Episode 33: How Stress Is Negatively Impacting Your Physical Pain W/ Dr. Devan Sedlacek

Transcript

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Did you know that stress can negatively impact the pain that you experience in your body? Well, I have a very special guest, Dr Devin Sedlacek of move RX physical therapy.

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She's a colleague and a friend who is going to be explaining the link between stress and physical pain. So stay tuned.

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Welcome to breaking the entrepreneur burnout cycle. Your go to resource helping service based entrepreneurs break free from burnout. Each week you'll learn how to identify and eliminate subconscious habits so that you can create a thriving business with greater income, greater impact and the freedom to live life to the fullest while having your time energy and health. This is breaking the entrepreneur burnout cycle. You Hey, everyone, welcome into another episode. I am so excited because I have Devin here of move RX, located here in Omaha.

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She is a physical therapist and a colleague who I am bringing on to just talk about, you know, how stress can negatively impact not just our physical functioning, but our pain and so Devin, I'm super excited to have you on.

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Thanks for having me. This is really exciting. I think this is my first podcast I've been invited to. So love it.

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I love it. So for those who are meeting you for the first time, tell us a little bit about like, who you are, who you help, and just kind of like what you do,

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yeah? So, yeah, I'm a physical therapist here in Omaha. I started my practice last year, and I essentially help individuals who are wanting to stay active and pain is stopping them from being active.

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So a lot of times that falls into CrossFitters, weightlifters, power lifters kind of more of the strength athlete. But I also see individuals that like to hike, or maybe they haven't been active for a long time, and they used to be active, and chronic pain has kind of stopped them over the years. So that's the typical individual that comes to see me, and I am, I essentially contract inside of gym spaces, so I'm kind of different than your average. PT, it's not like a, you know, you walk in the door and there's a receptionist that greets you, and there's some bands on the wall and, like, a little, you know, bike or something. It's like, I'm in a gym. So it's like, you walk in, it's there's people sweating, there's barbells everywhere, there's weights everywhere. So it can be kind of different than the typical setting, but that's how I like it, because I think promoting, you know, string training over the years is really important and beneficial for our health, and so I want to be in an environment that promotes that.

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So, yeah,

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I love it. And I love specifically that, like you're helping those with chronic pain who, you know, it's maybe the chronic pain has taken them out of the game, or it's made them feel like I can't do all the things I want to do. And you know, I think you and I have had all of these conversations a lot, as colleagues like, about how stress can just negatively impact pain. And so tell us a little bit about just kind of like, What drew you to this population, as far as, like, helping those with chronic pain who want to stay active,

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I would say so in college, I was trying to decide what I wanted to do with my life, and was thinking I really liked, you know, chemistry, biology, anatomy, stuff like that. So I was like, oh, maybe I'll try going to med school, just going off of the idea that I liked those subjects in school and I was good at them. And then I had shadowed a radiologist for about a week, and, you know, he was doing a lot of vertebral plastics and biopsies and nerve blocks and things like that. And I was kind of, I was also personal training at the time, and I was like, Isn't there something that can, you know, prevent this or, you know, how did it get this far for these people where they literally needed cement in their spine?

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Yeah. Yeah, and so then I kind of found physical therapy and started working at a clinic. And the clinic was attached to a kind of a Globo gym called it was like a snap fitness or something, or like an Anytime Fitness kind of a vibe. And so they had the clinic space, then you had, like the gym space, and they would see people in chronic pain, and just kind of take them through, like stretches and, you know, put them on a heating pad, and focus on, like, really minute muscle groups. And I started to really dive into the kind of the science behind pain, because it really interested me, and realized that there were actually, we were kind of doing a disservice to barbell athletes sometimes in talking about these kind of the minutiae of like, Let's activate this really specific muscle, and that's why your back hurts. You know, instead of helping them actually navigate their pain and get back to deadlifting again or squatting heavy again. And so the they didn't use the gym space as much they use it, but just like they never really grabbed a barbell, the dumbbells that they used were pretty small. And so I'm like, where's the where's the bridge here between these two things? And so I realized that I wanted to be in a gym treating people to maintain strength throughout their lifespan, and so to really empower people into building strength and capacity for their life, so that injury was less Often, or, you know, they were just felt more empowered to like move, I guess. So that's really what started to draw me to it.

