUR INTERVIEW IS CALLED WHEN MOVEMENT INTERRUPTS MINDFULNESS… CAN YOU ELABORATE ON WHAT THIS MEANS TO YOU AND HOW IN YOUR ROLE AS AN OSTEOPATH, YOU AIM TO HELP PEOPLE MOVE MORE MINDFULLY?

Mindfulness is more than just a buzzword taking the nation by storm. It’s an awareness of being in the present moment and being able to exist without trying to spend time thinking forwards or backwards in time, and being able to accept your thoughts, feelings and sensations of you and your surroundings.

To start a little about me and my interest in mindfulness. I graduated as an osteopath four years ago after finishing a degree in sports rehabilitation in 2004. University was a very different experience the second time around! I was taught how to be an osteopath, which was tough enough by itself. I knew in my final years of osteo I wanted to build a business, which is more than just one clinic with a couple of rooms. However, I wasn’t taught to be a business leader, which required a lot of extra learning on a topic I’m not familiar with.

About six months into this I had my first experience with anxiety. It took chatting to a friend and explaining why I was easily distracted, feeling tired, complaining about old injuries or new ones to be told this. I was surprised more than concerned! It’s something I hadn’t considered or identified with before. It took about a week to really understand what was happening and why. And it was only after this week I began reflecting on what was happening around me and what I was feeling, especially with pain and movement.

YOU TALK ABOUT PAIN. CAN YOU EXPLAIN MORE ABOUT THE MIND/BODY CONNECTION AND WHAT’S GOING ON IN THE MIND/BRAIN WHEN YOU FEEL PAIN?

Pain is a sensation that is created in the brain – it isn’t created by the skin or other tissues in the body. It’s an electrochemical signal that’s created and sent to the brain where it is assessed, interpreted and responded to.

Here’s a story from one of the world’s leading pain specialists – Dr Lorimer Moseley – Professor of Clinical Neuroscience based in Adelaide, Australia.

He was walking along through the outback when he felt something brush the skin on his leg. This activated fast conducting nerve fibres through his spinal cord transmitting a message to his brain – “You’ve been touched on the outside of your leg on the skin.” At the same time some slower nerve endings, which take more stimulation to send a signal are triggered, which go to the spinal cord and then up to the brain’s Thalamus. The brain has to make sense of this so it does has the following conversation…

Brain picture cartoon

Frontal Lobe (FL): “Have you been anywhere like this before? Hang on! I’ll ask the Posterior Parietal Cortex (PPC).” 

PPC: “Yes you have…” 

FL: “In this location?” 

PPC: “Yes. When you were growing up you used to scratch your leg on twigs – this is not dangerous.” 

The brain essentially pays no regard to the issue and the painful feeling disappears. 

What had actually happened was he was bitten by an eastern brown snake and almost died!

Next time he was walking in the bush six months later he felt the same feeling in the leg. The body went through the same cycle of signals up to the brain. The same conversation took place but this time the posterior parietal cortex had the information about the brown snake to consider. This time it created a feeling of pain so intense he collapsed to the floor holding his leg, only to discover that he had been scratched on the skin by a twig.

This example shows how past experiences can influence the level of pain felt in a moment of time.

WHAT STRUCTURES IN THE BODY CAN CREATE AND AFFECT PAIN?

Pain (danger) signals can arise from a wide range of tissues in the body. Some tissues have higher densities of free nerve endings and others, less. 

Why is a paper cut on your finger more painful than a cut on the knee? There’s a concept called the Sensory Homunculus which represents the amount of sensory feedback to the brain based upon its location. The nerve endings in the head are much larger than the body with eyes, ears, tongue and lips being very sensitive to pain. But the largest of all the body’s nerve endings are in the hands – an area of the body that needs the most amount of feedback based upon what we use them for.

A problem with this system is that the brain at times cannot tell two areas apart.

For example; the SupraClavicular nerve covers a broad area of the shoulder. There are many nerves from a range of locations and when danger is perceived to be high, the brain will create a pain pattern that’s much more spread out. As the injury to the area recovers the area of pain tends to localise as the threat levels are reduced to highlight the area of where the signal is coming from.

AT POINT3 WE TALK OF THINGS HOLISTICALLY IN TERMS OF MIND, BODY AND SOUL, CAN YOU SHARE YOUR THINKING ON YOUR APPROACH TO PATIENT TREATMENT FROM THE HOLISTIC PERSPECTIVE OF THE MIND, BODY AND SOUL?

Osteopathy is referred to as a more holistic approach to pain and dysfunction, meaning we have an understanding a broader range of factors that can affect someone’s pain and wellbeing. From day one at osteopathy school we discuss the topic of the Biopsychosocial model. This model is gradually being bought into mainstream medicine – one that typically focuses on the Bio-medical approach which is a more reductionist approach than holistic, meaning it tends to focus more on one issue to resolve a cascade of symptoms.

Biopsychosocial refers to three main areas of biological, psychological and social that can impact on a person’s overall sense of wellbeing.

  • Biological: Gender, Ability/disability, Physical health, Neurochemistry, Stress reactivity, Genetic vulnerability
  •  Psychological: Behaviour, Personality, Attitudes and beliefs, Learning and memory, Self-esteem & emotions
  • Social: Education, Social support, Family and background, Socioeconomic status

Somewhere in the middle – a blend of all three areas – is where you can find a great sense of wellbeing. I use this concept when treating my patients and the best way to describe how is through the analogy of an Iceberg.

The tip of the iceberg is the pain, below that is the number of reasons why the pain is there from a biopsychosocial point of view. My job is to identify the tip of the iceberg and where the pain is coming from. I don’t tend to treat the pain directly but try to understand what’s beneath causing the pain. And of course the water level around the iceberg can go up and down to reveal more of the iceberg or not depending on what’s going on in each person’s life, making someone more susceptible to pain or not. So a big part of my job is understanding what’s happening in people’s lives and how that is impacting on their pain.

AND TO FINISH, WE ALWAYS ASK THE FOLLOWING THREE QUESTIONS OF OUR INTERVIEWEES…

HOW DO YOU KEEP PHYSICALLY FIT?

I keep fit through doing things I enjoy. Growing up was no different to today. I come from a background of playing competitive football, which I loved as well as dancing and cycling. I’ve had sporadic and more concerted efforts in a gym environment, but I still see that work as teeth-brushing… It’s not the most exciting thing in the world but it is important for a number of reasons. Since hanging up my dancing shoes and football boots I now climb (boulder) and cycle mainly. Nothing is quite as enjoyable as hanging off a climbing wall or cycling around the Cotswolds.

HOW DO YOU KEEP MENTALLY FIT?

There are two elements of this for me. Firstly, being able to identify if my mental health is struggling. Secondly, having ways of improving it that I know work. I have had my brushes with anxiety since starting my business and it wasn’t until someone reeled off the symptoms I realised I was struggling. My solution has been a straightforward one. Look at the week and see when I need to be focused and when I can have fun, then making sure fun has a good share of the week.

AND FINALLY ANY TIPS & TRICKS ON WELLBEING?

Wellbeing for some can seem like a mountain. The pressures and strains in life can seem overwhelming. One of my favourite phrases “How do you move a mountain? By first moving small rocks.” Wellbeing is this; making small changes and if it’s useful making it consistent. With this approach it’s time that makes the difference. Trust what you’re doing is right and see what happens.

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