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And I found, you know, Pts on Instagram that were treating that way and treating those types of people. And so I found it really interesting, and I just thought it was really important. And so I knew that I wanted to do that, and if there wasn't a way, I was going to make a way. So yeah, I

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love it. I love it. And, yeah, I do 100% agree with you, where there's kind of like that gap of like, okay, we have this, but then how do they go from this to like, actually doing the things they want to do, like jumping, running, you know, not being afraid to even just lift a grandchild. That's like, I don't know, more than 10 pounds, right? And so I love that, you know, just seeing that gap really created that curiosity for you to dive into investigating what is the neuroscience behind pain. And I'd love for you to just chat about like, you know, I think there's so many misconceptions about pain. What were some of like, the biggest things that you started seeing as far as, like, the neuroscience of pain, and starting to understand that more,

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I think I started to see, I mean, I started to learn about it more in PT school. But even before that, just seeing how our nervous system creates just like we build memories, those memories. So think about like, the first time you, like your grandma made you cookies or something like that. And every time you smell cookies, it like takes you back to this feeling of being at your grandma's house, and that's your nervous system connecting that, that smell, to a memory, and then creating some sort of sometimes, like even like a physical response, like sometimes you feel hungry, or, you know, something like that. And that is very true with pain. So when we experience something scary or traumatic, which most injuries are. I mean, you could think of the most traumatic thing in the world, like a car accident, but like throwing your back out on a deadlift, can be traumatic for somebody if deadlifting is part of their identity and part of their life. And so you experience that, and then your nervous system sort of associates bending over with something dangerous, because there's a memory behind it, and a memory that's sort of traumatic and scary, and so then that act of bending over becomes even more painful, and it's It's not that, you know, there isn't some sort of biological injury, like a disc herniation going on that's probably there as well.

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But humans are much more than just the biological physical stuff. Like we have memories, we have emotions, and so our nervous system is very smart.

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What. All I think we talked about this last time, not necessarily smart, but it's very adaptive. So it adapts to things really easily, and it's all it's doing is trying to protect you.

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So when we have something seemingly dangerous that happens, doing that task again is threatening to us. And so because of that, our body develops pain responses when we are in that same contextual environment of the traumatic thing that happened. And so then, yeah, it creates these, these pain responses that are hard to stop and have to kind of dial down that, that danger signal and make it less threatening and less dangerous.

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Yeah,

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I love that. And, you know, I think we talked a lot about just how we're human beings, and we have a lot of emotions. And what have you seen, as far as, like, you know, even just thinking about doing the activity again, or going trying to do the activity again, can create a lot of fear and anxiety and sometimes like other emotions, like frustration and anger and those things. How have you seen those? Those things affect pain as well?

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Yeah, so again, like our our limbic system, our emotional system, is very close to the area that creates memories, and it also is close to the areas that kind of dictate pain responses. So they're all, like, kind of meshed together in one area. So when we have these negative feelings or emotions such as frustration or anxiety around a particular movement, then that can sort of perpetuate that pain cycle. And sometimes what I find with people is like, okay, maybe we, you know, somebody got hurt on a deadlift. We can't start with, can't always start with deadlifts. Of course, that'd be great, but we can't always. So we have to, we have to find ways to create some sort of hinging motion in the body that are non threatening and don't create that same fear response. And then over time, we kind of progress back into the scary thing. Because, you know, so you really have to kind of regress those patterns, because that sometimes, you know, if I, if I tell somebody, all right, you got hurt on a deadlift, we're going to treat you with deadlifts. And deadlifts are extremely scary to them. They are not going to be ready for that, just like if someone has agoraphobia and they can't go out into public because it's terrifying, I'm not going to throw them in the middle of Times Square. Not go well, it's finding where we can start the exposure so that the nervous system can get used to it and adapt to it, and then build back to the thing.

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Yeah, um, thank God you're not gonna just throw them into Times Square. But I'm curious to know, have you seen any overlap between you know, even if they're not doing the scary activity, but they are experiencing heightened emotions due to other stressors in life, whether it's like, you know, they're busy nine to five or just like all the things that we have on our plates as busy Human beings, does that also trigger some of these pain responses because they're similar emotions?

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Yeah. So what's really interesting about pain is because it's so connected to that limbic system, or that emotional center of the brain, even when you're not in the same context, using that deadlift example, you're not actually deadlifting right now, but you're doing something else that's stressful on you. Then it sort of takes away from I always give people this analogy of a cup. Greg Lehman is a really great physical therapist that kind of started this analogy. So we can only fill up our cup so much. We only have so much capacity in our cup at any one time for all of the stressors in life, including physical things.

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And so if outside of the physical task, you have stressors elsewhere, there's still reducing room in that cup for the physical stuff. And so oftentimes what he says is to try to build a bigger cup and try to give you more capacity and the ability to handle more stressors. But when somebody's in that chronic. Pain cycle, their cups pretty small, so we really have to create strategies to help them build bigger.

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Yeah, yeah. And, you know, does, has that, you know, learning about that has that changed your the way that you approach chronic pain, not just from like starting to reintroduce their tissues to loading certain things, but also how we treat people holistically to manage their stress.

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Yeah, so, you know, I'm always trying to, of course, I'm a physical therapist. So I'm very focused on the physical side of it and exposing them to the physical task. But if I know that they have challenges in their life at the moment, and I know that the physical thing isn't going to be it's not going to go as quickly as they want.

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Sometimes we're sitting down and we're just talking about, you know, it's kind of like a mental therapy session sometimes, where we're just talking about, hey, like, tell me more about what's stressful besides just this.

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Like, what's going on in your life right now? Are you sleeping well? Are you eating appropriately? You know what, what kind of things are you doing for you right now? Are you neglecting yourself in multiple ways? And so it kind of it comes becomes that conversation sometimes where it's like, Hey, have you? When's the last time you reached out to a friend of yours and asked them to do something together. Like, let's, where's the fun in your life?

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Let's get that back, you know, stop. Let's stop focusing on just the physical thing that you can't do. What are other things that maybe you haven't done in a while that are that fill your cup positively?

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Yeah, and have you noticed, like, you know, incorporating that when it's needed, has that made the outcomes for your patients better at times? Definitely?

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Um, yeah. So when we take a step, if somebody's really struggling with the pain side, we take a step back and just say, like, hey, you know, I see that you're struggling a bit mentally right now. Tell me more about that. What, what kinds of things are you struggling with?

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And just, to be honest, just me bringing that up sometimes, like nobody else has brought that up with them, or nobody's, I mean, they go to some sort of rehab person and and it's just, I'm going to do this thing to you and then leave. And I mean, I've had sessions with people where we're literally just talking the whole time, and we don't even do a lot of physical things, because that's just what they need somebody to listen to them and validate their experience and help them find a way through this experience and doing that and like addressing those things sometimes, is all a person needs to move the needle forward. And I think it's super important in the right context, especially if they're open to it. So I, yeah, I try to really encourage that, because once we address those things, then they're not as focused on the fact that they can't do deadlifts, right? Like, oh my gosh. I, you know, had so much fun this week, and like, they come the next I had so much fun. We went here, we did this, blah, blah, blah, and then it's like they're not even, like, thinking about the fact that they're not doing deadlifts right now because they're having fun in their life, and they're bringing back, you know, I always try to get people to think about how they were as a kid, and how you were a kid and you got up and you were just, you Know, summertime, right?

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Like you're just trying to, like, figure out what you're what fun thing you're going to do today. And as we get older and we become adults, being an adult sucks, and you have to go to work all the time because you have to make money to pay for a stupid mortgage that keeps increasing. And ensure you know just yeah, there's a lot of stresses as you get older and you forget how to be a kid, what that was like. And I always try to get people in touch with that part of themselves, because it's one of the best parts of yourself, and that being being able to be playful with life is so good for the the mental side and and that really helps with pain, because then, you know, you can you're not as worried so much about how your body feels all the time, because you're just having fun. Yeah,

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yeah. I see that so often too, just even in the clients that I help, is like, how much. Stress can negatively impact us in so many aspects of life, and yet we've normalized this whole thing of like, just keep pushing through. It is what it is, right? And it's like, but it doesn't have to be that way.

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I

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saw this video the other day was like a tick tock or something, and it was some kind of podcast interview, and someone said, How do you know you're doing well in life? And the other person said, you can measure that by how much fun you're having. Yeah. And so I that really stuck with me, because I'm like, That is so true, the fun wherever you are, and if, if you're in a situation where your job is just not fun, it's completely dreadful. Money is not worth it if you're not having fun, in my opinion, yeah, you know. So maybe it's worth it to some people. But in my opinion, I want my no matter if it's my job or with my loved ones or with my friends, I want to feel like I'm having a good time, you know, and I'm enjoying life, so, yeah,

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and I also think that's part of that, you know, you mentioned teaching people how to expand their cup, right?

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That that ability to have fun and not just have fun, but to just like, remember what the importance of life is, because, you know, we've normalized all these stressors. But at the end of the day, if you can't do the things that you're doing it all for in the first place, then why are we doing it?

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Yeah, yeah. And it's easy to get caught up in the mindset of, like, well, I can't, you know, I can't deadlift so I can't have, like, it's, I'm not having fun, you know. But like, thinking about it more from you can't do it. Maybe you're not able to do it yet in the way you want to, but it's definitely possible for it to happen again, you know. So let's focus on other things at the moment and just continue, like stay the course and give it, give ourselves some time to heal. And when people get there, when they get to that spot where they're like, Okay, this is going to take time. I'm going to focus on all of the things in life that bring me joy, besides this one thing, that's where the cup expands. And so that's, you know, when I said thinking of ways to expand your cup, that's where the that's where it is, is figuring out all the things that bring you joy in life and leaning into all of those things besides just this one area.

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Yeah,

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have you noticed people have a hard time doing that?

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Yes, because human nature causes us to focus on the negatives and what we lack, and I think there's a good evolutionary reason for that.

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That's why humans are a very success, the most successful species on the earth, as far as like growth, because we are always trying to move the needle forward and become better. And so the the most challenging part in that scenario is helping somebody realize that their life isn't just deadlifting and it will come back. It's just this isn't the season. Yeah,

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yeah. So I'd love to know, you know, you mentioned already, one of the strategies of, like, getting back in touch with what lights you up. Is there anything else that you coach a lot of people through, as far as, like, helping them to manage this stress, or even just this identity crisis of like, I can't deadlift, so I'm not happy.

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I think that's a little different for every person, but generally, what I try to help people understand is that the process is going to be messy, and just accepting helping them.

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I mean, obviously I can tell them, but it doesn't mean that they're ready to accept it. And what I mean is accepting the idea that you're going to have downs, you're going to have ups, you're going to have downs. And when you're in the downs, trying to remember what all of the UPS have been. So you know, to give you more of an example, potentially. So, back to deadlifting again. Let's say.

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Okay, we're a few weeks or a month in, and, you know, the the person still can't deadlift yet, but they don't have pain sitting for an hour. You know, maybe it takes two hours for them to feel any discomfort at all. And that's actually a pretty great win. And and so the strategies are helping them find those little wins. The non pain wins.

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Well, that's kind of a pain win, but like a non pain, one might be, I PR my strict press the other day or something, or I'm able to, like, take my laundry up the stairs, and, you know, so it's kind of like thinking, thinking about it more from a functional standpoint, like, what are you able What things are you able to do now that maybe you weren't able to do before? You're not deadlifting yet, but you're doing these things, that's the biggest strategy I use with people, is helping them find the little ones and bringing them back to that. Because it's really tough when you're in a stressful, painful situation. And I'm not always good at it. I I find myself thinking back on certain individuals that I could have done better with, and I'm always learning because every, like I said, every single person's a little different in how they interpret those things. But in general, I really try to help them find those little wins all the time, because that's where that's going to keep you going forwards instead of focusing on what you lack. So yeah,

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and it's that right? We, we all are our own worst critics, and we're so hard on ourselves where we forget to celebrate the little wins and to really just kind of, like, embrace the journey, but focus on, like, how far we've come from the work we're doing. Yeah, and yeah, like you said, it's so easy for us mentally to fall into those traps. And you know, have you seen when clients do get stuck in that that it really impacts not just their pain, but their ability to get out of pain.

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Definitely. So when someone's stuck in the lack those are my hardest patients to work with, I would say, when they're just, they can't find the silver lining anywhere, and so sometimes I'll, I'll even start, like, texting them daily and say, All right, tell me something good that happened today. I don't care, related to your injury or not. Like, just tell me something good that happened today. And you know, they're kind of rolling their eyes, but, but once we once we get through that, and, you know, I support them in that way, as soon as we do that, then all of a sudden we turn a corner. And I don't think that's coincidental.

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I think that that's because we've created some sort of positivity in their life, and they're not stuck in the negative. So yeah, again, like that emotional center is right next to where we interpret and create pain in the brain. So it's, it's all there, it's all together,

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yeah, and I love, this is why I love, like, bringing you on in those things too. Is because it's no different in any aspect of life.

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Like when we start looking at the little wins, the positive things that are happening for us, it's weird, and there's no way that I can describe it, but like, it's almost like what you start attracting gets better.

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And there's also the neuroscience right of like, as you're focusing on these positive wins, you're also, you know, triggering neuro chemicals that are communicating to your brain, like we're doing good.

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Like, yeah, we are not in the worst case scenario. We're not in catastrophization, like, we're okay, we're safe, we're good,

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yeah. Like, if you it's that whole idea of, you know, you kind of get what you what you think about, I guess I don't. That's not the right terminology, but, but as what you are looking for is what you're going to find. So if you say, I'm going to need surgery, I'm never going to be able to use my arm again, you're probably going to get that Yes.

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If you say to yourself, you know what, if I give this some time and I slowly work into things, I'm going to be able to do a lot with my arm again. Yeah, and you have that mindset, then that's.

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Probably what's going to happen.

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So I those are the people I love to work with. Well, maybe it becomes easier, I guess, because they already have that mindset.

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But the other side of it is I love seeing when we make a breakthrough mentally, and we start seeing those positive changes, and you know, then we can look back a few weeks later and say, like, remember when you thought you're going to be in a wheelchair? Remember when you thought you're going to need surgery and you're going to need all these injections? What do you think now? And they're just like, so most of the time, they're like, oh, I don't even remember being like that. They don't even remember because it's just, you know, that's just not how their brain is. It's not what their brains looking for anymore. So they don't remember thinking about it. Yeah,

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it's like, if you're gonna, if you're looking like, if you have it primed in your brain, that i this will happen. Well, guess what? Your brain's only job is to confirm or deny what you already believe.

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Where you said, you know, just in life, right? Like, let's say you're trying to achieve some sort of goal, like, financially, right? If you just say, like, if you just continually tell yourself how poor you are, you're going to stay there, you're going to stay there. You're never going to get, you know, and so you kind of act like the person you want to become, or start to behave in ways that, that, you know, it's like, okay, what would my if I was that person a year from now?

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How would she or he behave?

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Yes, yeah, those things, yeah. Is there anything else you wanted to add that you help people through as far as, like managing their stress and their pain.

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Um, I just try to be available, obviously, within my my energy availability, but I think in the medical field, there's such a disconnect between the actual patient and the provider. You have all of these people you have to jump through to even talk to the person that's making the your actual health decisions. And I like to create an environment with my patients where I'm easily accessible. Because I think that being able to support people in that way is not very common, unfortunately, but it's very important and it's very helpful. So you know, I have my patients text me. They text my personal phone number, you know, and that's, that's my choice. I don't recommend that for everybody. I set appropriate boundaries with it, but I like to be able to be there for them and to be able to help them troubleshoot through a thought or a movement that they're going to have to do at the gym later, and they don't know if it's appropriate yet. And I just like being able to be that really fills my my cup, personally when I'm when I can be there for somebody like that. So I would say, besides the other things I mentioned that's just being available, is I hope? Yeah,

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I think it goes a long way. I mean, we're in a time where people are craving connection and to be heard, and I think when you know you're not going in alone, that also just kind of helps support that notion of, I'm going to get better. I'm I have the support,

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yeah, another thing I do, too is if I have, um, you know, another individual that I think has been through something similar, and I know someone's struggling, I will say, like, Hey, is it okay if you know I have this person reach out to you? Or if I know that they know each other, I'll just say, hey, reach out to this person, because they've been there. And I think when somebody hears that, it may it really puts them at ease. Like, Oh, this isn't just me. I'm not the only person that is going through this, and when they can, when I can connect them to the right person, because I haven't experienced every single injury that my patients have experienced, and nor will I ever. And even if I've had the same ailment in the same area, it's never going to be the same as how somebody else experiences it. We could both have a herniation at l5, s1, but you're going to experience it way differently than I will, because I've had different life experiences than you so but just if I know I know someone that struggled similarly, um. Um, then I try to connect people that way too, because then that really helps move the needle forward for them. Love it.

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I love it. Well.

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Thank you again. So much for coming on to just share you know all of the things that you've learned, not just from your experience of helping people out of chronic pain, but also like your your drive to always like learn more, read more, do more.

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I think that that can be inspiring for so many people, no matter what field you're in, and for those who you know, even if you're not in Omaha, I know you work like coaching with people as well. Where can they come to find you? If they're like, You know what? Like? I resonated with everything Devin was saying, and I would really love to just see, can they help can she help me out of my chronic pain? Where can they find you?

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The best way is Instagram. I'm pretty active on there. So Devin dot moverx, Omaha. I'm in Omaha, Nebraska, but, yeah, I work remotely with people all the time. So if you go to that Instagram page, you can always book a free consult call if you want. There's links in the bio there, and that's probably or just send me a message,

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I love it. I will link that all up in the show notes down below. Guys, but again, Devin, thank you so much for being here, and I will see all of you guys on another episode. Bye for now. You.

Episode 33: How Stress Is Negatively Impacting Your Physical Pain W/ Dr. Devan Sedlacek

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